Kate Barrett is a landscape architect who has lived in Bozeman for about 15 years.
“I came here for skiing and outdoor activities and then got a so-called real job,” she said.
As Barrett and her husband were starting their family, she had a couple of miscarriages. Making it to twelve weeks, she says, was exciting, but then she got the devastating news that her baby had a chromosomal condition called trisomy 13.
“With ours it became apparent that the brain was not forming correctly in our baby as well as the heart," she said, "so we were told it was definitely going to be a fatal situation.
"If she even made it to birth she would not live."
Barrett, who was 43 years old at the time, says hearing that news was the worst thing she’s ever had to go through.
“I entertained the idea of not ending the pregnancy because I wanted to meet her and be a mom," she said. "My husband and I talked about it, and we didn’t want to make the decision for what we wanted. We were concerned about the baby. We didn’t want any suffering…whatsoever."
At the time, Barrett was a patient of Dr. Claire Putnam, who ran the private women’s clinic SHE Health & Wellness. Putnam’s clinic, which closed in September, was not set up to do later stage abortions. She did provide early stage elective abortions, the majority of which are done with medication, but it was a small part of her practice.
At 12 weeks, Barrett got the initial genetic screening at SHE Health & Wellness and later a diagnostic test at Bozeman Health that confirmed the genetic disorder. Putnam was told that ending this kind of pregnancy there was not an option.
“I spoke with a provider who said he would normally be able to do that, but Bozeman Health it’s not allowed, so that was what I ran into," Putnam said. "And I didn’t push it because I had heard and had other experiences where I knew they were not going to do these kinds of terminations."
Putnam found Barrett a provider in Missoula who was able to do the procedure.
“It was very stressful," Barrett said. "We were already in sort of chaos and grieving what we were going through and to have to leave your home and go do something when you’re grieving like that is hard."
Mothers in Gallatin County will no longer need to travel out of the area to end a pregnancy when the fetus has a fatal condition. That’s because the area’s largest health system, Bozeman Health, recently updated its policy.
Before, Bozeman Health allowed abortions only in instances when the mother’s life was in danger. Now, providers can perform them if the fetus has a fatal condition.
Still, navigating access is complex.
In late August YPR requested Bozeman Health’s abortion policy. Initially, the health system declined to be interviewed, but in a statement on Aug. 24 spokesperson Lauren Brendel said “abortions are provided only when the mother's life is in danger,” and the health system was looking into its reproductive policy as part of a routine review.
Bozeman Health later agreed to an interview. In September, Chief Government and Community Affairs Officer Denise Juneau said on reproductive issues, the health system is guided by the United Methodist Church and puts a high value on privacy between the provider and patient.
The health system does not provide elective abortions, "however, when there a cases where a mother’s life may be in danger or the fetus is not viable an abortion may be performed,” Juneau said.
Spokesperson Lauren Brendel said in an email late last month that since YPR initially reached out in August, the policy had been “more robustly discussed and defined,” and that now “pregnancy termination may occur when a person’s life is in danger or the fetus is not viable, which is the same as incompatible with life.”
Meanwhile, Billings Clinic has provided women’s reproductive healthcare out of a clinic at Bozeman Health’s Deaconess hospital for more than 15 years. In October providers will move to Billings Clinic’s new Bozeman campus.
The health system declined to be interviewed for the story. In a statement spokesman Zach Benoit said the health system does not provide elective abortions. He says as a physician-led organization the private relationship between the provider and patient is foundational.
In instances where the mother’s life is in danger or the fetus is not compatible with life – like when Kate Barrett learned her baby had Trisomy 13 – Benoit says providers work with patients to determine options, and make referrals when there are limitations.
At Billings Clinic’s new Bozeman location, the women’s clinic will not be not located at a hospital but rather on a medical campus with a 23-hour outpatient surgery center, which limits what kinds of procedures are available.
Finding out about hospital policies is not straightforward. Many mothers may not know what their options are until, like Kate Barett, they’re faced with difficult decisions later in their pregnancy.
“The situation that I went through is certainly not special. It’s not out of the ordinary," she said. "I mean, this is something that happens. People have to face these, coming to terms with the fact that your pregnancy, that your baby, is not healthy."
Barrett was relieved to hear about the policy change at Bozeman Health. She says for mothers navigating what can be painful and complex situations during a pregnancy, it’s important to have local options.
