By REBECCA BOONE

BOISE, Idaho (AP) — Four women suing over Idaho’s strict abortion bans told a judge Tuesday how excitement over their pregnancies turned to grief and fear after they learned their fetuses were not likely to survive to birth — and how they had to leave the state to get abortions amid fears that pregnancy complications would put their own health in danger.

“We felt like we were being made refugees, medical refugees,” said Jennifer Adkins, one of the plaintiffs in the case.

The women, represented by the Center for Reproductive Rights, aren’t asking for the state’s abortion ban to be overturned. Instead, they want the judge to clarify and expand the exceptions to the strict ban so that people facing serious pregnancy complications can receive abortions before they are at death’s door.

Currently, the state’s near-total ban makes performing an abortion a felony at any stage of pregnancy unless it is “necessary to prevent the death of the pregnant woman.”

Adkins’ fetus had a severe medical condition that meant it would not survive the pregnancy. The illness also put Adkins at risk of developing “mirror syndrome,” a dangerous syndrome that can cause fatally high blood pressure and other issues, she said.

Adkins and her husband decided to seek an abortion, and learned they would have to go out of state to get one after another ultrasound showed the fetus still had a heartbeat.

“No parent wants to wish that when they look at an ultrasound they don’t see their baby’s heartbeat, yet here I was hoping that I wouldn’t,” Adkins said. “I wanted the decision to be made for us, and I wanted to end her suffering, so it was really hard to see that and know that we had the challenges ahead of us that we did.”

Jilliane St. Michel and Rebecca Vincen-Brown shared similar stories, telling the judge how they were devastated when they learned their fetuses had severe conditions that were incompatible with life, and how being forced to travel out of state for abortion care complicated an already tragic experience.

Kayla Smith cried as she told the judge how she found out she was pregnant for a second time on Mother’s Day of 2022, and how she and her husband chose the name “Brooks” for their son. She was around 18 or 20 weeks along in her pregnancy when the sonographer grew quiet during a routine anatomy scan, Smith said.

Brooks’ heart had anomalies that were the most critical her doctor had ever seen — and the young family could not find a pediatric cardiologist anywhere who was willing to attempt an operation to correct the defects. Even if the heart could have been repaired, the veins supplying Brooks’ lungs were also abnormal, Smith said. It was possible that she could carry the fetus to term, but he would not survive birth, she said.

Smith already had experience with pregnancy complications. Her daughter was born by emergency c-section at 33 weeks after Smith developed preeclampsia, a dangerous high blood pressure condition that put her at a high risk of having a stroke. Doctors warned her she was at risk of developing preeclampsia again.

“If I were to continue pregnancy not only would I risk my life with preeclampsia, I was not willing to watch my son suffer and potentially gasp for air,” Smith said, crying.

Idaho’s abortion ban went into effect two days before Brooks’ diagnosis, she said, making it impossible for her to get an abortion in her home state.

“We wanted to meet our son — that was really important to us — so we needed to do it in a hospital,” she said. They took out a loan to cover the estimated $16,000 to $20,000 out-of-network cost and drove more than eight hours to a hospital where doctors induced labor.

They had an autopsy that confirmed the heart defect was even worse than what they had seen on the anatomy scan, she said. They also decided to have Brooks cremated, she said, which meant they had to drive back two weeks later to pick up his remains.

The cost, the inability to work with her chosen doctors, navigating the rules involving how to transport human remains — all of that would have been avoided if she could have received abortion care in Idaho, Smith said.

“All four of these women were overjoyed to be pregnant with their second child and all four of them received the worst news a mother can imagine,” attorney Gail Deady, with the Center for Reproductive Rights, told 4th District Judge Jason D. Scott during opening arguments. All of them sought abortions “to protect their health, to spare their babies from pain and suffering, and to remain alive and healthy to protect their young children.”

The exceptions to Idaho’s abortion bans are unworkable, and put people like Smith, St. Michel and hundreds of other Idaho residents facing similar conditions at risk, Deady said.

James Craig, a division chief with the Idaho Attorney General’s office, said the women and their attorneys are relying on hypotheticals rather than concrete facts to make their case. Under their proposal, a pregnant woman could receive her abortion for something as minor as stepping on a rusty nail — even though the risk of infection in that scenario could be easily treated by receiving a tetanus booster shot, Craig said.

“Unborn children have a fundamental right to life, and protecting the lives of children is a legitimate and fundamental government interest,” Craig said.

The state also has the same interest in protecting the lives of women, Craig said — and the abortion ban laws do both, he contended.

In the “rare circumstances where abortion is necessary” to prevent the death of the mother, Idaho law allows that to occur, Craig said. The women suing are trying to “usurp the role of the Legislature” by asking the judge to rewrite the law, he said, and that is not the proper role of the court.

The women were the first witnesses to testify in the trial that is expected to last through the month.