Boise, Idaho – Four Idaho women secured a landmark victory this week, settling a federal lawsuit challenging an Idaho law that voided the living wills – also known as advance directives – of all pregnant people. 

Idaho is not the only state that has attempted to exclude pregnant people from having the right to make their own advanced health care decisions; 10 other states have similar restrictions: Alabama, Indiana, Kansas, Kentucky, Michigan, Missouri, South Carolina, Texas, Utah, and Wisconsin. This settlement and the court ruling that precipitated it demonstrate that these laws are unconstitutional and harmful to pregnant people and their families. This is especially true during a global pandemic.

The four Idaho women filed a 2018 lawsuit, Almerico et al. v. State of Idaho et al., challenging the law as a violation of their constitutional rights to medical decision-making and bodily integrity, gender equality, and freedom of speech. 

This victory preserves a ruling from April 2021, when a federal court found the 2005 provision unconstitutional. State officials interpreted the provision to force pregnant people to receive life-sustaining treatment, even if it violated their advance directive.

Plaintiffs Anna Almerico, Chelsea Gaona-Lincoln, Micaela de Loyola-Carkin, and Hannah Sharp are women of childbearing age, two of whom were pregnant when the suit was filed. They are represented in the lawsuit by Compassion & Choices, If/When/How: Lawyering for Reproductive Justice, Legal Voice, and Perkins Coie, LLP.

“This settlement comes as a welcomed relief. My family and I can rest assured my rights and choices will be honored as we anticipate our family growing later this year,” said plaintiff Chelsea Gaona-Lincoln who is currently pregnant with their second child, “There is enough for expecting parents in Idaho to worry about; due to the previous pregnancy exclusion, I wasn’t granted that peace of mind with our first child.” 

Almerico plaintiff, Chelsea Gaona-Lincoln, has light brown skin, long brown hair, and glasses. She wears a yellow dress while visibly pregnant with her hands placed on her belly. Her partner stands to the right, looking over her shoulder, in a heartfelt embrace.
Chelsea Gaona-Lincoln and her spouse

“Over the last two years, we have seen an unprecedented global health crisis. We have also seen the exposure of an economy and society which does not prioritize or support caregivers, especially mothers,” said plaintiff Hannah Sharp, “It is more important now than ever to know that choices we make for our health and the health of our family will be honored, even if we are pregnant.”

“When an individual creates a living will, they determine what and how they want medical care provided. Most people in Idaho might not have even known that their living will would not have been followed if they were found to be pregnant,” said plaintiff Micaela de Loyola-Carkin. “This decision ensures that individuals are now aware of the pregnancy clause in the living will and can update their living will as they see fit.” 

The settlement requires Idaho state officials to make sure advance directives are honored, regardless of an individual’s pregnancy status. The measures Idaho must take include the creation of a new advance directive template without the pregnancy exclusion, and notifying everyone with a registered advance directive of the court’s decision. Notably, Idaho officials already began sending these notices. As of 2020, there were more than 40,000 advance directives filed in Idaho’s registry. The settlement is posted here.

“Singling out pregnant people–or any other demographic group–by taking away their autonomy to make their own healthcare decisions is blatantly discriminatory and offensive,” said Kevin Díaz, the chief legal advocacy officer for Compassion & Choices. “Thanks to the federal court righting this wrong, Idaho residents can rest assured that their rights will not be violated and their end-of-life care decisions will not be disregarded simply because they are pregnant.”

“In a moment when pregnant people’s fundamental rights to make decisions about their bodies are at risk, we are heartened that the state has agreed to take these crucial steps towards dignity and equality for all Idahoans,” said Farah Diaz-Tello, Senior Counsel & Legal Director for If/When/How: Lawyering for Reproductive Justice. “Everyone deserves the security of knowing that their decisions will be honored, and we are glad to see this become a reality for pregnant Idahoans.”

“Simply put, the bodies of pregnant people are not incubators to be co-opted by the state in service of gestating fetuses,” said Kim Clark, Senior Attorney on Reproductive Rights, Health and Justice at Legal Voice. “If the right to liberty and equality under the Fourteenth Amendment means anything, it is that all people have the fundamental right to make decisions about their own medical care and to be free from forced medical interventions by the state. Thankfully, the federal court in this case agreed.”

Compassion & Choices is the largest and oldest nonprofit working to improve care and expand options for the end of life in the United States, with 450,000 supporters nationwide. For more information, visit:

Compassion & Choices Media Contact: Sean Crowley, 202-495-8520, [email protected]                  

Compassion & Choices Latino Media Contact: Patricia A. González-Portillo, 323-819-0310, [email protected]  

If/When/How: Lawyering for Reproductive Justice transforms the law and policy landscape through advocacy, support, and organizing so all people have the power to determine if, when, and how to define, create, and sustain families with dignity and to actualize sexual and reproductive wellbeing on their own terms. We envision a transformation of the legal systems and institutions that perpetuate oppression into structures that realize justice, and a future when all people can self-determine their reproductive lives free from discrimination, coercion, or violence. For more information, visit

If/When/How Media Contact: Jen Girdish, 510-241-0721, [email protected] 

Legal Voice is a progressive feminist organization using the power of the law to make positive change for women, girls, and LGBTQ people in the Northwest. Legal Voices uses ground-breaking litigation, legislative advocacy, and community education to right gender oppression and injustice. More at (

Legal Voice Media Contact: Jennifer Martínez, 208-320-0596, [email protected]