Health Editor’s Note: Once again, politics seeks to control medicine. For now, a judge in Missouri gave the state’s last abortion clinic more time to resolve a dispute with the state health department, stopping the threat to shut down all abortion services…..Carol
Missouri May Soon Be First State Without an Abortion Clinic
By Joyce Frieden, News Editor, MedPage Today
The state of Missouri is poised to become the first state in the nation with no abortion clinics, the Planned Parenthood Federation of America said Tuesday.
“Today, Planned Parenthood is filing a lawsuit against Missouri to preserve our ability to provide abortion care at our health center here, which is the only abortion provider left in Missouri,” Leana Wen, MD, president and CEO of the Planned Parenthood Federation of America, said on a phone call with reporters; she was speaking from a Planned Parenthood clinic in St. Louis. “If the court doesn’t grant our restraining order, Missouri will go dark … This is not a drill. This is not a warning. This is real and it’s a public health crisis. It’s the first time since 1974 that abortion care will be inaccessible to an entire state.”
She added that over time, “Missouri politicians have layered restriction upon restriction” onto abortion clinics, passing laws requiring patients to wait 72 hours after their first clinic visit to have the procedure, requiring extra-wide hallways in the clinic, and requiring doctors to perform unnecessary pelvic exams. “These unnecessary restrictions [impede care] and hurt women.”
The pending closure is not a result of an abortion law — such as the law passed by the Missouri legislature on May 17, 2019 criminalizing abortions performed on a fetus older than 8 weeks, which was signed by Gov. Mike Parson (R) on May 24 — but rather because the Missouri Department of Health and Senior Services likely won’t allow the clinic, known as Reproductive Health Services of Planned Parenthood of the St. Louis Region, to renew its operating license. As part of the renewal process, the health department is asking to interview seven physicians working at the clinic — interviews that Wen called “interrogations.”
“Unless doctors consent to interrogation, the state will deny Planned Parenthood the license needed to keep providing abortion and other healthcare,” she said, noting that state officials have also talked about criminal charges and physician license revocation for the physicians who work at the clinic, depending on how they do in the interviews. “I call it ‘weaponization’ of the licensing process. It has nothing to do with medicine and everything to do with politics.”
If the center closes, as it will do on June 1 unless its operating license is renewed — women in places like Jefferson City, Missouri, will have to travel 2.5 hours to get to the nearest facility, in Kansas, that provides abortion care.
Colleen McNicholas, MD, who works at the clinic, has been providing abortion care to clinic patients for a decade. She said she was especially upset over the requirement to provide “unnecessary pelvic exams I know my patients do not need.” She noted that the closure will disproportionately affect low-income women, women of color, and those who live in rural areas, who often have a hard time taking off work and traveling long distances for care.
The Susan B. Anthony List, a pro-life organization, praised the facility’s impending shutdown. “The closure of the St. Louis Planned Parenthood abortion facility would be good news for health and safety,” Marjorie Dannenfelser, the organization’s president, said in a statement emailed to MedPage Today. “The big abortion industry has repeatedly shown it puts profits ahead of women’s health and safety and cannot be trusted to police itself.”
“Across the country, momentum is growing to rein in the status quo of abortion on demand through birth under Roe v. Wade, in direct response to extreme efforts to expand abortion in places like New York and Virginia,” she added. “Missouri lawmakers recently passed, and Governor Parson signed into law, some of the strongest pro-life provisions in the country and it would not be surprising to see Missouri become the nation’s first abortion-free state.”
Daniel Schmid, senior litigation counsel at the Liberty Counsel, which also advocates against abortion, also was pleased with the Missouri developments. “One less abortion clinic and one less state that has abortion clinics that slaughter innocent children is a positive day,” he said in a phone interview. “Roe v. Wade was incorrect when it was decided, and it’s incorrect today.”
The actions in Missouri came on a day when the Supreme Court made an announcement in another abortion-related case, Box v. Planned Parenthood, which involved an Indiana law that banned abortions performed for reasons of sex, race, and fetal anomaly, and also required that fetal remains from an abortion either be interred or cremated.
The U.S. Court of Appeals for the Seventh Circuit struck down the entire law, saying that the state did not have a valid interest in requiring fetal remains to be treated like other human remains because the Supreme Court has held that the fetus is not a person, and that, regarding the provisions on banning abortion, the state cannot prevent a woman from ending her pregnancy before the fetus is viable, regardless of the reason, according to an analysis on the SCOTUSblog.
The case was appealed to the Supreme Court, which on Tuesday declined to take on the question about the abortion ban but upheld the provisions about disposing of fetal remains. In declining to take on the ban, the court said it was “[following] our ordinary practice of denying petitions insofar as they raise legal issues that have not been considered by additional Courts of Appeals.”
That made sense to Schmid. “[The court] has a practice of letting state laws go to circuits first — they want to see it percolate a little bit” rather than going to just one appeals court, he said, noting that the court more often takes on an issue after appeals courts have issued conflicting rulings on several similar cases.