The state of Missouri is refusing to renew Planned Parenthood’s license to provide abortion, threatening to effectively end legal abortion access in the state, the nonprofit says. Planned Parenthood’s St. Louis health center is the last remaining abortion clinic in Missouri; if it closes, the state would become the first in the country without an abortion clinic since Roe v. Wade was decided.
The news that the Missouri Department of Health and Senior Services is withholding Planned Parenthood’s license comes only a few days after Missouri Gov. Mike Parson signed HB 126, one of the most restrictive abortion bans in the country, into law. Set to go into effect in August, the law bans abortion at eight weeks and includes no exceptions for rape or incest.
Planned Parenthood says the dispute arose last week, when the Missouri Department of Health and Senior Services informed the nonprofit it would only renew its license to provide abortions if the clinic agreed to three conditions.
The state demanded the clinic require an additional pelvic exam for patients seeking abortion, and institute new criteria governing who at the clinic could provide state-mandated counseling to patients. Planned Parenthood reluctantly agreed to these first two conditions, despite concerns from the clinic’s doctors.
It was the third condition — that all seven physicians and trainees practicing at the clinic submit for questioning as part of an investigation into a “large number of possible deficiencies” — at which Planned Parenthood balked.
State officials “have directed me, my colleagues and, most egregiously, medical trainees to submit to interrogation with no explanation, while making clear that we could be open to criminal proceedings or board review,” Dr. Colleen McNicholas, an OB-GYN at Reproductive Health Services of Planned Parenthood of the St. Louis Region, said in a call with reporters Tuesday. “To add insult to injury, I’ve been forced to accept a department of health mandate to perform medically unnecessary and invasive pelvic exams that I know my patients do not need — exams that, for some, have the potential for re-traumatization. All in an effort to keep services accessible.”
According to Helene Krasnoff, Planned Parenthood vice president for public policy litigation, the state has stonewalled the organization’s attempts to get more information. “They have refused to give any topics for the interview, they’ve refused to discuss the scope of the interview, and when asked about whether or not it could lead to criminal referral — because some of these abortion laws are criminal that run against doctors — or [the loss of] their medical licenses, [the state] said, basically, That’s not off the table, and we don’t have to tell you anything,” Krasnoff explained.
Several of the doctors the state is asking to interview are not employees of Planned Parenthood, but trainees and fellows at the clinic. According to Krasnoff, Planned Parenthood has made two of its attending physicians available for interviews — an offer the organization says the state initially rejected. Those interviews are now scheduled for Tuesday, but the remaining physicians and trainees have not agreed to be interviewed. (The Missouri Department of Health and Senior Services did not immediately respond to a request for comment.)
If the state refuses to back down from its demand, the clinic’s license will expire on Friday. Reproductive Health Services of Planned Parenthood of the St. Louis Region provides abortion services for several thousand women every year; without it, Planned Parenthood says, women in Missouri who need an abortion will be forced to travel to nearby states.
“If this sounds like state-sanctioned dystopia, well, it’s worse,” says McNicholas. “This could be the reality for more than a million Missourians of reproductive age.”
Planned Parenthood filed a lawsuit Tuesday, asking a circuit court in St. Louis to intervene to keep abortion access available in the state. A hearing is scheduled for Wednesday afternoon.
Planned Parenthood and its allies believe Missouri’s investigation is a thinly veiled premise to quickly end legal abortion access in the state. “There has long been at least two ways that states have attempted to restrict abortion, first through legislation, like the various abortion bans sweeping the country. The second, and less known, is through regulatory and inspection processes, informed and directed by political appointees,” McNicholas said Tuesday.
Dr. Leana Wen, who served as the health commissioner for Baltimore before she became president of Planned Parenthood, called the state’s move “the weaponization of the licensing process.”
Jennifer Dalven, director of the ACLU Reproductive Freedom Project, agreed. “This is a direct result of a years-long effort by anti-abortion politicians to pass medically unnecessary restrictions that burden providers with the goal of forcing them to shut down,” Dalven said in a statement.