Even after the Supreme Court case Roe v. Wade legalized abortion at a federal level in 1973, states have since reserved the right to place regulations and restriction on the process — and Missouri has several such rules.
In Missouri, abortion procedures are illegal after 21 weeks and 6 days from the date of conception unless a woman’s life or health is threatened. Other rules, like the 72-hour rule, make it so Missouri women must receive state-directed counseling and wait 72 hours before an abortion procedure is provided. Women under the age of 17 must receive parental consent before having an abortion.
In addition to the threats of cuts in federal funding to organizations like Planned Parenthood, hospitals in Missouri and other healthcare centers that perform abortions are also facing cuts to their Medicaid funding from the state due to a budget amendment introduced last year, as St. Louis Public Radio’s Durrie Bouscaren reported last month.
Last week, on St. Louis on the Air, we spoke with participants in an anti-abortion rights march who advocate for more restrictions on abortion and federally defunding organizations that provide abortions.
On Thursday’s St. Louis on the Air, we spoke with two women about the current restrictions on abortion in Missouri and possible cuts in federal and state funding. Joining the program were Mary Kogut, CEO, Planned Parenthood of the St. Louis Region and Southwest Missouri, and Kadie Tannehill, who terminated a pervious pregnancy at a hospital after numerous complications.
A personal story
Tannehill has experienced first-hand how different rules regarding abortion in Missouri impact women.
With a previous pregnancy, she went in for her 20-week anatomy scan and her OBGYN told her they saw some anomalies in the scan that looked like spina bifada in her son. She told her that she needed to go to a Level II facility for doctors to investigate the possibility right away.
She and her husband went to Mercy Hospital and had a 2-hour long ultrasound, after which doctors confirmed that her son had severe, inoperable spina bifada and that he was paralyzed from the waist down, among other complications.
A perinatologist with the hospital told Tannehill and her husband she could go to a different hospital to get a second opinion and information on services not provided by Mercy Hospital.
Tannehill had to wait over the weekend before they could see another doctor in another hospital who did another set of ultrasounds and found more complications: their son’s brain was being pulled through his skull, resulting in brain damage and fluid on his brain.
“The prognosis for life was not good, pretty much a zero percent chance of life,” Tannehill said. “At that point, my husband and I together decided we would not allow our son to suffer. We would be forcing him to be born for our own selfish reasons. That’s not how we want to raise our family. That’s not how we want to be as parents. All parents want the best thing for their children. We thought the best thing for him was to end his life knowing only love and that we did it with the most compassion in our heart. We know we did the best ultimate thing we could do for him.”
After making that decision, Tannehill had to sign paperwork stating she wanted to go forward with medical termination and that she saw her son’s heartbeat. They then had to return home to wait for 72 hours before the abortion could take place, which is required by Missouri law.
“Going home with that was utter agony,” Tannehill said. “I could feel my son wiggling around, not necessarily as normal as an active baby at his gestational size because he was paralyzed. It was agonizing, those 72 hours, asking: Am I making the best decision? Is this what we want to do? Are we sure we’re doing the best thing? Are we sure? Are we right? At the end of the day, again, we did not want him to suffer for a second of his life and he would have.”
Planned Parenthood’s services and funding concerns
Planned Parenthood of the St. Louis Region and Southwest Missouri has eight health centers and Planned Parenthood Great Plains has five health centers in Missouri. The only one of those centers that is a state-licensed abortion provider in Missouri is in St. Louis.
Only about three percent of Planned Parenthood’s services consist of abortion. About 90 percent of the care the organization provides is in the areas of prevention, Kogut said. Birth control, STD testing and treatment, pap smears, pelvic exams and breast exams make up the majority of that prevention care.
“We do provide abortion, we are proud of our abortion services and we won’t back down from providing it, but it is not the majority of our care,” Kogut said.
Kogut said that Planned Parenthood is concerned about funding, but that the term “defunding” is a misnomer because Planned Parenthood receives Medicaid just like any other provider in the Medicaid program, like a private doctor or health care.
“We provide care, put in a bill under a CPT code and we get reimbursed for care,” Kogut said. “We apply to reimbursement to the cost of our services we already provide to patients. It is like an insurance plan. And that insurance covers low income, rural women, women of color. These are the ones who will be most hurt and most impacted if Planned Parenthood is removed from funding.”
No matter if that funding is pulled from Planned Parenthood, the organization is committed to keeping its doors open.
“We feel strongly it is critical to offer full support and full information to every person but allow them to make the decision best for them and their family and not impose other’s values on them,” Kogut said.
The rate of abortion is the lowest it has been since 1974, Kogut said, and teen pregnancy rates are at the lowest they’ve been in 20 years.
“The reason is birth control,” Kogut said. “This is what I want to be so clear about: Planned Parenthood’s business is birth control. It is what we do, it is what we started with. Birth control is the solution, Planned Parenthood is the solution.”
Kogut understands that some people and some religions believe that life begins at conception, but said that there are other religions and science that disagree about when life begins. Under Roe v. Wade, she said, abortion is protected up to viability (that child could be born and survive without life support).
“We cannot put barriers and restrictions in front of women and families who are making the most healthy and best decision for them,” Kogut said.
She said that about 90 percent of abortions happen within the first 13 weeks of gestation and that abortions are happening earlier and earlier in the pregnancy — because women understand their choices earlier on. There are very few abortions done late in gestation and that when they are done late, it is often in the case of a fetal anomaly, like in Kadie’s situation.
Tannehill is concerned that abortion rights being further rolled back than they already are, especially in the cases of children diagnosed with severe cases of down syndrome.
“My husband and I made this heartbreaking decision together,” Tannehill said. “Our view: it would be no different if we chose to birth him and keep him alive on a ventilator, that’s what it would have been, with no brain function and then choosing to have to take him off life support. In this instance, my body was the ‘machine’ and we chose to take him off sooner so he wouldn’t have to feel an ounce of pain or sticking with needles or a vent tube being shoved down his throat.”
Kogut agreed, saying that not every piece of legislation that is being proposed nationwide leaves exceptions for women.
“There are people very extreme in what they are trying to do — they’re trying to take away access for a woman,” Kogut said.
There are currently 29 pieces of Missouri legislation that are anti-reproductive rights, Kogut said.
Planned Parenthood of the St. Louis Region and Southwest and Planned Parenthood Great Plains are currently challenging two of Missouri’s restriction on abortion, one requiring centers to be an ambulatory surgical center in order to provide and abortion and one challenging the need for doctor privileging within a certain amount of miles from the center.
This weekend, a grassroots group has organized a silent march and rally in defense of Planned Parenthood and women’s reproductive rights on Saturday, Feb. 11 from 9 a.m. to 12 p.m. at 4329 Chouteau Ave.
St. Louis on the Air brings you the stories of St. Louis and the people who live, work and create in our region. St. Louis on the Air host Don Marsh and producers Mary Edwards, Alex Heuer and Kelly Moffitt give you the information you need to make informed decisions and stay in touch with our diverse and vibrant St. Louis region.