This article first appeared in the St. Louis Beacon, Jan. 20, 2012 - Amid the economic and budget talk in Jefferson City and Washington, one topic is guaranteed to bubble to the surface every January -- the seemingly unending battle over reproductive rights.
The fact that this year features statewide and national elections simply heightens the tensions and the stakes.
Pam Fichter, president of Missouri Right to Life, was weathering the cold this week in Jefferson City to make her regular rounds of legislative offices to promote certain measures aimed at discouraging abortion and blocking certain forms of scientific research involving embryonic stem cells.
Paula Gianino, chief executive of Planned Parenthood of the St. Louis Region, is gearing up once again for fights in Washington and Jefferson City aimed at blocking measures that she says also target birth control by seeking to restrict access, allow pharmacies to decline to stock it, and end government spending to help pay for it for low-income women.
As they do every year, several thousand opponents to abortion in Missouri will board buses, planes and cars this weekend to head to Washington for Monday's annual national march to protest the Jan. 22, 1973 Supreme Court decision legalizing most abortions.
And in St. Louis on Saturday, the Archdiocese of St. Louis will once again hold a service at the Cathedral Basilica that decries abortion, followed by a silent march to Planned Parenthood, which will have extra client escorts on site.
Meanwhile, the St. Louis Freedom of Choice Council is holding a downtown reception Friday evening to raise money for its own legislative lobbying effort. The event also will feature an art exhibit dealing with the history of contraception and abortion.
Abortion In Missouri
Such activities provide the backdrop for the 39th anniversary of the Supreme Court ruling and the shifting front lines, which now increasingly involve contraception as much as abortion.
Sometimes lost in the emotional battle are statistics showing the declining number of abortions in Missouri.
The latest state figures, circulated by anti-abortion activists, report a drop of just under 10 percent between 2009 and 2010, with fewer than 10,000 Missouri women believed to have had abortions in 2010. That compares to almost 11,000 in 2009 -- and more than 21,000 in 1980, the peak year for abortions in Missouri.
The Missouri Department of Health has yet to respond to inquiries from the Beacon seeking to confirm the 2010 number. The figures on the department's website stop after 2009.
In any case, the statistics are not exact because the numbers include estimates on how many women obtain abortions elsewhere or use non-surgical methods such as RU-486, which are more difficult to track.
Gianino says she can't confirm the alleged state drop in abortions in 2010. Planned Parenthood did experience a 2 percent decline, which she attributes largely to the wider accessiblity of emergency contraception, or "the morning-after pill."
Many area pharmacies now stock the contraceptive, which is available without prescription to women age 18 and over.
Gianino also linked the decline, in part, to efforts to increase access to contraceptives. Planned Parenthood offers to women undergoing abortions a free, long-term contraceptive, such as an IUD, immediately afterward. Planned Parenthood of the St. Louis Region has provided such contraception to several thousand patients, she said.
The number of clinics providing abortions in Missouri currently has declined to one: Planned Parenthood in St. Louis. As a result, Gianino says, 20 percent of the office's patients now travel more than 100 miles.
At the same time, a national anti-abortion group -- Americans United for Life-- ranks Missouri as No. 6 in its Top 10 ranking of states that have been most successful in restricting the procedure or in adopting related measures.
Fichter says such a ranking reflects the successes by her side.
Looking overall, she added in a statement: "The legislative response to legalized abortion has played a critical role in reducing the number of abortions. Legislation supporting alternatives to abortion, increasing clinic regulations and requiring that women receive more information about the life of their unborn child and the dangers of abortion have saved thousands of lives."
Gianino paints a starkly different portrait: "We expect 2012 to be a year of extremes as lawmakers use women's health as a diversion from the real problems facing Americans. We anticipate attempts to place 'personhood' measures on state ballots, more legislation placing onerous and unnecessary regulations on health centers, and bills designed to eliminate funding for family planning services, Medicaid, or Planned Parenthood health services."
She added that in 2011, 92 various measures restricting abortion and contraceptive services were passed in states around the country. More than 1,100 were proposed, Gianino said.
Nixon And Abortion
Gov. Jay Nixon, a Democrat who has said he supports abortion rights, actually has been praised by anti-abortion leaders because he has allowed some measures imposing more restrictions to become law.
Sam Lee, head of the lobbying group Campaign Life Missouri, noted that Nixon's latest budget proposal calls for full funding of Missouri's Alternatives to Abortion program, which is slated to receive nearly $1.6 million for the fiscal year beginning July 1.
Lee said that many of the program's supporters had expected cutbacks because of the state's overall financial problems. Anti-abortion activists have organized an online effort to thank Nixon.
"We have no problems with the governor,'' Lee said.
That's not entirely true. Missouri Right to Life is among a coalition that sued the Nixon administration late last year to block the recently signed Missouri Science and Innovation Reinvestment Act -- widely known as MOSIRA. The law provides incentives to companies in certain scientific fields, including biotechnology and life sciences. The measure was one of the few bills to pass during last fall's special session.
Anti-abortion groups had opposed the measure, contending that it lacked adequate restrictions to prevent state money or tax breaks from aiding embryonic stem-cell research.
But they are suing on technical grounds, citing the new law's provision that it couldn't go into effect until a broader economic development package also was passed. The latter died in the special session. Nixon has said he plans to implement MOSIRA anyway.
Anti-abortion Proposals
Groups opposed to abortion and embryonic stem-cell research are focusing on almost a dozen bills filed in the Missouri General Assembly so far this session. Several are similar and center on a handful issues.
Some are pre-emptive. Fichter, for example, wants to see passage of a bill that would prevent discussions between the abortion physician or patient over the phone or internet. That's not believed to be happening in Missouri, she said, but abortion opponents have heard that it is happening elsewhere.
Several measures would impose more restrictions on the use of RU-486 and other drugs that can be used to end a pregnancy of less than 10 weeks. Fichter says the aim is to protect women's health. Gianino contends that the proposed requirements would mandate four trips to the health center, making it more difficult for women.
Such visits also would make the process "cost-prohibitive for women," Gianino said, would prompt more women to wait until later in their pregnancy, when they would have to undergo a surgical abortion.
Several lawmakers -- including some running for offices this fall -- have sponsored bills to allow pharmacies or pharmacists to decline to fill prescriptions for medicines to which they object. Some bills single out the "morning-after pill,'' a contraceptive taken after intercourse.
(RU-486 is administered in Missouri only through physicians or medical facilities, such as Planned Parenthood's abortion clinic.)
The sponsors include state Rep. Tim Jones, R-Eureka, who is slated to be the next state House speaker in 2013, and state Sen. Scott Rupp, R-Wentzville, who is running for Missouri secretary of state.
As it stands, many pharmacies don't require objecting pharmacists to fill certain prescriptions, but other pharmacists are available to fill those prescriptions.
The Missouri Family Policy Council, overseen by former St. Charles County Executive Joe Ortwerth, lauds some similar proposals that are broader, extending conscience protections to other medical professionals.
In a recent issue, the council contends that some proposals would provide "protect doctors and nurses from being involved against their will in additional areas of medical care, treatment, or procedures of moral consequence."
"Such medical services include sterilization, in vitro fertilization, artificial insemination, the prescribing or administration of abortion-inducing drugs or so-called 'emergency contraception' or the withdrawal of nutrition and hydration," the council says. "Medical researchers would also be protected from being required to engage in fetal tissue research, fetal experimentation, human cloning, human embryonic stem-cell research or human somatic cell nuclear transfer."
Gianino said that pharmacies have an obligation to fill legal prescriptions, although reproductive-rights advocates wouldn't object to conscience protections for an individual pharmacist, if another pharmacist is available.
Otherwise, she said that her camp would press for pharmacies to be required to post on their front door what prescriptions they would not fill, so that customers would know and not run into embarrassing situations at the pharmacy counter.
Other measures sought by abortion opponents would:
- reauthorize the state's tax credit for pregnancy resource centers, which specialize in promoting alternatives to abortion;
- prevent such centers from having to comply with requirements, stipulated in some other states, that they post signs making clear that they do not provide any abortion-related services nor do they refer to such facilities or medical professionals.
Fichter said she does not expect any effort in Missouri to pass the so-called "personhood'' bill that bars abortions after conception. The meaure has falled in every state where it has been put on the ballot, she said.
In addition, she added, such a proposal tends to "hurt pro-life candidates on the same ballot because it revs up the other side."
