Abortion rights advocates are concerned the legal dispute over the last existing abortion clinic in Missouri may have already hindered access to abortion.
The license for Reproductive Health Services of Planned Parenthood of the St. Louis Region has been in jeopardy for months as state officials delayed action on its application. To compel the state to act, Planned Parenthood took state officials to court.
Circuit Court Judge Michael Stelzer has kept the license in effect while the arguments play out in court. But abortion rights advocates say the legal process as well as Missouri’s increasingly stringent abortion regulations could discourage doctors from providing the procedure in the future.
“I definitely think of regardless of the outcome of the case, this case could have a chilling effect on doctors that provide abortions,” said Rebecca Reingold, a lawyer at Georgetown University’s O'Neill Institute for National and Global Health Law. “Not only in Missouri but also other parts of the country.”
In its lawsuit, Planned Parenthood’s alleges the state wasn’t following licensing renewal procedures and was pursuing an anti-abortion agenda.
Starting last year, Missouri regulators began enforcing more stringent rules for abortion providers, such as a law that mandates pelvic exams 72 hours before a person receives an abortion, the clinic’s doctors said. Although the law requiring pelvic exams has been on the books for 30 years, the state only last year decided to enforce it, they said.
Those increasingly strict rules are one reason several physicians who work or worked at Planned Parenthood didn’t want to be interviewed, said the organization’s lawyers. They were worried they subject themselves to prosecution or face medical board’s review.
“I think as more and more abortion restrictions that target providers in particular pass and get overturned, it increases the marginalization of the procedure of the people that provide it,” Reingold said.
The court case and a new Missouri law passed by the Republican-controlled Legislature that outlaws most abortions after eight weeks also could discourage young people from attending the state’s medical schools, said David Eisenberg, the clinic’s medical director.
“St. Louis specifically has wonderful training institutions for nurse practitioners, nurses, physicians, physical therapists, you name it,” Eisenberg said. “They don’t want to come here, because the state doesn’t value the more than 50 percent of potential new health care providers, because more than 50 percent of people enrolled in those professions are women.”
States that enforce stringent clinic rules can discourage doctors from working in places that offer the procedure, Reingold said.
“Each additional restriction increases the amount of stigma,” she said. “In the aggregate, that can eventually lead to physicians not providing abortions all together.”
Planned Parenthood contends that such regulations do not benefit patients.
“The laws they’ve passed and regulations have nothing to do with patient health and safety,” said Colleen McNicholas, an OB-GYN who works at the clinic. “They are about stigmatizing and shaming not only patients but the doctors that serve them.”
Officials from the state Department of Health and Senior Services could not be reached for comment. Missouri Health Director Randall Williams has said the regulations are about patient safety and not about advancing a political agenda.
It’s possible the state health department could still request interviews with the physicians who initially refused as a condition to renew the license, Planned Parenthood lawyers said.
If the state refuses to renew the license, Planned Parenthood lawyers said the clinic could take up its complaints with the state’s Administrative Hearing Commission, which oversees regulatory disputes between private citizens and state regulators.
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