The clinic, in St. Louis, is in a dispute with the Missouri Department of Health and Senior Services, which has refused to renew its license unless its doctors agree to interviews (i.e. interrogations) about what it says are “deficient practices.” Planned Parenthood claims that officials haven’t explained what the deficiencies are — and they fear that interviews could lead to criminal prosecution in Missouri, which recently passed a near-total ban on abortion.
Planned Parenthood has sued the state for the right to keep performing abortions at the clinic. A hearing in St. Louis yesterday initiated a judicial review.
If the clinic closes, Missouri would become the only state in the US without an abortion clinic. It would be the first time any state has lacked a functioning abortion clinic since Roe v. Wade was decided in 1973.
The story of how Missouri got to this point is a kind of capsule history of the anti-abortion movement over the past 10 years. In the early 2000s, abortion opponents backed incremental restrictions on abortion clinics at the state level. These laws are largely responsible for the closure of four abortion clinics in Missouri since 2008. In 2000 there were three times that number.
Today, Missouri has the highest ratio of women of reproductive age to abortion provider of any state in the country, with more than a million women in that age group for just one facility.
Meanwhile, since the election of President Trump, anti-abortion advocates have pursued an increasingly aggressive strategy, backing the near-total bans on abortion around the country that have passed in recent months. Missouri’s ban, which prohibits abortion at eight weeks’ gestation, was signed into law last week.
Many proponents of near-total abortion bans hope they will lead the Supreme Court to overturn Roe v. Wade, the decision that established the right to an abortion. But depending on what happens on Thursday, the incremental strategy might prevail in Missouri before the aggressive one — and Missouri could enter a post-Roe reality before the Court even takes up the case.
Planned Parenthood and the state of Missouri are at an “impasse” over the clinic’s license and that is the key to banning non-hospital based services in a state where only a handful of hospitals provide the services with their associated high costs and high bars that women must scale for access.
Regardless of what happens this week, the clinic will stay open and provide non-abortion services like STI screenings and contraceptive care, a Planned Parenthood representative told CNN. Protests/Demonstrations have been increasing in frequency and size, but so have counter-protests.
The story of how Missouri got here is the story of abortion law over the past decade
The situation in Missouri is in large part a result of restrictions known as targeted regulation of abortion providers, or TRAP, laws. These laws, backed by anti-abortion groups in the 2000s, and especially after Republicans gained majorities in many state legislatures in 2010, include requirements that abortion doctors have admitting privileges at a local hospital or that abortion clinics have hallways of a certain width, new codes that require complex renovation of standing buildings, procedural rules that have raised the cost of providing abortions to a point where they cannot be offered and more
Abortion opponents have said that these laws are necessary to protect patients’ health, but many doctors and researchers say they are medically unfounded.
The laws have had the effect of closing clinicsas the requirements prove too difficult to meet. It can be hard for abortion doctors to get admitting privileges, for instance, as hospitals often refuse to grant them.
TRAP laws passed around the country in the 2000s, but they have had an especially big impact in Missouri. In 2008, the state had five abortion clinics. In 2017, it had two. In October 2018, one of those clinics closed after it couldn’t meet a new requirement that abortion doctors have admitting privileges at a hospital within 15 minutes of the clinic, according to the Washington Post.
The Supreme Court in the 2016 decision Whole Woman’s Health v. Hellerstedt found TRAP laws in Texas unconstitutional. But the Eighth Circuit Court of Appeals, which includes Missouri in its jurisdiction, has failed to block such laws.
The ongoing march of restrictions has left the Planned Parenthood clinic in St. Louis to serve the more than 1 million patients of reproductive age in Missouri. Maine, the state with the lowest ratio of women of reproductive age to clinics, has one clinic for about every 13,000 women in the age group.
Springfield and Columbia, have been identified as “abortion deserts,” where patients have to travel 100 miles or more to get an abortion.
The situation in Missouri is a reminder that while near-total bans in Southern states like Georgia and Alabama have gotten attention in recent months, clinic restrictions in the Midwest have already made abortion out of reach for many patients there.