On Monday, Missouri’s last remaining abortion clinic will officially head to battle against the state. And if the Planned Parenthood clinic in St. Louis loses, Missouri is set to become the only state in the nation without an abortion clinic since the procedure was legalized more than 40 years ago.
Missouri and Planned Parenthood will argue over whether the clinic should keep its license to perform abortions during a weeklong hearing in front of the Administrative Hearing Commission. The state agency could rule anytime afterward.
Bonyen Lee-Gilmore, director of state media campaigns for Planned Parenthood Federation of America, told VICE News that Planned Parenthood’s appearance before the commission was unprecedented for the reproductive health care giant. Planned Parenthood, she said, is now wading into “uncharted waters.”
The number of abortion clinics in Missouri has dwindled over the last decade, as the deep-red state has tightened its restrictions on the procedure. Then, in late May, Planned Parenthood of St. Louis announced that its future was also in jeopardy. The clinic said that the state health department was refusing to renew its license to perform the procedure due to concerns about what case records call “deficiencies.”
“The weaponizing of inspections processes in the provision of abortion care has escalated as an anti-abortion tactic by anti-abortion politicians, to find ways of effectively banning abortion in states, without overturning Roe,” Lee-Gilmore said. “Really, what’s at stake is abortion access for 1.1 million women of reproductive age in the state.”
In court documents, Missouri alleged that its officials had discovered that evidence of two failed abortions, as well as an abortion that took place after the patient was more than 21 weeks into a pregnancy and resulted in her needing to be transferred to a hospital.
Missouri ultimately asked the Planned Parenthood clinic to comply with three demands. First, the clinic had to adjust which provider gave patients who want abortions state-mandated counseling. Second, its providers had to perform two pelvic exams on every patient who wanted an abortion. Finally, the clinic had to make its physicians available for interviews with state investigators.
Planned Parenthood initially agreed to the first two requests. But the organization said it could not force all of its physicians to sit for interviews, because several were not directly employed by Planned Parenthood. Those physicians had declined to participate in interviews.
Planned Parenthood asked a court to grant an order to let them continue performing abortions. The organization also eventually declared that it would not force patients to undergo two pelvic exams.
“Over the last few weeks, I have new evidence to say that 100% of the patients who I've taken care of who've undergone this inappropriate, medically unnecessary, unethical pelvic exam have been harmed by that,” David Eisenberg, the clinic’s medical director, told CBS News at the time. “Because to do so, in my opinion, is just assault.”
Missouri agreed not to enforce that requirement.
Still, after weeks of legal scuffling, Missouri declined to renew Planned Parenthood’s license — but a judge ruled that the clinic could keep offering abortions anyway and asked the Administrative Hearing Commission to weigh in on the case.
Arguments this week are expected to focus on questions about patients’ safety. A landmark report from the National Academies of Sciences, Engineering, and Medicine declared last year that abortion is “safe and effective.” Instead, the report blamed state regulations on abortion for creating barriers to “safe, effective, patient-centered, timely, efficient, and equitable abortion services.”
Lee-Gilmore maintains that Missouri’s case is politically motivated, pointing out that Republican Gov. Mike Parson recently signed into law a bill that included a cavalcade of abortion restrictions, including a ban on abortion as early as eight weeks into pregnancy. That law is currently blocked from taking effect.
The motives of Parson’s administration also came under scrutiny after the governor’s then-communications director, Steele Shippy, organized a conference call with Republican legislators and anti-abortion activists the night before a judge ruled in May to temporarily keep Planned Parenthood of St. Louis open, according to the Kansas City Star. The emailed invite for the call included the hashtag “#shutthemdown.”
Shippy has said that the governor’s office did not set up the call. The Missouri attorney general’s office has also said that Shippy did not have a formal role in the state’s health department.
“The state will have you believe that this is about abortion patient health and safety,” Lee-Gilmore said. “This has nothing to do with patient health and safety.”
Chris Nuelle, spokesperson for the Missouri Attorney General’s Office, said the office generally has a policy against commenting on ongoing litigation. “The Missouri Attorney General’s Office is tasked with defending the laws and statutes of the state from legal challenge — that’s what we’ve done in this suit and that’s what we’ll continue to do,” Nuelle told VICE News over email.
If the commission rules against Planned Parenthood, Lee-Gilmore said that the group would review all of its options, including, potentially, going back to traditional court. Planned Parenthood has also recently opened a new, 18,000-square-foot clinic just about 13 miles from its St. Louis location — but in Illinois, which is far friendlier to abortion rights.
Cover: Abortion-rights supporters stand on both sides of a street near the Gateway Arch as they take part in a protest in favor of reproductive rights Thursday, May 30, 2019, in St. Louis. (AP Photo/Jeff Roberson)
This article originally appeared on VICE US.