Missouri's Last Abortion Clinic Might Have Just Put Itself in More Danger of Closing

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Just days before Missouri’s only abortion clinic could lose its license to operate in the state, the facility announced that it will no longer make patients undergo two pelvic exams — even though state regulators have demanded that they do.

"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 medical director of Planned Parenthood of St. Louis, told CBS News, which first reported the news Wednesday. "Because to do so, in my opinion, is just assault."

Planned Parenthood’s patients will still undergo one pelvic exam, but the decision to skip another could endanger the clinic’s already imperiled annual license. Missouri officials must decide whether to renew its license by Friday, though the clinic will remain open until a judge rules otherwise.

If the clinic closes, Missouri would become the only state in the country without an abortion provider, for the first time in the 40-plus years since Roe v. Wade legalized the procedure nationwide.

Back in late May, the Missouri Department of Health and Senior Services told the clinic that it must conduct two pelvic exams on patients: once when she attends state-mandated counseling 72 hours before getting an abortion, and once before the procedure. Missouri health officials also asked the clinic to adjust who gave that counseling and to provide seven physicians who work at the clinic for interviews over concerns about what the state called “deficient practices.”

At the time, Planned Parenthood agreed to comply with the pelvic exam and counseling requirements — but not with the state’s request to interview physicians. Five of the doctors who provide care at the clinic were not directly employed by Planned Parenthood, and the organization couldn’t compel them to speak.

The clinic’s license was set to expire on May 31. But Planned Parenthood sued the state, and a judge pushed the deadline back to Friday.

That looming threat of losing its license makes the clinic’s decision to buck the pelvic exams requirement even more of a gamble. But Missouri’s battle over abortion access is part of a national war, and Planned Parenthood of St. Louis may be looking to create a bigger conversation over the requirement.

“If the state closes down a clinic and the clinic is saying, ‘We are refusing to comply because you are making us do something unethical,’ that is such a powerful statement to the country,” said Aziza Ahmed, a professor at Northeastern University School of Law who’s written about reproductive rights law.

“At this point, you know, the clinic is in many ways at the mercy of the state government,” she continued. “But this is one way they can force attention to the issue and force the state government into a corner.”

The American College of Obstetricians and Gynecologists has condemned Missouri’s law. “Routine multiple pelvic exams for women seeking abortion care are unwarranted, invasive, and not supported by evidence,” the group told Refinery29 in a statement.

The Missouri health department didn’t immediately respond to a request for comment on Planned Parenthood’s announcement.

Cover image: Anti-abortion advocates gather outside the Planned Parenthood clinic Tuesday, June 4, 2019, in St. Louis. A judge is considering whether the clinic, Missouri's only abortion provider, can remain open. (AP Photo/Jeff Roberson)