If Missouri’s Last Abortion Clinic Closes, Clinics In Nearby States May Be Overwhelmed
Missouri might become the first state without a single abortion services provider since 1974, the year after Roe v. Wade was handed down. The state's last remaining abortion clinic, the Reproductive Health Services of Planned Parenthood of the St. Louis Region, is currently at risk for losing its license and would be unable to perform the procedure after the end of the week. (The health center would still be allowed to provide STI testing, cancer screenings, and birth control.)
Planned Parenthood is currently in a standoff with Missouri state officials over an audit of the clinic, which began this spring, and argues that it has been "wide-ranging" and "unreasonable," according to the [New York Times](https://www.nytimes.com/2019/05/28/us/missouri-abortion-clinic.html). The clinic did comply with some of the state's demands, including a requirement that it provide a second pelvic exam for abortion patients, even though experts say that is unnecessary and invasive. But the clinic is now deadlocked with state officials over a request to interview seven of its doctors, including fellows and residents, which Planned Parenthood worries could lead to criminal action or board review of physicians.
Yesterday, Colleen McNicholas, a physician at the clinic, volunteered to interviewed by state officials along with one of her fellow doctors. "They asked about our practices and reproductive health services, including how we work with residents and fellow trainees," she tells Glamour. "And while I still believe the interviews are completely unnecessary—because we have provided exceptional care for a very long time—I am also glad that the department finally agreed to sit down with me, and hopefully, through that conversation, they now understand what is the standard medical education process. I hope that resolves any remaining issues for them."
Though McNicholas is hopeful about how her meeting went, she views the licensing debate as part of an ongoing strategy to criminalize abortion. "Most people are familiar with legislative attempts, with all of the [abortion] bans that are sweeping our country," she says. "But for states that have really hostile restrictions to abortion care, the licensing process has become a weapon of these politically appointed health directors. This is something we face on an annual basis, but this year it was ratcheted up and we really saw investigators asking and demanding for things like interrogating physicians, which is so outside the bounds of what this process is supposed to be."
While Planned Parenthood has filed a lawsuit requesting a restraining order against the state—which will be brought to a circuit court judge today and could enable them to keep the clinic's license—physicians there are already trying to make sure Missourians are granted access to abortion. One of the ways they'll do so is by having more patients go to nearby clinics across state lines in places like Illinois or Kansas. However, with increasing restrictions on abortion in Missouri, these neighboring clinics are becoming overcrowded.
"Over the last five to seven years, we've seen a significant increase in our number of patients from Missouri," says Erin King, an ob-gyn and executive director of Illinois' Hope Clinic for Women, which is located about 20 minutes from downtown St. Louis. "We've actually doubled the number of doctors that are seeing patients at our clinic in just the last year and a half. So we've really had to take on some of the burden of seeing those patients—and with the potential closing of this last clinic in Missouri, we anticipate a drastic increase [in patients] that we probably cannot accommodate right away. Obviously we're doing everything we can to help our colleagues in St. Louis, and we're working around the clock here to try to have the staff in place so that these patients can [come to us]."
In addition to the licensing threat, just last Friday, Missouri governor Mike Parson signed into law an antiabortion bill that prohibits the procedure after eight weeks of pregnancy. With so many restrictions McNicholas believes that self-managed abortion, or "DIY abortions," will become more and more of a reality for women seeking the procedure. "We know communities of color, people who are low-means or low-income, and rural Missourians [already] have tremendous difficulty accessing abortion care in the medical system," says McNicholas. "So it should be expected, and we’ve already seen this, that people will turn to self-managed abortion. There are a variety of ways that self-managed abortion can come to fruition. If patients are able to access the medications that we use traditionally for an abortion, then they can safely manage their own abortion through that process with the right education and tools. However, there are going to be patients who can’t access that medicine, or think they’re accessing that medicine but get the wrong one. So we still have to be prepared for other methods of self-managed abortion and helping people to safely end their pregnancy."
Missouri is currently one of six states with only one remaining clinic, according to data from the Guttmacher Institute, and would be the only state in the nation to not have a single clinic.
Originally Appeared on Glamour
