Abortion Clinic Chief Pushes Back Against Missouri in License Dispute

Anti-abortion advocates gather outside the Planned Parenthood clinic in St. Louis on June 4, 2019. (AP Photo/Jeff Roberson)

ST. LOUIS (CN) – The chief medical officer for Planned Parenthood of St. Louis defended her clinic’s quality of patient care on the third day of an administrative hearing to determine the fate of Missouri’s last remaining abortion facility.

Dr. Colleen McNicholas with Reproductive Health Services of Planned Parenthood of the St. Louis Region took the stand Wednesday before the Missouri Administrative Hearing Commission, in proceedings to determine whether the clinic in St. Louis can keep its license after an investigation into failed abortions.

According to Planned Parenthood’s definition, McNicholas said that there were only two failed abortions out of 4,251 patients seen at the clinic during the relevant time period.

“Complications and adverse events are unfortunate and we review every failed surgical attempt, but two failed surgical abortions out of 4,000 does not indicate” a systemic problem, McNicholas said.

She said she performs abortion care in Oklahoma, Kansas and Illinois as well as Missouri. She classified Oklahoma and Kansas as restrictive states, but claims Missouri is the most restrictive with a 72-hour waiting period and previous pelvic exam requirements.

The doctor painted a stark contrast in Illinois, where she said patients receive care based on the most recent medical based protocols in a non-restrictive environment.

McNicholas said the pressure and scrutiny by Missouri is felt by her staff who leave “in tears at the end of the day, saying that if they mishandle one piece of data” they would feel responsible if the state used that to revoke Planned Parenthood’s abortion license.

Planned Parenthood attorney Richard Muniz asked McNicholas if she was ever asked to participate in a state investigation as a resident doctor, as the Missouri Department of Health demanded in its investigation.

“In my three years of residency at Washington University and in my fellowship at Planned Parenthood, neither myself nor any of my colleagues were asked to submit to an interview,” she testified.

McNicholas said that the residents in question were told by Planned Parenthood to heed the advice of their legal counsel on whether to participate and that the clinic did not expressly tell them not to cooperate with the state’s investigation. She noted that seeking legal counsel is especially important, considering that the doctors could not only lose their medical license, but could also face criminal charges in Missouri.

She went into detail about the process a patient goes through to have an abortion in Missouri. She also defended the clinic’s actions in the four failed abortions on Patients 1, 2, 3 and 12 that are the basis of the state’s investigation.

“Our patients are living very complicated lives and I have yet to come across someone who is excited about having an abortion,” McNicholas said.

Missouri Solicitor General D. John Sauer began his cross-examination by questioning McNicholas on the definition of a failed abortion. In particular, he asked about the clinic’s willingness to consider a suggestion made during the testimony of Dr. Randall Williams the day before that would create two boxes – one for an immediate recognition and the other for a delayed recognition of a failed abortion – to be included on quality care records. Williams is the director of the Missouri Department of Health and Senior Services, which oversees Planned Parenthood’s abortion license.

“We’re willing to consider all reasonable changes that would help this department provide quality care,” McNicholas answered.

Sauer grilled McNicholas on her own notes, questioning what she meant by noting that she was either in the room or immediately available during abortion-related procedures.

McNicholas replied that such phrasing was general practice for supervisory notes.

Sauer finished the cross by questioning McNicholas in detail about the care of the four patients that prompted the state’s investigation.

The hearing is expected to last until late Friday afternoon and a decision on the clinic’s license isn’t expected until February at the earliest.

Planned Parenthood sued the Missouri Department of Health and Senior Services, Williams and Republican Governor Mike Parson in May, seeking injunctive relief with its license set to expire. It claims the state has illegally refused to renew the St. Louis clinic’s abortion license until officials complete an investigation into patient complaints.

After several rounds of legal wrangling, St. Louis Circuit Judge Michael Stelzer ruled that the Administrative Hearing Commission was the proper venue for Planned Parenthood’s petition since it involved state licensing. AHC Commissioner Sreenivasa Rao Dandamudi, who is overseeing the hearing, kept a preliminary injunction in place in June, keeping abortion services available at the clinic until a decision could be made.

If the license denial is ultimately allowed, Missouri would become the first state without any abortion providers since the U.S. Supreme Court’s 1973 landmark decision Roe v. Wade, which legalized abortion up until 22 to 24 weeks of pregnancy.

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