Lone Missouri Abortion Clinic Allowed to Stay Open

A member of the Coalition for Life St. Louis waves to a Planned Parenthood staff member at Missouri’s only abortion clinic in June 2019. (Robert Cohen/St. Louis Post-Dispatch via AP)

ST. LOUIS (CN) — Missouri wrongfully withheld Planned Parenthood’s license for the state’s only abortion clinic, an administrative panel ruled Friday.

In a 97-page opinion, Administrative Hearing Commissioner Sreenivasa Rao Dandamudi found two violations of law committed by Planned Parenthood at its St. Louis clinic, the only clinic in Missouri that provides abortion services.

But, in granting Planned Parenthood’s license, Dandamudi concluded that those violations did not constitute substantial failures to comply with the law and that the state failed to raise an affirmative defense to justify its denial of the clinic’s license.

“Planned Parenthood has demonstrated that it provides safe and legal abortion care,” Dandamudi wrote. “In over 4,000 abortions provided since 2018, the Department [of

 Health and Senior Services] has only identified two causes to deny its license. As such, we determine that Planned Parenthood has substantially complied with [state law].”

The decision keeps Missouri from becoming the first state without an abortion provider since the landmark 1973 U.S. Supreme Court ruling in Roe v. Wade, which legalized abortion up until 22 to 24 weeks of pregnancy.

“Today’s decision is a hard-fought victory for Planned Parenthood patients — and for people across Missouri,” Alexis McGill Johnson, acting president and CEO of Planned Parenthood Federation of America, said in a statement. “This is how we fight for our patients: case by case, day by day, to ensure abortion remains safe and legal across the country. The data shows that many have already paid the price, with the vast majority of Missouri patients forced to cross state lines to get the care they need.”

Chris Nuelle, a spokesman for Missouri Attorney General Eric Schmitt, declined comment to comment, citing the state’s policy on not commenting on ongoing litigation. He added that counsel is reviewing the decision and determining how to proceed.

The violations Dandamudi found – that Planned Parenthood failed to file a complication report for a patient and that the St. Louis facility did not document the actions the facility took regarding another patient – did not warrant revocation of the license.

“Ultimately, we have no concerns with the substance of Planned Parenthood’s quality assurance review, and there are no other indications of deficient practices,” he wrote.

The ruling comes after a contentious four-day hearing in October that made national headlines when Missouri’s Department of Health and Senior Services Director Randall Williams testified to keeping a spreadsheet of women’s menstrual cycles to track abortion patients.

The hearing was the culmination of a year-long struggle between Planned Parenthood, which argued that the GOP-dominated state was using its licensing process as a weaponizing mechanism to eradicate abortion, and Missouri health officials, who claimed care violations put patients at risk.

Planned Parenthood sued the Missouri Department of Health and Senior Services, Williams and Republican Governor Mike Parson in May 2019, seeking injunctive relief with its license set to expire.

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

In the October hearing, the state attempted to attack the standard of care Planned Parenthood provides.

Williams testified at length about quality assurance concerns surrounding four failed abortions at the St. Louis clinic on women identified as Patient 1, Patient 2, Patient 3 and Patient 12. He also pushed back on the clinic’s claims that his department was weaponizing the licensing process.

“While there’s been a false narrative that this has been a top-down initiative, it all starts with Patient 1,” Williams said during his two-hour testimony.

Dr. Colleen McNicholas, chief medical officer with Reproductive Health Services of Planned Parenthood of the St. Louis Region, defended the clinic’s standard of care during her testimony.

“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 told the commission.

McNicholas also testified that 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.

The hearing concluded with Kawanna Shannon, the clinic’s director of surgical services, testifying that inspectors seemed to be on a mission to close down the St. Louis clinic. In one instance, she said an inspector tried to cite Planned Parenthood for the placement of a shelf that had been approved by the state the year before.

Yamelsie Rodríguez, president and CEO of Reproductive Health Services of Planned Parenthood of the St. Louis Region, said Friday’s ruling provides vindication of the quality of services the clinic provides.

“But the reality is, abortion has essentially become a right in name only in Missouri,” Rodríguez said in a statement. “Missouri’s medically unnecessary requirements, two in-person trips to the health center at least 72 hours apart, a ban on using telehealth for an abortion and a needless invasive pelvic exam for medication abortion still make it extraordinarily difficult for people to access care in Missouri.”

She added, “An abortion license, while critical to our ability to provide care, still cannot undo the harm that medically unnecessary policies in our state inflict on patients.”

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