Missouri Left with a Single Abortion Provider, Following Court Decision

JEFFERSON CITY, Mo. – A federal district court today failed to block a medically unnecessary abortion restriction in Missouri, effectively ending access at all but one health center in the state. Comprehensive Health of Planned Parenthood Great Plains’ abortion license in Columbia expired Tuesday, so Planned Parenthood will ask the court to re-visit the temporary restraining order after the license is ready to be renewed.

The state’s delay in completing the license renewal process leaves Missouri with only one abortion provider. For now, women in areas like Springfield and Unionville face a 400-mile round trip to the state’s last remaining abortion provider, in St. Louis.

Last month, the Eighth Circuit Court of Appeals sidestepped Supreme Court precedent and allowed two abortion restrictions to take effect, even though they were virtually identical to those held unconstitutional by the U.S. Supreme Court in Whole Woman’s Health v. Hellerstedt two years prior.

Today’s decision allows the admitting privilege requirement to stand while Planned Parenthood continues to fight the restriction in court. Due to the hostile political environment surrounding its Columbia health center, Planned Parenthood had asked the court for emergency relief from the medically unnecessary restriction, citing evidence of the safety of abortion and the burden on Missouri women if abortion services end in Columbia.

The Columbia health center’s license expired October 2. Planned Parenthood has already addressed all findings from its recent inspections and called on the state to move forward with the renewal. Following the completion of the license renewal process, Planned Parenthood plans to ask the court again to intervene on behalf of Missouri women and block the admitting privilege requirement.

Patients across Missouri can contact Planned Parenthood at 1-800-230-PLAN and staff will help them navigate options based on their location and personal circumstances.

Statement from Dr. Brandon J. Hill, President and CEO of Comprehensive Health of Planned Parenthood Great Plains:

“The ruling today is a disappointing setback in our effort to protect access to safe, legal abortion in Missouri. Our patients already face tremendous barriers to accessing care, and now they will have to travel farther, take more time, and spend more resources to seek the health care they need. For women across the state experiencing confusion and frustration as they seek much-needed health care, we are here as a resource for you to determine your next steps. Our doors are open in Columbia, and we remain devoted to providing a full-range of sexual and reproductive health care services for our patients while we continue fighting to protect access to abortion.”

Statement from Mary Kogut, President and CEO of Reproductive Health Services of Planned Parenthood of the St. Louis Region:

“Today’s ruling will make it much harder for Missourians to get the health care they need. Barriers placed on patients by state leaders have kept quality health care out of reach in our community. For those seeking care, RHS in St. Louis is here to provide high-quality care without judgment. The legal hurdles to access critical health care in Missouri are unconscionable. We will continue our fight to expand access to care for anyone who needs it.”

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Background

In 2016, the U.S. Supreme Court ruled in Whole Woman’s Health v. Hellerstedt that admitting privileges and ambulatory surgical center requirements in Texas were unconstitutional, finding that the laws provided no medical benefit and greatly burdened women.

Leading medical experts like the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) oppose medically unnecessary restrictions like these because they bar access to safe medical care. According to the Centers for Disease Control (CDC), abortion has a more than 99% safety record. In those rare cases when complications do occur, they are similar to those that may occur from miscarriage, which ob-gyns and other physicians treat every day. Planned Parenthood works every day to make sure women receive high-quality health care in a safe, respectful environment. We have rigorous standards and training for staff as well as emergency plans in place because women’s safety is our first priority.

People in Missouri still face extreme hardships to access abortion. The two health centers that most recently provided abortions were located in St. Louis and Columbia, 125 miles apart. Without services currently in Columbia, mid-Missouri and the western part of the state have no health centers providing abortions.

The Kansas City health center recently lost its abortion facility license when state officials allowed the license to expire. Although Planned Parenthood had arranged for a new provider and continued to push for its license, the local admitting privilege requirement threatens to halt any progress, as the new provider does not currently have privileges. Planned expansion of services to Springfield and Joplin had initially been delayed by Missouri passing further restrictions in 2017, and could be further delayed by this requirement.

With these requirements in effect, women in areas like Springfield and Unionville face a more than 400-mile round trip to St. Louis. This is on top of a 72-hour mandatory waiting period and two-trip process. Planned Parenthood is doing everything in its power to expand access to care for people in the state.

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Timeline

• In 2016, the Supreme Court of the United States ruled medically unnecessary abortion restrictions in Texas requiring local hospital admitting privilege and that abortions be provided in ambulatory surgical centers (ASC) are unconstitutional.

• Similar restrictions were being enforced in the state of Missouri and created an undue burden for Missourians trying to access safe, legal abortion.

• Comprehensive Health of Planned Parenthood Great Plains and Reproductive Health Services of Planned Parenthood of St. Louis Region (RHS) filed a lawsuit in federal district court challenging these two restrictions in November 2016.

• In April 2017, a federal district judge issued a preliminary injunction blocking Missouri’s admitting privileges and ASC requirements, stating these medically unnecessary restrictions pose imminent harm toward Missouri women who need access to safe, legal abortion services.

• The state of Missouri sought an emergency stay of the preliminary injunction, but this stay was denied.

• The state of Missouri sought review en banc of the panel’s decision not to issue the stay. The Eighth Circuit granted that motion.

• On September 15, 2017 the Eighth Circuit Court of Appeals issued a stay, suspending the preliminary injunction issued by the federal district court.

• Planned Parenthood asked the Supreme Court to vacate the Eighth Circuit’s stay, allowing the federal district court’s preliminary injunction to remain in place while the case proceeds on appeal before the Circuit Court. The Eighth Circuit filed a response explaining its stay was temporary while it considered the state’s pending stay motion.

• On October 2, 2017, the Eight Circuit Court of Appeals denied the state’s pending stay motion allowing the preliminary injunction to remain in place while the Circuit Court considered the appeal.

• On September 10, 2018, a three-judge panel of the Eighth Circuit Court of Appeals reversed a preliminary injunction that had allowed Planned Parenthood to provide abortion services while fighting against the medically unnecessary restrictions.

• On September 12, Planned Parenthood requested a waiver from the state of Missouri on one ambulatory surgical center requirement for its Columbia health center, requesting that it be allowed to have only three recliners in its recovery room rather than the four mandated by the state.

• On October 3, 2018, a federal district court declined a request for a temporary restraining order against the admitting privileges requirement, effectively making Missouri a one-provider state.

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