Ruling means Missouri's last abortion clinic stays open

O'FALLON, Mo. — Missouri's only abortion clinic will be able to keep operating after a state government administrator decided Friday that the health department was wrong not to renew the license of the Planned Parenthood facility in St. Louis.

O'FALLON, Mo. — Missouri's only abortion clinic will be able to keep operating after a state government administrator decided Friday that the health department was wrong not to renew the license of the Planned Parenthood facility in St. Louis.

Missouri Administrative Hearing Commissioner Sreenivasa Rao Dandamudi’s decision means Missouri will not become the first state without a functioning abortion clinic since 1974, the year after the Supreme Court’s Roe v. Wade decision.

“In over 4,000 abortions provided since 2018, the Department has only identified two causes to deny its license,” Dandamudi wrote, adding that Planned Parenthood has “substantially complied” with state law.

“Therefore, Planned Parenthood is entitled to renewal of its abortion facility license,” Dandamudi wrote.

A Planned Parenthood spokeswoman said the decision will mean the St. Louis clinic’s license is renewed through May 2021.

It wasn’t immediately clear whether the state would ask a court to overturn the decision. A spokesman for the attorney general's office, which is defending the health department's decision in court, said the office was “reviewing the ruling and deciding on next steps.”

An email message seeking comment from the Missouri Department of Health and Senior Services was not immediately returned.

Yamelsie Rodriguez, president and CEO of Reproductive Health Services of Planned Parenthood of the St. Louis Region, said in a statement that the ruling “is vindication for Planned Parenthood and our patients who rely on us.” But she said Missouri’s abortion laws continue to make it difficult for women seeking abortions.

“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,” Rodriguez said.

The state refused to renew the license for Planned Parenthood’s St. Louis clinic in June 2019, after an investigation turned up four instances of what the state called “failed abortions.” Planned Parenthood officials contend the state “cherry-picked” a handful of difficult cases out of thousands of otherwise successful abortions. They have accused the state of using the licensing process as a tool to end abortions in Missouri, a conservative state with a decidedly anti-abortion governor in Republican Mike Parson.

Planned Parenthood’s challenge led to an administrative hearing in October.

The wrangling over the license began after an investigator in March 2019 found that a woman had undergone an abortion that took five attempts to complete. William Koebel, director of the section of the health department responsible for abortion clinic licensing, testified that the clinic failed to provide a “complication report.”

That led the health department to launch an investigation of other instances where women underwent multiple procedures to complete an abortion, Koebel said.

As part of that investigation, the state obtained the medical records of women who had abortions at the clinic. They found four who required multiple procedures, including one in which the physician apparently missed that a woman was pregnant with twins. The woman underwent two procedures five weeks apart.

The Administrative Hearing Commission agreed with the health department that Planned Parenthood should have filed a complication report for one of the patients and should have documented what it did to address the physician who missed that a woman was pregnant with twins.

But Dandamudi wrote that those two cases were atypical: one woman’s uterus was unusually shaped, and the woman pregnant with twins was “morbidly obese,” which can make diagnosis difficult. He said those two violations “did not constitute a substantial failure.”

Planned Parenthood has demonstrated that it provides safe and legal abortion care,” Dandamudi wrote.

Missouri is among several states to pass new restrictions on abortions in the hope that the increasingly conservative U.S. Supreme Court will eventually overturn Roe v. Wade. Parson signed legislation last year banning abortions at or beyond eight weeks of pregnancy, with exceptions for medical emergencies but not for rape or incest. The law is on hold amid a legal challenge.

While closing the clinic would have huge symbolic meaning, the practical impact on Missouri women seeking abortions would be minimized because Planned Parenthood last year built a new abortion clinic just across the Mississippi River from St. Louis in Fairview Heights, Illinois.

Other clinics are in Granite City, Illinois, another St. Louis suburb, and in Overland Park, Kansas, a Kansas City suburb just 2 miles (3 kilometres) from the state line.

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Ballentine reported from Columbia, Mo.

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This story has been corrected to reflect that Parson signed 8-week abortion ban last May.

Jim Salter And Summer Ballentine, The Associated Press