Thwarted in its attempt to block one part of Missouri’s newest abortion law, Planned Parenthood has now filed a second lawsuit challenging another part of the law, one involving medication abortions.
A medication abortion is a procedure involving a combination of two pills. The woman takes the first at an abortion clinic and typically takes the second at home.
Planned Parenthood's new lawsuit, filed in federal court in Kansas City on Monday, seeks to block a so-called complication plan regulation that requires medication-abortion providers to contract with an ob-gyn who has admitting privileges at a hospital. Under the regulation, the ob-gyn must be available 24 hours a day, seven days a week, to treat any complications from a medication abortion.
The regulation, Planned Parenthood says, “is the latest in a series of medically unnecessary requirements imposed by the State, which will, without basis, limit women’s access to an extremely safe procedure using medications alone.”
The lawsuit alleges that the regulation has already prevented Planned Parenthood’s clinic in Columbia from providing medication abortions and has forced it to cancel some patients’ procedures.
The regulation was enacted by the Missouri Department of Health and Senior Services (DHSS) under a new abortion law passed this summer in a special session called by Gov. Eric Greitens.
Last week, a Jackson County judge denied Planned Parenthood’s request to block another portion of the law. That provision requires the same physician providing an abortion to inform the patient of its medical risks three days before the procedure.
The judge found that the requirement did not impose an “undue burden” on women seeking abortions.
The earlier lawsuit was filed in state court and challenged the law under the Missouri Constitution. This time, Planned Parenthood filed its legal challenge in federal court, arguing that it violates the due process and equal protection clauses of the U.S. Constitution.
The latest lawsuit says medication abortions are among the safest procedures in medicine, with complication rates of 0.23 percent.
Planned Parenthood’s Columbia clinic has been at the center of ongoing legal battles with the state. A federal judge in 2015 blocked the state from revoking its abortion license after the clinic’s abortion physician lost her local hospital admitting privileges under legislative pressure. The clinic has since resumed providing surgical abortions.
Until 2007, providers of medication abortions in Missouri did not need a license. A law requiring abortion providers to be licensed as ambulatory surgical centers changed that.
The U.S. Supreme Court last year struck down a similar requirement in Texas, as well as Missouri's rule requiring abortion providers to have admitting privileges at nearby hospitals. A federal judge in Kansas City blocked those requirements this year and the case is now on appeal.
Since then, Planned Parenthood has sought licenses from DHSS to provide abortions at its clinics in Kansas City, Springfield and Joplin, as well as in Columbia.
“DHSS, however, has fought that result at every step,” Planned Parenthood’s lawsuit states.
The lawsuit says that even though a local hospital agreed to take any patients requiring follow-up care, DHSS still refused to approve the clinic’s complication plan.
The effect of the complication plan requirement, Planned Parenthood says, has been to ban medication abortions in Columbia, Joplin and Springfield. (Kansas City’s complication plan has been approved.)
“The Regulation harms women’s health by restricting access to medication abortion to only two abortion facilities located on either end of the state: one in St. Louis and one in Kansas City. Women from anywhere outside of those two areas must travel significant distances to obtain a medication abortion in their home state,” the lawsuit states.
“And due to other Missouri abortion restrictions," it says, "they must make this trip two times, at least 72 hours apart, and meet in person with the same physician who is going to provide the abortion.”
Aaron Samulcek, interim CEO of Planned Parenthood Great Plains, which filed the lawsuit, said the complication plan requirement “flies in the face of our patients’ constitutional rights to safe, legal abortion services without undue burden. Yet we find ourselves in court for the third time in one year, challenging clearly unconstitutional laws written by ideological extremists with one agenda — to end abortion access in Missouri.”
In a statement, Missouri Attorney General Josh Hawley, whose office is charged with defending Missouri’s laws, said, “The Missouri Complications Plan Requirement for medication abortions is a commonsense regulation that ensures women have access to adequate care in medical emergencies. My office will continue to vigorously defend these regulations.”
Dan Margolies is a senior reporter and editor for KCUR. You can reach him on Twitter @DanMargolies.