Judge Blocks Missouri Abortion Restrictions

Apr 19, 2017

This story was updated to include the comments of Missouri Attorney General Josh Hawley and the comments of Planned Parenthood. 

A federal judge has blocked Missouri’s restrictions requiring abortion doctors to have hospital admitting privileges and abortion clinics to meet the specifications of ambulatory surgical centers.

U.S. District Judge Howard Sachs said two weeks ago that he planned to enter a preliminary injunction against the requirements, so the ruling came as no surprise. 

But in his 17-page decision Wednesday, Sachs made clear that he was bound by the U.S. Supreme Court’s decision last year in Whole Woman’s Health v. Hellerstedt striking down similar abortion restrictions in Texas.

“The abortion rights of Missouri women, guaranteed by constitutional rulings, are being denied on a daily basis, in irreparable fashion,” Sachs wrote of Missouri’s abortion restrictions. “The public interest clearly favors prompt relief.”   

In Hellerstedt, the Supreme Court found that, “in the face of no threat to women’s health,” Texas had required women to travel to distant surgery centers.

The two Planned Parenthood affiliates that challenged the restrictions said that, in the wake of the decision, they would soon be offering four more locations in Missouri where women would be able to obtain abortions. The only clinic in Missouri that currently performs surgical abortions is Planned Parenthood’s facility in St. Louis. 

Bonyen Lee-Gilmore, a spokeswoman for Planned Parenthood Great Plains, said the locations that will be offering abortions are in midtown Kansas City, Columbia, Springfield and Joplin. 

Attorney General Josh Hawley, who defended the restrictions blocked by Sachs, said he plans to appeal. 

"Today a federal court struck down large portions of Missouri law that protect the health and safety of women who seek to obtain an abortion,” Hawley said. “This decision was wrong. I will appeal. Missouri has an obligation to do everything possible to ensure the health and safety of women undergoing medical procedures in state licensed medical facilities.”

In his ruling, Sachs said that accepting Missouri’s contention that he should reappraise the abortion safety issue would be akin to trying to undermine the Supreme Court’s 1954 school desegregation decision in Brown v. Board of Education.

Sachs noted that the Supreme Court found that the hospital affiliation requirement in Texas cured no significant health-related problem. And he cited the high court’s finding that tens of thousands of women in Texas would have been forced to travel more than 150 miles to find an open clinic had the affiliation requirement been allowed to stand.

“This case is not a close one in any event, as the absence of a clinic in central Missouri requires hundreds of miles of travel, round-trip, with two trips needed unless a woman has the means and time available for a long stay in St. Louis or other rather distant clinics,” Sachs wrote. He added that the hospital affiliation requirement, rather than furthering women’s safety, probably creates health hazards for them.   

Missouri’s hospital affiliation requirement forced the Planned Parenthood facility in Columbia to stop offering abortions there in 2015.

Similarly, Sachs blocked the ambulatory surgical center law requiring abortion clinics in Missouri to have facilities suitable for major surgery. The requirements include wide hallways and other physical specifications.

Sachs pointed out that the law would require Planned Parenthood’s Kansas City facility, which offers only medicinal abortions, to remodel the facility at a possible cost of millions of dollars.

The lack of necessity and “nearly arbitrary” imposition of the requirements, Sachs wrote, “adequately establishes that these plaintiffs are very likely to receive relief” – a requirement for the issuance of a preliminary injunction.

Sachs said the likelihood that the plaintiffs in the case – Planned Parenthood Great Plains and Planned Parenthood of the St. Louis Region and Southwest Missouri – would prevail at trial “is very high.”

“The ability to function as abortion clinics and to perform abortions is crippled in Columbia, Springfield and Joplin, and to some extent in Kansas City, by reason of the statutory and regulatory hospital affiliation requirement for doctors,” Sachs wrote.

“Especially in Springfield and Joplin, but to a lesser extent in Columbia and Kansas City, the ASC (surgery center) requirement imposes burdens that have closed or prevented development of clinics.”

He went on to say that a failure to act promptly would “seriously frustrate the opportunity to open clinics in Springfield and Joplin and the restoration of clinical service in Columbia and Kansas City.”

In a joint statement, the Planned Parenthood plaintiffs said, “Today’s victory means countless Missourians will have expanded access to safe, legal abortion. It is also the resounding affirmation we’ve long awaited – that medically unnecessary restrictions like admitting privileges and ambulatory surgical center requirements are state mandated laws thought up by extremists in Jefferson City. We will continue to fight these restrictions until they are permanently blocked in the state of Missouri.”  

Dan Margolies is KCUR’s health editor. You can reach him on Twitter @DanMargolies.