Missouri’s two Planned Parenthood affiliates on Wednesday morning sued to overturn the state’s highly restrictive abortion laws, a move expected since the U.S. Supreme Court struck down similar laws in Texas in June.
The lawsuit, filed in federal court in Jefferson City, sets up a showdown over state statutes that were enacted in the wake of the Supreme Court’s landmark Roe v. Wade decision, which held that the right to an abortion in the early stages of pregnancy is rooted in the Constitution.
Like the Texas laws found unconstitutional by the Supreme Court, Missouri requires abortion providers to have admitting privileges at local hospitals and to physically upgrade their facilities to meet the standards of ambulatory surgical centers.
Supporters of the laws say they’re meant to protect women’s health. Critics contend they’re aimed at shutting down abortion providers by imposing unnecessary, burdensome and costly requirements.
Missouri was the first state to enact such regulations. The state has also enacted a host of other abortion restrictions. Among others, they require women to wait 72 hours between visiting a doctor and having an abortion; require parental consent for minors; and prohibit the use of telemedicine in medication abortions.
At its peak in 1985, there were 19,482 abortions performed in Missouri facilities, according to state figures. In 2014, the last year for which information is available, the number had fallen to 5,060.
Right now, Planned Parenthood’s clinic in St. Louis is the only abortion provider in Missouri. There were more than two dozen 35 years ago.
The lawsuit filed by Missouri’s Planned Parenthood affiliates – Planned Parenthood Great Plains and Planned Parenthood of the St. Louis Region – was joined by Dr. Ronald N. Yeomans, a Kansas City-area doctor who provides abortions at Planned Parenthood Great Plains’ clinics in Overland Park and Wichita, Kansas.
The suit names as defendants Peter Lyskowski, director of the Missouri Department of Health and Senior Services; Chris Koster, the state’s attorney general; Jean Peters Baker, the Jackson County Prosecutor; Daniel Knight, the Boone County Prosecutor; Dean Dankelson, the Jasper County Prosecutor; and Dan Patterson, the Greene County Prosecutor.
A spokeswoman for Koster said that his office had yet to receive the lawsuit. Lyskowski and the county prosecutors could not immediately be reached for comment.
The prosecutors are in counties where Planned Parenthood has clinics that it says have been unable to provide abortions because of the hospital admitting and ambulatory surgical center requirements. The suit alleges the requirements “unconstitutionally burden access to abortion in the state.”
“The Restrictions severely restrict access to abortion in Missouri, which currently has only one licensed abortion facility in the entire state, located in St. Louis, to serve the nearly 1.2 million Missouri women of reproductive age,” the suit states. “Plaintiffs have four additional health centers that are prevented from providing abortion by the Restrictions, despite being able to safely do so. Women from all corners of Missouri, therefore, must currently travel up to 370 miles to obtain an in-state abortion.”
The four other health centers are in Kansas City, Columbia, Joplin and Springfield.
The Supreme Court “made it very clear that politically and ideologically motivated restrictions that serve no medical purpose are unconstitutional,” Laura McQuade, president and CEO of Planned Parenthood Great Plains, which is based in Overland Park, said in a telephone interview.
“And the two that were specifically dealt with in regard to that case out of Texas were admitting privilege requirements and ambulatory surgical center requirements or building facility requirements. And so the ruling that those entirely medically unnecessary procedures served only to hinder access to abortion and were therefore unconstitutional was the impetus to file this lawsuit in Missouri, as Missouri has almost identical restrictions in place for abortion access in the state.”
Among other requirements, the ambulatory surgical center statute mandates that surgery rooms have dimensions of at least 12 feet by 12 feet, a ceiling height of at least nine feet, patient corridors of at least 6 feet and door widths of at least 44 inches.
The lawsuit says there is no medical basis for those requirements, since surgical abortions can be safely performed in office-based settings and medication abortions involve patients simply swallowing a pill.
Moreover, the lawsuit states, Missouri settled an earlier case brought by Planned Parenthood that allows its Columbia facility to provide abortions without complying with those requirements. (The suit goes on to say, however, that the state has repeatedly changed its position on what it will require under the settlement agreement.)
Likewise, the suit alleges, the law requiring abortion doctors to have admitting privileges at a local hospital is medically unnecessary and harms patients by restricting their access to abortion services.
Although similar lawsuits have been filed by other abortion providers in other states, this appears to be the first legal challenge based on the Supreme Court decision, Whole Woman’s Health v. Hellerstedt, brought by Planned Parenthood affiliates.
“I think it’s an important moment in time for Planned Parenthood to be filing these challenges because of the perceived threat that the organization is under with the incoming (Trump) administration, both at the federal and state level in Missouri,” McQuade said.
“So I think that it’s something that we need to be doing at this moment in time, not only to challenge it and seek care for our patients but for people to know that, no matter what happens, we are going to be here and we are going to continue to fight for the privilege of providing the care we know our patients need.”
Dan Margolies, editor of the Heartland Health Monitor team, is based at KCUR. You can reach him on Twitter @DanMargolies.