Abortion – Abortion Clinics, Abortion Pill, Abortion Information

Anti-choice advocates were confident going into yesterday’s state elections. The Susan B. Anthony List, a group that has seized on Donald Trump’s presidency to try and finally overturn Roe v. Wade, had spent $750,000 on ads, mailers, and door-knocking on behalf of incumbent Governor Matt Bevin, who is incredibly unpopular except for one issue (or so they thought): abortion. Since he’s known for trying to throw poor people off of Obamacare and blaming striking Kentucky teachers for the death of a 7-year-old girl who was home from school, Bevin’s best chance of beating Democratic opponent Andy Beshear was supposed to be his bombastic anti-abortion stance.

Except that it wasn’t. The race is still too close to officially call, but as of now, Beshear is ahead by 5,300 ballots, poised to become a governor of Kentucky who ran on protecting abortion rights. Kentucky voters rebuked the narrative that GOP operatives have been trying to sell us us with state ban after state ban: that America’s protection of reproductive choice, enshrined in a constitutional amendment since 1973, is no longer popular nationwide.

And Kentucky wasn’t the only loss for the anti-choice lobby. In Virginia last night, Democrats flipped both houses in the state legislature, finally wresting narrowly held control from Republicans. This is particularly notable because the state was recently the epicenter of a bitter fight over access to late abortion care: After Democratic lawmaker Kathy Tran introduced legislation that would have reduced onerous state requirements around terminating a pregnancy in the third trimester, she was accused of “supporting infanticide” and faced a torrent of death threats. Conservatives gleefully used the controversy to argue that such unapologetic pro-choice positions would alienate voters and ensure Trump’s re-election. But they misjudged. “Today’s Election Will Determine The Future Of Late-Term Abortions In Virginia,” the Federalist wrote. It did — just not in the way they hoped. Tran ultimately kept her seat.

“SBA List used the Kentucky governor’s race and the Virginia state elections the same way they used the 2016 presidential race,” Robin Marty, author of Handbook for a Post-Roe America, told the Cut, “by investing all of their money and resources into motivating voters who were wavering on GOP politicians to believe that opposing abortion is the only issue that should matter. And they failed. Spectacularly.”

The results are a blow to the coordinated, decades-long effort by far-right groups to overturn Roe through state laws and an anti-choice judiciary, which has been terrifyingly successful so far; the Supreme Court announced on October 4 that the court would consider a Louisiana abortion law, the first major test of Roe since Justice Brett Kavanaugh was confirmed last year. SBA List helped hammer through the confirmation of both anti-choice justices Kavanaugh and Neil Gorsuch.

“For 2020 they will no doubt try again, focusing on small populations in swing states to give them just the right margin to win the electoral college for Trump, despite his massive unpopularity. They could still pull it off, because their pockets are deep, but clearly it will be a much harder battle than they were expecting,” Marty says.

Last night’s results should be a bellwether for not just abortion rights, but for many progressive policies Democrats will be running on in future state elections, and in 2020. Supposedly controversial issues like abortion, Medicare for All, the Green New Deal, and free college tuition are, in fact, widely popular, and the GOP’s attempts to consolidate power by turning them into poison pills should embolden Democrats, not push them to appeal to some ostensibly “moderate” base — despite what some people have been trying to tell us.

Speaking of a so-called moderate base, Joe Biden’s hometown of Scranton just elected its first woman mayor: a 39-year-old insurgent candidate who ran on finally defeating “the same old boys club.” Its members far and wide should be worried.

Roger Severino, director of the Office for Civil Rights at the Department of Health and Human Services, was a major driver of the rule struck down Wednesday. A federal judge found the rule issued earlier this year — making it easier for health care workers to refuse care for religious reasons — to be an overreach by the department.
Aaron P. Bernstein/Getty Images

In a blow to the Trump administration, a federal court in Manhattan has knocked down a rule that would make it easier for doctors and other health care workers to refuse care for religious reasons.

U.S. District Judge Paul Engelmayer ruled Wednesday that the Department of Health and Human Services, which issued the regulation earlier this year, exceeded its authority and “acted arbitrarily and capriciously” in promoting it.

The department’s violations of federal law, according to the judge’s opinion, were “numerous, fundamental, and far-reaching” — and he vacated the rule entirely, just over two weeks before it was set to take effect on Nov. 22.

The Trump administration had asserted that the rule would give health care providers the freedom to opt out of providing care or services — such as abortions — that violate their conscience. Employers that did not comply with the rule could have had their federal funding withdrawn.

“This rule ensures that healthcare entities and professionals won’t be bullied out of the health care field because they decline to participate in actions that violate their conscience, including the taking of human life,” Roger Severino, director of HHS’s Office for Civil Rights, argued in a written statement when the regulation was issued in early May.

The rule’s critics, however, saw it as a means of allowing health care workers to circumvent rules against discrimination. And they quickly took the Trump administration to court — with more than two dozen states, cities and organizations such as Planned Parenthood filing lawsuits against Severino and Health and Human Services Secretary Alex Azar. Those suits were later consolidated into one case, which Engelmayer oversaw.

There’s also another lawsuit against this rule, filed in the U.S. District Court for the Northern District of California. The plaintiffs in that consolidated case include the state of California, Santa Clara County and organizations such as Lambda Legal. It wasn’t immediately clear what Wednesday’s ruling means for the case in California.

As NPR has reported, this rule was part of a big push from the Office for Civil Rights to bolster “religious freedom” in health care. Severino, who is Catholic and formerly of the conservative Heritage Foundation, has argued that previous administrations did not fully enforce existing law that protected what supporters call health care workers’ “conscience rights.”

To remedy that, Severino created a Conscience and Religious Freedom Division in January 2018, and in May of this year, his office issued this rule.

The rule was designed to bolster the rights of providers to opt out of care, even without prior notice of their objections to their employer. It also expanded the type of workers who are able to file complaints about rights violations to include billing staff, receptionists and anyone else who in any way “assist[s] in the performance” of a procedure.

Complaints of such violations are relatively rare — for a decade, the office would receive an average of one complaint like this each year. Severino frequently pointed to a jump in those complaints to 343 last year as proving the need for this rule. He attributed that increase to a strong message from his office that they were “open for business” when it came to issues of religious freedom.

However, that increase in the number of complaints is “demonstrably false,” according to Engelmayer’s ruling. Nearly 80% of all the complaints given to the court were about vaccinations — unrelated to health care workers and their religious beliefs in providing care.

The judge writes that only 21 — or 6% — of the complaints that the government provided the court are even potentially related to providers’ moral or religious objections. During oral arguments, the government’s attorney conceded that the real number of complaints was “in that ballpark.”

“This conceded fact is fatal to HHS’s stated justification for the Rule,” Engelmayer writes. “Even assuming that all 20 or 21 complaints implicated the Conscience Provisions, those 20 or 21 are a far cry from the 343 that the Rule declared represented a ‘significant increase’ in complaints.”

In a statement to NPR, the government said, “HHS, together with DOJ, is reviewing the court’s opinion and so will not comment on the pending litigation at this time.”

Closing the last abortion clinic in the Dayton, Ohio, area would have a major effect on people of color and those with low incomes, groups that make up a large portion of Dayton’s population.

Gov. Mike DeWine (R) has pledged to continue Kasich’s assault on abortion access.
Justin Merriman / Getty Images

Unrestricted abortion would be available in Northern Ireland up to 12 or 14 weeks under UK Government proposals.

Ministers are bound to introduce a system governing terminations by next spring.

MPs at Westminster forced the Northern Ireland Office (NIO) to act after legislation passed earlier this year reformed the most restrictive laws surrounding child birth in the UK.

An official consultation said: “Twelve weeks gestation has been considered because it is the end of the first trimester of pregnancy and in England and Wales 90% of abortions are performed within this timeframe.

“However, an alternative approach would be allowing for a termination up to 14 weeks gestation without conditionality, as some women and girls may have been delayed in finding out that they are pregnant and others may need more time to reach a decision.”

Abortion is a deeply divisive issue in Northern Ireland.

Abortion is a deeply divisive issue in Northern Ireland (Niall Carson/PA)

The DUP failed in a last-ditch bid at Stormont to thwart legalisation last month.

The British Government said it was concerned that it may not be appropriate for a new process to be applied that requires a woman or girl to give evidence that the pregnancy is a result of sexual crime and to obtain certification from a medical professional on that basis.

Its consultation added: “No certificate of opinion may be required from a doctor for the early termination (up to 12/14 weeks gestation), because it is proposed that termination will be available up to this gestational limit without any medical grounds being required to be met.”

Mental well-being grounds may allow an abortion after 14 weeks under the proposals.

Abortion without time limit may be available in cases of fatal foetal abnormality or where a woman’s life was at risk or she was in danger of suffering permanent injury.

Any medical practitioner may perform the procedure and flexibility would be shown about where, recognising the use of pills at a woman’s home.

Later stage abortions would take place in hospital.

A provision allowing medics to opt out on conscientious objection grounds would cover the course of treatment.

An exclusion or safe zone would be in place allowing women to obtain the procedure without facing protest.

Source: https://www.irishexaminer.com/breakingnews/ireland/unrestricted-abortion-proposed-for-ni-up-to-14-weeks-961796.html?fbclid=IwAR0c6SGMXWnraEQ0nkvvt683YC3anpwJEv8YUfiLP5TDUG1viLrEAFNs4pA

Dr. Yashica Robinson, one of the last remaining abortion providers in Alabama, is taking on the state’s abortion ban law alongside Planned Parenthood and the American Civil Liberties Union of Alabama.

A Notasulga, Alabama native, Robinson decided she wanted to go into obstetrics when she became a teen mother. She attended medical school at Morehouse School of Medicine and completed her residency in obstetrics and gynecology at the University of Alabama at Birmingham School of Medicine.

Today Robinson works at her OBGYN office in Huntsville and provides abortion care at that city’s Alabama Women’s Center, one of Alabama’s last three remaining abortion clinics. Both offices are under a constant barrage of protesters, some who film patients entering and exiting and broadcasting them onto Facebook live.

Alabama is one of nine states who passed abortion ban laws this year. In May, Gov. Kay Ivey passed a law banning nearly all abortion, including pregnancies conceived by rape or incest. Robinson is the lone person – along with Planned Parenthood and the ACLU of Alabama – who filed a lawsuit challenging the law. A federal judge issued a preliminary injunction on Oct. 29, temporarily prohibiting the law from going into effect until the law makes its way through higher courts.

Abortion is still legal in all 50 states. Alabama’s two other abortion clinics are West Alabama Women’s Center in Tuscaloosa and Reproductive Health Services in Montgomery.

Why did you decide to be one of the plaintiffs in the state’s abortion ban case?

As a physician, I care deeply for my patients. I know how critical abortion care is. I understand how bans like the one Alabama passed hurt patients who are already marginalized the most. The majority of my patients do not have the resources to challenge these unconstitutional laws themselves. Therefore, I feel it is my responsibility to stand and fight on their behalf.

Why did you decide to go into gynecology and then decide to perform the entire spectrum of women’s healthcare?

My passion for helping people led to a career in medicine. Becoming pregnant as a teenager influenced my decision to choose Obstetrics and Gynecology as a specialty. I understand that women need different types of care over the course of their reproductive life span – comprehensive contraceptive education, prenatal care, abortion care without judgment and compassionate management of miscarriages. I did not decide to go into gynecology, and then perform the entire spectrum of women’s healthcare. Abortion care is simply part of the work that defines a specialist who is an Obstetrician-Gynecologist. I chose to care for women, and refused to be bullied into negating part of my duties by leaving abortion care out of my practice.

What needs did you see in the state for more doctors who perform abortions?

There is a critical need to provide more protections for abortion providers and their families against harassment and violence in their communities and at work. The hostility and stigma leads to a shortage of physicians who are trained and willing to provide this needed medical service for patients. It also leads to a dearth of medical professionals willing to provide proper referrals. This hurts patients. There is also a need for local law enforcement agents to be educated and willing to be responsive when abortion providers and their patients are violated.

Why did you decide to be one of the plaintiffs in the state’s abortion ban case?

As a physician, I care deeply for my patients. I know how critical abortion care is. I understand how bans like the one Alabama passed hurt patients who are already marginalized the most. The majority of my patients do not have the resources to challenge these unconstitutional laws themselves. Therefore, I feel it is my responsibility to stand and fight on their behalf.

How does your community/family respond to the work you do?

There are many people in my community who are supportive and appreciate the need for the care that I provide. Of course, there are many who staunchly oppose the work I do, and they work hard to drive me out of the community. It is unfortunate that those against comprehensive health care for women, are the ones who are most vocal and active. My family members are supportive. Any concern they have comes from their concern for my safety.

Yashica Robinson: My patients are complex, unique, thoughtful.

I am a mother and an OB/GYN. Every day I care for women and honor the decisions they make about their bodies, their families and their futures. I deliver babies, support patients through miscarriage and I provide abortions.

Source: https://www.al.com/news/2019/11/one-of-alabamas-last-remaining-abortion-providers-fights-back.html?fbclid=IwAR3fZ3C0Gz4MfiA3LZAOm75i4N5X0AjopqL-oEkvAuKwWiqO2YFnoWxKpMU

The new U.S. Ambassador to the United Nation (UN), Kelly Craft, takes up the United State’s seat at the Security Council at UN headquarters on September 12, 2019 in New York City.SPENCER PLATT/GETTY

Shortly after a unanimous vote in the UN Security Council to pass a resolution on women, peace and security, the U.S. Mission to the UN, headed by Ambassador Kelly Craft, released a press statement criticizing references to “sexual and reproductive health.”

The resolution referenced previously passed resolutions including the term, which Craft deemed unacceptable. “I must note that we cannot accept references to ‘sexual and reproductive health,’ nor any references to ‘safe termination of pregnancy’ or language that would promote abortion or suggest a right to abortion.”

The statement continues, “The U.N should not put itself in a position of promoting or suggesting a right to abortion, whether it is humanitarian or development work.”

Other countries in the open debate spoke strongly of including references to sexual and reproductive health, including the United Kingdom and Belgium.

This is not the first time that that the U.S. has pushed back against including these rights in Security Council resolutions.

In April 2019, a draft resolution circulated prior to the Security Council vote included the term. The U.S. Mission responded by threatening to veto, thereby killing the resolution, if the term was not taken out.

The resolution, which centered on sexual and gender-based violence in conflict, was passed without the inclusion of any reference to sexual and reproductive health.

In an article on International Peace Institute’s Global Observatory, Siri May from Center for Reproductive Rights wrote, “It is arcane to suggest that providing sexual and reproductive health (SRH) services to survivors of conflict-related sexual violence is even up for debate.”

May also noted that quality sexual and reproductive health can address issues such as, “unsafe abortion, maternal and low birthweight, miscarriage, premature labor and sexually transmitted infections for women and girls.” These quality health services are particularly difficult to access in conflict situations, May said.

Representatives of the Trump administration at the UN have been consistent with the position, pushing back on the inclusion of sexual and reproductive health not just in the Security Council, but across the UN.

In September, US Health and Human Services Secretary Alex Azar spoke at the General Assembly, saying, “We do not support references to ambiguous terms and expressions such as ‘sexual and reproductive health and rights’ in U.N. documents, because they can undermine the critical role of the family and promote practices like abortion in circumstances that do not enjoy international consensus and which can be misinterpreted by U.N. agencies.”

Source: https://www.newsweek.com/-1468541

I am a family doctor who provides abortion care in the Philadelphia suburbs. While that may sound like a bit of an oxymoron, the reality is that abortion is just like any other health care decision. Prenatal care and abortion care comprise the full spectrum of reproductive health care. Sometimes the decision to have an abortion is complex and full of emotions, sometimes it’s straightforward, and sometimes it’s heartbreaking and full of grief. No matter how easy or difficult, the only person who knows what the right decision is for the woman sitting in front of me is that woman herself.

What do my patients want when they decide to have an abortion? They want the same type of information and support as any other patient. They want honesty from their physician. They want clear and accurate information. They want support to make decisions that are right for them and assistance to navigate a complex health care system.

Last week, Pennsylvania became the latest state to introduce a ban on abortions when a baby’s heartbeat is detectable. While Gov. Tom Wolf has promised to veto such a ban, House Bill 1977 will create a climate of uncertainty and fear for the people I care for. If passed, the bill will ban abortions as early as six weeks into pregnancy, when most women don’t even know they’re pregnant.

HB 1977 would prevent me from offering essential medical advice to my patients. When it comes to abortion, women are likely to receive misinformation bordering on deception and outright lies. I’ve had women ask me if they were going to be cut up with metal instruments, making them infertile. I had to reassure them that abortion is a safe, medical procedure.

Apart from HB 1977, Pennsylvania already restricts abortion access through laws that have nothing to do with safety. If you want an abortion, the state mandates that you receive counseling designed to discourage you, and wait a full 24 hours before the procedure. What’s worse, about 85 percent of our counties lack a health care clinic that provides abortion care. From 2014 to 2017, our state saw a 10 percent decline in the number of abortion clinics.

The numbers are troubling, and my experiences concern me. I once saw a 30-year old woman who struggled with many years of opioid use. She was finally recovering in a program and taking suboxone, medication that has proven to be successful at helping people stay sober. We had a conversation about the benefits and risks of suboxone during pregnancy, and how pregnancy could impact her recovery. After much discussion, after learning about all of her health care options, she decided that an abortion was the best decision for her. But due to Pennsylvania’s laws, I could not provide her with an abortion right in my office. I had to refer her to another clinic.

Another woman, a 26-year-old mother of two young children, came to see me about her miscarriage. We were able to discuss all of her treatment options: she could wait and let her body naturally take care of the miscarriage; she could take medication to help her uterus pass the pregnancy; or she could have a suction procedure and shorten the entire process. She didn’t want to worry about bleeding, working, and caring for her children, so she decided on the suction procedure, which I was able to do in my office. But due to Pennsylvania’s laws, I would not have been able to provide the same exact procedure had it been her abortion.

I have the skills, the knowledge, and the trust of my patients. As a physician, I want to be in a position to help people when they need it most. Pennsylvania’s laws, however, make it difficult for family doctors like me to provide all forms of care, including abortion care. HB 1977 would be yet another nail on the coffin for women’s health in our state.

Lin-Fan Wang is a family physician who practices in the Greater Philadelphia Area. She is a member of Eastern PA’s Reproductive Health Access Project Cluster and fellow with Physicians for Reproductive Health.

Source: https://www.inquirer.com/opinion/commentary/pennsylvnia-heartbeat-bill-abortion-laws-access-20191031.html

• A federal judge on Tuesday ruled that an Alabama abortion law considered the strictest in the country will not go into effect.

Pro-choice supporters protest in front of the Alabama State House as Alabama state Senate votes on the strictest anti-abortion bill in the United States at the Alabama Legislature in Montgomery, Alabama, U.S. May 14, 2019.
Chris Aluka Berry | Reuters

A federal judge on Tuesday ruled that an Alabama abortion law considered the strictest in the country will not go into effect, citing Supreme Court precedents that forbid bans on abortion prior to fetal viability.

Supporters of the Alabama law hope to use it to spur the Supreme Court to revisit those reproductive rights precedents, including the landmark decision Roe v. Wade. They expected lower courts to block the law.

The law criminalizes providing an abortion at any stage during a pregnancy, threatening doctors with prison sentences up to 99 years. It was set to take effect Nov. 15. The law provides no exception for rape or incest victims, but allows the procedure in cases where the patient’s life is at risk.

“Enforcement of the ban would yield serious and irreparable harm, violating the right to privacy and preventing women from obtaining abortions in Alabama,” District Judge Myron Thompson wrote. Thompson issued a temporary injunction that will prevent the law from going into effect until the court resolves the case in full.

Gov. Kay Ivey signed the law in May, acknowledging at the time that it was illegal under federal law and likely unenforceable.

The law came amid a flurry of other abortion restrictions passed in states led by Republicans attempting to test the Supreme Court’s new conservative majority.

The nine-judge panel has five Republican appointees, including Justice Brett Kavanaugh, whom President Donald Trump selected to replace Justice Anthony Kennedy. Kavanaugh is generally seen as more conservative than his predecessor.

The ACLU, which has challenged a number of those laws, said in a statement that none of those measures have survived legal scrutiny.

“With this federal court ruling, it’s official: None of the state abortion bans passed earlier this year are in effect,” the group wrote in a post on Twitter.

In a statement, Attorney General Steve Marshall said that the district court’s decision was “not unexpected.”

“As we have stated before, the State’s objective is to advance our case to the U.S. Supreme Court where we intend to submit evidence that supports our argument that Roe and Casey were wrongly decided and that the Constitution does not prohibit states from protecting unborn children from abortion,” he said.

Planned Parenthood v. Casey was a 1992 Supreme Court decision that affirmed the central holding of Roe v. Wade.

The lawsuit was brought by Planned Parenthood and the American Civil Liberties Union in the United States District Court for Middle Alabama.

The Supreme Court will hear a case this term challenging a Louisiana abortion law that opponents say will limit the state to one provider. The law requires doctors who perform abortions to have admitting privileges at hospitals within 30 miles of their clinics.

Source: https://www.cnbc.com/2019/10/29/federal-court-strikes-down-alabama-abortion-law.html

The state could become the first without an abortion clinic since Roe v. Wade.

Anti-abortion demonstrators outside Reproductive Health Services of Planned Parenthood of the St. Louis region in St. Louis, Missouri, on May 31, 2019. Saul Loeb/AFP/Getty Images

The last abortion clinic in Missouri is battling for its existence.

Reproductive Health Services of Planned Parenthood of the St. Louis region has been operating for 46 years, serving thousands of patients annually for STI testing, cancer screenings, and abortions. But it might have to stop offering abortion care thanks to a months-long dispute with state regulators.

The controversy started after an audit earlier this year, when officials say they found “deficient practices” at the clinic. While they haven’t been very specific about what those practices are, officials requested interviews with doctors working at the clinic. Some of the doctors agreed, but others did not, possibly fearing that the state would launch criminal proceedings against them. Meanwhile, officials said that if they couldn’t interview all the doctors, they would revoke the clinic’s license to perform abortions.

Beginning Monday, representatives from the clinic and the state will testify at a weeklong series of hearings to determine if the facility can keep its license. If the clinic loses, Missouri residents — including more than a million people who can become pregnant — will have to travel across state lines if they want to end a pregnancy. Advocates say this will increase the already significant obstacles that patients — who are disproportionately low-income — face when trying to get the procedure.

The outcome of the hearing could also signal the end of an era in abortion access: if Missouri loses its clinic, it will become the first state with no provider since Roe v. Wade, the landmark 1973 Supreme Court decision that established the right to an abortion in America.

While near-total bans on abortion grabbed headlines earlier this year, states have also been engaged in quieter, more incremental efforts to restrict abortion. Some, including Missouri, have passed restrictions on abortion doctors, laws similar to one in Louisiana that will go before the Supreme Court this term. But Planned Parenthood says it is also using the clinic licensing process as a roundabout way of shutting the clinic down. If the facility has to stop providing abortions, advocates say, it could be the biggest success yet for the strategy of eliminating access without banning the procedure outright.

“It is the moment that we have long been warning about,” Bonyen Lee-Gilmore, director of state media campaigns at Planned Parenthood Federation of America, told Vox: “the day that abortion access is eliminated without ever overturning Roe.”

State regulators say they have concerns about the clinic. It’s not clear what the concerns are.

The clinic that is now Reproductive Health Services of Planned Parenthood of the St. Louis Region was founded in 1973, the year Roe was decided. Planned Parenthood bought the facility in 1996. Over the years, the clinic has been inspected a number of times, and inspectors were always collegial and professional, Dr. David Eisenberg, the clinic’s former medical director who still provides abortions and other care there, told Vox. But things started to change after the appointment of a new director, Dr. Randall Williams, to lead the Missouri Department of Health and Senior Services in 2017.

Williams, an OB-GYN, was appointed by former Missouri Gov. Eric Greitens, a Republican, and has spoken little publicly about his position on abortion. In an interview with the St. Louis Post-Dispatch earlier this year, he said only, “Abortion is legal in Missouri, and I want it to be safe.”

But soon after his appointment, Eisenberg said, state regulators essentially started saying, “We have reinterpreted the rules and regulations and found what you do to no longer be compliant.” (The health department has not yet responded to Vox’s request for comment.)

The department conducted an audit of the clinic in March, and said it had found “deficient practices,” according to Planned Parenthood, but it didn’t clarify what practices it found deficient. In a statement in June, the department said it was “reviewing incidents with significant medical evidence which point to troubling instances and deviations from the standard care, resulting in serious patient harm.”

To further investigate the deficiencies, the health department said it needed to interview all the doctors who practice at the clinic. The two doctors who are Planned Parenthood employees agreed to the interviews — but others, who were medical residents affiliated with a St. Louis hospital, did not do so.

The state said the results of the interviews could include “board review” or “criminal proceedings,” a spokesperson for Planned Parenthood said earlier this year. And Planned Parenthood said it could not force the residents to sit for interviews because they were not employees, according to the Kansas City Star.

The clinic was threatened with closure at the end of May, when its license was scheduled to expire and the health department declined to renew it. But a judge issued a preliminary injunction allowing the clinic to stay open.

Since then, the case has been referred to the state’s Administrative Hearing Commission, which handles disputes between state agencies and private individuals or groups. The commission will hold all-day hearings in the case this Monday through Friday.

It’s not clear when the commission will issue a decision, but the process could take months, Gilmore said.

Planned Parenthood says the state’s goal is simple: shut the clinic down

Throughout the process, the state has maintained that there are safety issues at the clinic. According to the statement issued by the health department in June, officials are “concerned by the refusal of physicians to provide explanations for the deeply troubling instances of patient care and conduct under investigation.”

Details about the department’s concerns have been difficult to obtain — the statement of deficiencies was not made public. But a conference call between state officials and anti-abortion activists in May suggests that the state wanted to investigate “failed” abortions, in which a patient remained pregnant, and the number of ambulance visits to the clinic, according to the Kansas City Star.

Planned Parenthood, meanwhile, says the concerns about patient care are essentially a ruse, and the state’s real goal is simply to shut down the clinic. “The state of Missouri has waged political theater in order to ban abortion,” Gilmore said.

The organization points to the May conference call between Steele Shippy, then-communications director for Missouri Gov. Mike Parson, a Republican, and Republican legislators and anti-abortion activists. The email invitation to the call ended with the phrase “#shutthemdown,” the Kansas City Star reported.

On the call, Shippy said that media would ask whether the state’s goal was to shut the clinic down. “While some of us, yes, it’s a main goal, but it also should be our main goal to protect the health and safety of women,” Shippy said.

The governor’s office declined to comment to Vox for this story. Shippy, who is now Parson’s campaign manager in his reelection campaign, has said that the call was nor arranged by the governor’s office. He is scheduled to testify at the hearings this week.

The closure of the clinic would mark a new era for abortion in America

Ahead of the hearings, Planned Parenthood said the stakes could not be higher. Even with the clinic open, “there’s over a million women” of reproductive age “in the state of Missouri with one freestanding health center providing abortion care,” Eisenberg said. If the clinic no longer provides abortions, any of those people facing an unwanted pregnancy would have to go to another state for care.

The majority of people seeking abortions in America are low-income, which means that traveling added distances can be a real financial hardship, especially if it means extra time off work. Last week, Planned Parenthood opened a new clinic just across the Mississippi River from St. Louis, in Illinois, which could see Missourians if the Missouri clinic cannot. But other neighboring states, like Iowa, Kentucky, and Kansas, are restricting abortion access, not expanding it.

Meanwhile, the battle with state regulators is already having an effect, according to Eisenberg. “There’s a lot of confusion,” he said. “People think that abortion’s no longer available, when it is.”

And the outcome of the hearing will have implications outside Missouri too. In the last year, states around the country have passed strict bans on abortion. A Missouri law, for example, bans the procedure at eight weeks into pregnancy, with no exceptions for rape or incest. But all these laws, including Missouri’s, have been blocked by courts.

Another, quieter movement against abortion, however, may be coming to fruition. Since 2010, states have been passing restrictions on abortion clinics and providers that have had the effect of shutting clinics down. A 2016 Supreme Court decision, Whole Woman’s Health v. Hellerstedt, found several such restrictions in Texas unconstitutional and struck a major blow to them nationwide. But since then, President Trump has appointed two conservative justices, Brett Kavanaugh and Neil Gorsuch, to the court.

And earlier this month, the court announced it would hear the case June Medical Services v. Gee, which concerns a law in Louisiana very similar to those at issue in Whole Woman’s Health. Many abortion-rights advocates fear that the court will rule in favor of Louisiana, essentially giving states a green light to pass more and more onerous restrictions on clinics until abortion is impossible to access, even if it’s not banned outright.

The conflict in Missouri right now is about health department regulation and inspections, not laws. But, Gilmore said, the situation is still similar to the one in Louisiana — officials are “using the regulatory process under the guise of health and safety” to try to stamp out abortion in the state.

If the clinic does stop providing abortions, it will likely be seen as a sign by advocates on both sides of the issue that the strategy of restricting or regulating abortion out of existence is working.

That could have the effect of keeping doctors from entering the field of abortion care, Eisenberg said, exacerbating an existing shortage of abortion doctors in many places. Faced with increasing restrictions, they may feel that “this is ridiculous, I’m going to go find something else to do where the government’s not going to get in my way,” he said.

But, he said, the situation in Missouri should also galvanize activism around abortion rights: “for anyone who cares about the rights of people who can become pregnant in this country, now is the time to get up and fight back.”

Source: https://www.vox.com/identities/2019/10/28/20932235/planned-parenthood-missouri-abortion-clinic-roe-wade