The Missouri Department of Health and Senior Services still hasn’t indicated how soon it will act on Planned Parenthood’s medication abortion complication plan
BY: ANNA SPOERRE
Missouri Independent
Missouri Attorney General Andrew Bailey is doubling down on his demand that Planned Parenthood stop performing a type of abortion that its clinics aren’t actually offering patients.
On Monday, Bailey issued a notice of an intent to serve a cease and desist letter to Planned Parenthood Great Plains, which operates clinics in the Kansas City metro and Columbia.
It’s an identical threat to the one Bailey issued earlier this month to Planned Parenthood Great Rivers, which operates clinics in the St. Louis metro, Springfield and Rolla.
Bailey is demanding the clinics not perform medication abortions without an approved complication plan from state health officials.
But clinic leadership has said they have no intention of offering medication abortion without an approved complication plan, which they have submitted for approval to the Missouri Department of Health and Senior Services.
The health department has not yet responded with a timeline for approval.
Emily Wales, president and CEO of Planned Parenthood Great Plains, and Margot Riphagen, president and CEO of Planned Parenthood Great Rivers, in a written response this week to the attorney general’s office called Bailey’s notice “baseless political posturing” and an attempt at intimidation.
Rather than urging the state health department to respond to the proposed complication plan, Wales and Riphagen wrote, Bailey has instead “threatened to ‘take action’ against (Planned Parenthood) for hypothetical, future medication abortion which you have no reason to believe will occur without such a plan.”
Asked if the attorney general’s office has any reason to believe Planned Parenthood intends to start providing medication abortions without authorization from the state, James Lawson, deputy chief of staff in Bailey’s office, said Planned Parenthood “has a documented history of subverting state law and providing unauthorized services.”
“This cease and desist letter provides a forcing function to ensure basic health and safety standards,” Lawson said.
As of Wednesday, only a handful of procedural abortions have been performed up to 12 weeks gestation, and only at the clinics in Columbia and Kansas City.
Wales previously said Planned Parenthood’s clinics in Kansas City and Columbia are stocked with abortion medication and ready to administer it as soon as the state allows. Leadership at the clinic in St. Louis said they are also ready to begin providing the medication as soon as the state signs off on a complication plan.
Complication plans are “important to ensure the safety of patients because medication abortions will likely be completed at home without a physician present,” Sami Jo Freeman, a spokeswoman with the department, said in an emailed statement in late February.
In 2023, nearly two-thirds of abortions in the United States took place using medication as opposed to in-clinic procedures, according to the Guttmacher Institute, a reproductive rights research group.
In states where abortion is legal, medication that induces a miscarriage is available to patients in their first trimester of pregnancy. Patients typically take two doses of medication, the second of which is often taken at home. In recent years, a growing number of women have been ordering abortion medication from online providers in the United States and abroad, including to states where abortion remains illegal.
Bailey is also among a trio of attorneys general who filed litigation asking a judge in Texas to order the U.S. Food and Drug Administration to reinstate restrictions on mifepristone, one of two medications prescribed to induce chemical abortions.
According to the FDA, mifepristone is safe to use if taken as directed. Cramping and bleeding are common side effects of the medication. Those prescribed mifepristone are urged to call their doctor if they experience heavy bleeding, abdominal pain or a fever. The same guidance applies to those who recently underwent procedural abortions, experienced miscarriages or delivered a baby.
Since the medication was approved for use 28 years ago, only 32 deaths have been reported associated with mifepristone, according to the FDA.
Bailey is also expected to appeal the most recent order out of Jackson County which allowed Planned Parenthood to restart procedural abortions.
In an email last month, a spokeswoman for the attorney general said the office intends to appeal the judge’s Feb. 14 order “immediately.” As of Wednesday, the office had not filed an appeal.
“Should the attorney general wish to appeal, there are the correct avenues to go through an appeal,” Riphagen said. “Instead, sending a cease and desist that ignores both the law and the truth leads us to the conclusion that this is politically motivated.”
Court to hear more arguments Wednesday
Missouri Attorney General Andrew Bailey answers questions from reporters about Gov. Mike Kehoe’s executive orders in January (Annelise Hanshaw/Missouri Independent).
Shortly after Missourians in November narrowly approved Amendment 3, granting the constitutional right to an abortion, Planned Parenthood sued the state in Jackson County arguing dozens of regulations on abortion providers were no longer constitutional.
Several days later, Bailey’s office filed a petition in Cole County seeking to throw out Planned Parenthood’s lawsuit based on a 2010 settlement agreement.
“The terms of the contract were plain: the state will let (Planned Parenthood) operate in partial compliance with the state’s licensure requirements in exchange for (Planned Parenthood’s) promise never to challenge Missouri’s abortion licensure regulations again,” the attorney general’s office wrote in a recent court filing.
About a week after the Jackson County ruling opened the door for procedural abortions in February, Bailey asked a Cole County judge to consider a temporary restraining order against Planned Parenthood that would halt any abortions at the Columbia and Kansas City clinics.
Planned Parenthood maintains that because the 2010 settlement was made with different federal and state constitution laws around abortion in place, the AG’s arguments are no longer relevant.
“The state is attempting to enforce an outdated agreement regarding a regime of laws and regulations that now conflict with the Missouri Constitution,” attorneys for Planned Parenthood wrote in court filings.
Planned Parenthood and the attorney general’s office are again scheduled to meet in court Wednesday morning. The hearing, to take place before Cole County Judge Daniel Green, will address Planned Parenthood’s request that the court dismiss the case or move it to Jackson County. It will also address Bailey’s request for a temporary restraining order.
Wales called Wednesday’s case “entirely about distraction and delay.”
“I don’t think what’s happening in our Amendment 3 litigation is that far removed from the federal chaos …” she said. “There is an element of creating chaos in the courts and having us respond to a million different demands and requests. It’s the same approach, fundamentally.”