Missouri Health Clinic May Be Forced To Stop Abortion Services
STEVE INSKEEP, HOST:
The state of Missouri is days away from becoming the first state without a single health facility that provides abortions. The state health department is threatening not to renew the license of the last clinic that does. Dr. Leana Wen of Planned Parenthood, which runs that clinic, discussed the case yesterday on NPR's All Things Considered.
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LEANA WEN: If the court does not grant us a restraining order, Missouri will go dark. And more than 1.1 million women of reproductive age will be living in a state where they cannot access essential health care - the first time since 1974 that safe, legal abortion is inaccessible to people in an entire state.
INSKEEP: The state is asserting its right to interview the employees of the clinic, but some do not want to talk. And that's where the conflict lies. Dr. Colleen McNicholas did answer the state's questions. She is an OB-GYN and has performed abortions at Planned Parenthood of the St. Louis region. She's on the line.
COLLEEN MCNICHOLAS: Good morning, Steven. Thanks for having me.
INSKEEP: I know you may not be able to say every detail. But, broadly speaking, what is it that the state wants to know?
MCNICHOLAS: Yes. I can't get into specifics, but I can say generally that the department asked about our practices at RHS, including - and maybe really specifically focusing on - how we work with residents and fellow trainees. And while I still believe that the interviews are unnecessary, as I'm confident about the exceptional care that we provide, I do also hope that the department now feels that with a better understanding of how medical education works that they can resolve any remaining issues.
INSKEEP: That, on the surface, doesn't sound unreasonable; that the state - which licenses your facility, wants to make sure that it's safe and in accordance with laws and regulations - would ask people about that subject.
MCNICHOLAS: That's exactly right. And Planned Parenthood has - for as long as I have been working with Planned Parenthood - has been responsive to oversight. And we are interested in sincere and reasonable oversight to help make health care more safe and appropriate for our patients. However, it's impossible for us to do that when they use that oversight process as a weapon to politically drive an agenda.
INSKEEP: That sounds like you do not think that this is sincere and reasonable oversight.
MCNICHOLAS: It's hard to believe that it is when, in fact, the state department of health continues to reassess and reinterpret their own regulations from year to year.
INSKEEP: Would it not make sense, though, for some of your colleagues who have declined to answer questions to simply do as you have done and answer them?
MCNICHOLAS: You know, it's interesting because one of the tactics they're using is to really focus on trainees. Those are residents and fellows who are still in training, who are only providing care under the supervision of attending physicians. And the standard sort of across medical education is that, ultimately, the attending physicians are responsible for the care provided. And, really, this can only be seen as a tactic to harass and intimidate those trainees.
INSKEEP: I guess we should just be - residents, doctors in training; these are people who are - apprenticed is the wrong word. But they're working under someone like you. That's the kind of person you're talking about, right?
MCNICHOLAS: That's correct.
INSKEEP: And are they especially vulnerable in some ways - legally vulnerable or otherwise - if they're answering a lot of questions?
MCNICHOLAS: Well, you know, this is part of the larger context of criminalizing abortion across the states - criminalizing it for patients who are seeking abortion and for physicians and clinicians who are providing that care. And so certainly in Missouri, like in many other states, there are some abortion statutes that are tied to criminal penalties.
INSKEEP: Again, granting that you can't get into all the specifics - but I want to know if there is evidence to back up what you just said. You've essentially said this is a process where they're asking questions that, on the surface, are reasonable. But it seems like they're in bad faith. Was there something that any state official has done or said to you in that questioning or elsewhere that makes you think they're just trying to shut this clinic down?
MCNICHOLAS: Well, here, I can give you this as an example. So there has long been a requirement to include pelvic exams in the provision of our care, which is part of standard medical care for providing a surgical aspiration abortion. However, this year, despite this being part of our practice forever, the state has now reinterpreted its own regulation to say we must provide that pelvic exam at the same time that we perform their consent, which is at least three days and, sometimes, weeks before the patient actually has the procedure - which has no medical relevance to their care.
And so that's just one example of how the state is continuing to reinterpret their own regulations - really making the goalpost for compliance continuously moving and impossible for us to comply with.
INSKEEP: Dr. McNicholas, I want to take a moment to ask a really big question here. You are providing a service - abortions - a service that is a constitutional right according to Roe v. Wade in many, many circumstances but a service that a lot of people in this country and probably a lot of people listening now find fundamentally wrong. What have you said when you've encountered - I don't know - a friend or a relative or an acquaintance who just disagrees with what you do?
MCNICHOLAS: You know, everybody has an opinion on abortion until they need one. And so what I remind people is that it is completely appropriate for them to have an opinion on it, but their opinion should direct their own health care and that public health policy should really be driven by science and evidence and that every person deserves to make their health care decisions consistent and in line with their own values.
INSKEEP: Even if those values, in the case of some people listening now, would include protecting the unborn - that's the way they would phrase it.
MCNICHOLAS: Again, you know, my experience has been that everybody's opinion on abortion changes once they face a situation or their sister or their brother or their mom faces a situation in which they might need one.
INSKEEP: Well, Dr. McNicholas, you're still on the job today. Correct?
MCNICHOLAS: That's true. We are still open.
INSKEEP: Until Friday.
MCNICHOLAS: We are open and providing abortion services until Friday, and we will continue to provide the remainder of the services that we provide beyond then.
INSKEEP: OK. Dr. McNicholas, thanks so much - really appreciate it.
MCNICHOLAS: Thanks, Steven.
INSKEEP: Colleen McNicholas is an OB-GYN who has provided abortions at the last clinic that is still doing so in Missouri. We should note that NPR's reached out to Governor Mike Parson and also to Dr. Randall Williams, the director of Missouri's Health Department. They have not yet responded to our requests for comment. But if you or your staff are listening, that invitation is still open. Transcript provided by NPR, Copyright NPR.