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Missouri's last abortion clinic will defy an 'inhumane' state mandate as it battles to stay open

The state must decide Friday whether to renew the license of Planned Parenthood of St. Louis, the only remaining clinic providing abortions in Missouri.
Image: Abortion rights advocates and Planned Parenthood staff hold a rally outside a clinic in St. Louis, Missouri, on May 31, 2019.
Abortion rights advocates and Planned Parenthood staff hold a rally outside a clinic in St. Louis, Missouri, on May 31, 2019.Saul Loeb / AFP - Getty Images file

Missouri's last remaining abortion clinic, already battling with the state to stay open, announced that its doctors would no longer subject women seeking an abortion to multiple pelvic exams, a practice it said is "inhumane."

Wednesday's announcement came just two days before Missouri’s Department of Health and Senior Services must decide whether to renew the Planned Parenthood of St. Louis clinic's abortion license.

Planned Parenthood sued the state health department last month, accusing it of refusing to renew the clinic’s license “unless doctors consent to inappropriate interrogation, bordering on harassment.”

Planned Parenthood said that, prior to the legal battle, state regulators reinterpreted a rule mandating pelvic exams before abortions to mean the exam must be administered 72 hours prior to an abortion in addition to on the day of the procedure. Planned Parenthood at first agreed to comply, but on Wednesday changed course.

"The additional medically unnecessary forced pelvic exam newly interpreted by the state is deeply traumatizing and inhumane," said Dr. Colleen McNicholas, an OB-GYN at Planned Parenthood of St. Louis. "Let’s be clear — we have always complied with the regulation, but we as doctors reject this new interpretation because it defies patient-centered care."

"We believe continuing to force an additional invasive and uncomfortable vaginal exam on patients at least three days before her abortion procedure, when it is not medically indicated, and when she will have the identical exam on the day of the abortion procedure, is not patient-centered; it is disrespectful and dehumanizing," McNicholas said.

Both the American College of Physicians and The American College of Obstetricians and Gynecologists disagree with performing repeat pelvic exams on women seeking abortion. "While pelvic exams may be appropriate for patients with certain conditions, routine multiple pelvic exams for women seeking abortion care are unwarranted, invasive, and not supported by evidence," a statement in May from the physicians group said.

The state health department said in a June 10 statement that it has required pelvic exams prior to abortions since 1988, and the requirement that the exam be performed 72 hours before an abortion has been in state law since 2014.

Lisa Cox, chief public information officer for the department, told NBC News on Thursday that the doctor can decide whether to perform another pelvic exam on the same day as an abortion.

Planned Parenthood alleged in its lawsuit that the health department also recently reinterpreted the pelvic-exam rule to apply to medication-induced abortions. Doctors at the clinic refused to perform the exam prior to medication-induced abortions, so the clinic stopped offering them and now only provides surgical abortions.

If the state fails to renew Planned Parenthood St. Louis' license Friday, it will be up to a judge to decide on the next steps.

Planned Parenthood officials said that if the clinic loses its license, Missouri would become the first state without an abortion facility since the Supreme Court legalized the procedure in the 1973 Roe v. Wade ruling.

The fight over the survival of the state's last abortion clinic comes as Missouri and other states have passed laws that would severely restrict access to abortion.

Missouri already had some of the strictest abortion regulations in the country — including a requirement that doctors performing abortions have partnerships with nearby hospitals — before Gov. Mike Parson signed legislation last month that seeks to ban abortions after eight weeks of pregnancy.

Most parts of the new law are to take effect Aug. 28.