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ST. LOUIS — Planned Parenthood will continue providing abortions at least until a St. Louis judge issues a ruling in the clinic’s legal battle with the state Department of Health and Senior Services, which on Friday declined to renew the facility’s license.

Circuit Judge Michael Stelzer said in a brief court hearing Friday that despite the state’s decision, the abortion clinic’s license remains valid because of his June 10 preliminary injunction preserving the license

“Planned Parenthood’s doors remain open,” M’Evie Mead, director of Planned Parenthood Advocates of Missouri, said after the hearing. “The judge left his injunction in place, which means that Missourians can continue to access the full range of reproductive health care in Missouri for now.”

The fate of the license now rests with Stelzer, who said he would issue a ruling soon.

If the state’s denial stands, Missouri would become the first U.S. state without an abortion clinic since the Supreme Court’s Roe v. Wade decision in 1973 established a woman’s right to terminate her pregnancy. The denial means Planned Parenthood can appeal to a state licensing commission.

The state license only affects abortion services. The clinic also provides routine medical care to men and women, cancer screenings, sexually transmitted disease tests, permanent birth control procedures and counseling.

Dr. Randall Williams, director of the Department of Health and Senior Services, said at a news conference Friday in Gov. Mike Parson’s office that politics played no role in the state’s decision to deny the license and that the clinic had not corrected more than two dozen deficiencies state inspectors had identified earlier this year.

Dr. Randall Williams

Dr. Randall Williams, director of Missouri’s Department of Health and Senior Services, talks to reporters Wednesday, June 5, 2019, on the steps of the Civil Courts building in downtown St. Louis. Photo by Joel Currier, jcurrier@post-dispatch.com

A key point of contention has been the state’s requirement of pelvic exams prior to an abortion. 

The clinic said a recent state requirement had compelled physicians to perform two pelvic exams before an abortion — one 72 hours prior, and the second the same day of the abortion.

The department, however, said pelvic exams must be completed 72 hours prior to an abortion because of the state’s informed consent law, which says doctors must identify risks to a patient three days before an abortion.

On Friday, a Planned Parenthood spokeswoman said the St. Louis clinic a day earlier had stopped performing pelvic exams three days before an abortion, instead resuming its practice of doing exams on the same day of abortions.

Williams said his agency had issued a regulation that would allow Planned Parenthood to conduct pelvic exams when it sees fit.

“I am issuing an emergency rule today that Planned Parenthood can defer the pelvic exam until the day of the surgery if in their estimation — using their clinical judgment — that they think there’s a medical reason that they should do that,” Williams said. “We do not want patients having two pelvic exams.”

Lisa Cox, spokeswoman for DHSS, said the state had not required two pelvic exams prior to an abortion. She said the disagreement over the timing of the exam is what led to physicians performing two pelvic exams.

“We’ve never required two,” she said.

Missouri health officials had asked Stelzer to reconsider his order allowing Missouri’s only abortion clinic to remain open through Friday. Health officials also filed records of its two-month investigation into the clinic noting “at least 30 deficiencies” that the state says must be corrected before the clinic’s license can be renewed.

Deficiencies the state cited last week included inadequately supervised pelvic exams, failed surgical and medication abortions, untimely reporting of those failed procedures and poor communication with a contracted laboratory.

The state investigation found four instances of incomplete surgical abortions, which may have been hindered by patients’ obesity or uterine malformations. One of the patients also experienced a failed medication abortion, according to the state’s report.

Incomplete abortions are a rare complication occurring in fewer than 1% of all procedures.

Planned Parenthood officials accused Parson’s administration of politicizing health regulations to restrict access to legal abortions in Missouri.

In a statement issued Friday, Parson said “Planned Parenthood is losing its license because it failed to meet basic standards of care.”

Planned Parenthood sued the department last month claiming the state agency had illegally refused to renew the St. Louis abortion clinic’s yearly license until the state could complete an investigation. The state says Planned Parenthood has failed to comply with licensing regulations by not compelling five doctors who have worked at the clinic to be interviewed.

In May, Parson signed one of the nation’s strictest abortion laws, banning the procedures after the eighth week of pregnancy. Most of the provisions in that law take effect Aug. 28.

Jack Suntrup and Blythe Bernhard of the Post-Dispatch contributed to this report. 

Abortion protests since 1973

Joel Currier is a reporter for the St. Louis Post-Dispatch. Follow him on Twitter here: @joelcurrier.