The fate of Missouri's only abortion clinic is at stake starting Monday, when a member of the state's Administrative Hearing Commission will begin hearing arguments over whether the clinic can keep its abortion license.
The hearing at a downtown St. Louis state office building is expected to last five days. Missouri officials have asked St. Louis police for heightened security since the licensing issue has generated protests from those on both sides of the debate.
Commissioner Sreenivasa Rao Dandamudi will preside over the hearing. A commission official said that in his role, Dandamudi "acts as an independent trial judge." A ruling isn't expected until February at the earliest.
Missouri would become the first state since 1974, the year after the Supreme Court's Roe v. Wade decision, without a functioning abortion clinic if the license revocation is allowed. The battle also comes as abortion rights supporters raise concerns that conservative-led states, including Missouri, are attempting to end abortion through tough new laws and tighter regulation.
Planned Parenthood has been battling the Missouri Department of Health and Senior Services for months to try and keep open its St. Louis clinic.
The state said concerns arose from inspections in March. Among the problems health department investigators cited were three "failed abortions" requiring additional surgeries and another that led to life-threatening complications for the mother.
The health department has sought to interview physicians involved in those abortions, including medical residents who no longer work there. Planned Parenthood has said it can't force them to talk and that the state's concerns were addressed long ago. Attorneys for the health department wrote in legal filings to the commission that physicians' refusal to talk "presents the final, critical obstacle."
Missouri is among several states to pass new restrictions on abortions in the hope that the increasingly conservative U.S. Supreme Court will eventually overturn Roe v. Wade. Republican Gov. Mike Parson signed legislation in May banning abortions at or beyond eight weeks of pregnancy, with exceptions for medical emergencies but not for rape or incest.
A federal judge in August temporarily blocked implementation of the law until the legal challenge plays out in court, which could take several months.
While the Missouri case unfolded, Planned Parenthood quietly built a new abortion clinic in Illinois, just across the Mississippi River from St. Louis. The 18,000-square-foot (1,700-square-meter) clinic in Fairview Heights, 12 miles (19 kilometers) east of St. Louis, opened Wednesday, in part to meet the demand for abortions from Missouri residents.
Missouri women have been increasingly getting abortions at the Hope Clinic for Women in Granite City, Illinois, another St. Louis suburb. Deputy Director Alison Dreith said 58% of the abortions performed at the Hope Clinic through August of this year involved Missouri women, compared with 37% involving Illinois women.
Another abortion clinic sits in Overland Park, Kansas, a Kansas City suburb. The clinic is 2 miles (3 kilometers) from the state line. Information from the state of Kansas shows about 3,300 of the 7,000 abortions performed there last year involved Missouri residents.