The last abortion clinic in Missouri is currently teetering on the edge of extinction. How it became the sole surviving abortion provider in the state has its roots in one of the most gruesome criminal cases in abortion law history.
In 2010, FBI agents kicked down the doors at the Women’s Medical Society clinic in Philadelphia after hearing rumors for years about Kermit Gosnell, its owner and operator.
Inside, agents found a house of horrors. The remains of at least 47 fetuses were stored haphazardly around the clinic in jugs, bags and freezers. Sam Gulino, Philadelphia’s chief medical examiner, said afterwards that some of them appeared to be old enough to be viable outside the womb, though he could not say for certain. A cat roamed freely amid blood-stained blankets, urine-splattered walls and rusted medical equipment.
During court procedures, horrifying details emerged about Gosnell’s practice of dealing with failed, extremely late-term abortions by snipping the baby’s spinal cord with scissors. He also egregiously overprescribed his mostly low-income patients, sometimes with expired medication and sometimes administered by unlicensed workers. Karnamaya Mongar, one of Gosnell’s patients, died after he gave her a lethal cocktail of anesthesia and painkillers.
The gruesome details (eventually) attracted nationwide media attention as Gosnell headed to court. He was ultimately convicted of three counts of first-degree murder for killing infants after birth and one count of involuntary manslaughter for Mongar’s death. Beyond the murder charges, he was convicted of 21 felony counts of illegal late-term abortion plus another 211 counts of violating the 24-hour informed consent law.
Gosnell is now serving life in prison without parole. But his crimes have permanently left their mark on the abortion debate.
“Gosnell became the boogeyman here,” Columbia Law professor Carol Sanger told TPM.
She described “TRAP” (targeted restrictions on abortion providers) laws, or regulations heaped upon abortion clinics that are so costly that they are forced to shutter, a practice that predated but was given a significant boost by the Gosnell case.
“When abortion clinics said ‘you’re slamming us with all those TRAP laws, we’re gonna have to close,’ the pro-lifers would come back with, ‘do you want more Kurt Gosnells?’” she explained. “He became a political symbol.”
Pro-choice activists did have a win in this arena with the decision of a landmark 2016 case called Whole Woman’s Health v. Hellerstedt.
That case came after Texas passed a law requiring that abortion providers have admitting privileges at a hospital within 30 miles, and that clinics meet the same requirements as “ambulatory surgical centers.”
“Centers that perform knee surgeries and colonoscopies don’t need admitting privileges,” Sanger pointed out. “The court concluded — and this was only two years ago, is the heartbreaking part — that not only do these restrictions not advance women’s health, they injure women’s health by creating requirements clinics cannot meet and forcing them to close.”
“If they close, women have to drive huge distances to get to available abortion clinics which are crammed to capacity,” she continued. “It’s bad for women’s health since women wouldn’t get individual attention, doctors and staff don’t have time to be caring.”
That brings us to current day Missouri, where the Department of Health has declined to renew the clinic’s permit, leaving the last provider in the state on tenterhooks. Should it shutter, Missouri would be the first state to be completely devoid of abortion providers since Roe v. Wade became the law of the land nearly 50 years ago.
The Health Department accused the clinic of a whole host of violations, including grave accusations of at least one patient being hospitalized with serious complications after the surgery, according to the Associated Press. That court filing is now sealed, after initial leaks.
The clinic did not immediately respond to a request for explanation of the violations but is currently still operating under a preliminary injunction.
“[There is] no date set at this point, the judge will issue an order possibly next week (he did not give any timeline) regarding next steps,” Jesse Lawder, spokesperson at Planned Parenthood St. Louis, told TPM on Friday. “In the meantime we’re going to keep doing what we do best and take care of patients.”
The judge will decide on the veracity of the charges against the clinic. But there is little doubt that the position Missouri is in, with only one option for abortion-seekers statewide, is the direct result of an onslaught of intense and ever-increasing regulation.
As NBC reported, “Missouri had more abortion clinics in the past; in 2008, there were five. But in the past decade, the clinics were unable to keep up with the state’s stringent and perpetually evolving requirements, with some closing and then reopening again and then shuttering for good.”
“It’s pretextual,” Sanger said of the restrictions. “Some of them are so ridiculous or unnecessary — like countertops having to be a certain number of inches from the floor, or having to use a specific kind of cleaning fluid. Some of them are preposterous in their specificity.”
Despite the bleak landscape for pro-choice Missourians, Sanger said that she still sees a thin silver lining.
“I don’t like to spin a really bad situation but something has to wake people up and I don’t know what it’s gonna take for people to say ‘oh actually you can’t get an abortion in this state,’” she said. “It could make people in other states pay attention: ‘I didn’t know this could happen here.’”