Abortion in Missouri

In 1900, Missouri criminalized abortion . It was legalized after the Roe v. Wade decision in 1973. Peaking at 29 abortion clinics in 1982, the number began to decline, going from twelve in 1992 to one in 2014, down to zero for a time in 2016, but back to one from 2017 to May 2019 when the last remaining clinic announced it would likely lose its license. However, the clinic remains open as of 2020.

Abortion in Missouri is legal.

A parental consent law came into effect in 1990.  Informed consent laws existed by 2007. 

According to Guttmacher Institute, in 2017, there were 4,710 abortions in Missouri, and that there was an eight percent decline in the abortion rate in Missouri between 2014 and 2017, from 4.4 to 4.0 abortions per 1,000 women of reproductive age. Abortions in Missouri represent 0.5 percent of all abortions in the United States.

In 2017, about 33 percent of abortions were medicated abortions.

The state saw anti-abortion rights violence in 2000 in Marion County.

Terminology
Main article: Abortion
See also: Definitions of abortion

The abortion debate most commonly relates to the "induced abortion" of an embryo or fetus at some point in a pregnancy, which is also how the term is used in a legal sense.[note 1] Some also use the term "elective abortion", which is used in relation to a claim to an unrestricted right of a woman to an abortion, whether or not she chooses to have one. The term elective abortion or voluntary abortion describes the interruption of pregnancy before viability at the request of the woman, but not for medical reasons.[1]

Anti-abortion advocates tend to use terms such as "unborn baby", "unborn child", or "pre-born child",[2][3] and see the medical terms "embryo", "zygote", and "fetus" as dehumanizing.[4][5] Both "pro-choice" and "pro-life" are examples of terms labeled as political framing: they are terms which purposely try to define their philosophies in the best possible light, while by definition attempting to describe their opposition in the worst possible light. "Pro-choice" implies that the alternative viewpoint is "anti-choice", while "pro-life" implies the alternative viewpoint is "pro-death" or "anti-life".[6] The Associated Press encourages journalists to use the terms "abortion rights" and "anti-abortion".[7]

Context
See also: Abortion in the United States

According to a 2017 report from the Center for Reproductive Rights and Ibis Reproductive Health, states that tried to pass additional constraints on a women's ability to access legal abortions had fewer policies supporting women's health, maternal health and children's health.  These states also tended to resist expanding Medicaid, family leave, medical leave, and sex education in public schools.[8] In 2017, Georgia, Ohio, Missouri, Louisiana, Alabama and Mississippi have among the highest rates of infant mortality in the United States.[8] In 2017, Missouri had an infant mortality rate of 6.2 infant deaths per 1,000 live births.[8] Medicaid expansion under the Affordable Care Act was rejected by Alabama, Georgia, Mississippi and Missouri.  Consequently, poor women in the typical age range to become mothers had a gap in coverage for prenatal care. According to Georgetown University Center for Children and Families research professor Adam Searing, "The uninsured rate for women of childbearing age is nearly twice as high in states that have not expanded Medicaid. [...] That means a lot more women who don't have health coverage before they get pregnant or after they have their children. [...] If states would expand Medicaid coverage, they would improve the health of mothers and babies and save lives."[8] According to the 2018 Premature Birth Report Cards, Louisiana, Mississippi and Alabama were all given an F.[8] According to the 2018 America's Health Rankings produced by United Health Foundation, Missouri ranked 42nd among US states for maternal mortality.[8]

Poor women in the United States had problems paying for menstrual pads and tampons in 2018 and 2019. Almost two-thirds of American women could not pay for them. These were not available through the federal Women, Infants, and Children Program (WIC).[9] Lack of menstrual supplies has an economic impact on poor women.  A study in St. Louis found that 36% had to miss days of work because they lacked adequate menstrual hygiene supplies during their period.  This was on top of the fact that many had other menstrual issues including bleeding, cramps and other menstrual induced health issues.[9] This state was one of a majority that taxed essential hygiene products like tampons and menstrual pads as of November 2018.[10][11][12][13]

History

Legislative history
Fetal heartbeat bills by state, including time limit without exceptions marked:
  Heartbeat bill passed (to go into effect)
  Law partially passed by state legislature
  Law blocked by court order

By the end of the 1800s, all states in the Union except Louisiana had therapeutic exceptions in their legislative bans on abortions.[14] In the 19th century, bans by state legislatures on abortion were about protecting the life of the mother given the number of deaths caused by abortions; state governments saw themselves as looking out for the lives of their citizens.[14]

Missouri passed a parental consent law in the early 1990s.  This law impacted when minors sought abortions, resulting in an increase of 19% to 22% for abortions sought after 12 weeks.[15][16] The state was one of 10 states in 2007 to have a customary informed consent provision for abortions.[17]

In 2015, the state was one of five where the legislature introduced a bill that would have banned abortion in almost all cases.  It did not pass. They tried and failed again in 2017 and 2018.[18] The 2018 bill was introduced in the legislature to ban abortion after 15 weeks.[19] Around 2016, the state legislature passed a law that said facilities providing abortions needed to be licensed ambulatory surgical centers and to have hospital admitting privileges.[20] The state legislature was one of eight states nationwide that tried, and failed, to pass a fetal heartbeat bill in 2017. They tried and failed again in 2018.[18]

Nationally, 2019 was one of the most active years for state legislatures in terms of trying to pass abortion rights restrictions. These state governments generally saw this as a positive sign that new moves to restrict abortion rights would less likely face resistance by the courts.[18] In mid-2019, the state legislature passed a law that would make abortion illegal in almost cases after 8 weeks. It was one of several states passing such laws in May 2019 alongside Georgia, Louisiana and Alabama. The law was a "fetal heartbeat" bill.[21][22][18]

Dates of when heartbeat laws come into effect (as of May 25, 2019)

Two fetal heartbeat bills have been filed in Missouri on January 9, 2019.[23] SB 139 was filed in the Missouri Senate by Sen. Andrew Koenig; the bill is pending in the Health and Pensions Committee.[24] HB 126 was filed in the Missouri House of Representatives by Rep. Nick Schroer.[25] On January 30, 2019, HB 126 was referred to the Children and Families Committee, and on February 12, 2019, a public hearing on the bill was completed.[26] On February 21, 2018, HB 126 was voted out of committee to the full House with the recommendation that it "do pass."[27][28] On February 27, 2019, HB 126 was passed out of the Missouri House and was sent to the state Senate.[29] Missouri's House Speaker Elijah Haahr has said he supports the “heartbeat bill” calling it a top priority for the 2019 session.[30][31] When asked if he would sign a fetal heartbeat bill, Governor Mike Parson said, "I’ve been pro-life my entire career, and I support that all the time."[32] At the time the bill passed, only 25% of the state legislators were female.[33]

In March 2019, Missouri Family Health Council was the state's only Title X administrator.  The Council distributed approximately 34% of its funding to Planned Parenthood clinics.[34] In 2019, women in Missouri were eligible for pregnancy accommodation and pregnancy related disability as a result of legal abortion or miscarriage, and women claim such disability could not be treated differently than any other employee claiming disability.[35][36]

Judicial history

The US Supreme Court's decision in 1973's Roe v. Wade ruling meant the state could no longer regulate abortion in the first trimester.[14] In 1979, a court found that the part of Missouri law dealing with women having abortions after the first trimester needing to have it performed in a hospital was unconstitutional.[37] Webster v. Reproductive Health Services was before the US Supreme Court in 1989.  The Court ruled in a case over a Missouri law that banned abortions being performed in public buildings unless there was a need to save the life of the mother, required physicians to determine if a fetus was past 20 weeks and was viable in addition to other restrictions on a woman's ability to get an abortion.  The US Supreme Court largely ruled in favor of the law, but made clear that this was not an overruling of Roe v. Wade.[38]

In 2019, a judge blocked a state law which would have banned abortion after eight weeks.[39]

Clinic history
Number of abortion clinics in Missouri by year.
See also: Abortion clinic

Following the Roe v. Wade ruling, a number of abortion clinics quickly set up in the state. These included private suppliers, many of which remained in the state during the 1980s.[20] Reproductive Health Services was a non-profit that provided abortion services in the state operating during that time.[20] Between 1982 and 1992, the number of abortion clinics in the state decreased by 17, going from 29 in 1982 to 12 in 1992.[40]

Planned Parenthood in St. Louis took over operations of Reproductive Health Services on May 1, 1996. Prior to this, while Planned Parenthood had operated in the state, they had not provided abortion services.[20] In 1998, they moved three blocks to a new building.[20] After TRAP laws came into effect in Missouri and Texas, women had to travel even greater distances to be able to visit an abortion clinic.[41]

In 2014, there was only one abortion clinic in the state.[42] In 2014, 99% of the counties in the state did not have an abortion clinic. That year, 94% of women in the state aged 15–44 lived in a county without an abortion clinic.[41] In March 2016, there were 13 Planned Parenthood clinics in the state.[43] In 2016, Planned Parenthood's clinic that provided abortions in Colombia had to stop doing so while they faced a court injunction they were challenging over the legal need to be a licensed ambulatory surgical centers and to have hospital admitting privileges.[20]

In 2017, there were 12 Planned Parenthood clinics in a state with a population of 1,365,575 women aged 15–49 of which 1 offered abortion services.[44][20] Reproductive Health Services of Planned Parenthood St. Louis Region was the only licensed abortion service provider in the state in 2017, providing reproductive services primarily to women from Missouri and Illinois but also 10 other states. Only about 10% of their operations were related to abortion services.[20] On May 28, 2019, the sole remaining abortion clinic in Missouri announced it would likely be shutting down by the end of the week as the state pulled its operating license. They were seeking an injunction to prevent that from happening.[45] They succeeded when Missouri Circuit Court Judge Michael Stelzer granted a temporary injunction, saying in giving the order that the clinic "demonstrated that immediate and irreparable injury will result" and also saying that doing so "is necessary to preserve the status quo and prevent irreparable injury."[46] He then set a hearing date for June 4, 2019.[46]

Statistics

In the period between 1972 and 1974, there were zero recorded illegal abortion death in the state.[47] In 1990, 597,000 women in the state faced the risk of an unintended pregnancy.[40] In 2010, the state had zero publicly funded abortions.[48] In 2013, among white women aged 15–19, there were  abortions 670, 440 abortions for black women aged 15–19, 80 abortions for Hispanic women aged 15–19, and 80 abortions for women of all other races.[49] In 2014, 45% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases.[50] According to a 2014  Public Religion Research Institute (PRRI) study, 51% of white women in the state believed that abortion be legal in all or most cases.[51] In 2017, about 33% of abortions were performed using drug induced abortions. The percentage had been increasing every year for several years.[20]

Number of reported abortions, abortion rate and percentage change in rate by geographic region and state in 1992, 1995 and 1996[52]
Census division and stateNumberRate% change 1992–1996
199219951996199219951996
West North Central57,34048,53048,66014.311.911.9–16
Iowa6,9706,0405,78011.49.89.4–17
Kansas12,57010,31010,63022.418.318.9–16
Minnesota16,18014,91014,66015.614.213.9–11
Missouri13,51010,54010,81011.68.99.1–21
Nebraska5,5804,3604,46015.712.112.3–22
North Dakota1,4901,3301,29010.79.69.4–13
South Dakota1,0401,0401,0306.86.66.5–4
Number, rate, and ratio of reported abortions, by reporting area of residence and occurrence and by percentage of abortions obtained by out-of-state residents, US CDC estimates
LocationResidenceOccurrence% obtained by

out-of-state residents

 YearRef
No.Rate^Ratio^^No.Rate^Ratio^^
Missouri 13,510 11.6 1992 [52]
Missouri 10,540 8.9 1995 [52]
Missouri 10,810 9.1 1996 [52]
Missouri8,9357.61195,0604.3678.82014[53]
Missouri8,6367.31154,7654639.52015[54]
Missouri 9,036 7.7 121 4,562 3.9 61 9.0 2016 [55]
^number of abortions per 1,000 women aged 15–44; ^^number of abortions per 1,000 live births


Women's abortion experiences

Janice Mac Avoy, a lawyer with Fried, Frank, Harris, Shriver & Jacobson, had an abortion when she was an 18-year-old in high school.  She was on track to become the first person in her family to graduate from high school and go to college, for which she had a scholarship, and then hopefully on to law school. She decided to have an abortion because she saw becoming a mother as not compatible with her goals.[56]

Then 36-year-old Robin Utz of St. Louis had an abortion in November 2016 in week 21 of her pregnancy.  The reason she got an abortion was she was told by her doctors that her daughter had a fatal kidney disease and could not survive outside the womb.  Submitting testimony to the Missouri legislature in early 2018, she said, "A 20-week abortion ban sounds OK, but if that gets passed, what's next — 18 weeks, 15 weeks? At what point does it make abortion truly illegal? It's terrifying and it's willfully ignorant."[19]

30-year-old Missouri resident Lexi Moore got a medicated abortion at a Planned Parenthood clinic in September 2018.  She said, "It's safe and comfortable. [...] You get to sit in the comfort of your home instead of doing it in a clinic or in a back alley. ... You will have cramps, like a heavy period. But it's worth it in the end, and you have control over that."[57]

Abortion rights views and activities
Women's March on St. Louis 1-21-17
Women's March on St. Louis 1-21-17

Pro-abortion Views

In talking about the granting of a temporary restraining order allowing the state's last remaining abortion clinic to remain open, President and CEO of Planned Parenthood Leana Wen said, "This is a victory for women across Missouri, but this fight is far from over. We have seen just how vulnerable access to abortion care is in Missouri — and in the rest of the country."

Protests

Women from the state participated in marches supporting abortion rights as part of a #StoptheBans movement in May 2019.[58]

Anti-abortion views and activities

Views

In talking about the granting of a temporary restraining order allowing the state's last remaining abortion clinic to remain open, Students for Life of America President Kristan Hawkins said, "Planned Parenthood caused this artificial crisis when they ignored the law and refused to comply with the state of Missouri's very reasonable requests." [46]

Footnotes
  1. According to the Supreme Court's decision in Roe v. Wade:
    (a) For the stage prior to approximately the end of the first trimester, the abortion decision and its effectuation must be left to the medical judgement of the pregnant woman's attending physician. (b) For the stage subsequent to approximately the end of the first trimester, the State, in promoting its interest in the health of the mother, may, if it chooses, regulate the abortion procedure in ways that are reasonably related to maternal health. (c) For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgement, for the preservation of the life or health of the mother.
    Likewise, Black's Law Dictionary defines abortion as "knowing destruction" or "intentional expulsion or removal".

References
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