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Missouri’s Last Abortion Clinic Could Stop Providing the Procedure This Week

Missouri has not renewed the license of a Planned Parenthood clinic in St. Louis.Credit...Jim Salter/Associated Press

Missouri’s last abortion clinic might have to stop providing the procedure by the end of the week because of a standoff with state officials over an audit.

Lawyers for the clinic, which is operated by Planned Parenthood, say that the audit, which began this spring, has become wide-ranging and includes demands they consider to be unreasonable. They say the clinic’s license is due to expire at midnight on June 1, and if the disagreement is not sorted out by then, the clinic will be forced to stop providing abortions.

Helene Krasnoff, head of litigation at Planned Parenthood Federation of America, said the group filed suit on Tuesday in court in St. Louis, where the clinic is, to try to prevent that outcome. A hearing scheduled for Wednesday was postponed until Thursday at 10:30 a.m. Central time.

If the clinic’s license is not renewed, Missouri would become the first state in the United States without access to abortion services since 1974, the year after the Supreme Court extended federal protections for the procedure in its landmark Roe v. Wade decision.

Gov. Mike Parson said Wednesday that the clinic had not met all of the state’s demands, but that it still had time to do so.

“There are a number of serious health concerns that still exist at the Planned Parenthood St. Louis facility,” he said in a news conference. “To be clear, the state has not taken any actions regarding the Planned Parenthood license in St. Louis.”

He added that he did not think the court should weigh in.

“It would be reckless for any judge to grant a temporary restraining order ruling before the state has taken action on a license renewal,” the governor said.

The disagreement comes toward the end of a busy legislative season, in which states across the country, including Missouri, have passed some of the strictest abortion laws the country has ever seen. Earlier this month, Alabama passed a law that would ban abortion at any stage of pregnancy. This week, Louisiana lawmakers are expected to vote to ban abortion as early as six weeks into a woman’s pregnancy.

Abortion politics have changed dramatically since the election of President Trump. His two new appointments on the Supreme Court have shifted the math in favor of conservatives on the issue, and activists on both sides are holding their breath — in excitement and in fear — for what might come next.

[Inside the network of anti-abortion activists winning across the country.]

So far, the court has held back. On Tuesday, it sidestepped part of a case that could have tested the constitutional right to abortion established in Roe v. Wade, turning down an appeal to reinstate a strict Indiana abortion law.

Missouri has been on the front line of the abortion wars, with increasingly stringent laws leaving the state with one clinic. But the conflict that flared this week seemed to have little to do with legislation.

It began with the audit, a kind of annual inspection, which started around March 11, Ms. Krasnoff said. The state found deficiencies, she said, and the clinic, Reproductive Health Services of Planned Parenthood of the St. Louis Region, submitted its plan for correcting them on April 9.

The clinic agreed to meet a number of the state’s demands, including a requirement that it provide an additional pelvic exam for abortion patients. But the clinic is now deadlocked with state officials over a request to interview seven of its doctors, including fellows and residents.

“This is harassment and attempted intimidation of doctors at the highest levels of government,” said Dr. Colleen McNicholas, a physician at the clinic.

Governor Parson did not say exactly why the state wanted to interview the seven doctors, but he said that health officials had found “significant medical evidence showing at least three failed surgical abortions” at the clinic, including one in which a patient was later taken to a hospital for surgery, and another in which a woman came back to the clinic because she found she was still pregnant.

“We want to know what took place,” he said. “I think the important thing here is to find out the facts. What really is going on in there? What happened?”

Planned Parenthood did not comment on the governor’s specific statements. But Dr. Leana Wen, the organization’s president, said in a statement on Wednesday: “We do everything to ensure our patients get the best medical care available. When we find anything that does not meet our high standards of care, we take swift action.”

Ms. Krasnoff said the clinic has objected to interviews with so many of its physicians because the state has not explained what the interviews would be about or whether the doctors could face criminal consequences.

“At this point, we have reached an impasse,” Ms. Krasnoff said in a phone call with journalists on Tuesday.

A spokeswoman for Planned Parenthood said the legal team for the state indicated that it could refer information from the interviews to the state’s attorney general or to the board that regulates doctors in Missouri.

“They refused to discuss the scope of the interview,” Ms. Krasnoff said. “And when asked about whether or not it could lead to criminal referrals,” she added, “they have said, basically, that’s not off the table.”

Ms. Krasnoff said that the two most senior doctors at the clinic, Dr. David Eisenberg and Dr. McNicholas, agreed to speak anyway. But so far, the others have not.

The state has made clear that it could not complete its investigation — or take the next step, which would be to renew the clinic’s license — until it speaks to all the residents and fellows, Ms. Krasnoff said.

Julie Bosman contributed reporting.

A version of this article appears in print on  , Section A, Page 12 of the New York edition with the headline: Missouri Facing the Possibility of Losing Its Last Abortion Clinic. Order Reprints | Today’s Paper | Subscribe

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