It’s time for Missouri hospitals to find their voice and fight back

February 22, 2023 5:55 am

The exterior of a Planned Parenthood Reproductive Health Services Center on May 28, 2019 in St Louis (Michael B. Thomas/Getty Images).

As one of the last abortion providers in Missouri, I was part of the fight to preserve reproductive freedom, a fight that was siloed, isolated and othered in the practice of medicine.

Today, the same medical institutions that stayed silent on abortion are now the targets of attacks we, as abortion providers, long ago warned about.

For example, in 2015–2016, several Missouri agencies investigated Planned Parenthood and found no wrongdoing. Despite that, the Senate Interim Committee on the Sanctity of Life, whose singular focus was to investigate and malign Planned Parenthood, pressured the University of Missouri Hospital to cancel my clinical privileges, forcing the closure of abortion services at the Planned Parenthood clinic in Columbia.

The committee also pressured the Department of Health and Senior Services to conduct more and more unannounced, random inspections, at a rate no other ambulatory surgical center experienced. State investigators came every month in 2019 until June, when the department unlawfully denied our license. As the last abortion clinic in the state, we had no choice but to fight back, and after a year of litigation, we prevailed.

And I now see the same “Planned Parenthood playbook” being used elsewhere.

St. Louis Children’s Hospital at Washington University is now under a sham investigation led by transphobic politicians. Hospital staff and patients are now harassed by anti-abortion protesters. Hospitals across the state are paralyzed, unable to care for pregnant people because they’re fearful of criminal prosecution.

The inaction of medical and higher education institutions created this reality. Their continued silence will only leave a void for anti-trans junk scientists to fill with the same harm and regret narratives that paved the way to total abortion bans.

For decades, my colleagues and I have seen the interconnectedness of abortion care to trans care, maternal mortality and the whole of medicine. We’ve spent countless hours behind closed doors pushing these institutions to say something, do something — anything that leveraged their power to stop attacks on the practice of medicine.

Professional societies, some individual universities, certifying boards and the public health community are listening, engaging and shifting strategy. There has been movement, but not fast enough.

There are no quick fixes to the havoc politicians have wreaked upon reproductive health care, and now trans care and rights. What the public health community must do is learn from our shared past and unite against these political attacks on medicine.

Abortion providers know it well: Politicians will fearmonger about medical treatments they don’t like or understand. Next, they’ll isolate providers and manufacture controversy with hit pieces and sham investigations. Politicians will shame and stigmatize patients who are seeking care.

Then, medically unnecessary restrictions will come fast and furious — age restrictions, medical carve outs, waiting periods, insurance bans. This will continue until another critical aspect of health care is banned.

As we listen to young trans and non-binary people speak truth to power in Jefferson City; while their parents take targeted hits in right-wing media; for the 1.3 million Missourians who no longer have abortion access in the state; it’s time for medical institutions to find their voice and wield it publicly.

To my institutional colleagues, inaction has led you to the same road abortion providers like me have long walked. Change your strategy and save yourselves and your patients.

To my colleagues providing lifesaving care in a political system that cares only about power, not people, please know you are on the right side and you are not alone.

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Colleen McNicholas
Colleen McNicholas

Dr. Colleen McNicholas is the chief medical officer for Reproductive Health Services of Planned Parenthood of the St. Louis Region. In addition to providing abortion care, family planning services, and advanced GYN care to patients in Missouri and Illinois, Dr. McNicholas oversees the operational aspects of the Regional Logistics Center including partnerships with abortion funds, independent clinics, and other logistical resources. She serves on the Government Affairs Committee for the American College of Obstetricians and Gynecologists (ACOG).