Abortion in Missouri Is the Wait of a Lifetime

A 72-hour waiting period imposed on women by the Republican legislature has given the state the most restrictive abortion laws in the country.

ST. LOUIS—Outside Planned Parenthood, Paula stands in a steady drizzle along with others at the edge of the abortion clinic’s parking lot. They hold signs depicting a fetus with a hanging umbilical cord. Pro-lifers like Paula, who are mostly of the Christian variety, are here every day. They offer words of persuasion to women who might be on the fence about keeping their babies, and direct them across the street to an idling bus that serves as a pro-life alternative to the Planned Parenthood if they’re receptive to the message.

“Confidential medical services,” reads one sign on the bus. “NO CASH NO DRUGS ON BOARD,” screams another. Mostly, though, women like Paula, a Catholic who volunteers to protest outside Missouri’s only abortion clinic, hold their signs and point toward the fetus as cars enter the lot.

“We saved two today,” she tells me. “One turned around and left and another came up to us and said ‘That was my last cigarette in nine months.’”

While Paula takes small victories like convincing a woman to keep her child, her pro-life allies in the Missouri House of Representative aim higher. In September, legislators passed HB 1307, which mandates a 72-hour waiting period for all women seeking an abortion. The bill soared past a veto by Democratic Gov. Jay Nixon, thanks to the help of 117 members of the state’s House of Representatives. An overwhelming majority of yes votes—89 of them—came from Republican men.

Those lawmakers didn’t think or, perhaps, didn’t care about the implications of the new waiting period. For Missouri Planned Parenthood CEO Paula Gianino, the measure has required her to add physicians at health centers throughout the state who are qualified to perform the “informed consent” visits that start the 72-hour waiting period. Besides the main location in St. Louis—the only facility in the state where abortions can be performed—these 13 centers are crucial to easing the burden for women faced not just with a big decision, but a new, stronger grip by the hand of government.

“Women have not been required to come here to St. Louis and then drive home and then drive back for the procedure,” Gianino says. “If at all possible we’re able to provide that first visit in our other health center locations. That really minimizes the burdensome aspects of this law for some women.”

But more physicians and nurse practitioners legally qualified to fill out the paperwork at the onset of the state’s new waiting period are needed, Gianino says. That’s because, while some on the borders of Kansas and Illinois may find it easier to seek abortions in those states, the level of services provided at the St. Louis facility actually draws non-Missourians in.

Physicians there are skilled enough to perform mid-trimester abortions, as well as procedures for women with fetal anomalies.

“Because of that we have always been a place where women have come to and are referred by physicians from many states that border Missouri,” Gianino says.

Those women often end up in the parking lot guarded by Paula and her placard-bearing friends not far from the Gateway Arch in St. Louis. Only there will they be able to have an abortion performed, but first, they must wait—exactly 72 hours, not three calendar days. A physician or nurse notes the time on a form that later becomes part of permanent record with the state’s department of health. Employees with the agency are responsible for ultimately enforcing the new law, and if they find it’s been broken, a physician could lose his license. Worse yet, if a doctor flubs an hour and a sharp eye at the department of health catches it, Planned Parenthood could have its status as the state’s sole abortion provider yanked. That means a lot of checking and re-checking the clock for the nearly 6,000 women a year who have abortions at the St. Louis facility.

“This is very tricky to manage,” Gianino says.

Planned Parenthood is taking steps to ensure facilities in bordering states have personnel versed in the new law, but that’s just part of the challenge. Competing schedules between informed consent providers, women seeking abortions, and the physicians who perform the procedures cause headaches. Exacerbating this is the fact that many doctors caring for women at Planned Parenthood often run private practices as well. In addition to calendar clutter, there are health issues that arise with the new waiting period, especially for women seeking abortions later in their pregnancy. For some, 72 hours will mark the difference between having a medical vs. a surgical procedure. But for all, Gianino says, the new waiting period means something almost every pro-life advocate doesn’t want: abortions later in pregnancy.

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“What we’ve found—for every state that has passed these waiting period laws—is that there’s no decrease in abortions,” Gianino says. “But there is an increase in later abortions because these laws are forcing women to wait.”

Which is exactly what they should do, says Kenny Capps, a volunteer for Coalition for Life, a group that helps to organize pro-life efforts like the daily protests handled by women like Paula. Capps, who has been with the group for about a year, felt comfortable fielding any questions about the new law, which he said would help not only pro-life efforts in Missouri but across the country as well.

“It stands to reason that if [women] have more time to make an informed decision they won’t be rushed into anything.”

But that victory comes with an obvious caveat.

“Are we completely satisfied? Well, no, because this isn’t the end to abortion,” Capps says.

The reversal of Roe v. Wade is the clear endgame for all pro-life advocates, but it’s one that remains out of reach. That doesn’t stop legislatures like those in Missouri, South Dakota and Utah—where 72-hour waiting periods are also in effect—from pushing for more restrictions on abortions.

The problem is that those restrictions—like jumping from a 24- to a 72-hour waiting period—seem fairly arbitrary.

“What’s next, a nine-month waiting period?” quips Rep. Chris Molendorp, whose middle-class suburb of Belton represents the geographic center of his district. Molendorp is one of just two Republicans who voted against the measure, and he’s not afraid to say why. The fact that he isn’t seeking reelection this year is only a part of that decision.

“I’m an adopted child, so I don’t need any street cred when it comes to being pro-life,” Molendorp says. “I’ve generally voted along the lines of right to life, but we’re down to one abortion clinic in the state. At some point you just say, ‘OK guys, come on.’”

Molendorp is exhausted by the “constant purity exams” being conducted by his fellow party members. If you are pro-life in Missouri it means being so without deviation, Molendorp says. That mentality is reflected in one of the more stunning aspects of the new waiting period: No exceptions are made for victims of rape and incest.

To his fellow Republican members of the house, Molendorp’s vote made him “look like a baby killer.”

“Now I’m some kind of radical leftist because I say ‘I think [a woman] should wait one day, but I don’t think she should wait three,’” he says. “For a party that desperately needs to get younger women to view our economic message favorably, our upwardly mobile economic policies favorably, we have to stop looking unreasonable and we’re not doing that.”

Gianino says the state’s new law is beyond unreasonable.

“I know there’s been a big spotlight on Texas, but I think people need to know that what happened there we’ve had for decades,” Gianino says of the state’s law that was filibustered by Democratic Sen. Wendy Davis last June. “Missouri now has the most restrictive abortion laws in the country.”

Capps, the pro-life volunteer, insists the new law gives women much-needed time to make a decision. Gianino says it’s another hoop to jump through in a state run by politicians who are “obsessed” with the issue of abortion. For Molendorp, the bill is one of many reasons he’s giving up his three-hour drives to Jefferson City, the state capital, and settling in to work at a health-care nonprofit.

“That 72-hour vote kind of encapsulates it for me, that we’ve really moved into punitive territory.”

Telling his fellow Republicans that they’re punishing women for exercising their right to choose didn’t make Molendorp many friends in the capital. But many of those men, like the bill’s sponsor, Sen. David Sater, would likely argue they’re offering a friendly and caring hand to a helpless child.

“I’m sure the unborn child probably would like to see an extra 48 hours for the mother to decide on whether or not to have the abortion done,” he told The New York Times.

That’s the kind of thinking that brings Paula out to point at the fetus on her sign. Along with the people in the bus across the street—a group called thriVe—Paula and others see themselves as protectors of the unborn, a voice for the voiceless. They and their allies seem to have the upper hand in Missouri.

Inside the thriVe bus, a woman in purple scrubs opens the door but directs questions to the organization’s headquarters. I get a business card and no call back. Gianino says thriVe doesn’t give victims of sexual assault information about emergency contraception. And unlike Planned Parenthood, which is required by law to provide information about pro-life groups who advocate against abortion, thriVe isn’t as closely monitored by the department of health and Missouri’s politicians.

Like Paula, the Coalition for Life and a good portion of Missouri’s politicians, thriVe sees itself as being governed by a higher power.

“We’ve had our own activists go in there disguised as patients,” Gianino says of the idling bus across from the state’s only abortion clinic, “and the second and third questions are always ‘Do you believe in God?’ and ‘Have you been saved?’”