Birth control access in Missouri after abortion ban
Saint Luke’s Health System said Tuesday night it would stopped offering emergency contraception after Missouri’s abortion ban went into effect following the U.S. Supreme Court decision overturning Roe v. Wade. On Wednesday, it announced it would resume providing emergency contraceptives, reversing course after less than 24 hours.
Missouri’s trigger ban on abortions does not explicitly ban birth control, but some local hospitals are reviewing or changing their prescribing policies in light of the new law.
A leading health system in Kansas City is no longer providing emergency contraception in Missouri after the state banned abortion with no exceptions for rape or incest.
Saint Luke’s Health System confirmed the decision to The Star on Tuesday night after word of the change began circulating among advocates for sexual assault victims.
Saint Luke’s has a significant presence across Kansas City, operating 16 hospitals and campuses across the region, in both Kansas and Missouri. In a statement, Saint Luke’s spokesperson Laurel Gifford said the health system continues to evaluate the U.S. Supreme Court’s decision overturning Roe v. Wade and Missouri’s abortion ban, which went into effect following the decision.
“To ensure we adhere to all state and federal laws—and until the law in this area becomes better defined—Saint Luke’s will not provide emergency contraception at our Missouri-based locations,” Gifford said in a statement.
The new policy may add to fears that Missouri’s abortion ban will eventually affect access to the birth control. Contraceptives, including Plan B, remain legal in Missouri and there have been no reports of pharmacies refusing to sell them in the wake of the ban.
But the health system’s decision suggests at least some level of concern that offering emergency contraception may place medical personnel or hospitals at legal risk. Missouri law now allows abortions only in the case of medical emergencies.
“First, the Missouri law is ambiguous but may be interpreted as criminalizing emergency contraception,” Gifford said. “As a System that deeply cares about its team, we simply cannot put our clinicians in a position that might result in criminal prosecution.”
Iman Alsaden, medical director of Planned Parenthood Great Plains, condemned Saint Luke’s decision. She emphasized that emergency contraception is not abortion and said Saint Luke’s decision was exactly what the Missouri General Assembly was seeking, which she said was to scare providers and patients into restricting legal care.
“I think it’s dangerous when there’s a health care system whose primary focus and concern should be delivering the best health care to patients to the most patients possible at the lowest cost to the patient and then you have a health care system that’s now participating in the shame and stigma and fear of accessing something that’s still readily available to people in Missouri,” Alsaden said.
Saint Luke’s didn’t immediately respond Wednesday to questions about the legal reasoning behind its decision. But a memo by Joe Bednar, an attorney at the law firm Spencer Fane, posted online over the weekend has drawn attention for describing how a “zealous prosecutor” could bring a case related to the use of birth control.
In his memo, Bednar argues Missouri law could be interpreted as defining the start of pregnancy as the date of the woman’s last menstrual period – not the moment when the egg is fertilized. Under that definition, any use of Plan B with an intention other than to increase the the probability of live birth could constitute an abortion, according to the law.
State Rep. Mary Elizabeth Coleman, an Arnold Republican and one of Missouri’s staunchest anti-abortion legislators, said Saint Luke’s interpretation of the law is “clearly wrong.” Missouri’s ban didn’t change the definition of abortion, she said, only how abortion is regulated.
The same care can be provided at Saint Luke’s Kansas facilities “safely, legally, and without putting our clinicians at legal risk,” Gifford said in the statement. She acknowledged that option may not be the most convenient for patients, but for now it is the “best solution available.”
“It’s important for survivors to know that if they are concerned that they need emergency contraception as part of their health care following a rape, that they should not go to Saint Luke’s Missouri,” said Julie Donelon, president and CEO of the Kansas City-based Metropolitan Organization to Counter Sexual Assault.
Donelon said her organization wasn’t aware of any other Kansas City hospitals withholding emergency contraception. Those who need emergency contraception after a rape should go to non-Saint Luke’s hospitals or Saint Luke’s facilities in Kansas, Donelon said.
The criminal threat facing doctors who perform illegal abortions in Missouri is significant. Doctors who violate the abortion ban can be charged with a class B felony and lose their medical license. Class B felonies come with a prison sentence of five to 15 years.
Missouri Attorney General Eric Schmitt, a Republican running for U.S. Senate, has authority to prosecute abortion violations, along with local prosecutors. Jackson County Prosecutor Jean Peters Baker, a former chair of the Missouri Democratic Party, has said she will use her discretion to limit the “erosion” of reproductive rights.
Missouri state legislators approved the abortion ban in 2019 as part of a larger anti-abortion bill. But the ban would only go into effect if the 1973 Roe v. Wade decision that had legalized abortion nationwide was overturned.
Minutes after the U.S. Supreme Court on Friday struck down Roe, Schmitt issued a legal opinion to put the ban into effect.
The Star’s Lisa Gutierrez contributed reporting.
The Metropolitan Organization to Counter Sexual Assault’s 24-hour crisis line can answer questions regarding medical or forensic care for survivors at 816-531-0233 or 913-642-0233.
This story was originally published June 28, 2022 10:01 PM.