Reproductive-rights advocates in Missouri are preparing for a future without Roe v. Wade, the 1973 landmark Supreme Court decision guaranteeing the right to an abortion.

After last week's leaked draft opinion indicating five of the nine high-court justices could vote to overturn Roe, health professionals are letting people know abortion is still legal in all 50 states.

If the draft decision is made final, Missourians would lose access.

Dr. Colleen McNicholas, chief medical officer for Planned Parenthood of the St. Louis Region and Southwest Missouri, noted the Show-Me State is one of dozens with so-called trigger laws.

"For folks who have an appointment with us in Missouri in the coming days, that appointment is still valid," McNicholas emphasized. "We will do our very best to continue to communicate with them and be open, and honest and transparent, about when the reality changes and where they can no longer get access in Missouri."

Missouri's 2019 law banned abortions after eight weeks of pregnancy, with a stipulation it would ban all abortions if Roe v. Wade is overturned. It has been held up in court since then, but Missouri Attorney General Eric Schmitt has said he will take immediate action to put it into effect when the draft opinion becomes official.

McNicholas pointed out Missouri is already one of the most restrictive states for anyone seeking an abortion, and many residents already turn to neighboring states like Illinois and Kansas.

She added now is the time to start focusing on logistics to help Missourians get care in legal states.

"How are we going to make sure that they were connected to abortion funds or practical support organizations?" McNicholas outlined. "How are we going to make sure that if they needed to travel by plane, that they had plane tickets secured? Did they need to bring their kids or need help with managing child care while they were gone?"

Missouri voters are nearly evenly split on whether they think abortion should be legal in most cases. But nationwide, nearly three-quarters of Americans think the Roe decision should remain in place, with just under 30% saying it should be overturned.

Nevada health-care providers, patients and advocates are responding to the U.S. Supreme Court case that'll determine the future of the Emergency Medical Treatment and Labor Act.

The federal law mandates Medicare-funded hospitals provide patients with stabilizing care in emergency situations, which include abortions.

Dr. Christine Miyake is an emergency physician with the Valley Health System in Las Vegas, and said abortions are sometimes a necessary part of health care.

"I saw a patient who ruptured her membranes early and developed a severe uterine infection," said Miyake. "She was dying from that infection. If they were not able to provide the abortion, she surely would have died - as no amount of antibiotics would've helped her."

Miyake said abortion bans around the country have driven physicians out of their respective states - causing hospitals to shut down their labor-maternity wards, making it harder for women to access what she called "basic pregnancy care."

In Nevada the right to an abortion is protected though state law, but an initiative petition is working to enshrine abortion rights in the state's constitution.

Laura Campbell is the director of the National Organization for Women's Nevada Chapter, and said she received lifesaving care while she was pregnant - and contended that EMTALA is key to protecting the very care that saved her life.

But anti-abortion proponents argue that state laws that ban abortion access can coexist with the federal law. Campbell disagreed.

"With total bans on abortions in neighboring states like Arizona, Utah, and Idaho," said Campbell, "there is no question that Nevadans deserve to have their abortion rights protected in the state constitution to ensure that no judge or politician can strip away the right to make their own health-care choices."

Eighty-six percent of the public supports protecting access to abortion for patients experiencing pregnancy-related emergencies, according to a recent KFF poll.




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The Missouri Legislature has approved a law to stop its Medicaid program, known as MO HealthNet, from paying Planned Parenthood for medical services for Medicaid patients.

The decision follows a court ruling which found not reimbursing Planned Parenthood through Medicaid goes against Missouri's constitution.

Emily Wales, president and CEO of Planned Parenthood Great Plains, said they have joined forces with Planned Parenthood St. Louis Region and Southwest Missouri and stand behind providing health care to those who need it. She argued the Legislature is causing confusion despite a clear decision from the highest court.

"Despite the court's repeatedly ruling that 'defunding' Planned Parenthood health centers is unconstitutional, lawmakers continue to deny critical care like birth control, cancer screenings, wellness exams and STI testing and treatment from the patients who need it," Wales stressed.

According to the Missouri Family Health Council, Planned Parenthood health centers serve nearly half of patients who rely on family planning safety net providers in the state. Planned Parenthood Great Plains and St. Louis Region Southwest Missouri will continue serving patients and is looking for alternative solutions for funding.

The new law also blocks Planned Parenthood from being a recognized provider in the state's Medicaid program. Wales pointed out it could hurt health care for people who rely on the safety net.

"There are not enough other providers in the health care safety-net system to absorb Planned Parenthood's patients," Wales pointed out. "At Planned Parenthood, we'll continue to do everything we can to serve our patients, no matter what."

Planned Parenthood Great Plains provides health care to more than 30,000 people in 13 health centers across Missouri, Arkansas, Kansas and Oklahoma. The St. Louis Region and Southwest Missouri chapter has been serving for more than 90 years.

The U.S. Supreme Court is set to hear oral arguments today in a case about whether patients have access to emergency room abortions in states banning the procedure.

Idaho v. United States could determine if providers can perform medically necessary abortions for women experiencing complications under decades-old rules known as the Emergency Medical Treatment and Labor Act.

Dr. Polly Wiltz, a second-year emergency medicine resident at University Hospitals in Cleveland, said she is worried about her ability to care for patients who need abortions, if protections end.

"We are putting ourselves at risk for allowing legislators -- allowing people who do not have medical training -- to pick and choose which procedures, which life-stabilizing treatments and medications can and cannot be applied in the emergency department," Wiltz pointed out. "It's infringing on patient rights."

The Center for American Progress said pregnant patients with severe complications who are denied abortions could develop severe sepsis requiring limb amputation, uncontrollable uterine hemorrhage requiring hysterectomy, kidney failure requiring lifelong dialysis, hypoxic brain injury and other severe conditions.

Wiltz added most of the patients with pregnancy complications coming into the hospital lack access to routine OBGYN-related care.

"Regarding pregnancy related complaints, I see first trimester pregnant patients every single day," Wiltz noted. "In my shift, I have caught ectopic pregnancies that have ruptured."

Hospitals made up 33% of the facilities providing abortions in 2020, according to data from the Pew Research Center. Last fall, a majority of Ohio voters chose to approve a constitutional amendment, "Issue 1," establishing a statewide right to abortion and reproductive care in the aftermath of the Roe versus Wade decision.


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