Saint Luke’s condemned for ‘dangerous’ decision to stop offering emergency contraception

Jonathan Shorman
·6 min read

A leading Kansas City health system faced criticism from both Planned Parenthood Great Plains and an anti-abortion state legislator after it cited Missouri’s new abortion ban to stop offering emergency contraception.

Saint Luke’s Health System – with 16 hospitals and campuses across the region – told The Star late Tuesday it made the change following the U.S. Supreme Court’s decision overturning Roe v. Wade and a statewide ban that quickly went into effect.

The decision immediately fueled fears that birth control access in Missouri is under threat because of the ban. But Planned Parenthood Great Plains, which has repeatedly disputed the idea that Missouri law blocks access to contraceptives, rebuked the health system’s decision.

Saint Luke’s announcement itself risks leading other providers to restrict access to Plan B and other emergency contraceptives, said Planned Parenthood, which provides access to abortion on the Kansas side of the metro and also offers other reproductive health services in Missouri.

“We are very concerned that Saint Luke’s decision will have a triggering effect for other institutions and I also think it is a slippery slope,” said Emily Wales, Planned Parenthood Great Plains president and CEO.

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.

Even before Saint Luke’s announcement, concerns were mounting that Missouri’s abortion ban would affect access to birth control. The decision appears to mark the first known instance of a medical provider restricting contraception since the ban was triggered on Friday by documents signed by Missouri Attorney General Eric Schmitt and Gov. Mike Parson, both Republicans.

Schmitt on Wednesday dismissed the idea that contraception was illegal under Missouri law.

“Missouri law does not prohibit the use or provision of Plan B, or contraception,” Schmitt spokesperson Chris Nuelle said.

Parson spokeswoman Kelli Jones said nothing in the Missouri abortion ban makes drugs illegal. She said the Missouri Department of Health and Senior Services was reviewing its regulations to ensure they comply with state law.

“An abortion is defined in Missouri law as taking action with the intent to destroy an embryo or fetus,” Jones said in a statement. “Abortion and contraception are different things, one ends life while the other prevents pregnancy. A medical professional’s intent when prescribing medication is always relevant to the lawfulness of their action.”

Some providers rushed to reassure the public that they were continuing to provide emergency contraception. PPGP said Plan B and other forms of emergency contraception continue to be available at their Missouri clinics. University Health, another major hospital in Kansas City, said bluntly that it would continue providing emergency contraception because doing so “is not in conflict with Missouri state law.”

But Saint Luke’s, a health system affiliated with the Episcopal Church, voiced concern that the ban could, at least in theory, place its employees in legal jeopardy. Violations of the abortion ban are a class B felony, punishable by five to 15 years in prison.

“First, the Missouri law is ambiguous but may be interpreted as criminalizing emergency contraception,” Saint Luke’s spokeswoman Laurel Gifford said in a statement. “As a System that deeply cares about its team, we simply cannot put our clinicians in a position that might result in criminal prosecution.”

Gifford said the health system had stopped providing emergency contraception to ensure it was adhering to federal and state law and “until the law in this area becomes better defined” – leaving open the possibility it will reverse course in the future.

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.

Iman Alsaden, medical director of Planned Parenthood Great Plains, emphasized that emergency contraception is not abortion.

“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.

During a visit to St. Louis on Wednesday, Parson didn’t provide a clear answer about whether Missouri residents should be worried about access to birth control, St. Louis Public Radio reported.

“I think the Department of Health will make those clarifications for us. I think they’re in the process of making that clarification so everybody knows how we’re going to read that,” Parson said.

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. Schmitt, a Republican running for U.S. Senate, has authority to prosecute abortion violations, along with local prosecutors.

Critics of the law warn that its ambiguities could be used against patients and doctors alike.

“I would love to be able to reassure the women of Missouri that everything was fine. But if you read the law, there are just some glaring problems with the way it’s written,” former U.S. Sen. Claire McCaskill, a Democrat, told The Star Wednesday.

Saint Luke’s decision reverberated among advocates for sexual assault victims. Pregnancies as the result of rape can compound the trauma survivors experience, those who work with them say.

Access to emergency contraception in the hours after a rape has taken on even more importance since Friday because abortion is no longer an option under Missouri law.

“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 other area hospitals or Saint Luke’s facilities in Kansas, Donelon said.

Missouri Hospital Association spokesman Dave Dillon said a few hospitals have approached the association about state law, but none have asked about emergency contraception. Hospitals set their own policies surrounding abortion and pregnancies, but will now take into account the state’s new abortion ban.

“They will likely each have new policies built around the new requirements and prohibitions,” Dillon said.

The Star’s Kacen Bayless 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.

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