This doctor performed Missouri’s last abortion before ban. Here’s her message to patients

·4 min read
Provided by Emily Barker

Emily Barker, a fellowship physician in St. Louis, was part of a team of doctors that performed an abortion in Missouri less than an hour before the U.S. Supreme Court struck down Roe v. Wade and triggered a statewide ban of the procedure.

The patient, who was born with a medical condition that made pregnancy a risk to her health, was originally scheduled to have the abortion on Friday afternoon. Fearing that the Supreme Court decision would come down prior to the procedure, Barker and a team of healthcare providers rearranged the woman’s travel from rural Missouri and scrambled to get her to St. Louis earlier in the day.

As of Friday morning at 9:18 a.m., Missouri now forbids abortion in nearly all circumstances, including in cases of incest and rape, under a 2019 law that went into effect minutes after Roe v. Wade was overturned. While abortions are still allowed in medical emergencies, some critics say the emergency provision is poorly defined and could be interpreted differently by certain doctors.

Barker, a fellowship OB-GYN physician at Washington University in St. Louis, said she believes the abortion she performed on Friday would not have constituted a medical emergency and would now be considered illegal under state law. In a phone interview with The Star, Barker said she was not speaking on behalf of the university.

“We were genuinely fearful Thursday afternoon and evening that if we couldn’t rearrange the care for this patient, that she would genuinely not be able to have her procedure,” Barker told The Star. “It was a procedure that was potentially life saving and absolutely, at the very least, averted what could have been serious complications with a pregnancy if she had carried to term.”

Although the patient did not know it at the time, the doctors that performed the procedure knew it was likely the final legal abortion in Missouri before the Supreme Court struck down the federal right to an abortion. In the early hours of Friday, the procedure in St. Louis illustrated the chaos that health care providers and women seeking abortions have had to endure in the months, days and minutes leading up to Missouri’s decision to ban the procedure.

Now, the Supreme Court decision ushers in a new, tumultuous era for OB-GYN physicians like Barker, who fear that state legislators will effectively overrule the medical advice and practices of trained doctors.

“It brings up a lot of worry,” Barker said. “What if she presented to us just a week or two later? Her story would look really, really different.”

As she finalized the medical orders and operative notes for the patient on Friday, Baker said she frantically refreshed SCOTUSblog, an independent website that posts news about the Supreme Court, on her phone and waited for the decision to be released. When the decision finally came down, the relief she felt after completing the procedure was replaced with worry for the women who won’t be able to receive similar care, she said.

“When it came through, I just felt a huge pit in my stomach,” she said. “I was pretty overwhelmed in a way that surprised me because I wasn’t surprised, but I still felt a lot of disappointment and worry when that screen refreshed.”

Barker said she wants patients to understand that even though abortion is illegal in Missouri, it’s still safe and legal in other parts of the country. As of now, there are resources to help Missourians travel to get an abortion — likely to Illinois or Kansas, she said. Organizations like Planned Parenthood offer to help women seeking abortions with travel, lodging and financial assistance.

But even with those resources, Barker said she fears Missouri’s abortion ban will create an “insurmountable set of challenges” for women who can’t take time off work and pay to travel out of state to terminate a pregnancy. She wonders whether the state is prepared to care for the flurry of women who will be forced to carry a child to term.

The lack of exemptions for rape and incest victims will have “huge implications” on victims’ mental and physical health, particularly women who are forced to have a child with their abuser, she said.

Missouri law requires patients to undergo a 72-hour waiting period before a doctor can proceed with an abortion. In the weeks leading up to the Supreme Court decision, Barker said she had to tell frustrated patients over the phone that the procedure could be outlawed during that waiting period.

After Friday’s decision, Barker said she wouldn’t be surprised if a number of Missouri doctors decide to relocate to another state because of the ambiguity of Missouri’s laws. She said there’s a looming worry among people in the medical community that state legislators and untrained professionals will interpret the medical field differently than actual doctors.

“We absolutely know that this is going to affect the lives of people in Missouri,” she said. “We know that abortion is safe and in most cases, much safer than carrying a pregnancy to full term.

“We know that this is going to have medical and social implications for people in the state. And there’s there’s no medical reason that it has to be that way.”

This story has been updated to accurately reflect what website Barker checked for the ruling news on Friday.

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