Late last month, the fight for abortion access in Missouri took a disturbing turn when the state health department made a shocking admission. During sworn testimony, the agency’s director, Randall Williams, admitted that the government had kept a spreadsheet of our patients’ menstrual cycles.

The public learned about this dystopian practice during a licensing hearing for Planned Parenthood’s St. Louis location, the culmination of an increasingly hostile fight with politicians intent on shutting down the state’s last abortion clinic. It’s true that, legally, state health inspectors have access to medical records and that, shockingly, they’re not bound by federal privacy laws, such as HIPAA. But what they did with that power was inappropriate and creepy. Officials combed through the data of thousands of patients, compiling a spreadsheet that listed medical ID numbers, the gestational age of the pregnancy and when procedures took place. The last column calculated the date of nearly 70 patients’ last normal period.

As a practicing OB/GYN and abortion provider for more than a decade, I can think of no medical reason to collect this information. What I do know is that officials abused their authority and misused my patients’ private information under the guise of public safety, all for one reason: to try to end abortion access. The creation of this spreadsheet shows, in stark terms, that zealous politicians will stop at nothing to ban abortion.

AD
AD

This isn’t the first time the administration of Gov. Mike Parson (R) has barged into our exam rooms to try to regulate abortion out of existence. A long-standing state regulation required a pelvic exam before abortions, as part of a doctor’s evaluation of the patient. But that rule was obsolete: We now date pregnancies using ultrasounds, and medication abortions have become more common. Pelvic exams aren’t necessary before simply handing a patient a pill, so we omitted them, consistent with guidelines from the American College of Obstetricians and Gynecologists. Health inspectors had never once cited us for this — until 2018, when Williams suddenly decided to enforce the rule. This posed a dilemma: We couldn’t subject patients to invasive exams that provided us with no information relevant to their care. Instead, we recommended that they go across the river to Illinois.

In May, the state went even further. This time, Williams decreed that patients seeking aspiration abortions had to have two pelvic exams: one during the state-mandated “consenting” visit (which must be at least 72 hours before the procedure), when it serves no medical purpose, and one on the day of the abortion, when the doctor needs to assess the position of the uterus. Then, like now, we protested this unnecessary invasion of our patients’ bodies. We provided reams of evidence that an additional exam was not just superfluous but harmful. As our medical director explained, for someone who has experienced sexual assault, “that exam can be miserably painful — physically, emotionally and psychologically.” But the state pushed ahead. Again, this put us in an impossible position. If we refused, the state was prepared to eliminate abortion in Missouri by refusing to renew our license. If we complied, we would knowingly, albeit reluctantly, contribute to their trauma.

The reality that our decision could result in the end of abortion access weighed heavy, so for a brief period, we complied. Those weeks were brutal. My colleagues and I felt that we were rewarding the trust of our patients with a state-sanctioned assault. A few patients, seeing how upset we were, apologized to us. Williams forced more than 100 women to undergo these exams before backing off, amid a huge public outcry.

AD
AD

Still, the state kept trying to find ways to deny our license: Inspectors came to our clinic five times in five months, fishing for any reason to shut us down. Now we know that their scrutiny even reached into our patients’ private information. Williams claimed to be investigating abortion complications, but the date of someone’s last period can’t tell him that. During an abortion, known and rare complications can occur, including an ongoing pregnancy (what Williams calls a “failed abortion”); at our health center, that happened with less than one-tenth of 1 percent of patients. But these few complications don’t indicate a systematic flaw in our clinic’s care — or with abortion, which is an exceptionally safe medical procedure. The government admitted during the licensing hearings that it doesn’t have the resources to inspect every hospital or outpatient surgery center each year, or even every few years, even though such facilities perform far riskier procedures. (Somehow, officials managed to visit us multiple times a year.) This elaborate investigation, supposedly motivated by “grave concerns,” was just an attempt to distort our excellent health and safety record.

Additional pelvic exams, repeated inspections, amassing period data — all are solutions in search of a problem. Meanwhile, in Missouri, maternal mortality is on the rise. We rank 44th in the nation for maternal mortality, black women die during pregnancy or childbirth at three times the rate of white women, and a syphilis outbreak is sweeping the state. This has all unfolded under Parson’s watch, while his health officials spend countless hours digging through our patients’ files. This is the dangerous reality of what happens when abortion-obsessed politicians make decisions about us, for us and without us.

Everyone should be able to go to their doctor without fear that their data will be weaponized for a political agenda. But such intrusions are all we can expect when the government seeks to control our reproductive decisions. It’s clear that Missouri officials don’t trust people to make choices for themselves and their families, and that they don’t trust doctors to provide health care in line with best medical practice. As a result, they felt entitled to collect intimate information about patients and their bodies without their consent. They claim to be protecting people’s health. After this abuse of power, it’s unclear why anyone should believe that.

As told to Post editor Sophia Nguyen.

AD
AD