KANSAS CITY, Mo. — Saint Luke’s Health System said Wednesday it would resume providing emergency contraceptives, reversing course less than 24 hours after The Kansas City Star first reported it was no longer providing Plan B.
Saint Luke’s confirmed late Tuesday night that it was no longer providing emergency contraceptives. By the next day, the health system was facing enormous pressure from abortion rights advocates, including Planned Parenthood, not to curtail access.
The move by the Kansas City health system, made in the wake of last week’s Supreme Court ruling, received national attention and criticism from both sides of the abortion debate. The episode also underscored the concerns of those who fear Missouri’s abortion ban could be wielded to reduce access to over-the-counter birth control.
Missouri is one of more than a dozen states with trigger laws that were designed to immediately or quickly ban abortion following the overturning of Roe v. Wade. State legislators approved the ban in 2019, but its instantaneous implementation has led to confusion over what is legal and what isn’t even as Planned Parenthood and other providers of reproductive services have been adamant that the law doesn’t affect contraception.
Ultimately, Saint Luke’s said it was changing course after Missouri Attorney General Eric Schmitt and Gov. Mike Parson, both Republicans, gave assurances that the state’s new abortion ban doesn’t affect contraception.
“Following further internal review, Saint Luke’s will now resume providing emergency contraceptives, under new protocols, at all Missouri-based Saint Luke’s hospitals and clinics,” Saint Luke’s spokesperson Laurel Gifford said in a statement.
Gifford didn’t immediately respond to a follow-up question about the new protocols.
But Gifford said the ambiguity of Missouri law and uncertainty among state officials about what is prohibited “continues to cause grave concern and will require careful monitoring.”
“This is especially true because the penalty for violation of the statute includes the criminal prosecution of health care providers whose sole focus is to provide medically necessary care for their patients,” Gifford said.
Violations of Missouri’s abortion ban are a class B felony, punishable by between five and 15 years in prison. Abortion is only allowed for medical emergencies. No exception exists for rape or incest.
At least one public analysis of the new law, by Spencer Fane attorney Joe Bednar, outlines how a “zealous prosecutor” could build a case that Missouri law prohibits certain forms of birth control, such as Plan B.
In a public 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.
“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.
When Saint Luke’s disclosed its decision to stop offering emergency contraception, the health system said the law is ambiguous but “may be interpreted as criminalizing emergency contraception.”
The decision was particularly frustrating to advocates for sexual assault victims. Pregnancies as the result of rape can compound the trauma survivor's 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.
“I’m thrilled to know that survivors of rape will be able to receive the care they need at Saint Luke’s after having such a harrowing experience,” state Sen. Lauren Arthur, a Kansas City Democrat, said in a phone call.
“But I can tell you from conversations today that health care providers still have questions and uncertainty about the law and I fear that means women with ectopic pregnancies will suffer more than they should have to.”
Saint Luke’s appears to have been alone in cutting off access to emergency contraception following the implementation of Missouri’s abortion ban. No other Kansas City-area hospital approached by The Star on Wednesday said it had taken such a step because of the law.
University Health, formerly Truman Medical Centers, at one point issued a statement saying emergency contraception was “not in conflict with Missouri state law.”
By around midday Wednesday, Schmitt's and Parson’s offices issued statements seeking to clear the air about contraception.
“Missouri law does not prohibit the use or provision of Plan B, or contraception,” Schmitt spokesman Chris Nuelle said.
Kelli Jones, a spokeswoman for Parson, said nothing in either the U.S. Supreme Court’s decision or in the abortion ban makes individual drugs illegal.
Both Planned Parenthood Great Plains and state Rep. Mary Elizabeth Coleman, an Arnold Republican and a staunch abortion opponent, had previously also said they disagreed with Saint Luke’s interpretation of the law. Missouri’s ban didn’t change the definition of abortion, Coleman said, only how abortion is regulated.
Emily Wales, Planned Parenthood Great Plains president and CEO, had also said Saint Luke’s decision to stop offering emergency contraception could have a “triggering effect” on other institutions, leading more providers to block access. Wales called the situation a “slippery slope.”
A spokesperson for Planned Parenthood Great Plains didn’t immediately respond to a request for comment on Saint Luke’s decision to resume offering emergency contraception.
The comments from Schmitt's and Parson’s offices — and others — are unlikely to fully quiet concerns about access to contraception.
Missouri House Minority Leader Crystal Quade, a Springfield Democrat, asked Schmitt on Wednesday for a formal legal opinion on whether women can be prosecuted for using contraception. She also released a legal analysis by her office that says the use of contraceptives remains fully legal.
“I think that’s really great news for the people of Missouri,” Quade said of Saint Luke’s reversal. “But this also continues to show why it is important that we get some very specific clarity from the Attorney General’s Office on the interpretation.”
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(The Star’s Lisa Gutierrez contributed reporting.)
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