Missouri Abortion Ruling Brings Unforeseen Results

The moment she saw the blurred outline of the fetus on the sonogram on Sept. 11, Maralee Dinsdale knew something was horribly wrong.

“There just wasn’t a definite round little head,” Dinsdale recalled, starting to cry quietly. She spelled the word that the doctor used: a-n-e-n-c-e-p-h-a-l-i-c. It meant that the 22-week fetus would be born without a brain.

Three months ago, she might have had an abortion at either of the two hospitals where her doctor practices. But when he tried to schedule one for her earlier this month, both facilities refused, saying they had changed their policies to conform with a Missouri law that had been upheld in July by the U.S. Supreme Court.

Dinsdale, confused and desperate, was advised to cross the state line to get her abortion at a clinic--one that was not as well equipped as a hospital to handle the potentially dangerous medical complications that arose.

For all the attention that has been paid the Supreme Court decision in Webster vs. Reproductive Health Services, neither side of the abortion debate expected the Missouri law to have much of an immediate impact. The law’s relatively narrow restrictions were seen as merely a first step--and a very small one, at that--toward the gradual chipping away of abortion rights.

The statute bars the state from using its money, facilities or employees for abortion, except in cases where the woman’s life is in danger.

However, as the law is being implemented, it is having some unexpected consequences.

“It may be more far-reaching than many at first recognized,” said Barbara Hackett, president of Missouri Citizens for Life. “It’s really a hopeful situation, no doubt about it.”

“Now the chickens are coming home to roost. There are all these crazy situations happening in Missouri,” said Roger Evans, litigation director for Planned Parenthood and counsel in the Webster case.

Though Dinsdale’s case was extreme, her experiences are only one example of the effects that the Supreme Court decision is having on availability of abortion here. It is being felt in several areas, among them:

--More hospitals than initially expected have stopped performing abortions, leaving women with fewer options, and forcing a few, such as Dinsdale, to take greater risks to get an abortion.

--In apparent contradiction with assurances that the Missouri attorney general made to the U.S. Supreme Court, at least one state college has put its staff on notice that it may not provide anyone with information on abortion. Other state officials say they are unsure how far their employees may go in discussing the topic.

Blockades Allowed

--Two judges have ruled that the law’s preamble justifies such tactics as sit-ins and blockades by anti-abortion groups seeking to shut down abortion clinics.

Originally, the law was thought to apply mainly to Truman Medical Center, a private facility located on public land in Kansas City. But several other hospitals have since announced that they can no longer do abortions.

Mario Mandina, president of the anti-abortion group Missouri Lawyers for Life, said some hospitals will define the law’s prohibition as broadly as possible. “Some of those people were looking for excuses to get out of (abortion) and this was a convenient excuse,” he said.

The loss of public facilities does not present a major obstacle for the vast majority of women seeking an abortion in Missouri. Fully 90% have the procedure in private clinics, which are not covered by the law.

But Dinsdale was well beyond the point in her pregnancy where most clinics will do the procedure, and she was fast approaching a time where it would be difficult to get one anywhere.

Dinsdale, a 32-year-old substitute teacher and girls basketball coach, could have carried her doomed fetus to term. But she and her husband, Kevin, had been devastated by both a fetal death and a miscarriage in the past three years. She could not bear thinking what it would be like “to feel it move every day, to know every day that when it was born, it wouldn’t live.”

Shocked by Options

After some hasty consultation with a colleague, her doctor recommended that she go to Comprehensive Health for Women, a clinic in Kansas. Had she had more time and information, Dinsdale might have continued her search for a private hospital in Missouri that still does abortions. But Dinsdale and her husband were shocked and confused at the limited options presented to them. Her doctor did not return a call requesting an interview.

Comprehensive Health officials say they have seen several women forced across the state line by the Supreme Court decision. However, Dinsdale’s case caused them particular concern.

In an earlier delivery, placenta had adhered to her uterine wall and she had hemorrhaged. Doctors at Comprehensive Health knew that could happen again, and were uncomfortable about performing the abortion there.

“With her history of bleeding . . . the abortion should have been done in a hospital,” said clinic director Adele Hughey.

Begins Bleeding Heavily

As they feared, Dinsdale began bleeding heavily as soon as they completed it and suffered an adverse drug reaction, according to nurse-practitioner Ada Anderson, who attended the procedure.

Clinic staff quickly summoned an ambulance, and Dinsdale recovered in a hospital.

“People think that cutting off access to public facilities won’t really hurt women, but it already has,” said Lynn M. Paltrow, an attorney with the American Civil Liberties Union.

Missouri hospitals are not the only institutions in the state distancing themselves from abortion. The law also prohibits use of public funds, facilities or employees for “encouraging or counseling” abortion.

In a July 13 memorandum to top officials at Southwest Missouri State University, Vice President Herbert L. Lunday warned that university employees are not to discuss the subject “when an individual (client, patient or other) raises the issue of abortion with an employee of the university” or “if an individual requests referral to an abortion clinic.”

The Supreme Court decision was based in part on assurances from Missouri Atty. Gen. William L. Webster that the statute “is directed solely at those persons responsible for expending public funds” and “does not prohibit the use of public funds to provide information regarding abortions or to inform a woman of the options she may have to cope with an unwanted pregnancy.”

Will Retain Policy

However, university attorney John Black said Southwest Missouri State plans to stick by its new policy. “Any public employee, I would think at this point in time, has some reason for concern,” he said in an interview.

“There had been great concern on our part early on as to even mentioning the word (abortion). . . . Anything any one of our staff does is supported with state funds,” said Michael R. Henry, director of legal services for the Missouri Department of Social Services. “At this point, we have not issued any instructions to staff.”

Anti-abortion groups argue that while the law’s limitations may make it more complicated for some women to obtain an abortion, they do not make it impossible, or even difficult. “Basically, the Webster decision hasn’t stopped one abortion,” said Mandina, the president of Missouri Lawyers for Life.

Far more significant, he said, is the new interpretation that some Missouri courts are giving the law’s assertions that “the life of each human being begins at conception” and that “unborn children have protectable interests in life, health and well-being.”

The state had argued that this passage was “abortion-neutral,” and the Supreme Court left it up to Missouri courts to decide what that section of the law means.

It has been cited in a number of unusual cases since July, including one in which a defendant accused of underage drinking is trying to add nine months to his age and another in which a pregnant imprisoned woman is claiming her fetus is illegally incarcerated because it committed no crime.

What has elated abortion foes, however, are separate decisions last month by two state judges, who cited that language from the law’s preamble as their justification for freeing protesters charged with trespassing on abortion clinic property.

St. Louis Judge Arthur Miorelli acquitted four protesters, saying: “I’m satisfied that Missouri law provides for the protection of these children.”

In the earlier case, Associate Circuit Judge George R. Gerhard acknowledged that 11 people had disrupted a clinic, but said their actions were “necessary as emergency measures” to prevent the “death and maiming of unborn children.”

Judges in other parts of the country, including Los Angeles and San Diego, have rejected such “necessity defenses” by anti-abortion groups.

Neither of the two Missouri cases may be appealed, but the issue is expected to ultimately reach the state supreme court.

If the necessity defense is upheld, “I don’t know how the abortuaries could stay open here, because there would be so many people who would be sitting in. . . . They would shut (abortion clinics) down, day in and day out. They would have to move out of the state,” Mandina said.

But St. Louis County prosecutor Tom Wehrle said: “We don’t read the law that way. Our county police will still be there making arrests.”