ST. LOUIS (AP) — The top doctor at Missouri’s sole abortion clinic on Wednesday defended its handling of four patients who faced complications — women whose care has been cited by the state as it seeks to revoke the clinic’s license.

The testimony from Dr. Colleen McNicholas at a hearing that could determine the St. Louis clinic’s fate came as the state faced fallout over a revelation a day earlier from Missouri’s top health official that he kept a spreadsheet that tracked the menstrual cycles of women who obtained abortions.

Missouri officials were staying mum, while Democrats and abortion-rights supporters decried what they called government overreach into women’s private lives.

During testimony Tuesday, Missouri Department of Health and Senior Services Director Randall Williams said the spreadsheet was compiled at his request. He said the goal was to find women who had what the state calls “failed abortions,” in which a woman is still pregnant after an abortion and needs more than one procedure to complete it.

McNicholas told the administrative hearing that the Planned Parenthood clinic in St. Louis followed protocol in all of the instances cited by the state. She said that while a surgical abortion is safer than even a colonoscopy or tonsillectomy, complications do happen.

Yamelsie Rodriguez, president and CEO of Reproductive Health Services of Planned Parenthood of the St. Louis Region, told reporters that the organization learned of Williams’ spreadsheet from his testimony. She did not know how many patients were listed on the spreadsheet.

“I think what is deeply disturbing about that is the fact that Director Randall Williams is using his position of authority and power to push a political agenda in order to try to end access to safe and legal abortion in the state of Missouri,” Rodriguez said.

Williams declined an interview request, and spokeswomen for him and Gov. Mike Parson didn’t respond to messages seeking comment. But Wednesday night the health department emailed a statement denying Williams compiled spreadsheets tracking menstrual cycles, claiming that his testimony was misinterpreted. According to the statement, which was titled “DHSS denies false allegation,” the department investigated concerns about missing reports into failed surgical abortions by using “legally-obtained information which was required by law and which Planned Parenthood routinely submits.”

The Associated Press also submitted open records requests seeking additional information.

Williams testified that the spreadsheet contained information accessible by the state through its annual inspection, performed in March. It also included medication identification numbers, dates of procedures and the gestational ages of fetuses, The Kansas City Star reported. The spreadsheet did not include patients’ names.

The state has said it is concerned about patient care, and Williams called safety “the North Star” of the licensing process.

Missouri House Minority Leader Crystal Quade, a Democrat, called for an investigation to determine whether patient privacy was compromised or laws were broken. State Auditor Nicole Galloway, who is running for governor in 2020, called for Williams to be fired.

The spreadsheet was developed after an inspector raised concerns about an abortion that took five procedures to complete. That led to an investigation that found four overall instances where women underwent multiple procedures to complete their abortions. Among those cases was one where the doctor missed that the patient was pregnant with twins, requiring two procedures five weeks apart, according to Williams’ testimony.

Elizabeth Nash, a state policy analyst for the Guttmacher Institute, a national research group that supports abortion rights and tracks abortion legislation, told the AP she hasn’t heard of another case where a state agency has tracked menstruation as part of regulating a clinic.

Dr. Jennifer Conti, a San Francisco-area abortion provider, said in an interview that tracking periods is not a reliable way to determine when a pregnancy has ended and suggested that data was used to avoid having to obtain women’s consent for access to addition information.

“It’s very odd and it feels like an invasion of privacy,” said Conti, who is a fellow with Physicians for Reproductive Health.

The state moved to revoke the clinic’s license in June, prompting a court fight that was turned over to the Missouri Administrative Hearing Commission, which is conducting the hearing. A ruling isn’t expected before February.

Missouri would become the first state since 1974, the year after the Supreme Court’s Roe v. Wade decision, without a functioning abortion clinic if the license is revoked. Three clinics near Missouri offer the procedure. Two are in Illinois suburbs of St. Louis, and one is in a Kansas suburb of Kansas City.


For your information, we have also copied the press release sent by the Department of Health and Senior Services:

JEFFERSON CITY, MO – Irresponsible reporting has led to false claims that Dr. Randall Williams tracks the menstrual cycles of women seeking abortions at Planned Parenthood.

The story was based on an erroneous email subject line that both staff and sworn testimony has acknowledged is not accurate. Nothing in the Administrative Hearing Commission testimony that Dr. Williams gave on Oct. 29, or in the Oct. 17 deposition, could in any way be cited to support this false claim that he ordered “spreadsheets” or any document to be created to do such. In fact, during Dr. Williams’ Oct.17 deposition, Planned Parenthood’s attorney Chuck Hatfield asked, “Do you recall making a request related to duplicate records which appear to be duplicate ITOPs [Induced Termination of Pregnancy] with last normal menses date?” Dr. Williams answered, “No, sir.” This “issue” was given very little attention at the hearing and has been falsely reported with the purpose of sensationalizing the hearing, drawing in readers and distracting from the truth.

The truth is that as part of our initial inspection, a concern came up that DHSS may not be receiving complication reports for all failed surgical abortions, as required by law. Without a directive from Dr. Randall Williams, regulators devised a means to efficiently investigate that concern using legally-obtained information which was required by law and which Planned Parenthood routinely submits. A Department investigator took the data in DHSS possession and narrowed if from approximately 3,000 abortions conducted in 2018 to 67 instances where the same woman had multiple abortions in the same year. The data was further narrowed to exclude multiple abortions and ultimately identified a case where a failed abortion was not reported by Planned Parenthood, in violation of Missouri Law. Only then was the case shared by regulators with Dr. Williams. Dr. Williams did not possess a spreadsheet of patient information, and although there was no wrong-doing by regulators, the first time he saw the spreadsheet was at the time of his deposition on Oct. 17. HIPAA compliance was not a factor in this activity as no patient data has been released. This information, in fact, was important in the investigative process in ensuring that facilities are safe for patients.

A long-standing legal mandate requires that “an individual abortion report for each abortion performed or induced upon a woman shall be completed by the physician who performed or induced the abortion.” (RSMo 188.052) With regard to these reports, a regulation was promulgated to detail the required contents of the reports. This rule, 19 CSR 10-15.010, establishes the content of the ITOP report to be filed with the Department. One of the required details in the rule is last normal menses (menstruation). Necessarily, DHSS retains this documentation. Per practice, the reports are reviewed when a complication is reported for an abortion procedure. In order to ensure that our laws and health care standards are being met, reports from abortion facilities, by law, must be reviewed. In this case, Planned Parenthood was not compliant with the complication report requirement for failed abortions. Regulators realized this, and as a result they used the tools they had to protect the health of those who seek abortions at Planned Parenthood.