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It’s Open Season on Abortion Access, and Missouri Is Leading the Charge 

Protestors standing outside of the Planned Parenthood clinic in St. Louis.

FLICKR/ PAUL SABLEMAN

Protestors standing outside of the Planned Parenthood clinic in St. Louis.

On a chilly Wednesday night this winter, students huddle around a bay of computers at a library in St. Louis County — some of them studying, some possibly playing Fortnite. Brightly lit with pristine white walls and furniture featuring sleek finishes, the space feels shiny and new.

Just behind the fleet of computers is a glass-lined meeting room, its design reminiscent of an observation room. Or a fishbowl. The space sometimes hosts anime movie nights or slide-dancing classes, but tonight, it's where a group of people have gathered to discuss their personal experiences learning about sex ed, reproductive health care and more.

These groups, often ranging from teens to people in their 70s or 80s, are hosted by NARAL Pro-Choice Missouri, the state affiliate of the national nonprofit that aims to protect and expand abortion access. The events are part of NARAL's Reproductive Freedom Listening Tour, which began last August and ends in June.

The tour has taken NARAL's team of six employees across Missouri to hear what reproductive health issues are impacting the lives of people in the state. So far, the small staff has visited Rolla, Kansas City, Joplin, Cape Girardeau, Potosi, Jefferson City and Columbia, as well as spots across the St. Louis area. The conversations have included questions about abortion access — including people wondering if the procedure is still legal in Missouri — while also covering issues across the spectrum of reproductive health care.

"The Listening Tour is empowering people that their voices will be heard and mean something, and encouraging them to tell their stories, not just on abortion but on the full range of reproductive freedom health issues," says Mallory Schwarz, executive director of NARAL Pro-Choice Missouri. "Your voice is powerful; your voice moves policymakers."

The Listening Tour is also an opportunity for NARAL to connect with people across the state after a particularly tumultuous 2019 that saw major gains for anti-abortion politicians and activists.

For decades, conservative legislators have hollowed out the abortion provider network in Missouri, resulting in only one clinic still offering those services in the state today. Access to care is as bad as it's been in generations, and the state is presently in danger of becoming the first in the U.S. with no abortion provider.

While abortion bans are being proposed and signed into law across the country, in Missouri, little by little, anti-abortion legislation has chipped away at access through regulations — ones that critics say are medically unnecessary. This has left groups such as NARAL with their backs against the wall, but the fight isn't over. In fact, abortion could be a crucial issue in the upcoming Missouri gubernatorial race, perhaps for the first time ever.

Sitting around a table at the library, it may seem a little odd to share such personal stories with strangers — stories about your earliest memories of sex ed at home or in school, your experiences giving birth and raising children, or why you chose to have an abortion. These conversations feel even stranger as we're sitting in that fishbowl — but the group quickly opens up and finds connections in shared life experiences.

As the discussion gets underway, an elderly woman describes her earliest memories of sex ed — or more specifically, the lack of it. Growing up in the '40s and '50s, she says her parents never uttered the word "sex" at home. School didn't prove any more informative on the subject.

By 21 she had two children born within two years of one another. To support herself, she took a job at a fast-food restaurant and, later, at a factory. With the help of a physician, she also gained access to birth control for the first time in her life. Although her pregnancies were not planned, she says she would never have chosen to have an abortion because of her Christian faith. Her path as a single parent wasn't easy, she says, but she has no regrets.

Sitting next to the woman is a teenager, the youngest person in the room, who recently graduated from high school. When asked if she's comfortable sharing her earliest memories of sex education, she describes positive experiences both at home and in school, where she says she learned about reproductive health care and sex ed during all four years of high school. Birth control, she says, was the main thing the school communicated to students, as well as how to avoid sexually transmitted infections.

This comprehensive approach to sex ed surprises the room — it is the first story shared so far that reflects medically factual information and promoted various methods of birth control and contraception. (Several of the other sex ed stories previously shared in the group involved fourth or fifth graders being separated by gender and watching films about "our changing bodies.")

The teen's experience is encouraging to everyone in the group — perhaps sex ed has come a long way since the days of stilted videos and clumsy euphemisms. After all, study after study, including one from 2019 published by the Brookings Institution, has shown that when people are educated about contraceptives and have easy access to them, unintended pregnancy rates decline.

Schwarz says that some of the most frequent subjects discussed at the events have been sex education and birth control. In Missouri, state statute is somewhat vague with regard to sex ed, stating only that programs should teach children about contraception and preventing STIs, but that every curriculum must teach that abstinence is the preferred way to prevent both.

The vagueness at the top means that at the local level, every school is distinct and curriculums can vary widely. "Really the biggest thing that's come out [of the Listening Tour] that we've heard is sex education," Schwarz says "[Students] are not learning about how to prevent STIs, and we're seeing the STI rates across the state skyrocket, with outbreaks across rural Missouri. So this isn't an issue where you can say, 'Oh, well it's just in the cities.' We're just not setting our kids up to go out in the world and be healthy adults."

Unfortunately, comprehensive sex ed is only one way that Missouri isn't supporting reproductive health care for people across the state.

Clinic escorts wear brightly colored smocks so patients can easily see them. - KAYLA CALAC
  • KAYLA CALAC
  • Clinic escorts wear brightly colored smocks so patients can easily see them.

By late 2016, the pro-choice movement seemed worse off than it had ever been in Missouri. Abortion access had been steadily stripped away by politicians in Jefferson City, where Republicans controlled the House and Senate, and by November conservative Eric Greitens seemed poised to beat then-incumbent Governor Jay Nixon, a Democrat. Following the election of President Donald Trump, though, those ever-present concerns about reproductive rights in Missouri and across the country escalated into very real fears.

Desiring to help in whatever small way I could, I signed up to be a clinic escort with NARAL. I was assigned to volunteer at Hope Clinic in Granite City, Illinois, which has provided abortion care since 1974. It is one of two abortion providers located just across the river from St. Louis; the other is a new Planned Parenthood facility in Fairview Heights, Illinois.

There is no fence separating Hope Clinic and its small parking area from the sidewalk, which means that anti-abortion protestors — sometimes three busloads at a time — can stand on the sidewalk next to the parking lot as patients exit their vehicles. When that small lot fills up, some patients are forced to park in nearby lots off of the clinic's property, which means that protestors can walk right up to them as they exit their cars and trail them until they step onto clinic property. Health care providers and employees of the clinic also experience the same treatment as they enter and exit work.

To help lessen the barrage, clinic escorts, clad in brightly colored smocks, walk patients to the clinic entrance. The escorts stay mostly silent, as their role isn't to educate or influence patients — only to make them feel safe and oriented amid the chaos.

Some protesters are soft spoken, gently singing hymns or offering to hand patients flowers to engage them in conversation. Others take a more aggressive posture, barking Bible verses or medically inaccurate information in an attempt to shame them. Because clinic escorting is a volunteer program, the numbers in attendance fluctuate from week to week; sometimes the group is as big as six or seven people, other times it's just two.

You hear protestors yelling "Don't kill your baby!" and "Abortion is murder!" You see people holding infant onesies and offering them to patients, while others sing gospel songs or clutch rosaries. The most unsettling among them just stand silently, some not even holding signs, just staring ahead, their eyes fixed on patients.

Things look fairly similar in Missouri, where the only abortion provider is the Planned Parenthood clinic on Forest Park Avenue in St. Louis. Here, on any given Saturday morning, anti-abortion protesters are lining up along the edges of the clinic by 7 a.m.

Caught between the protestors and the clinic entrance are patients. Some are here for contraceptives, STI testing or treatment, breast exams and mammograms, as the clinic offers a full range of health care services. Other patients are here for abortions, having possibly traveled halfway across the state multiple times to receive care.

Last year, a slew of reproductive rights issues in Missouri made national headlines. One of the stories broadcast widely concerned the possible closure of this Planned Parenthood clinic.

In late May 2019, the Missouri Department of Health and Senior Services denied the clinic a license renewal after months of inspections. During those inspections, the DHSS mandated a new requirement for the clinic: Patients must undergo a pelvic exam at least 72 hours before a surgical abortion. (The clinic had stopped offering medication abortions a year earlier due to the same mandate being required by the state health department and deemed medically unnecessary by clinic physicians.)

The new mandate would mean that patients must undergo a pelvic exam twice in 72 hours, which doctors at the clinic — and across the country — reiterated was also medically unnecessary. In two episodes dedicated to the issue, MSNBC host Rachel Maddow described it as "state-sanctioned sexual assault."

Following the health department inspections, DHSS reported that the clinic had performed several "failed abortions," citing the care of four Planned Parenthood patients who returned to the clinic for multiple procedures. DHSS director Dr. Randall Williams also issued a statement of deficiencies reported to the clinic by DHSS — but a list of those deficiencies has never been released publicly. Instead, throughout months of legal filings and public statements, the state's health officials hammered at Planned Parenthood's refusal to force its doctors and medical staff to appear for interrogations.

The clinic filed a lawsuit on May 28 against Williams, DHSS and Missouri Governor Mike Parson to fight the anticipated license denial. The lawsuit alleges that the state essentially launched a coordinated effort to close the clinic, blowing up small problems, such as a failure to have all staff participate in a fire drill, that are "typical of the license renewal process" and a small handful of complications to make them look like widespread, critical issues. State agencies have also tried to bury the clinic under the burden of unnecessary procedures, including the two pelvic exams for patients.

"There will be times when there are complications — [it] doesn't demonstrate any systematic or systemic-wide problem," Dr. Colleen McNicholas, chief medical officer at the clinic, told NPR at the time. "Abortion is health care, and we'll continue to provide that quality health care and fight for people to have access to that."

In the months since Planned Parenthood filed its lawsuit, the two sides have fought a long and often fiery legal battle. Planned Parenthood won an early round in late June when the Missouri Administrative Hearing Commission granted Planned Parenthood's motion to stay the case and allow the license to remain active until the commission made a final decision.

In October, DHSS became the target of yet another nationwide backlash when Williams revealed in a hearing that his department had been tracking the menstrual cycles of patients at the clinic in a spreadsheet and had used that information to identify alleged "failed abortions," as first reported by the Kansas City Star.

In a statement titled "DHSS Denies False Allegation" sent to media outlets, Williams and his department defended the spreadsheet as "legally-obtained information which was required by law and which Planned Parenthood routinely submits."

By November, the licensing battle had made it all the way to Washington, where McNicholas along with other pro-choice advocates answered questions about abortion from the House Oversight and Government Reform Committee.

"My colleagues and I could not in good conscience force patients to take off their clothes unnecessarily and endure an extra, state-mandated vaginal exam," McNicholas said in her testimony. "Due to public outcry, the department relented, but that only confirms there was no medical need for the extra exams."

If Planned Parenthood's license is indeed revoked, the clinic would be forced to stop providing abortions, meaning that Missouri would be the first state in the U.S. to effectively eliminate access to abortion.

There was a time in Missouri's history, as in most states in America, when clinics offering abortions were numerous; at the height of abortion access in Missouri, nearly 30 providers were operating across the state. Anti-abortion advocates, including none other than Governor Parson, point to the falling numbers of abortions performed in the state as evidence that Missourians are "choosing life" due to "decades of pro-life leadership."

There's no denying that the number of abortions performed in Missouri has dropped dramatically in the past three decades. As of 2015, the number of abortions performed in the state was 4,765, and that figure fell to 3,903 in 2017, according to the DHSS. The historic high, by comparison, was upwards of 17,000.

Yet from the stories Mallory Schwarz has heard on the NARAL Listening Tour, it's not necessarily that more people are "choosing life" — it's that their access to abortion in Missouri has been so restricted that it has become too burdensome to receive care.

Attendees at stops on the Listening Tour have asked NARAL employees whether or not abortion is still legal in the state, confused by the chaos of last summer. In other cases, people may think that abortion access is not currently an issue, unaware that there has not yet been a final decision in the courts. In both cases, Missourians are confused about the issue.

For many pro-choice activists, including Schwarz, that has been the real success of the anti-abortion movement: Why bother overturning Roe v. Wade — the 1973 U.S. Supreme Court ruling protecting abortion without excessive government restriction — when eliminating access would achieve a similar result?

"That's their goal: adding all of these restrictions in the hopes that they will push a person far enough along in their pregnancy that they will no longer be able to access [abortion], and force pregnancy and force birth upon that person," Schwarz says. "And that's what's really amazing: What is the world that you envision for that child that you have manipulated their parents into having them? It's straight manipulation."

It's true that for decades the Republican-led fight against abortion has steadily added new barriers to access. In 1989, publicly financed medical units in Missouri could no longer perform abortions unless the mother's life was in danger. By 2005, the state passed a law requiring abortion providers to be located within 30 miles of a hospital, including in rural areas where hospitals are now few and far between.

One of the most restrictive Missouri laws concerning abortion is a mandatory 72-hour waiting period for those seeking care. After a patient's initial in-person consultation with a physician about having an abortion, the patient must wait three days before scheduling the procedure. For people who can't miss a week of work or don't have the means to travel hours back and forth to St. Louis for multiple clinic visits, those 72 hours can make a major difference in their access to care.

"The mandatory 72-hour waiting period encourages people to think about it, but they've already thought about it — no one calls if they haven't thought about it," Schwarz says. "There are people who are out there who are pretending they want what's best for these people, but they're the ones inflicting this trauma on them, and that's a really sad thing."

Such restrictions have forced some Missouri folks to travel to Kansas or Illinois, where limits on abortion are less severe. In Kansas, patients must wait only 24 hours, while in Illinois, they face no waiting period at all. Last week, Planned Parenthood released a press release outlining data showing that the number of abortions performed at the clinic on Forest Park Avenue has decreased significantly. In February 2019, 174 patients were provided with abortion care at that clinic; a year later, that number dropped to just three.

"What we've seen recently in the devastating number of Missourians being able to access abortion in their own state, is that really these legislators and appointed officials don't care if abortion is happening; they care where it's happening," McNicholas says. "It really shows that the state and the public-health system here in Missouri has completely abdicated its responsibility to meet the needs of the people who live here."

Across the river in Fairview Heights, however, the Planned Parenthood clinic there recorded providing some 96 abortions last October, the first month that service was offered. Last month, that number had jumped to 323. While the number of abortions in Missouri has declined precipitously over the years, falling to just 100 last September, the number of abortions performed at the new Illinois clinic has steadily risen, indicating that Missouri women are likely just crossing state lines for care.

"Relative to other states, we're lucky to have a haven like Illinois right there, because abortion is inaccessible in Missouri — abortion has been inaccessible in Missouri for years, especially for communities of low income, of color, LGBTQ communities and young people," Schwarz says.

In recent years, emboldened by the anti-abortion Trump administration (and the confirmation of his Supreme Court nominee Justice Brett M. Kavanaugh), nine states across the U.S. have sought to severely limit or restrict abortion access, including Missouri. These laws are likely to be appealed all the way to the Supreme Court, and with a conservative-leaning court, including Kavanaugh, they may very well be upheld.

"People are very fearful and concerned about abortion access; they've been hearing all of the misinformation and there are a lot of questions," Schwarz says. "Most people don't think about abortion until the moment that they need it, and that's why our work is so important: We need to make sure it's available and legal when they need it."

Protestors gather outside of Hope Clinic in Granite City, Illinois. - KAYLA CALAC
  • KAYLA CALAC
  • Protestors gather outside of Hope Clinic in Granite City, Illinois.

Katie was using birth control when she learned that she was pregnant almost a decade ago. When she first thought her birth control may have failed, she took a home pregnancy test that came back positive. After that, she scheduled an appointment at a Planned Parenthood clinic to confirm the result.

"My birth control failed, because there is no such thing as an entirely foolproof form of birth control," she says. (Failure rates for birth control vary from method to method, according to the Centers for Disease Control and Prevention, with a statistical likelihood of failure ranging from 0.01 to 27 percent depending on the method.)

Katie was in a happy relationship at the time, but she knew she didn't want to have children with her then partner. "He left the decision entirely up to me," she says.

Her choice was to have an abortion. About a week later, she returned to the Planned Parenthood facility for an exam and to recieve the medication and instructions for usage to have a medication abortion at home. Unlike a surgical abortion, medication abortion is taken orally.

"It induces basically a pretty heavy period, so it flushes out the inside of your uterus," Katie says. "It's not a fun experience by any means; I spent what I would describe as kind of an uncomfortable day at home. But afterward I was totally fine, and I've never regretted the decision that I made."

Katie was living on the East Coast at the time and recalls no barriers for care, no mandatory waiting period and no protestors harrassing her.

"I was lucky in that I didn't have any waiting periods; I didn't have any misinformation that my doctor was required to give me the way that they have in a lot of states," Katie says. "There were no protestors or anyone blocking me from having access to the clinic — it felt very safe, always, and felt very easy to come and go to get the services that I needed."

Nine years later, Katie says she feels very fortunate to have been able to make this choice about her health care and family planning.

"I don't take for granted the fact that my experience was relatively stress free and mundane, and I really think that everyone who needs reproductive health care should have that kind of experience," she says. "I was confident in my decision, and I was confident in the medical care that I received."

Katie has been a pro-choice activist for years, she says, and has long supported the work of Planned Parenthood and other pro-choice advocacy groups. A few years ago, while discussing her support of reproductive rights with her paternal grandmother, Katie learned that in the 1920s or 1930s, her paternal great-grandmother had an abortion. Her great-grandmother was married and living in Brooklyn when she learned she was pregnant, and although she wanted children eventually, she was not yet ready to become a mother.

"I was surprised, because you don't hear too many stories about folks in the early 1900s having had access to reproductive services like that," Katie says. "She was able to find access to reproductive care and had an abortion and then later, when she was ready, went on to have the family that she wanted, one of those girls being my grandmother."

In Katie's view, through her great-grandmother being able to make a choice about her own family planning, she was able to build a better life for herself and her family down the road. Abortion was not legal at the time, of course, but it was happening across the country despite the procedure not being generally included in obstetrics and gynecology training for physicians, according to reporting by the Guttmacher Institute.

"I literally wouldn't be here if it weren't for reproductive services access," Katie says. "I was kind of floored — I come from a long line of smart, strong women who make the decisions that they need to for themselves and for their health. It felt kind of validating — I made the same decisions, and I know that my decision was the right thing, and my great-grandmother did the same thing."

At first Katie didn't tell many people about her abortion. She says her reasons were mixed — she did worry about the stigma she might face from some people in her life, but she also viewed it as a medical procedure that just felt private. Fairly recently, though, she's become comfortable sharing her story. Not long ago she participated in a stop on the NARAL Listening Tour and was encouraged watching people connect in real time about their different experiences accessing reproductive health care services.

"It felt like a really comfortable atmosphere where people were able to share their experiences," Katie says. "We talked a lot about our experiences with sex education, because that's a foundational element of how someone thinks about their reproductive health care, and then moved on to other topics, culminating in talking about the current state of affairs in Missouri legislation and in the country, and what opportunies people have through NARAL to help build the world that we want to see both locally and on a larger scale."

When you lie, people die!"

That chant thundered through the Missouri House on an unseasonably warm day last May. A group of activists roared in unison from the chamber gallery overlooking the House floor, many of them clad in white T-shirts proclaiming "Stop the Bans" in orange type.

Tempers and emotions were high that day following the passage of HB 126, or the "Missouri Stands for the Unborn Act," which had already passed in the state House and Senate and was now given final legislative approval before heading to the governor's desk. The bill bans all abortions in Missouri, including those that are the product of rape or incest, at eight weeks of pregnancy. With lawmakers aware that the eight-week gestational ban would almost certainly be challenged, the bill suggests a series of alternative bans at fourteen, eighteen and twenty weeks of pregnancy.

The only exception outlined in the bill is in cases where the mother's life is in danger. In addition to those provisions, "trigger" language was included that if Roe v. Wade is ever overturned federally, abortion in Missouri would be banned at every stage of pregnancy outside of medical emergencies.

The legislation includes an emergency clause requiring two-parent consent for minors seeking abortions. (Missouri currently requires one-parent consent for minors.) The bill also includes provisions banning abortion due to the sex or race of the fetus, or a Down syndrome diagnosis. The latter provisions are often called "reason bans" and aim to restrict the reasons patients can seek abortions, although critics say they're hard to prove or enforce and only serve to further reduce abortion access.

On May 24, less than a week after the Missouri General Assembly approved HB 126, Governor Parson signed the bill into law. Religious groups and anti-abortion politicians and citizens alike heralded the decision.

"By signing this bill today, we are sending a strong signal to the nation that, in Missouri, we stand for life, protect women's health and advocate for the unborn," Parson said in a release. "All life has value and is worth protecting."

Just days later, Republican Senator Andrew Koenig, who represents District 15 in St. Louis County and managed the passage of the bill, was featured on Politically Speaking, a weekly podcast produced by St. Louis Public Radio. In the episode, host Jason Rosenbaum questioned Koenig about the law.

"I think this is important because the Fourteenth Amendment says that every person has a right to life," Koenig said. "When you peer inside the womb, all the evidence points to that life exists. And why eight weeks? Because at that point in time there's a heartbeat and so, literally, inside the womb, you have the heartbeat of an unborn child and you also have, you know, the mother has her own heartbeat, so you have two separate heartbeats at that point in time."

When Rosenbaum asked Koenig to specify why there were no exceptions written into the bill for survivors of rape or incest — noting that even President Trump, who is anti-abortion, supports such exceptions — Koenig doubled down on his belief that a fetus has the same constitutional rights as a pregnant woman in all circumstances.

"Rape or incest are horrific acts; I think that you can't go far enough on the punishment on the people who do these acts. They're just completely horrific. But one bad act doesn't ... we shouldn't do another bad act because one bad act happened."

The host also questioned Koenig on the far-reaching nature of HB 126. "Was the reason that Republicans in particular went along with this because Trump is president and there's a feeling with the judiciary changing that there needs to be a more aggressive posture on this issue?" Rosenbaum asked.

"This is a unique bill," Koenig responded. "It's a little different than other heartbeat bills that you've seen across the states. What makes this bill different is that we've made legal arguments that have never been argued in court. We consider, at eight weeks, to be a viable pregnancy; there's a 95 percent chance that the child will make it to birth at the point in time that heartbeat is detected."

What Koenig and his colleagues consider a viable pregnancy, though, doesn't align with the scientific and medical definitions accepted by most doctors. A fetus is usually considered viable — meaning it could live outside the womb — at 22 to 24 weeks from a woman's last menstrual period, although factors can vary in every case.

A study led by neonatologist Dr. Noelle Younge in 2017 in The New England Journal of Medicine proposed that fetuses born outside the womb after 22 weeks could survive in clinics with advanced neonatal units. That study, however, which was conducted over twelve years, found that only 1 percent of babies born at 22 weeks survived without neurodevelopmental impairment.

"With the 22-weekers we didn't see a lot of difference," Younge told Reuters Health in 2017.

Prior to the proposal of HB 126, abortion was legal in Missouri up to 22 weeks.

There are signs that Missouri politicians — both Republicans and Democrats — who supported HB 126 may have overplayed their hands. One Republican member of the Missouri House, Shamed Dogan, who represents the 98th District in St. Louis County, voted no.

"I really struggled with this one," Dogan told the St. Louis Post-Dispatch at the time. "I wanted to, as we talked about earlier, include rape or incest exceptions."

Dogan wasn't alone in his concerns. Conservative allies also saw the legislation as too extreme, including David Humphreys. The prominent Joplin-based businessman and generous donor to the Missouri Republican Party opposed the lack of exceptions for survivors of rape or incest.

Pro-choice advocates immediately rallied to oppose HB 126 with a referendum proposal, or public state-wide vote, one of which was filed by the American Civil Liberties Union on May 28. Another referendum filed against HB 126 came from The Committee to Protect the Rights of Victims of rape or incest, a petition Humphreys supported with a $1 million donation.

"I support the committee's referendum petition to overturn HB 126," Humphreys said in a statement last summer. "Abortion is a very personal subject with complicated moral issues for all involved. With no consideration given to victims of rape or incest, this legislation's impact reflects bad public policy with negative consequences for Missourians. As such, I support the committee's effort to protect women in the case of rape or incest."

Due to the emergency clause in the bill requiring two-parent consent, though, that provision in the bill immediately became law after it was signed by Governor Parson. And that opened the door to a bit of political gamesmanship by Missouri Secretary of State Jay Ashcroft. The Republican at first refused to approve referendum proposals, claiming he didn't have the legal authority to approve them because of the bill's emergency clause.

When an appeals court disagreed, ruling that Ashcroft could not deny the referenda, he waited for more than two months to release the petitions needed to begin gathering signatures. According to Andrew Koenig's interview with St. Louis Public Radio on June 3, that move by Ashcroft was intentional to block a public vote.

"What we did in the bill is actually preempt that type of situation by putting an emergency clause in there, so there can't be a referendum," Koenig told Politically Speaking.

Ashcroft finally released them in mid-August, which gave petitioners just fourteen days to collect the needed 100,000 signatures. Critics insisted Ashcroft had intentionally slow-walked the petition to undercut their efforts.

The secretary of state defended the move in a press release specifically outlining the timeline afforded to the ACLU petition. "The referendum process is available for bills that have not yet become law, and a portion of the bill had become law," Ashcroft said at the time. "I had no other choice than to reject the referendum when it was originally filed."

Protestors pretending to be clinic escorts to confuse patients. - VIA NARAL PRO-CHOICE MISSOUR
  • VIA NARAL PRO-CHOICE MISSOUR
  • Protestors pretending to be clinic escorts to confuse patients.

As HB 126 quickly transformed from bill into law last spring, Schwarz says that NARAL Pro-Choice Missouri heard rising concerns from citizens. After the referendum was thwarted, though, she says her office was flooded with calls and emails from Missourians who wanted to advocate for their reproductive rights.

"I think that passing HB 126 caused outrage across the state and really woke people up — people who don't pay a lot of attention to politics, people who are busy with their kids and jobs and lives and haven't thought about what abortion access could mean," Schwarz says. "All of a sudden they heard this, they saw this, and I think those people were awakened, are increasingly engaged and are fed up."

On the eve of HB 126 going into effect on August 28, U.S. District Judge Howard Sachs issued a preliminary injunction blocking the gestational age bans outlined in the bill. A month later, the federal judge issued a separate preliminary injunction blocking the bill's provision banning abortion due to the sex or race of the fetus, or a Down syndrome diagnosis.

Currently the bill is caught up in appeals courts, with Missouri Attorney General Eric Schmitt seeking to reverse the preliminary injunctions issued by Sachs. The appeals are scheduled for argument during the week of April 13.

For his part, Parson still seems motivated to see HB 126 or legislation similar to it take effect in Missouri under his tenure. On February 1, the governor reaffirmed his position on abortion, becoming the first sitting state governor to speak at the Midwest March for Life rally.

"We're just part of the troops, in Army terms, because we've still got to fight battle after battle after battle," Parson said at the rally, as reported by the News Tribune in Jefferson City. "But I will guarantee you, sure as I'm standing here in front of you as governor of the state of Missouri, we're winning the war."

Long before Mike Parson was a politician, he was a Missouri farmer and U.S. Army serviceman. Raised in Hickory County near Bolivar, he would eventually become the third generation in his family to earn his livelihood off the land. After graduating from Wheatland High School in rural western Missouri, Parson served in the Army for six years and later was the Polk County sheriff for twelve years before running for state representative. He later moved up to the state senate and, eventually, lieutenant governor.

As a politician, he has cultivated an image as a gentleman farmer — he still runs a cattle operation in Bolivar with his wife, Teresa — and state Republicans welcomed his promotion in 2018 to replace departing Governor Eric Greitens, who clashed with party leaders before allegations surrounding an affair led to his resignation.

Parson had only been governor for a year when he signed HB 126. During his time working in the Missouri General Assembly, Parson had voted in favor of several bills seeking to restrict abortion access. When he announced his plans to run for a full term as governor this past September, Missouri Right to Life fully endorsed him. (A Parson spokeswoman said the governor was not available for an interview.)

As Parson gears up for his first gubernatorial race, he'll have to double down on his anti-abortion views and politics more fiercely than ever. Abortion is expected to be a central issue in the race given the extreme nature of HB 126 — even some conservatives find the lack of exception for survivors of rape and incest to be egregious.

This fall, Parson will face off in the gubernatorial election against State Auditor Nicole Galloway, who has specifically come out against HB 126 and its lack of exceptions for survivors of rape or incest. Democrats seeking to win over Republican moderates in Missouri have traditionally avoided pushing abortion access as a key part of their platform, but advocates see an opening in the extreme measures of the ban.

(Repeated attempts to interview Galloway were not successful.)

Although most Missouri voters identify as "pro-life," according to a survey conducted by Kansas City-based Remington Research Group (founded by Republican strategist Jeff Roe), 54 percent of those surveyed opposed an abortion ban with no exceptions for survivors of rape or incest, including 42 percent of Republicans and 58 percent of independents.

Last summer, an NPR/PBS NewsHour/Marist Poll of voters across the U.S. found similar results, including that a majority of Americans are against overturning Roe v. Wade, although 61 percent of those surveyed believed in some sort of abortion restrictions.

"What it speaks to is the fact that the debate is dominated by the extreme positions on both sides," said Barbara Carvalho, director of the Marist Poll, in a story with NPR. "People do see the issue as very complicated, very complex. Their positions don't fall along one side or the other. ... The debate is about the extremes, and that's not where the public is."

Schwarz has found the same to be true in her work with NARAL Pro-Choice Missouri. "Polling has shown that seven in ten Missourians, like seven in ten Americans, support access to legal abortion and support Roe v. Wade," Schwarz says.

Even before Galloway announced her campaign for governor, she began to attack Parson on the issue. In an editorial published in the St. Louis Post-Dispatch in June 2019, she called HB 126 "a travesty for women."

"[Parson] wants rapists in Missouri to have more power over their victims. He wants a woman's decisions over her health care to be criminalized. These positions are extreme and cruel.

"I join the probable majority of Missourians who are appalled by this new law. But I also know this law represents another emotion for Missouri women — fear."

Days before Galloway's op-ed, the state auditor spoke at the Jackson County Democrats' 32nd annual Truman Gala.

"Until now, a survivor of rape could decide what came next," Galloway said at the gala, as reported by the Kansas City Star. "Governor Parson has taken that choice away from women, and instead a survivor must accept that her rapist could have parental rights."

Although Missouri has lit up red in presidential elections in recent years, Galloway has proven to be a viable candidate in historically Republican-leaning counties. She is currently the only Democrat to hold statewide office, and in 2018, when she was reelected as state auditor, she won eight typically red counties: Buchanan, Callaway, Cole, Greene, Howard, Platte, Ste. Genevieve and St. Charles. Those rural and suburban victories were crucial for Galloway, who won the election with just 50.413 percent of the vote, according to reporting by St. Louis Magazine.

Galloway isn't the only Democrat to sway a historically Republican suburban area in recent years. In St. Louis County, Democratic Representative Trish Gunby flipped the 99th District, which represents communities including Twin Oaks, Valley Park and Manchester, in a special election.

Gunby is running again this year, currently against two Republican challengers. She credits her victory in 2019 to voters who cared less about voting along party lines and more about where candidates stood on the issues.

"I think there's a lot of people who are more focused on the candidate, and I think that's what I found," Gunby says. "I know Republicans voted for me because they told me they did. They were more focused on the candidate and that candidate's willingness to work with people and work across the aisle. That's what resonated with them."

Galloway and Gunby are both backed by EMILY's List, the influential political action committee that has recruited pro-choice candidates across the nation. Just across the border in Kansas, the group played what the Kansas City Star described as a "major role" in the election of Democrat Sharice Davids, a gay Native American who defeated a Republican incumbent for U.S. representative in Kansas' 3rd congressional district. It was one of the most shocking upsets of the 2018 cycle.

In a story about Galloway's then-rumored bid for governor, the Kansas City Star suggested that if EMILY's List were to get behind Galloway's campaign in a big way in 2020, it could potentially give her a similar boost.

EMILY'S List helps with campaign fundraising efforts for candidates and can donate to those campaigns directly as a political action committee, but the real money — including most of what funded Davids' historic run — comes from Women Vote. The Super PAC is connected to but legally independent of EMILY's List.

According to an EMILY'S List representative who spoke to the Riverfront Times on background, EMILY's List and Women Vote don't communicate with one another and there's a wall separating the two groups for campaign finance law purposes. Women Vote advocates for pro-choice candidates through advertising. It's not yet clear if Women Vote will do the same for any Missouri candidates.

In a conversation with the RFT, an EMILY's List representative acknowledged that a lot of people in Missouri and across the U.S. don't support abortion, but that doesn't mean they agree with how extremely a bill like HB 126 aims to limit access.

Gunby agrees, suggesting that even members on both sides of the aisle in the Missouri General Assembly may not support the more extreme bans outlined in HB 126. She points to legislation that was passed earlier in the current session around lifting the statute of limitations for survivors of sexual abuse.

"I find it very interesting," Gunby says. "So the [legislative] body is OK with doing something like that, acknowledging that somebody who has been sexually harmed may wait years before she comes forward, and yet they expect somebody who experienced sexual trauma through rape or incest to know in less than eight weeks what they should do around that issue. That to me is a disconnect. I feel like we're in a time and a place in Missouri where the rules of logic are not being utilized depending on the topic, and what's good for one issue does not apply to another, and that's what we're dealing with around the abortion issue."

In addition to Galloway and Gunby, EMILY's List is also rallying behind State Senator Jill Schupp, who is running for the U.S. House of Representatives. Schupp has supported reproductive rights throughout her political career, which includes tenures in the Missouri House and Senate, and has seen how abortion access has gradually been whittled down by conservative legislation over time.

"Over the years I've seen actions to chip away and to put stumbling blocks in front of women trying to access abortions or their right to choose," Schupp says. "And that chipping away, year after year, making a woman wait 72 hours, having restrictions on the kind of facility that offers women the choice of abortion, all of the relationships with hospitals — all of these laws have been to chip away at a women's access, and this is now just the outright ban."

Not unlike the fight between Galloway and Parson, Schupp is also challenging a staunch anti-abortion politician, Ann Wagner, in the 2020 cycle. Wagner has represented Missouri's 2nd congressional district since 2013.

In that time, she has been outspoken about her unwavering views on abortion. She introduced a bill, the "Born Alive Abortion Survivors Protection Act," in early 2019 which seeks to "ensure any infant born alive after an abortion receives the same protection of law as any newborn: mandating care and instituting penalties for doctors who allow such infants to die or who intentionally kill a newborn."

Under Roe v. Wade and state law, abortion is banned after fetal viability except in rare cases of medical emergency. Therefore, critics of the "Born Alive Abortion Survivors Protection Act" say that it won't apply to most abortion procedures.

"Congress must act to protect those who cannot protect themselves," Wagner said in a press release issued in February 2019. "That is why I introduced the 'Born Alive Abortion Survivors Protection Act,' which merely ensures that babies who survive abortions receive immediate, lifesaving care — just as any other baby would. To my colleagues, this is the simplest vote you will ever take: either you support babies being killed after they are born or you don't."

Wagner has also previously opposed anti-abortion legislation including exceptions for survivors of rape or incest similar to the language used in HB 126. Schupp believes that HB 126 has potentially alienated even Missourians who don't identify as pro-choice.

"I think this is such an irresponsible and extreme law — it's dangerous, it's outrageous, and frankly it's unconstitutional," Schupp says. "I think people are appalled knowing that regardless of their situation or circumstance that this law makes abortion illegal. I think that women and common-sense people in the state of Missouri are saying, 'This is absolutely a bridge too far.' Even people who have not been pro-choice are so offended by the way that this has come about and the extreme measures that are in this piece of legislation."

Sitting around the table at that library for the NARAL Listening Tour, people agree. The night is winding down and we're now discussing the events of last summer, including HB 126. Most of the people in the room aren't aware of the most extreme measures in HB 126; some aren't aware of it at all. When they're informed that the people of Missouri were denied the chance to put the bill to a public vote, emotions run even higher.

Gazing into the faces of people ranging in age from seventeen to 70, it's hard not to consider the generational impact of HB 126. It's been almost fifty years since Roe v. Wade became federal law, and the people in this room and their stories represent our world before and after its passage. It's hard not to consider Katie's great-grandmother in Brooklyn, who chose to have an abortion decades before the procedure was legal. It's hard not to think of the people who will still seek out abortion if it's once again denied to women under the law.

Given what's at stake, this next election cycle feels like another major defining moment for America. We will either remain a country where people are allowed to make their own decisions about their personal health care, or we will begin banning people's access to it, starting with abortion.

"The future of women's health care in the state of Missouri will be determined in November," Schupp says. "My Republican colleagues have made it illegal to have an abortion even if you're the victim of rape or incest. It is really critical that people who are concerned about women's access to abortion, which will affect one in four women in the state, get out and vote. That's how we're going to make change."

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