JEFFERSON CITY, Mo. -- When lawmakers passed new regulations for some abortion providers last month, Planned Parenthood claimed the "onerous requirements" would force it to halt abortions in Kansas City and Columbia.
But that may not be the case.
Rather than quitting its Missouri abortion business, Planned Parenthood of Kansas and Mid-Missouri now is studying how it could comply with the new requirements. A preliminary review shows it would cost substantially more than $1 million to make the necessary changes at each of its abortion clinics, chief executive officer Peter Brownlie said.
In contrast to his May 18 assertion that the legislation "will shut down abortion services," Brownlie now says "our intent is to continue offering that service, if we can."
At issue is a measure that would require any facility that performs more than five first-trimester abortions a month, or any second- or third-trimester abortions, to meet the state licensure requirements for an "ambulatory surgical center."
Republican Gov. Matt Blunt supported the bill and is expected to sign it into law, meaning the new requirements would take effect Aug. 28.
The state already requires abortion facilities to be licensed, setting forth specific standards for their staff, operations and buildings. But because of the definition of an abortion facility -- requiring abortions to generate half its revenue or patients -- a St. Louis Planned Parenthood clinic is the only facility in Missouri actually regulated as an abortion clinic.
The Department of Health and Senior Services said the new language about ambulatory surgical centers would cause three additional abortion facilities to fall under its licensure. The department declined to identify those facilities.
But Planned Parenthood confirms its offices in Columbia and Kansas City both would be affected.
Brownlie estimates the Columbia facility performs 600 to 700 abortions a year. The Kansas City office performs about 100 abortions induced only by medication; the area's surgical abortions are performed a few miles west at a Planned Parenthood facility in Overland Park, Kan.
To comply with the specifications for an ambulatory surgical center, the Columbia and Kansas City clinics likely would have to be remodeled, Brownlie said. For example, state regulations require halls to be at least 8 feet wide leading to operating and recovery rooms and at least 5 feet wide elsewhere. Doors to exits, operating rooms and recovery rooms must be at least 44 inches wide while other doors must be at least 32 inches wide.
Ambulatory surgical centers also must meet requirements for emergency equipment, infection control, medical staffing and numerous other things.
"There's no question that it imposes considerable expense and considerable difficulty in maintaining access to that service," Brownlie said.
Following the ambulatory surgical standards at the Kansas City office is particularly "ludicrous," Brownlie said.
"There is no surgery there," he said. "It's literally a matter of doing an exam and giving pills" that later induce an abortion.
While Brownlie contends abortion is generally safer for women than live birth, abortion opponents point to cases of complications with both surgical and pill-induced abortions.
Bill sponsor Rep. Therese Sander, R-Moberly, said a lot of first-trimester abortions use a "dilation and curettage" procedure similar to what's performed in hospitals or ambulatory surgical centers after miscarriages or for other women's health treatments.
"Because they're doing the same kinds of procedures, they should have to operate under the same kinds of safety standards, inspection standards, staffing standards [and] keeping adequate medical-record standards," Sander said.
She added: "We're simply taking steps that are necessary to protect the safety of the women undergoing these procedures."
Health department records show almost half of Missourians already travel out of state for abortions.
In 2005, Missouri residents had 7,340 abortions performed in-state. But the department estimates the total number of abortions performed on Missourians at 13,955, when counting those who traveled to Kansas, Illinois and a few other states. Figures for 2006 aren't expected to be available until July.
Planned Parenthood said it is still weighing whether to challenge the legislation in court, comply with the ambulatory surgical center standards or simply stop offering abortion services at its Columbia and Kansas City clinics.
Halting the service could force more women to drive out of state for abortions, or perhaps cause some to reconsider whether to actually get an abortion.
Planned Parenthood asserts the result of the bill is to make it more difficult to perform abortions in Missouri. The bill's backers might not mind that, though they insist the intent is simply to ensure safety.