MHPRR Statement on the Missouri Family and Women Research Fund

We are physicians and healthcare providers in the state of Missouri and we are appalled at the steps our state has taken to interfere with the basic relationship between a patient and physician.  Missourians for Constitutional Freedom has been working since March to remedy the situation in our state and to return bodily autonomy to people in Missouri.  Yesterday, on August 30, Missouri Women and Family Research Fund threw their initiative petitions into the ring.  And while we applaud their recognition that our current laws “make Missouri [look] draconian, punitive and unsafe for families”, we find their proposals dangerous substitutes for the petitions currently making their way through our courts.

In each of the six versions the right to refuse abortion leads the petition.  This insinuates that somehow abortions are being forced on women who somehow need protection.  Some of the filings also preserve the right to refuse contraceptives.  It is unclear if this is for the patient, which would be an unnecessary provision, or for providers to give them legal protection if they refuse to prescribe or dispense contraception.  It is unfathomable that we would enshrine in our state constitution the ability to refuse a patient contraception!

Multiple versions of the initiative would amend the Missouri constitution to say a right to abortion exists only in cases of rape or incest, threats to the mother’s health, or fatal fetal anomalies. The rape exception would apply only if victims have reported said rape to a rape or sexual assault crisis hotline, something which would be nearly impossible to verify, and thus deny most victims abortion care.  Rape is the most underreported crime in the country.  By some estimates, 63% of rapes go unreported and only 13% of child sexual abuse is reported.  This is an incredibly dangerous provision and cannot be part of any initiative petition that goes forward.

Other versions of the initiative would permit abortion until 12 weeks. However, the initiatives are written in such a way that early abortion would be legal on paper, but not available in reality.  The initiative proposals explicitly state that they should not be “construed to repeal any law existing at the time of its passage unless such existing law directly conflicts with any provision [. . . ]” This appears to protect medically unnecessary “targeted regulations of abortion providers” or “TRAP” laws that were used to make abortion almost unavailable in Missouri even when abortion was a federally protected right. Permitting abortion up until 12 weeks gestation would do little if patients are left with an impossibly short window between discovering they are pregnant and managing to get one of few available appointments for abortion care.  Prior to the fall of Roe only about 200 patients a year managed to get an abortion in Missouri.

Further, we already have a law that provides exceptions for a mother’s health, but it is clear that over the past 15 months since the overturning of Roe, providers are uncertain and the state government has been quite opaque about what constitutes a threat to a mother’s life. This has forced patients into extremely dangerous situations before care is rendered.  It is unclear how many lives have been lost, but indeed lives are lost under a law that doesn’t allow physicians and patients to determine what is best for their health without government interference.

As healthcare providers we understand that provisions for fatal fetal anomalies until the time of viability is another carrot thrown to Missouri voters with the expectation that it sounds moderate and permissive.  In reality, fetal anomalies are diagnosed at a 20 week ultrasound.  It generally takes more than one ultrasound and consultations with high risk providers as well as neonatologists and pediatric specialists to appropriately diagnose and advise a couple who is presented with the nightmare scenario of a fetus with any sort of anomaly.  Many anomalies are not fatal at birth but would render a child to a life of pain, constant medical interventions and no potential to live to adulthood.  The amendments proposed by Missouri Women and Family Research Fund may appear friendly to families, but it would force people to make decisions before they are able to obtain all the information necessary to make a choice before viability (which is also not defined here).  It also denies these choices to families who may have to quit their jobs, sacrifice their other children, go into medical bankruptcy or simply do not have the heart to bring a child into a life of pain and illness.

In short, we oppose these initiative petitions.  They attempt to appeal to voters as a “moderate” alternative while actually placing more restrictions on the doctor patient relationship.  Our government does not belong in our exam rooms, and we exhort voters to demand full reproductive freedom including the right to contraception, safe prenatal care and birth conditions as well as the right to safe abortion care.