Planned Parenthood of St. Louis plans to defy a regulation that Missouri says legally requires women to undergo two pelvic exams prior to obtaining an abortion, as state health officials get set to decide whether to renew the clinic's medical license.

If the St. Louis facility is closed, Missouri would be the first state without a functioning abortion clinic since 1974, the year after the landmark Roe v. Wade decision that legalized abortion nationwide.

In a statement to Fox News on Thursday, Dr. Colleen McNicholas, an OBGYN for the Reproductive Health Services of Planned Parenthood of the St. Louis Region, said the orgainzation was simply rejecting Missouri's improper policy determination, not defying the law.

Last month, Missouri officials issued a regulation requiring pelvic exams at both initial consultations, and just prior to abortions. Planned Parenthood initially followed that rule before challenging it.

“Patients have confirmed for us what we already knew — that the additional medically unnecessary forced pelvic exam newly interpreted by the state is deeply traumatizing and inhumane," McNicholas said. "Let’s be clear — we have always complied with the regulation, but we as doctors reject this new interpretation because it defies patient-centered care."

Other Planned Parenthood officials backed up McNicholas, saying multiple pelvic exams are unnecessary.

"We are choosing to provide the best quality, patient-centered care that we've always provided at Planned Parenthood," Dr. David Eisenberg, Planned Parenthood of St. Louis' medical director, told CBS News on Wednesday. "And that includes doing things that are driven by science, by evidence, and by what's medically appropriate."

Eisenberg continued: "Over the last few weeks, I have new evidence to say that 100 percent of the patients who I've taken care of who've undergone this inappropriate, medically unnecessary, unethical pelvic exam have been harmed by that. Because to do so, in my opinion, is just assault."

Planned Parenthood did not respond to Fox News' request for comment. The organization told CBS News it would only conduct one pelvic exam, at the time of the abortion procedure.

Missouri's case for not renewing the clinic's license includes a claim that three "failed abortions" there required additional surgeries and another led to life-threatening complications for the mother, according to a now-sealed court filing. The documents, a letter and statement of deficiencies the Department of Health and Senior Services sent Friday to the St. Louis Planned Parenthood clinic provide the most specific details to date about a state investigation that triggered a licensing dispute now playing out in court.

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State attorneys filed the records in court after Planned Parenthood sued last month in an attempt to continue providing abortion, despite the state health department's refusal to renew its license amid an ongoing investigation.

Anti-abortion group Operation Rescue put the health department records on its website before St. Louis Circuit Judge Michael Stelzer sealed them Monday per a request by Planned Parenthood.

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Jesse Lawder, a spokesman for Planned Parenthood of the St. Louis Region and Southwest Missouri, said the state violated patient-privacy laws by releasing the records.

According to the documents, three patients remained pregnant after surgical or medical abortions and required follow-up surgical abortions, Missouri Department of Health official William Koebel wrote Friday to Planned Parenthood. Koebel said that one of those patients developed sepsis after the second surgical abortion.

Koebel wrote that a fourth patient was hospitalized with life-threatening complications following an abortion at 21 weeks of pregnancy.

Medical residents performed some of the abortions at issue and have refused interviews with the health department, according to the agency. Part of the agency's concern, Koebel wrote, is that the residents were not properly supervised.

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Planned Parenthood has said that the residents and several other physicians are not staffers and some no longer practice there, so the organization can't force them to cooperate. Two on-staff doctors agreed to speak with investigators.

But Koebel warned that it's "imperative" that Planned Parenthood addresses the agency's concerns about interviews with the other physicians.

"Refusal of health care providers to cooperate in the Department's investigations thwarts the Department's ability to conduct meaningful review of troubling instances of patient care, and obstructs the Department's ability to ensure that problems will not be repeated," Koebel wrote.

The judge has set a Friday deadline for the health department to decide whether to renew the clinic's license, which was set to expire May 31. Stelzer has allowed the clinic to continue providing abortions as the legal challenge plays out in court.

The fight over the clinic's license comes as lawmakers in many Republican-led states, including Missouri, are passing new restrictions that take aim at Roe. Abortion opponents, emboldened by new conservative justices on the Supreme Court, hope federal courts will uphold laws that prohibit abortions before a fetus is viable outside the womb, the line the high court set in Roe.

Missouri Gov. Mike Parson signed legislation on May 24 to ban abortions at or beyond eight weeks of pregnancy, with exceptions for medical emergencies but not for rape or incest. Efforts to put the new law to a public vote are tied up in court.

Separately, Planned Parenthood is building the stage for another possible fight over abortion in Alabama: a large women's clinic that's under construction despite the state's passage of a near-total ban on abortions.

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Located beside an interstate highway in downtown Birmingham, the 10,000-square-foot structure is now nothing but a steel frame and roof. Workers under the constant watch of security guards appear to be installing electrical wiring, plus heating and cooling units.

The new facility could be complete around November, which is the same time the new state law will take effect unless blocked by courts. Abortion critics vow to oppose the opening, but a spokeswoman for the women's health organization said neither the new law nor opponents were a factor in the project.

Fox News' Frank Miles and The Associated Press contributed to this report.