Concerns cited by the state health department in refusing to renew the business’ license are reflective of Planned Parenthood’s habitual shortcomings in meeting medical standards, according to former employees.

ST. LOUIS — A judge in St. Louis is deciding whether to issue an injunction allowing the last abortion facility in the state to remain open, amid the state health department’s refusal to renew its license due to concerns that include patient safety, failed surgical abortions and failure to obtain informed consent.

And while Planned Parenthood argues that the state is targeting abortion access, some former abortion clinic workers say that the case is indicative of a larger problem that the organization has with meeting medical standards.

The St. Louis Planned Parenthood filed a lawsuit last week and obtained a temporary restraining order Friday that permits it to continue to offer abortions despite the health department’s refusal to renew the license.

The Missouri Department of Health and Senior Services’ concerns include “at least one incident in which patient safety was gravely compromised,” failed surgical abortions, and “concerns about quality control and communication with a contracted pathology lab.”

The health department noted that “the continued refusal of several physicians to cooperate in interviews regarding DHSS’s ongoing complaint investigation obstructs the state’s ability to verify that this facility is in compliance with all requirements of applicable statutes and regulations.”

Missouri issued subpoenas in an effort to speak with seven doctors who had worked at the facility. Two staff doctors agreed to interviews with health officials, but others who are contractors or no longer work at the clinic refused interviews.

Planned Parenthood responded that it could not “in good faith” ask the doctors to comply with the investigation, claiming the health department has continued to shift its interpretations of regulations that could leave doctors open to criminal penalties. The organization also characterized the state’s request to interview the facility’s doctors as “inappropriate interrogation, bordering on harassment,” and asked that the court throw out the state’s subpoenas.

St. Louis circuit Judge Michael Stelzer, who granted Planned Parenthood a temporary restraining order last week, held a hearing on the case Tuesday and ruled that the doctors did not have to testify, and requiring them to do so would constitute an “undue burden.”

While the state’s last abortion business insists that it’s being unfairly targeted, former abortion worker-turned-pro-life advocate Abby Johnson highlighted public-health violations by the Missouri facility on her “Check My Clinic” website. These included the repeated use of expired medication and IV fluids, staff “using single dosable medication to ‘save money,’” and a failure to “properly sterilize instruments that are used from woman to woman.”

A St. Louis Worker’s Story

A former abortion worker who did administrative work for a few months at the Reproductive Health Services of Planned Parenthood of the St. Louis Region involved in the case in 2016 spoke with the Register about the center, asking to be referred to only by the initials D.B. The worker talked about an incident that indicated that abortion was the bottom line at the facility.

“I had a phone call that really sticks out in my mind. It was a young lady that was expecting, and she was looking for information for actually keeping her baby, and we had a folder — like a binder full of information — and all of the information was dated, and none of it was accurate,” D.B. said. “I told her to ask her OB-GYN for resources at the hospital. I told her maybe check with the fire department or the police station in her local area and maybe visit churches in the area.”

“My conversation with this young lady was overheard, and my boss pulled me into an office, and she asked me what I thought I was doing by giving out that information. And I explained that the information in the binder was dated and that the young lady had specific questions about resources for her unborn baby,” D.B. continued. “Her response to me was: ‘Don’t ever do that again. We don’t do that here.’”

D.B. said that from past work in health care and medical insurance, “when someone asks you a question about resources and you’re in a position to do something or point them in that direction, that’s what you’re supposed to do.”

D.B. added that Planned Parenthood never said in her job interview or hiring process that the facility did abortions.

“It was maybe two to three days after I started, and I was being trained by the girl that I was taking her position,” D.B. said. “I heard a strange noise, and I was like ‘What was that noise? … It’s like a humming sound.’ And she said: ‘Today is procedure day so we can actually here the humming of the equipment coming up through the floor.’ That’s how I found out that they actually did abortion procedures at that clinic.”

When asked about the court case over the state’s investigation of the facility, D.B. shared “suspicions” about the cleanliness standards of the location, despite not working in the procedure area, and cited the lack of cleanliness in the kitchen area, where there were “dead fruit flies.” D.B. ended up cleaning and bleaching the refrigerator, which was “disgusting” and “a nightmare,” with rotten food.

A National Problem

In a statement last week, Johnson alleged that health-and-safety violations are a problem for the organization nationally.

"When I worked at Planned Parenthood, we almost always knew when the state health inspector was coming so we could clean up and present a facility in compliance with the law,” she said. “Abortion clinics across the country operate in similar manners and yet are still cited for disgusting violations that leave women exposed to negligence and possible infections. If Planned Parenthood cared about their patients, they would clean up their clinics and be held to the same commonsense medical regulations that other medical facilities must uphold."

The Charlotte Lozier Institute, the research arm of the pro-life Susan B. Anthony List, has kept a tally of some of Planned Parenthood’s and other abortion providers’ more egregious abuses of health-and-safety standards. These included frequent hospitalizations due to botched abortions and unsanitary conditions that led to the closure of some facilities.

Dr. Donna Harrison, a physician and executive director of the American Association of Pro-Life Obstetricians and Gynecologists, told the Register that abortion businesses want to have it both ways when it comes to meeting medical standards.

“Unless the state specifically includes abortion clinics in their regulation, abortion clinics are generally under the category of doctor’s offices so as a doctor’s office they avoid accountability by the state,” she said. “So despite the fact that they’re doing a real surgery, with real complications, including the risk of death and bleeding and infection, unless the state has listed them as a surgical center, then they don’t have to meet the requirements that other surgical centers have to meet.”

Harrison argued that “if the abortion industry is going to claim that they follow medical standards, then they have to be held accountable to the same standards that every other physician and surgeon are held accountable to,” emphasizing that “you can’t both be medical and avoid accountability.”

The Smell of Dried Blood

Myra Neyer, who formerly worked as a surgical assistant at a Planned Parenthood facility in Baltimore told the Register how the center handled health inspections during her time there.

“All of us would talk about this,” she said. “When the state is coming to inspect, guess what? They know, Planned Parenthood in Baltimore, they know what day they’re coming — someone tips them off and tells them.” Ahead of health inspections, Neyer said that “they would coach us before the state would come in: ‘Well, the state’s probably going to ask you this.’”

She outlined some of the violations and unsanitary conditions the inspectors never saw.

“We would have so many patients. We did 50 [abortions] a day; we only had, like, 20, 30 trays, but 50 scheduled, so the problem with that is that we had two procedure rooms,” she said. “We were running back and forth through each procedure room, and then you had to wipe everything down so you think: ‘You got to be so fast when you’re in there wiping; you’re missing blood.’ There would be bloodstains on the floor.”

“The trays — they would get stacked up in the POC [products of conception] room, so they would be there for hours,” she continued. “I’ll never forget the smell of dried blood. Just the smell of blood now makes me sick, but they would be stacked up, and they shouldn’t have been stacked up like that. They should’ve been cleaned and sterilized and all that stuff.”

While Neyer could only speak to her experience at the Baltimore facility, she said she was “not surprised” the St. Louis facility was under scrutiny. She also told the story of a clear instance of abortion from rape that she saw in the facility and how Planned Parenthood’s handling of it haunts her to this day.

“The girl was disabled, Down syndrome, and she came in with a guardian, and she’s not in her right mind to consent — there’s no way she could’ve consented to having sex with someone,” she said. “So who got her pregnant? Her caregiver, and this girl — he brought her for an abortion. She was about to deliver. She was already like 36 weeks, but she had no idea.”

“She didn’t even speak — that’s the thing. She would go back and forth like she wasn’t aware of what was going on,” Neyer said. “And we didn’t report that. You know what we did? We gave her a referral to go somewhere else, but the doctor said, ‘She’s going to have to deliver,’ like she’s about to deliver that baby; baby’s full-term, so who did that to her? Nobody cared to ask the question.”

“Those are the ones that are starting to come back to me now,” she emphasized. “We’re supposed to be mandatory reporters. We don’t report anything. That will stay with me.”

‘I Couldn’t Do It Anymore’

Neyer was a struggling widowed mother during her time working for the abortion provider and remained there for a year but left in 2014 due to witnessing a woman go through an abortion of identical quadruplets after being coerced by her boyfriend.

“Our sonogram machine showed that she was 13 weeks — our clinic went up to 14 weeks,” she recounted, adding that “no one was certified. We weren’t sonogram technicians; we were just taught how to measure the baby by their head. We would measure the head and the femur, and that would tell us how old the baby was.”

Neyer refused to sign off on the procedure because the woman clearly didn’t want to have the abortion after discovering she was carrying a rare natural instance of identical quadruplets. However, the woman’s boyfriend was coercive and took her to another facility, where she was given something to start the abortion process, and she returned to their facility in pain, seeking help.

“One of the babies fell in the toilet, and the baby was already dead, so we picked that baby up,” she recounted. “Two more babies fell out — they were just hanging from her, and these two babies were holding on to each other.”

She described being unable to move and crying with her co-worker as they worked to dispose of the babies. “Once that happened, I couldn’t do it anymore,” she said. “I saw the humanity in those babies.”

Lauretta Brown is the Register’s Washington-based staff writer.