Missouri Assistant Attorney General John Sauer, left, talks with Randall Williams, director of the Missouri Department of Health, during the first day of hearings between the state and Planned Parenthood. Photo: Cristina M. Fletes/St. Louis Post-Dispatch via AP

Tuesday already had extremely high stakes: It was the second day of a hearing to decide if the Planned Parenthood clinic in St. Louis could keep the license that allows its providers to perform abortions. If Missouri revokes the license, it would become the first state in the country without an abortion clinic in more than 40 years. Then, the state health director admitted that the department kept a spreadsheet that tracked the menstrual cycles of people who visited the clinic. It’s a harrowingly Big Brother-ish move by anti-choice government officials that would seem unimaginable—if the federal government hadn’t already engaged in similar behavior last year.

Randall Williams, the Missouri state health director, testified that the state’s main inspector made a spreadsheet to attempt to figure out which patients “had undergone failed abortions,” meaning they had to return to the clinic for an additional procedure, according to the Kansas City Star. While the spreadsheet did not identify patients by name, the document included medical ID numbers and procedure dates, as well as the gestational age of the fetus and day of the patients’ last period, the newspaper reported. The Missouri department of health issued a statement denying allegations that Williams himself created the spreadsheet but acknowledged that others in the department did create such a document.

Yamelsie Rodriguez, president and CEO of Reproductive Health Services of Planned Parenthood of the St. Louis Region, said Williams’ spreadsheet was an “outrageous and disgusting” practice. “As part of Gov. Parson’s effort to end abortion access in Missouri, Williams manufactured a solution in search of a problem,” Rodriguez said in a statement. The Missouri House Minority Leader Crystal Quade (a Democrat) called the tracking spreadsheet “deeply disturbing” and questioned Williams’ fitness for a role in the state health department. “Governor Parson must immediately investigate whether patient privacy was compromised or laws broken and determine if this is a person who Missourians can be comfortable behaving in a position of public trust,” Quade said in a statement on Tuesday. NARAL Pro-Choice Missouri is calling for Williams to resign.

Despite the immediate dystopian visions conjured by this Missouri spreadsheet, it’s not the first time government officials have engaged in tracking the periods of menstruating people whose bodies or medical records they have access to.

The Office of Refugee Resettlement, which is part of the Department of Health and Human Services and is in charge of the care of all unaccompanied minors, kept increasingly close tabs on the goings on of every girl’s uterus in their custody before the courts stepped in. In 2017, then-agency head Scott Lloyd started to receive weekly reports on every unaccompanied minor who was pregnant and the details of her pregnancy. (In May 2019, a government transparency group published the actual spreadsheet, which the agency still seemed to be tracking until at least March of this year.)

ORR tracked pregnancy tests, gestational age, whether the pregnancy was the result of rape and if it was reported, whether an abortion was requested as well as other notes like who who the father was (for example, “with 22 yo ex-boyfriend in [country of origin]”). The data from the centralized spreadsheet was then used to restrict the girls' access to abortion care or coerce them into carrying to term, as VICE News reported exclusively in February 2018.

Brigitte Amiri, the deputy director of the ACLU’s Reproductive Freedom Project who represented four abortion-seeking teenagers in the lawsuit against ORR, told VICE on Wednesday that it's critical to ask why this level of tracking is even taking place. “Why was this tracking happening with such a level of detail to include last menstrual period and information about how the minor got pregnant? We still don’t have a good answer,” Amiri said of the ORR spreadsheet, and calling the Missouri aggregation of such data “creepy” and “bizarre.”

"Given how much the Trump administration has given the green light to anti-abortion politicians in the states to infringe on people’s right to access abortion, I wouldn’t be surprised if this was something ripped out of the Trump administration’s playbook.”

Amiri said the surveillance by ORR and the state of Missouri were invasions of privacy. "To have your intimate information in the hands of the government for whatever the government’s purpose is in both situations is concerning,” Amiri said.

But knowing exactly what this data will be used for can be tricky, as Amiri hasn’t deposed Lloyd. “It’s a mystery, and that just reinforces the idea that there should be no reason to keep this level of detail on any individual," Amiri told VICE. "There is no legitimate reason to track this level of detail of any person by the government.”

At least one of the girls Amiri represented was detained in Texas, which bans abortions after 20 weeks. After weeks of delays, a judge ruled that Jane Doe could obtain an abortion, and she was more than 15 weeks along when she had the procedure.

The spreadsheet in Missouri was used to determine that four patients had had “failed abortions” that weren’t properly reported to the state, an infraction the state could try to use to deny the clinic its license to perform abortions.

While the period tracking may have different ends, the tactics are incredibly similar. “It’s odd, and I wonder if the official in Missouri got the idea from Scott Lloyd,” Amiri said. “Given how much the Trump administration has given the green light to anti-abortion politicians in the states to infringe on people’s right to access abortion, I wouldn’t be surprised if this was something ripped out of the Trump administration’s playbook.”

Roe v. Wade found that the right to abortion is guaranteed under the "right to privacy" as enshrined in the due process clause of the Fourteenth Amendment. And while fighting to hold up the right to abortion, it looks like the Missouri clinic and its supporters have stumbled down an entirely new path along that right to privacy.

The hearings before the state's administrative hearing commission will continue all week, but a ruling isn’t expected until at least February 2020, the Associated Press reported. The Missouri clinic remains open in the meantime.

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