BY: NATANYA FRIEDHEIM

Doctor David Mehr spoke to a dozen voters gathered Saturday morning at the Columbia headquarters of Missourians for Constitutional Freedom, the coalition behind a proposed amendment that would enshrine the right to abortion in the constitution of Missouri.

Meanwhile, doctors hosted volunteers in St. Louis County, and still others rallied in Kansas City, as part of the coalition’s final mobilization drive before the Nov. 5 election.

“I have taken care of women my whole life,” Mehr told the group of volunteers in Colombia. “It is important that this decision remains between a woman and her doctor.”

Mehr works at University of Missouri Health Care, but spoke as an individual and not on behalf of the hospital.

An hour later, he was wandering a thicket in a northwest Columbia neighborhood, looking for the right door to knock on. By the end of the day, he and his canvassing partner had knocked on 44 doors.

Like other states banning abortion, Missouri state law provides “medical emergency” exceptions. Medical professionals who perform abortions deemed unnecessary may be convicted of a class B felony and have their licenses revoked or suspended.

“There is no definition of what a medical emergency is,” said Betsy Wickstrom, a high-risk obstetrician who works in Kansas City. “So if my patient is bleeding and her cervix is ​​open, there’s still cardiac activity, how much do I need to let her bleed? »

Wickstrom preferred not to disclose his affiliation with the hospital. His reluctance was shared by doctors gathered in St. Louis on Saturday and reflects a broader trend of doctors keeping their workplaces hidden when talking about abortion, identified in a 2023 study.

Last month, a group of 800 Missouri medical professionals, including 500 doctors, signed a letter supporting the abortion rights amendment, which appears on the ballot as Amendment 3.

No doctor in any state has been criminally prosecuted for performing an abortion during a medical emergency, according to an article published last month by the Association of American Medical Colleges. However, doctors across the country have warned that the lack of clarity over what constitutes a medical emergency is undermining their ability to provide emergency abortions.

In August, a group of Missouri obstetrics and gynecology resident physicians anonymously published an article in the Journal of Graduate Medical Education describing their shock and fear of entering the profession in a state where abortion is strictly prohibited.

“Because the text of the law is written in a highly punitive manner, it has instilled fear among clinicians and resulted in the unnecessary delay or blatant denial of life-saving care,” the authors wrote.

Since abortion became illegal in Missouri in 2022, the state has seen a more than 25% decline in applications for OB-GYN medicine residencies, according to a May report from the Association of American Medical Colleges.

In a widely publicized case from 2022, two hospitals, including one in Missouri, turned away Missouri resident Mylissa Farmer when she sought care after her water broke at just 18 weeks pregnant. Last year, the Centers for Medicare and Medicaid found that the two hospitals — Freeman Hospital West in Joplin and the University of Kansas Health System in Kansas City, Kansas — violated federal law by denying care to farmers.

Many other examples of women being denied emergency medical care have appeared in the media since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization ended the constitutional right to abortion.

Health professionals opposed to abortion say the media promotes an exaggerated narrative that banning abortion compromises women’s access to emergency care.

“All state laws permit fetal-maternal separations (by any means necessary) in order to save the life of the mother,” Christina Francis, OB-GYN and CEO of the American Association of Pro-Life OB-GYNs, ” wrote in testimony before the U.S. Senate Finance Committee in September.

In medicine, decisions are rarely made in black and white. When a woman’s water breaks early enough that the viability of the fetus is compromised, abortion is the standard of care, Wickstrom said. As a woman approaches 20 weeks, factors such as bleeding, signs of infection, and the amount of amniotic fluid in the uterus are considered.

Some women want to wait and a doctor guides the patient in this choice.

“Of course we do, because the main thing is to choose. The fact is that it is her body that determines for itself what is good for her, and we come alongside her and support her and guide her in what is good for her,” Wickstrom said.

If a woman does not want to continue with her nonviable pregnancy, the fetus has a heartbeat and her condition is not considered an emergency, she must leave the state to have an abortion, Wickstrom said. In Kansas City and St. Louis, women can more easily travel to clinics offering abortion care in Kansas and Illinois than in central Missouri.

Wickstrom brings his metal water bottle to work at a Kansas City hospital. She keeps it on display when she talks to patients so they can see the stickers adorning it: Right above a cutout of Taylor Swift is a sticker that reads “ABORTION RESOURCES,” followed by a list of phone numbers and website URLs.

Wickstrom said she finds it difficult to speak candidly about the options available to women who have high-risk pregnancies.

“You have to dance around a lot more,” she said, “because the waters are muddy. »

This story was originally published in the Columbian Missourian. It may be republished in print or online.