Why is the St. Louis Planned Parenthood Allowed to Remain Open?

Placenta accreta is a serious complication of pregnancy that is becoming increasingly common. The cause of the increase is related to scarring of the uterus, which can be due to cesarean delivery, curettage for any reason (including post-partum hemorrhage, miscarriage or abortion) and increased parity or maternal age.

When a subsequent pregnancy results in the placenta attaching over the scar there is a possibility of the placenta growing into the uterus at the point of the scar. That is what accreta is: the placenta grows into the uterus in a way that is difficult, if not impossible, to detach.

I have two friends who have experienced this complication. When their OB/GYNs discovered the condition at prenatal visits they were advised that in order to save their lives, they must deliver in a high-risk hospital, and that hysterectomy would be very likely. (The reason being that when the uterus and placenta do not separate, the placenta becomes an open wound and will continue to bleed until there is a successful intervention, or until the blood supply is exhausted, resulting in death.)

Both of my friends ended up having hysterectomies. One required multiple blood transfusions and was so close to death that her body never produced milk for her baby.

Placenta accreta can be diagnosed in pregnancy, and standard medical practice dictates that it should be looked for when a woman has a history of cesarean deliveries and the placenta is overlying the scar.

“Massive Uncontrolled Bleeding”

On April 24, 2019, at the Planned Parenthood abortion facility in St. Louis, Missouri, a woman had an abortion who had a history of cesarean deliveries and was suspected of having placenta previa/accreta.  The fact that she had accreta was not the fault of Planned Parenthood or their physicians. However, that they chose to do the abortion anyway at a facility ill-equipped for the known serious complications was very much their fault. In the words of the Missouri Department of Health and Senior Services:

The treatment provided to “Patient 12” raises particularly grave concerns. Patient 12 was recommended to have a therapeutic abortion after 21 weeks’ gestation. The patient was examined by an RHS [Planned Parenthood Reproductive Health Services] physician at a hospital, who concluded that the patient had placenta previa—which in the majority of cases resolves as the uterus grows and the placenta moves up—and/or placenta accreta, along with a history of C-section. An ultrasound was performed which did not have findings to completely exclude or confirm placenta accreta. If a surgical abortion is to be performed, given the high risks of such a procedure. an ACOG Committee Opinion states that a second-trimester abortion on such a patient should be performed at a facility with blood products and the capacity for interventional radiology and/or hysterectomy; RHS lacks all three. For unexplained reasons, the physician nevertheless referred the patient to RHS’s facility for the second-trimester abortion, where that physician attempted the abortion at a gestational age of 21 weeks and five days. The abortion attempt failed, and it resulted in massive uncontrolled bleeding and an emergency transfer of the patient to the hospital. The patient lost over two liters of blood, underwent a uterine artery embolization, and was described in hospital records as “critically ill”. This complication was both life-threatening and potentially preventable, and the physician’s conduct appears to have potentially deviated from standard care in a manner that inflicted serious patient harm. The physician involved in this incident has refused to be interviewed. and no other physician has first-hand knowledge of the treatment.

In addition to these deficiencies in patient care, it is imperative that your Plan of Correction must address the failure of RHS and its physicians to cooperate in this investigation, which is unprecedented and unacceptable [emphasis in the original]. 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.

When you hear Planned Parenthood complain that the Missouri Department of Health and Senior Services is harassing them—and throwing out red herrings about the Department forcing women to undergo pelvic exams and tracking women’s menstrual periods—remember Patient 12 and Planned Parenthood’s refusal to have the physician responsible for her dangerous abortion discuss it with the Department to prevent reoccurrence.

This is by no means the only case of placenta accreta occurring at an ill-prepared abortion clinic. Stay tuned.

Decision expected soon

Recently an ambulance was called to the Planned Parenthood facility in St. Louis for the 75th time. You might wonder how this abortion clinic—clearly, one of the most notorious in the nation—is allowed to remain open.

In June 2019, the DHSS announced it would not renew the St. Louis Planned Parenthood’s abortion facility license. Planned Parenthood appealed the decision at an administrative hearing in October, and for the time being, the facility is operating on a stay from the Administrative Court. According to NBC News, a decision from the court is expected some time in the coming weeks.

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