Missouri Attorney General Andrew Bailey sent a strongly-worded letter this week demanding that Planned Parenthood Great Rivers not perform medication abortions until state regulators approve what’s known as a complication plan — but that’s already what the organization is doing.
The leader of the St. Louis-based agency is blasting Bailey, calling his action harassment.
Planned Parenthood Great Rivers President and CEO Margot Riphagen accused Bailey of “exploiting the powers of his office to play political games, lie about the safety of medication abortion, and attempt to block patients from their constitutional right to access abortion care.”
On Wednesday, Bailey sent Riphagen a letter stating that his office plans to issue a cease-and-desist order that would prohibit her agency “from performing chemically induced abortions in Missouri for the duration of the order.”
He said the agency needs what’s known as a complication plan that details how clinic staff would react if there’s a medication abortion-related emergency.
And in a press release promoting the letter, Bailey said he “will not stand by while Planned Parenthood continues to flout the law and put women’s lives at risk."
But several clinics, including Planned Parenthood Great Rivers, haven’t resumed medication abortions because they’re waiting for the Department of Health and Senior Services to approve their complication plan. On a recent episode of the Politically Speaking Hour on St. Louis on the Air, Planned Parenthood Great Rivers’ Nick Dunne detailed why the clinic in St. Louis hadn’t resumed medication abortions yet because of the lack of complication plan approval.
“As Bailey is fully aware, Planned Parenthood Great Rivers submitted a complication plan to the state Department of Health and Senior Services on February 20 for approval,” Riphagen said in response to Bailey’s letter. “As of this moment, DHSS has not acknowledged receipt of our complication plan, much less approved it. This is an urgent matter, and once again we see Missouri politicians doing all they can to get between patients and the care they need. Enough is enough.”
Bailey’s deputy chief of staff, James Lawson, said in an email to St. Louis Public Radio that the order “simply provides a forcing function to ensure Planned Parenthood’s compliance with state statute and protect the health of women in Missouri.” He pointed to how the FDA found that a small percentage of people who took medication that induces an abortion end up in the emergency room.
Awaiting word on complication plan approval
Last month, Jackson County Judge Jerri Zhang paved the way for legal abortion when she blocked licensing requirements for clinics. Planned Parenthood clinics in Kansas City and Columbia have since performed procedural abortions since that Feb. 14 ruling.
But because Zhang didn’t freeze the statute requiring the complication plan, clinics in St. Louis, Kansas City and Columbia held off on resuming medication abortions.
It’s unclear when the Department of Health and Senior Services will decide on those agencies’ complication plans.
DHSS spokeswoman Sami Jo Freeman has said she did not have an “anticipated timeline for approval or denial of the pending complication plans.” She added that her department received complication plans from Planned Parenthood Great Plains on Feb. 19, and Planned Parenthood Great Rivers on Feb. 20.
“A primary objective of complication plans is to recognize the importance of the physician-patient relationship by providing for continuity of care and ensuring communication among the physician who induced the abortion and all subsequent health care providers involved in treating the patient's complication,” Freeman said.
Copyright 2025 St. Louis Public Radio
