Regulators in Missouri are in the process of determining whether the state’s last remaining abortion clinic can keep its license to perform abortions, after a hearing wrapped up Thursday.

The hearing before the Missouri Administrative Hearing Commission began on Monday to determine the clinic’s fate. In June, the state refused to grant the Planned Parenthood of the St. Louis Region clinic a license, saying concerns at the facility must first be addressed.

The St. Louis Post-Dispatch reports that after four days of testimony, attorneys in the case will now begin trading paperwork and issuing briefs. Hearing commissioner Sreenivasa Dandamudi is expected to issue a ruling sometime after Feb. 7, 2020.

Missouri’s health department had submitted a “Statement of Deficiencies” of the clinic to a court, which cited an “unprecedented lack of cooperation” on the part of the clinic, as well as its “failure to meet basic standards of patient care.”

The statement also identified four instances of failed abortion procedures at the clinic. Dr. Randall Williams, director of the Missouri Department of Public Health, reportedly used a spreadsheet to track the menstrual periods of Planned Parenthood patients in order to determine which patients had to come back for multiple procedures to complete their abortion.

According to the Post-Dispatch, Planned Parenthood’s attorneys argued that the state “cherry-picked” a “handful of difficult cases” out of an estimated 3,000 abortions performed at the facility.

According to the health department, Planned Parenthood went back on its agreement to perform pelvic examinations as a “preoperative health requirement,” the state said, several doctors at the clinic refused requests to provide interviews with the health department, and the clinic would not have been prepared for a case of “severe hemorrhaging” of a woman that occurred at a hospital.

Kawanna Shannon, director of surgical services at the clinic, testified that the clinic had initially complied with with the pelvic exam requirement, but soon stopped performing them.

The clinic had submitted a “Plan of Correction” as requested by the Missouri Department of Health and Human Services, but it had not properly addressed all the stated deficiencies, the health department said.

Planned Parenthood responded by saying that the health department “weaponized a regulatory process” and required pelvic exams that it admitted were “medically unnecessary” amidst “public outcry and the medical community coming out strongly against” the required exams.

After the state’s refusal to grant a license, a judge and the Administration Hearing Commission both granted a temporary stay of the health department’s decision, allowing the clinic to remain open while the case was reviewed.

Jacinta Florence, Missouri and Arkansas Regional Coordinator for Students for Life, told CNA she did not think the doctors who tesitifed at the hearing this week showed any empathy towards the women who had botched abortions.

“I was also annoyed with [Planned Parenthood’s] use of words,” she said.

“Instead of saying fetal parts when describing a procedure, they used ‘products of conception.’ While a baby is a product of conception, lets call a spade a spade.”

Missouri also enacted a comprehensive abortion ban in 2019, which Governor Mike Parson (R) signed into law in May. The legislation was supported by St. Louis Archbishop Robert Carlson.

Missouri’s law set up a multi-tier ban on abortions after eight weeks, 14 weeks, 18 weeks and 20 weeks, as well as bans on abortions conducted solely because of the baby’s race, sex, or Down syndrome diagnosis.

The law was crafted to be able to survive in the courts, but a federal judge in August struck down all of the bans related to the stage in pregnancy, leaving intact the disability, race and sex-selective abortion bans for the time being.

Meanwhile, as the fate of the St. Louis clinic is being determined, Planned Parenthood has opened a “mega” abortion clinic just 13 miles away across the Mississippi River in Fairview Heights, Illinois that will have the ability to see 11,000 patients annually.

The new clinic replaced a smaller Planned Parenthood clinic in Fairview Heights that offered medication abortions but not surgical abortions.

In a controversial move, the organization used a shell company under which the facility was purportedly being constructed, and tried to shield from public view the fact that the building under construction was an abortion clinic.