The hearing in St. Louis before a commissioner with the Missouri Administrative Hearing Commission was expected to last five days but wrapped up a day early. A ruling isn’t expected until February at the earliest.

The state health department wants to revoke the license for Planned Parenthood’s St. Louis clinic, citing concerns about four instances of what the state called “failed abortions.” Planned Parenthood officials say conservatives are trying to use the licensing process to end abortions in Missouri.

Revocation would make Missouri the first state since 1974, the year after the Supreme Court’s Roe v. Wade decision, without a functioning abortion clinic. The St. Louis clinic remains open pending the commission’s ruling.

Kawanna Shannon, director of surgical services at the clinic, testified that the state’s March inspection was tense from the start. It was the first inspection under the administration of Republican Gov. Mike Parson, a staunch abortion opponent who ascended to governor in June 2018 after Republican Gov. Eric Greitens resigned.

Investigators were adamant that the clinic should be performing two pelvic exams before an abortion, at a patient’s first visit and again immediately before the procedure. The clinic initially agreed to the second exam, but soon decided it was so “unbearable” for patients that it stopped in defiance of the state law, Shannon said, her voice breaking.

“Patients were made to get unnecessarily violated,” Shannon said.

The health department relented in June, issuing an emergency rule relieving Planned Parenthood of the requirement.

Shannon said that a month after the March inspection, a top health department official showed up to scrutinize records. That investigator was William Koebel, chief of the division that oversees licensing of abortion clinics and other surgical centers. Koebel told Shannon he was there in response to an unspecified complaint, Shannon said. She later learned it was Koebel himself who filed the complaint, she said.

The investigation eventually turned up four instances where women required multiple procedures before abortions were successfully completed.