A recovery room at the Planned Parenthood Great Plains office is pictured on June 21, 2024, in Overland Park, Kansas (Anna Spoerre/Missouri Independent).
Nearly two months after a voter-approved constitutional amendment legalizing abortion went into effect, the procedure remains inaccessible in Missouri.
On Friday, a Jackson County judge heard arguments over whether to grant an injunction requested by Planned Parenthood that would permit the organization to offer abortion services almost immediately.
Last month, Jackson County Judge Jerri Zhang struck down a number of “targeted regulation of abortion provider” statutes, better known as TRAP laws.
Laws mandating a 72-hour waiting period for an abortion and a requirement that physicians performing the procedure have admitting privileges at nearby hospitals were put on hold.
But other regulations the judge allowed to remain — such as state licensing requirements and a mandate to receive a pelvic exam before being prescribed the pill used in medication abortion — have left clinics unable to perform the procedure in Missouri.
On Friday afternoon, Zhang again listened to arguments from Planned Parenthood and the Missouri Attorney General’s Office during the hearing in downtown Kansas City.
Missouri judge strikes down abortion ban, but clinics say access remains blocked
“We have still not been able to restore abortion access in Missouri,” Eleanor Spottswood, an attorney with Planned Parenthood, argued Friday.
Zhang asked how Planned Parenthood clinics would be regulated if she were to strike down the current licensing requirements from the Missouri Department of Health and Senior Services. Spottswood said that like other outpatient practices, the facility would not require a license, but the providers would need to meet their own professional licensing requirements through the Missouri Board of Healing Arts.
Planned Parenthood is currently held to a much higher threshold of regulations, she said.
Pottswood said if the judge strikes down the remaining TRAP laws, it’s Planned Parenthood’s intention to offer medication abortions at all nine clinics across the state within a week The organization hopes it can hire and train the necessary staff to also begin performing surgical abortions at its clinics in St. Louis and Kansas City.
The state previously asked that the case be dismissed, arguing that because abortion is still accessible by mail or by leaving the state, Planned Parenthood didn’t have the standing to ask for a temporary ruling.
Much of Friday’s hearing revolved around pelvic exams, which Planned Parenthood’s attorneys maintained are “invasive and unnecessary” ahead of prescribing abortion medication. Instead, Pottswood said, the clinics use other methods to determine if the pregnancy is at risk of being ectopic, meaning the fertilized egg has implanted itself outside the uterus.
Taking abortion medication to end an ectopic pregnancy can be dangerous.
Missouri Solicitor General Joshua Divine argued that pelvic exams ahead of any procedure are “routine care,” and should remain in place.
Zhang asked if hospitals can perform abortions following passage of Amendment 3 last year, seemingly attempting to determine whether the current pelvic exam law is discriminatory against abortion clinics or if it would also be required at hospitals.
Pottswood said they presumably can, but a question remains of whether any will. Divine agreed that while he believes hospitals can now provide abortions, it is “very, very rare” that they do so in Missouri … so there’s not much need to regulate.”
Without a broader injunction, Pottswood argued, “the state will enforce the law in the most obstructive way possible” and “treat abortion providers differently and worse than other providers.”
This interferes with patients rights, she said, which is in violation of Amendment 3, which states in part that “the right to reproductive freedom shall not be denied, interfered with, delayed, or otherwise restricted unless the government demonstrates that such action is justifiable by a compelling governmental interest achieved by the least restrictive means.”
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A decade ago, more than 5,000 abortions were performed in Missouri, according to the Missouri Department of Health and Senior Services. By 2020, when abortions were still legal, that number fell to 167, a drop that abortion providers attributed to the state’s growing list of regulations.
Divine questioned why the Planned Parenthood clinic in St. Louis hadn’t reapplied for a license, since they were the only clinic in the state that still met licensing requirements when the U.S. Supreme Court overturned Roe v. Wade in June 2022. He called the lack of access a “purely self-inflicted injury.”
Missouri’s trigger law banning all abortions with limited exceptions for medical emergencies went into effect the same day, ending the procedure at the St. Louis clinic.
Assuming that the state would grant the license, Pottswood said by limiting patients’ choices to one clinic in the state, “the licensing law inserts the state between the patient and the provider.”
The hearing, which lasted four hours, also discussed the state’s continued objection to the Jackson County prosecutor, formerly Jean Peters Baker and currently Melesa Johnson, being named as the defendants representing all county prosecutors in the case.
The attorney general’s office argues Johnson, who was endorsed by the advocacy arm of Planned Parenthood, does not appropriately represent all statewide prosecutors.
Zhang previously denied the state’s request to remove the Jackson County prosecutor as a representative for the defendant class and move the case to Cole County, where last summer a judge attempted to strike the abortion-rights amendment from the ballot.
On Friday, the prosecutors from Wright, Texas, Franklin and Saline counties showed up in court to continue to object, arguing that because there isn’t a Planned Parenthood clinic in any of their counties, all county prosecutors shouldn’t necessarily be a party in the case.
Zhang said her concern centers around the possibility that residents in any county could be prescribed abortion medication at a clinic before returning to their home counties. She also noted that three of the four counties have emergency rooms where women experiencing any abortion complications could be admitted.
“There could be a risk of prosecution across the state because of telemedicine,” she said.
No specific examples of what cases could be prosecuted were entertained. Tyrrell added that if he did prosecute an abortion case, he was confident he’d quickly find himself again sitting across from Planned Parenthood in a courtroom.
“I won’t swear I won’t and I won’t swear I will prosecute,” Wright County ProsecutorJohn Tyrrell told Zhang. “ … but the likelihood is very, very low.”
Zhang gave both parties one week to file additional briefings. Her decision is expected after that. The bench trial, at which point the judge will make a permanent ruling, has been set for January 2026.
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