Missouri judge blocks some, not all, abortion restrictions. What that means for restoring access

KANSAS CITY, Mo. — A Missouri judge on Friday blocked a series of long-standing restrictions on abortion, but kept in place a licensing requirement that could delay providers from immediately restoring access to the procedure.

The decision from Jackson County Circuit Court Judge Jerri Zhang came after voters last month overturned the state’s abortion ban and enshrined a right to reproductive freedom in the state constitution.

Zhang issued a preliminary injunction blocking state officials from enforcing a series of abortion restrictions. The restrictions include a requirement that patients wait 72 hours between seeing a doctor and having an abortion and another that requires doctors to be physically present when a patient takes medication abortion.

However, Zhang kept in place a requirement that abortion facilities must be licensed by the state, a key decision that could pose a hurdle for providers by giving the state power to deny licenses. Zhang also kept in place several other restrictions, including a regulation that only physicians can perform abortions.

Planned Parenthood has said it planned to begin offering medication abortions in Kansas City, Columbia and St. Louis if Zhang halted all of the restrictions. The nonprofit organization, which operates clinics across the state, filed a lawsuit challenging the state laws the day after the November election, leading to the judge’s decision.

Planned Parenthood did not immediately say whether it would be able to restore access to abortions after Friday’s ruling, which blocked some but not all of the regulations.

Whether Zhang’s ruling will remain in place isn’t clear. Missouri Attorney General Andrew Bailey, who is defending the restrictions, is certain to appeal parts of the decision. The case is likely to end up before the Missouri Supreme Court.

A spokesperson for Bailey did not immediately respond to a request for comment.

If Zhang’s decision allows Planned Parenthood to eventually resume offering abortions, it will mark a dramatic return for abortion access in Missouri. Abortion had been illegal since a statewide ban took effect moments after the U.S. Supreme Court ended the federal right to abortion in 2022.

Even before the ban, abortion access was limited to a single Planned Parenthood clinic in St. Louis. State lawmakers spent decades whittling away access through progressively more stringent restrictions, after the Roe v. Wade decision in 1973 required Missouri to allow legal abortion.

But Missouri residents on Nov. 5 approved Amendment 3, a ballot measure championed by abortion rights advocates and providers, that provides a fundamental right to reproductive freedom. The final vote was 51.6% in favor and 48.4% opposed.

Zhang’s order on Friday was largely in favor of abortion rights proponents. The ruling blocked a slew of restrictions on the procedure, including the 72-hour waiting period and another requirement that doctors have admitting privileges at a hospital no more than 15 minutes away.

However, Zhang denied a request to block a licensing requirement for abortion facilities. This gives the Missouri Department of Health and Services the power to issue — and potentially deny — facilities licenses to perform abortions. Zhang also kept in place other restrictions such as a requirement that patients have an in-person appointment before receiving pills used in medication abortions.

The appeals process also leaves open the possibility that some of the blocked restrictions will eventually be restored, forcing providers to comply with rules they say are onerous. Zhang’s decision is preliminary and a full trial is potentially months away.

“Obviously, we hope to prevail at trial,” Missouri Solicitor General Joshua Divine said during a December hearing. “We’re going to take this through appeals and fight this all the way.”

The decision by Zhang, a 2021 appointee of Republican Gov. Mike Parson, came after a more than three-hour hearing on Dec. 4, where lawyers for Planned Parenthood and the Missouri Attorney General’s Office fought over whether the restrictions are unconstitutional.

The lawsuit takes aim at the regulations — a patchwork of TRAP laws, or “targeted regulation of abortion providers,” that lawmakers enacted over the years.

Bailey’s office contended that while Amendment 3 does end Missouri’s near-total abortion ban, it also protects a right to childbirth. The measure lists childbirth among the matters related to reproductive health care in which the government cannot deny or infringe on someone’s rights.

Some abortion restrictions should remain because of that right to childbirth, Divine told Zhang during the hearing. “There’s no actual individual women in this lawsuit and that’s because it’s not in their interest to eliminate these statutes,” he said.

Lawyers for Planned Parenthood said Amendment 3 includes a “very clear standard” for the court to apply. The measure requires any restrictions on abortion before fetal viability must be “presumed invalid” unless the government shows it has a compelling interest achieved by the least-restrictive means.

“The Missouri government has spent decades passing and enforcing laws that restrict abortions … the voters have now changed all that,” Planned Parenthood attorney Eleanor Spottswood said.

Amendment 3 may not be the last time Missouri voters weigh in on abortion. Republican lawmakers are already moving to restore some level of an abortion ban, introducing a slew of measures aimed at rolling back the new constitutional rights.

At least 11 pieces of legislation were filed during the first week of bill filing center on curtailing, or outlawing abortion access. They range from bills that make a modest gesture toward access to constitutional amendments that would almost entirely overhaul Amendment 3 and once again enact a near-total abortion ban.

Sen. Rick Brattin, a Republican, told reporters recently that lawmakers will be “trying to unravel what people unfortunately passed.”