ST. LOUIS — Providers across Missouri are resuming abortion services, months after voters approved a measure to enshrine reproductive rights in the state constitution.
Planned Parenthood’s Midtown location in Kansas City, Missouri, opened up its doors on Feb. 15 to help its first abortion patient — a Missouri resident who’d planned to travel to Kansas to seek care. They were able to get medical treatment closer to home instead.
“We’re really lucky to get ahold of a patient who was thrilled to get to come in earlier than she’d expected,” said Emily Wales, president and CEO of Planned Parenthood Great Plains.
Abortions are available again in Missouri, two and a half years after the state became the first in the country to ban abortion following the Supreme Court’s 2022 reversal of Roe v. Wade.
Residents and medical providers had been in limbo since voters backed a constitutional amendment for reproductive freedom in November’s election. Almost immediately after Amendment 3 passed, Planned Parenthood filed a lawsuit to restore abortion access. Since then, the issue has been caught in a legal back-and-forth as opponents challenged the amendment and providers fought challenges. In early February, a judge temporarily halted a key challenge prohibiting abortions from being performed in the state.
Clinic staff volunteered right away to come in as they navigated how to open up care to the public, Wales said.
During the ban, patients seeking abortion care in Missouri had to travel elsewhere. According to data from Planned Parenthood Great Plains, 25 percent of patients in Kansas came from Missouri, 15 percent from Oklahoma, and the majority — 28 percent — traveled from Texas.
Since Feb. 15, Planned Parenthood’s Kansas City, Missouri, location said it has provided one abortion in the city’s Midtown location and four in Columbia.
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Patients in Columbia, which is about halfway between St. Louis and Kansas City, were able to seek abortion care for the first time since 2018, about four years before Roe was overturned. That location stopped performing abortions in 2018 when its license expired after it could not meet several state restrictions, including one that required abortion providers to have admitting privileges at a local hospital.
About two hours away in St. Louis, the recovery room in the Planned Parenthood in the Central West End sits empty. It’s one of the clinics that are, in some ways, starting from scratch. The clinic is looking to bring back the staff, equipment and medications required for abortion care, said Dr. Margaret Baum, interim chief medical officer at Planned Parenthood Great Rivers, which serves St. Louis and Southwest Missouri.
“All of our resources went to Illinois, our staff and our equipment and our medications, everything, because Illinois let us take care of patients as we know how they need to be taken care of. So now we are actively working to reopen here. So restaffing, bringing back things, getting everything set up,” she said.
It’s a process that will take time. Mary Ziegler, a law professor at University of California Davis, likened the process to when the Supreme Court first ruled in Roe V. Wade in 1973.
“It wasn’t as if the court made a decision and magically, clinics appeared,” she said. “People had to decide how they were going to provide services, raise money to start … all of that needed to happen.”
Legal challenges and restrictions
In the weeks after November’s election, lawmakers challenged attempts to restart abortion in the state. The state said that clinics did not meet licensing restrictions on abortion clinics.
In a three-page ruling on Feb. 14 blocking those restrictions, Jackson County Circuit Court Judge Jerri Zhang said the statues and regulations the state referenced “apply only to abortion facilities and not to any other similarly situated health care facility.”
“The regulations mandate physicians to perform certain exams and testing that are unnecessary when the physicians themselves are authorized and enabled to make the determination on what is and is not necessary for their individual patients,” Zhang wrote.
While the ruling allowed abortions to resume, it is only temporary. Another hearing is scheduled for January 2026, said Margot Riphagen, president of Planned Parenthood Great Rivers.
In the meantime, one concern for Baum is misinformation.
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Attorney General Andrew Bailey announced last week his office intended to serve a cease and desist letter to Planned Parenthood, claiming it was violating state law because it did not have an approved complication plan for the small number of patients who have adverse effects from medication abortion.
Bailey referenced concerns often touted by the anti-abortion movement about the FDA’s approval of the drug mifepristone, considered safe by the medical community. Bailey wrote that “chemically inducing an abortion creates a serious risk of injury.” This echoes a since-retracted study about emergency room visits by patients who’d had medication abortions.
“The Courts have stripped away basic licensing requirements that protect women, but I will not stand by while Planned Parenthood continues to flout the law and put women’s lives at risk,” he said in a press release.
In a letter responding to these claims, Planned Parenthood said it was not providing medication abortion and was waiting for the state to approve its complication plan, which it filed about two weeks earlier. It called the notice “baseless political posturing.”
“To date, Great Rivers has received zero response from DHSS despite our repeated follow up inquiries. Rather than urging DHSS to respond to Great Rivers’s weeks-ago-submitted proposed complication plan, you instead threaten to ‘take action’ against Great Rivers for hypothetical, future medication abortion occurring without such a plan,” the letter, signed by Riphagen, read.
DHSS confirmed to PBS News that Planned Parenthood Great Plains’ plan was received Feb. 19, and Planned Parenthood Great Rivers’ plan was received Feb. 20.
“I do not have an anticipated timeline for approval or denial of the pending complication plans,” Lisa Cox, communications director for the department, said by email.
The attorney general’s office did not respond to a request for comment.
What this means for the region
This 2022 file photo shows protesters on the lot of St. Louis Planned Parenthood after the United States Supreme Court ruled in the Dobbs v. Women’s Health Organization abortion case, overturning the landmark Roe v Wade abortion decision. Today, patients in Missouri, Kansas and Illinois can access abortion care. File photo by Lawrence Bryant/ Reuters
Today, Missouri and its neighbors, Kansas and Illinois, allow abortions again, Baum said, which could mean some people may not have to travel as far.
“Every day that I provide abortion care in Illinois, I see patients from Texas, Louisiana, Florida, Mississippi, Tennessee, all over … and it is routine to hear, ‘I got up at four yesterday morning and we drove 13 hours,” Baum said. “And then folks get a three-minute procedure, sit in a recovery room for half an hour, and they’re getting right back in their car to drive home.”
Missouri is one of seven states that passed amendments codifying abortion in their constitutions in November’s election. Measures in Nebraska, South Dakota, and Florida all failed.
While some states offer more robust protections now than they did under Roe v. Wade, in some ways the opposite can also be true, Ziegler said.
“If there were some sort of federal limit, it would override whatever Missouri voters had tried to do and that obviously means the protections. So the protections in some way are stronger in the sense that they reflect the will of the people of Missouri, but they’re also weaker in the sense that if the federal government were to put its thumb on the scale, Missourians wouldn’t be able to do a whole lot about that other than vote against people who did that,” she said.
