Missouri’s Supreme Court issued a ruling Tuesday effectively banning most abortions in the state, resulting in Planned Parenthood canceling abortion appointments.
Chief Justice Mary R. Russell handed down a decision vacating two lower court rulings from Jackson County Circuit Court Judge Jerri Zhang that had temporarily restored access to abortion services.
Zhang applied the wrong standard in rulings in December and February that allowed abortions to resume by blocking regulations on the abortion industry, Russell wrote. The Jackson County judge used the wrong legal test to grant two injunctions because she failed to consider whether there would be harm from lifting state regulations overseeing the abortion industry, the Missouri Supreme Court ruled.
The case in question surrounds Zhang’s move in recent months to lift a number of the state’s “targeted regulation[s] of abortion providers,” at Planned Parenthood’s request.
Missouri Attorney General Andrew Bailey asked the Supreme Court to reinstate the restrictions, arguing that women “would have no guarantee of health and safety because abortion facilities are functionally unregulated under state law in Missouri.”
After the top court sided with Bailey on Tuesday, Planned Parenthood, which runs the state’s only abortion clinics, immediately started calling patients to cancel abortion appointments at Missouri clinics in Columbia and Kansas City, per NBC News.
However, the order’s text appears to allow Zhang to issue another preliminary injunction blocking the restrictions on abortion access, according to the Kansas City Star. While the Supreme Court judges agreed that Zhang had not met the correct legal standard in issuing a temporary restraining order, they wrote that the Jackson County judge could reissue the order at a later date with different reasoning.
The Missouri Supreme Court ruling marks the latest twist in a yearslong debate over abortion access in the state.
In 2019, the state passed a law banning abortion after eight weeks of pregnancy, restricting pregnancy terminations except for when the life of the mother was in danger.
Due to legal challenges, the law was not enacted until 2022, when the Supreme Court’s decision to overturn Roe v. Wade allowed the near-total abortion ban to take effect.
In November 2024, abortion restrictions were once again rolled back when voters narrowly approved an amendment enshrining abortion access in Missouri’s constitution. Missouri Amendment 3 allowed abortions to be performed until fetal viability, or the point at which the baby can survive outside the womb, which can be as early as the 21-week mark of pregnancy.
But the amendment didn’t necessarily significantly expand abortion access, at least not immediately.
Missouri Amendment 3 did not specifically override any state laws, instead leaving it to the courts to reverse abortion restrictions considered unconstitutional under the new amendment. And there was also the matter of the state’s TRAP laws, which were in place even before the 2019 abortion law took effect in 2022. Among the regulations the abortion industry criticized were TRAP regulations that established a 72-hour waiting period before undergoing an abortion procedure and a provision requiring women seeking abortions first be given the state’s informed consent booklet that outlines the risks of having an abortion and states that “abortion will terminate the life of a separate, unique, living human.”
Planned Parenthood took both issues to court in November, arguing that the near-total abortion ban and the TRAP laws must be overturned to allow the amendment to take effect. The abortion provider asked Zhang to issue a preliminary injunction that would immediately declare the current ban and the TRAP laws unconstitutional.
However, the Missouri Attorney General’s office argued that rolling back TRAP’s regulatory guidance for abortion providers could incentivize unsafe health practices harmful to women and put more pressure on women to have abortions without the full knowledge of the scope of the procedure. Solicitor General Josh Divine cited a study showing that up to 5% of women who took mifepristone, a medication used to induce an abortion, ended up in the emergency room.
“What [Planned Parenthood] is saying is that there’s just no health justification for any of [these TRAP regulations], and, every time they’ve said that in the past, we’ve won in front of a variety of different judges — both in federal courts and state courts,” Divine said. “I’m hoping the judge will just let this go to trial as cases normally do, and we’ll be able to show why the other side is not going to win.”
However, in a December ruling, Zhang handed Planned Parenthood a partial victory, agreeing that Missouri’s near-total abortion ban was unenforceable under the new constitutional amendment. And in addition to waiving the waiting period and informed consent requirements, the Jackson County judge lifted a TRAP provision prohibiting abortions solely because of a diagnosis indicating Down Syndrome and a regulation requiring a doctor to be physically present in the room while a patient takes an abortion-causing medication such as mifepristone. Zhang also blocked another TRAP regulation requiring physicians who perform abortions to have admitting privileges at certain types of hospitals located within 30 miles or 15 minutes of where an abortion is performed.
But because Zhang declined to lift several other TRAP regulations overseeing the abortion industry, Planned Parenthood moved to expand abortion access further, asking the judge to reconsider her ruling.
Among the additional TRAP provisions Planned Parenthood fought to lift were requirements allowing only physicians to perform abortions, a rule mandating in-person appointments before abortions, and a requirement for abortion facilities to be licensed by the Missouri Department of Health and Senior Services.
In February, Zhang handed down a critical victory for Planned Parenthood when she blocked the licensing requirement for abortion clinics.
“Today’s decision is a triumph for all Missourians: for the voters who demanded their rights, for the medical providers we trust to provide care, and most importantly, for patients who will now be able to receive high-quality care without fear,” Emily Wales, the president of Comprehensive Health of Planned Parenthood of Great Plains, said in a statement responding to the February decision. “Abortion care will be restored immediately.”
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Advocates of restricting abortions celebrated Tuesday after the Missouri Supreme Court issued its decision temporarily blocking Zhang’s February and December orders.
“The laws that have been passed over the decades were not only designed to prevent abortions but also to protect the health of women who do get abortions,” Sam Lee, director of Campaign Life Missouri, told National Public Radio. “So we’re happy that those and other pro-life laws are now back in effect. We’ll just see what happens going down the road. But we expect no abortions in Missouri at least for now.”