Abortion clinics have resumed service in Missouri after voters opted to enshrine abortion rights in the state constitution and a federal judge temporarily blocked restrictions that had lingered after the election.
Abortion providers in the state worry the restoration of access could soon be undone, however, given the breadth of anti-abortion bills being considered by the state legislature.
“I’m happy and optimistic but in the back of my mind I do worry,” said Margaret Baum, chief medical officer for Planned Parenthood Great Rivers, one of two abortion providers in the state outside of hospitals. “Are we going to go backwards again?”
Republican lawmakers in Missouri introduced a slew of bills aimed at weakening or getting rid of the state's newabortion protections at the beginning of the state legislative session in January. Those bills include two proposed constitutional amendments, the first of whichwould outlaw the procedure except in medical emergencies and in cases with fetal anomalies,as well as in some cases involving rape or incest if patients presented required documentation. Lawmakers held a public hearing on the measure last month, a few weeks before abortion services resumed in the state.
If the amendmentpasses the state’s General Assembly, Missourians could vote on whether to adopt itas early as this year.
The second proposed amendment would make abortion illegal after the point of fetal viability, around 24 weeks into pregnancy. Other abortion-related bills state lawmakers have introduced also seek to change at what point an abortion can be performed. House Bill 194,for instance, seeks to prohibit the procedure in Missouri after the detection of a fetal heartbeat.
Lawmakers have targeted medication abortion as well, including in a bill proposing the abortion drug mifepristone be reclassified as a Class IV controlled substance — just as it was under a law passed by Republicans in Louisiana last year.
“The legislature has shown its cards,” said Emily Wales, president and CEO of Planned Parenthood Great Plains, the second abortion provider in the state. “They don’t want people to get reproductive care. They don’t trust people to make their own medical decisions.”
Missouri became the first state to overturn a near-total ban on abortion last year whenvoters approved a constitutional amendment to include a fundamental right to reproductive freedom.
Abortions had previouslybeen outlawed in Missouri since 2022, when the state became the first in the country to enact a trigger law banning the procedure after the Supreme Court overturned Roe v. Wade.
After Roe was overturned, the state’s Planned Parenthood branches were still connecting people to abortions, but Missourians had to travel to clinics in neighboring states Kansas and Illinois.
Soon after the constitutional amendment was approved in November, Planned Parenthood sued the state for its abortion ban and a number of other restrictions on the procedure.
A Jackson County Circuit Court judge ruled in Decemberthat the ban was unenforceable, but did not issue any judgments regarding the state’s other abortion laws, like one requiring abortion facilities to be licensed by the Missouri Department of Health and Senior Services.
The same Jackson County judge issued a temporary injunction on the clinical requirements in February after Planned Parenthood argued they made it impossible for it to provide abortions in the state, allowing the organization to perform the procedure again.
The case is slated to go to trial again in 2026.
Even if none of the proposed legislation passes this year, the future of abortion access in the state will remain precarious until a final decision on the case is made next January, according to Baum.
For now, however, abortion providers at both Planned Parenthood affiliates arereturning to more normal abortion services,though theycan only provide surgical abortions for the time being. The clinics will not be able to give patients abortion pills until the state approves a required plan for reporting complications from taking the drugs.
A Planned Parenthood in Colombia, Mo., started to schedule and see patients for surgical abortions this week.
“As a physician, and just as a human in general, [I think] it is always better for people to get the care they need in the community they live in,” said Imam Alsaden, chief medical director of Planned Parenthood Great Plains. “Or at least as close to the community they live in as possible.”
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