The landscape of abortion rights in Missouri could change drastically because of a trial set to begin Monday in Jackson County Circuit Court.
Over the course of 10 days, abortion providers, anti-abortion doctors, patients, and others with ties to reproductive health care are expected to testify in front of Judge Jerri Zhang on the impacts of the state's so-called TRAP laws, or targeted regulations of abortion providers.
According to attorneys for Comprehensive Health of Planned Parenthood Great Plains and Planned Parenthood Great Rivers, which brought the lawsuit along with the ACLU of Missouri, these abortion restrictions violate "Missouri's fundamental right to reproductive freedom."
In court documents filed before the trial, Planned Parenthood attorneys write they will demonstrate the "breadth and complexity" of restrictions the state has imposed on abortion providers long before Roe v. Wade was overturned in 2022.
"For decades, the State has worked to legislate and regulate abortion out of existence. And it has been tremendously successful," ACLU of Missouri attorney Gillian Wilcox writes. "Long before the Dobbs decision allowed Missouri's multiple abortion bans to take effect, the other statutes and regulations Plaintiffs challenge had decimated access to what is now constitutionally-protected health care for Missourians."
Attorneys for the state disagree, instead suggesting these laws have given women seeking an abortion necessary statutory rights against abortion providers. Attorney General Catherine Hanaway and Solicitor General Louis Capozzi argue in pretrial documents that the laws in question in Monday's trial are critical to protecting mothers from bad actors and to preserving the right to childbirth.
"Planned Parenthood will not provide the Court with one patient to speak to her experience with abortion. Not one," the brief reads. "Instead, Plaintiffs (Planned Parenthood) invite the Court to rely on the say-so of their own employees and a few activist experts."
Even though Missourians passed a constitutional amendment in November 2024 that enshrines the right to an abortion up until fetal viability, TRAP laws and several other regulations on the procedure and providers remain on the books. State lawmakers also approved a trigger ban on abortions, which automatically went into effect after the overturn of Roe v. Wade and remained active.
Planned Parenthood asked the Jackson County Circuit Court to block all these laws shortly after Missouri voters passed Amendment 3 in 2024.
In a series of decisions since, Judge Zhang has granted Planned Parenthood's request to temporarily block the state's trigger ban on abortions and several additional TRAP laws, including requirements that:
- abortion clinics be located within 30 miles or 15 minutes of a hospital where the clinic's doctors have admitting privileges,
- patients wait 72 hours between initial consultation and when a procedure is performed,
- pelvic exams be performed before every procedure,
- and an informed consent booklet be distributed before an abortion.
Zhang also blocked an abortion facility licensing requirement.
Hanaway and Capozzi argue in court documents that Planned Parenthood's attempt to block these requirements defies common sense.
"If the right to reproductive freedom means anything, it must mean that a patient has a right to understand the decisions she is making, rather than having anyone rush her into irreversible decisions without fully informed consent or less than three days to consider her options after viewing an ultrasound," they write.
Abortion providers in Missouri are still unable to prescribe medication abortions because two regulations — a complication plan approved by the state and a supplemental insurance requirement — were not blocked. Medication abortion is the most commonly used method to terminate a pregnancy in the U.S.
Following Zhang's injunction, Planned Parenthood began offering in-clinic abortions.
According to the Missouri Independent, between then and October 2025, only 80 abortions have been performed across clinics in Kansas City, St. Louis and Columbia. While that's a stark contrast to 2023 and 2024, when no elective abortions were performed in the state, many patients still needed to seek care out of state.
According to the Kansas Department of Health and Environment, more than 15,000 women from other states got abortions in Kansas in 2024, the most recent year for which data is available. Most of those women came from Texas, Ohio and Missouri.
Abortion advocates in Missouri say that is likely to remain the case until the state's provider regulations are entirely off the books and a now-gutted care system can rebuild.
"There's going to be a lot of discussion with the court in the next couple of weeks explaining why those laws are discriminatory and go exactly against what the constitutional protection provides," Planned Parenthood Great Plains CEO Emily Wales told KCUR's Up To Date last week.
Regardless of the outcome in the trial beginning Monday, the case is likely to reach the state Supreme Court.
And Missouri lawmakers continue to prioritize abortion regulations. This year's November ballot will include a proposed abortion ban that would undo the 2024 amendment voters approved.
In that case, a three-judge panel ruled late last year that Secretary of State Denny Hoskins erred in the crafting of ballot language and did not sufficiently inform voters of the changes it would impose. Rather than allow Hoskins another chance at the verbiage, the judges issued new ballot language for the proposed amendment.
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