Many of Missouri’s abortion regulations, including laws that Planned Parenthood said made it impossible for providers to prescribe medication abortion, were struck down in a ruling Thursday by a Jackson County judge.
One of the regulations most widely condemned by abortion rights supporters, a 72-hour waiting period between an initial consultation and an abortion, has been unenforceable for several months under a temporary ruling. The 20-page decision from Jackson County Circuit Judge Jerri Zhang makes that decision permanent.
One of the few laws upheld Thursday by Zhang is a requirement that patients meet with a doctor in-person before being prescribed medication abortion. Zhang also upheld a requirement that only physicians can perform abortions.
In the ruling, Zhang alluded to the long and contentious political fights over abortion and her “limited constitutional role in this much broader discussion.”
The ruling comes after a 10-day-long bench trial played out in January in Kansas City in which Zhang heard from abortion providers, Planned Parenthood employees and women who underwent abortions they later regretted. And it comes more than 18 months after voters passed a constitutional amendment protecting the right to abortion up to the point of fetal viability.
“Debate and litigation around the topic of abortion has occurred for several decades. It is a deeply personal, philosophical, and moral issue to many on both sides of the argument. It has also played a significant role in elected politics,” Zhang wrote in her decision Thursday. “ … It is clear to this court that the beliefs surrounding abortion are, and will continue to be, an ongoing conversation and debate in American society.”
The ruling opens up access to medication abortion for Missourians for the first time since 2018. Medication abortion is the most common method to end a pregnancy in the United States, used in about two-thirds of abortions. Planned Parenthood in a statement Thursday said it will begin offering medication abortion appointments next week.
“This decision brings compassion and common sense back to Missouri health care,” Emily Wales, president and CEO of Planned Parenthood Great Plains said in a statement. “For too long, politicians forced patients to leave the state for an evidence-based and trusted form of abortion care. Now, that care is coming home and with it, we move closer to fulfilling the promise of reproductive freedom Missourians demanded.”
Missouri Attorney General Catherine Hanaway said in a statement Thursday that she plans to “expeditiously” appeal the decision to the Missouri Supreme Court.
“This radical decision gives abortion providers a free pass to police themselves,” Hanaway said. “Women are no longer entitled to the same level of care in an abortion clinic that they would receive in other healthcare settings: providers are no longer required to maintain complication plans or insurance, and the state cannot even conduct basic health and safety inspections to ensure patient safety.”
The laws declared unconstitutional by Zhang include:
- Special licensing requirements for abortion providers.
- A ban on telemedicine that requires a physician be present when a patient takes abortion medication.
- Hospital admitting privileges for physicians performing abortions.
- A requirement for physicians prescribing medication abortions to have a state-approved complication plan.
- That medication abortion providers carry insurance covering physicians after they leave employment.
- Tissue removed during a surgical abortion be sent to a pathologist
- That patients be given material created by the state Department of Health and Senior Services, including a pamphlet that reads “The life of each human being begins at conception. Abortion will terminate the life of a separate, unique, living human being.”
Medication abortion appointments will be available at the Planned Parenthood clinics in Kansas City and St. Louis on Monday and in Columbia on Wednesday, spokespeople said Thursday.
In post-trial briefings filed in April, the Missouri attorney general’s office argued that Planned Parenthood “brings this case to eliminate nearly all of Missouri’s health and safety abortion laws in one fell swoop.”
The ACLU of Missouri and Planned Parenthood, who filed the lawsuit immediately following the November 2024 election, argued that the abortion regulations were designed to ensure abortion was “regulated out of existence” by creating logistical nightmares for patients and ethical dilemmas for providers without making procedures safer.
In 2022, Missouri became the first state to ban nearly all abortions after the U.S. Supreme Court overturned Roe v. Wade. In 2024, Missouri also became the first state to overturn an abortion ban by the vote of the people.
In response, lawmakers sent voters a new proposal that would ban abortion with limited exceptions for survivors of rape and incest. Missourians will vote on the measure listed as Amendment 3 in November.
“The role of the court is to apply the law in any given case,” Zhang wrote, “and to base its decision solely on its interpretation of the law as applied to the evidence before it.”
