COLUMBIA, Mo. (AP) — Planned Parenthood on Thursday resumed surgical abortions in St. Louis, months after voters in November enshrined abortion rights in the Missouri Constitution.
The same day, the state health department effectively blocked medication abortions throughout Missouri.
The decision leaves abortion access in Missouri in a confusing state: surgical abortions are legal, but Planned Parenthood still cannot offer medication abortions.
Where are surgical abortions offered?
Planned Parenthood now offers surgical abortions in Kansas City, Columbia and St. Louis.
Planned Parenthood Great Plains in February at a Kansas City area clinic performed the first abortion in the state since the fall of Roe v. Wade. A Columbia clinic restarted abortions earlier this month. The first abortion at the St. Louis center since 2022 occurred Thursday.
“We stand ready to welcome more patients to ensure they can get the care they need, when they need it,” Great Rivers President and CEO Margot Riphagen said in a statement.
A history of Missouri abortion laws
Missouri banned almost all abortions in 2022, when the U.S. Supreme Court overturned Roe v. Wade. The ban included exceptions in cases of emergencies, but not for rape or incest.
Voters in November responded by passing a constitutional amendment protecting reproductive rights.
While many believed the amendment would undo the ban, the measure left it up to judges to decide whether the state's long list of laws and other regulations are now unconstitutional. A lawsuit filed by Planned Parenthood and other abortion-rights advocates to overturn most of the state's abortion laws is set for trial in January 2026.
What about medication abortions?
Planned Parenthood currently cannot provide medication abortions in Missouri, but affiliates in February submitted complication plans to the state health department in order to begin offering medication abortions.
Complication plans detail what clinics will do in case of complications from abortions.
On March 13, the Department of Health and Senior Services filed emergency complication plan regulations to “protect Missourians’ access to safe and reliable care,” according to the rule.
“The rule will ensure that women can quickly and safely receive proper emergency care for abortion-related complications at a convenient location,” the regulation states.
The regulations took effect Thursday. That day, the health department notified Planned Parenthood that its complication plans do not comply with the new rules, without being more specific.
A spokesperson for the health department did not immediately return Associated Press requests for comment Friday.
Planned Parenthood Great Plains President and CEO Emily Wales said medication abortion is popular among patients, who might want a less-invasive abortion because of past abuse.
“We do have patients who've contacted us in the last few months who prefer medication abortion and who will choose to travel rather than exercise their right to abortion in Missouri because medication isn’t available to them,” Wales said.
Republicans push back
GOP Attorney General Andrew Bailey, whose office is defending Missouri's abortion laws in court, in March ordered Planned Parenthood to not provide medication abortions because the health department has not approved its complication plans.
“This cease and desist letter ensures that basic health and safety standards are met,” Bailey said in a statement after issuing the order. "Given Planned Parenthood’s history, I will continue to ensure their compliance with state law.”
Planned Parenthood said it has no plans to provide medication abortions without proper permission.
“There was nothing to cease and desist,” Wales said.
Missouri's Republican-led Legislature, which passed the near-total ban, is trying again to limit abortions.
A House committee next week is scheduled to advance a new constitutional amendment that would impose additional restrictions on abortion, GOP House Speaker Jon Patterson said.
Any proposed amendment would need to be approved by voters.
It's unclear exactly how House lawmakers want to further regulation abortions. Patterson said the legislation is currently in negotiations.
Summer Ballentine, The Associated Press
