What to know about abortion access in Missouri

KANSAS CITY, Mo. (AP) — Planned Parenthood wanted to resume offering abortions in several Missouri clinics on Friday, immediately after a newly passed constitutional amendment rolling back the state’s near-total ban took effect, but they remain on hold as a complicated court battle drags on.

The issue is that the amendment does not specifically override any state laws. And even before the end of Roe v. Wade enabled Missouri's Republican-led legislature to approve a near-total ban, the state's numerous restrictions left it with just one abortion clinic, in St. Louis.

Missouri's Republican attorney general says many of those old laws — like a 72-hour waiting period — should still be enforced despite the amendment; Planned Parenthood says they shouldn't.

Prosecutors are caught in the middle. They want a preliminary injunction halting enforcement of the old laws while attorneys argue about what to do.

But so far, Jackson County Circuit Judge Jerri Zhang hasn't acted on that request.

“As of today, Missourians have an unrealized constitutional right,” said Emily Wales, president and CEO of the Planned Parenthood Great Plains in a written statement. "They are entitled to access abortion under the state’s constitution, and every day they cannot get that care here at home, their rights are being violated.”

Here is what to know about the complicated legal battle and the state of abortion access:

Missouri was one of several states that moved to expand access

Missouri is one of five states where voters approved ballot measures in November adding the right to an abortion to their state constitutions. Ultimately approved by almost 52% of voters, it guarantees people's right to make decisions about their reproductive health, such as whether to get an abortion, take birth control or get in vitro fertilization.

While the amendment is widely understood to prevent the state from restricting abortions up to the point of viability, abortion-rights advocates must persuade judges to prevent old regulations from being enforced.

“There were certainly people who thought the issue was decided after the vote — that we would have access," Wales said Friday. “We’ve had patients calling for weeks now saying, ‘Can I get in? Can I stay close to home?’ Of course, that’s not true.”

Reproductive rights activists are also suing to dismantle Arizona's 15-week abortion ban that conflicts with the fundamental right to abortion voters approved.

Maryland's new abortion rights amendment won't make an immediate difference, since the state already allows access to abortion. It's a similar situation in Montana, where abortion is already legal until viability. Colorado's measure enshrined already-existing access and undoes an earlier amendment that prohibited state and local government funding for abortion, opening the possibility of state Medicaid and government employee insurance plans covering care.

From voting booths to a courtroom in Kansas City

The day after voters approved Missouri's amendment, the two Planned Parenthood branches asked a judge to find the state’s near-total ban and most of its other abortion regulations unenforceable.

Republican Attorney General Andrew Bailey has already conceded that most abortions are now legal. He issued an opinion last month, stating that he will not enforce Missouri's ban on abortions before viability.

But his office is still fighting to keep a 72-hour waiting period before an abortion can be performed; bans on abortions based on race, sex or a possible Down syndrome diagnosis; and a requirement that medical facilities that provide abortions be licensed as ambulatory surgical centers, among other regulations.

The amendment leaves attorneys struggling with old laws

This patchwork of old laws is a big problem for abortion providers. They say those restrictions had effectively blocked abortions across most of the state even before Missouri enacted a law banning all abortions except in cases of medical emergency, minutes after Roe was toppled.

“We have already been living in a post-Roe world,” Dr. Iman Alsaden, the medical director of the Planned Parenthood Great Plains, said at the time.

But Missouri Solicitor General Josh Divine has defended these laws, arguing that most women regret their abortions and that the requirements are designed to give them the time to think through their decisions.

"What we are trying to do is create a situation where women can in fact make the choice they want to do — and we know that most of the time that is childbirth,” Divine said after a court hearing Wednesday.

Wales, of Planned Parenthood, said Missourians showed at the ballot box that they value reproductive rights. And she expressed frustration with what she described as "an Attorney General’s office that has made clear it will fight tooth and nail to prevent Missourians from accessing their new constitutional right to reproductive freedom.”

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Ballentine reported from Columbia, Missouri.