Missourians can once again obtain medication abortions at clinics in St. Louis and other parts of the state after a Jackson County Circuit Court judge permanently blocked several abortion restrictions that had prevented providers from offering the care.
Judge Jerri Zhang’s ruling last month struck down numerous state abortion regulations, including Missouri’s abortion ban, the 72-hour waiting period, abortion facility licensing requirements, physician-admitting privileges requirements, medication abortion complication plan mandates, pathology requirements and reporting requirements.
Medication abortion is a nonsurgical method of ending an established early pregnancy, typically through 10 weeks. It uses two medications — mifepristone and misoprostol — taken over one to two days and is the most common form of abortion care in the United States.
Following the ruling, Planned Parenthood resumed offering medication abortions at clinics in St. Louis, Kansas City and Columbia, restoring a service that had not been available in Missouri for years.
“Once again, the courts have affirmed Missourians’ constitutional right to access abortion without interference or delays from their government,” said Margot Riphagen-Dunn, president and CEO of Planned Parenthood Great Rivers. “The truth is: medication abortion is the most common form of abortion care and has been proven to be safe and effective for the past 25 years. Yet, since Missourians voted for abortion access in 2024, it has been impossible to access the full spectrum of abortion care in our own state.
“That ends today,” Riphagen-Dunn said.
The ruling follows Missouri voters’ approval of Amendment 3 in November 2024, which added a right to reproductive freedom to the Missouri Constitution. Although that amendment restored abortion rights, abortion providers argued that numerous pre-existing state laws and regulations continued to prevent them from offering the full range of abortion services.
The ruling expanded clinics’ ability to provide medication abortion but did not allow fully remote telehealth abortions. Patients must still be seen in person and receive the medication at a clinic. Missouri also continues to require that only licensed physicians provide abortion care.
Gillian Wilcox, director of litigation at the ACLU of Missouri, called the ruling “a monumental win for reproductive freedom and abortion access.”
The decision could have a significant impact on access to care. During 2023, when abortion services were largely unavailable in Missouri, the state recorded just 37 abortions performed within its borders while thousands of Missouri residents traveled to Kansas, Illinois and other states to obtain abortion care.
Emily Wales, president and CEO of Comprehensive Health of Planned Parenthood Great Plains, said the ruling allows more patients to receive care closer to home.
“For too long, politicians forced patients to leave the state for an evidence-based and trusted form of abortion care,” Wales said.
Missouri Attorney General Catherine Hanaway said she will appeal the ruling to the Missouri Supreme Court.
“My heart is broken by today’s ruling. This is exactly the Pandora’s box we warned of, and the women of Missouri will pay the price. … My office will expeditiously appeal this dangerous decision to the Missouri Supreme Court, and I will never stop fighting for the safety of women and children,” Hanaway said.
The legal battle is expected to continue. Missouri voters will decide in November whether to approve a constitutional amendment that would repeal the reproductive-rights protections adopted by voters in 2024.
“This decision brings compassion and common sense back to Missouri health care,” Wales said. “Now, that care is coming home and with it, we move closer to fulfilling the promise of reproductive freedom Missourians demanded.”
Sylvester Brown Jr. is the Deaconess Foundation Community Advocacy Fellow.