Abortion services in Missouri have come to an abrupt halt once again after the state’s Supreme Court ruled Tuesday that a lower court used the wrong legal standard in allowing the procedure to resume.
The two-page ruling from the Missouri Supreme Court directed Circuit Judge Jerri Zhang to vacate her earlier orders, which had temporarily blocked enforcement of the state’s sweeping abortion restrictions. The justices said Zhang’s rationale, that abortion rights advocates were likely to win their case, was not sufficient to allow the procedures to continue during litigation. Instead, the high court said she must first weigh the potential harms of permitting abortions to resume.
The ruling marks a dramatic reversal in Missouri’s ongoing legal saga over abortion rights. It comes just months after voters approved a ballot measure overturning the state’s near-total abortion ban, making Missouri the only state to have done so via referendum since the U.S. Supreme Court overturned Roe v. Wade in 2022.
Planned Parenthood, which operates the state’s only abortion clinics in Columbia and Kansas City, immediately began calling patients to cancel appointments.
“We’ve had to make these calls before,” said Emily Wales, President and CEO of Planned Parenthood Great Plains. “To be in that position again, after the people of Missouri voted to ensure abortion access, is incredibly frustrating. Once again, political interference has denied patients care they were scheduled to receive.”
Among the regulations that will now be enforced again are requirements for abortion providers to have admitting privileges at nearby hospitals and maintain strict sanitation standards, rules Planned Parenthood argues are medically unnecessary and intentionally burdensome.
Missouri Attorney General Andrew Bailey hailed the court’s decision, calling it “a win for women and children.”
“This ruling sends a clear message: abortion providers must comply with state law regarding basic safety and sanitation requirements,” Bailey said.
Supporters of the abortion restrictions, like Sam Lee of Campaign Life Missouri, celebrated the court’s order.
“This means that our pro-life laws, which include many health and safety protections for women, will remain in place,” Lee said. “How long they’ll remain is up to the courts, but for now, this is a victory.”
Planned Parenthood has signalled its intent to return to court quickly. The organisation contends the laws in question were passed not to protect health, but to make abortion functionally inaccessible in the state.
Tuesday’s ruling is the latest twist in a contentious back-and-forth between Missouri’s courts, voters, and lawmakers. Although voters rejected the ban at the ballot box last November, abortions did not resume until more than three months later due to continued legal challenges from the state.
Earlier this month, Republican lawmakers took steps to revive abortion restrictions via another proposed constitutional amendment. The new measure, which includes exceptions for pregnancies resulting from rape or incest, could go before voters as soon as 2026, or sooner if Gov. Mike Kehoe calls a special election.
The amendment passed the House last month and cleared the Senate 21-11 after Republicans used rare procedural manoeuvres to block extended debate from Democrats. The vote prompted an outcry from abortion rights advocates, with protesters erupting into chants of “Stop the ban!” before being removed from the chamber.
Missouri enforcing abortion ban
Missouri remains one of 12 states currently enforcing full abortion bans. Four others restrict the procedure after roughly six weeks of pregnancy, often before individuals are even aware they are pregnant.
