Missouri's abortion rights in murky waters following judge's ruling
Practical effect of ruling means abortion clinics still can't operate.
A Missouri judge issued a ruling that once again shows protections for abortion afforded by ballot initiatives go only so far as how expansive interpretation courts give them when reviewing or nullifying bans and restrictions.
Restoring abortion access in some states requires a multi-step process. First, activists must get a ballot initiative passed, and then a court must review the existing laws with the new rights settled in the state constitution. Depending on the judiciary’s political makeup, they may provide robust or narrow protections.
The case, Comprehensive Health of Planned Parenthood Great Plains and Planned Parenthood Great Rivers v. State of Missouri, was brought within 24 hours of Missouri voters passing the Right to Reproductive Freedom Initiative, which appeared as Amendment 3 on the 2024 General Election ballot. The amendment creates and protects the fundamental right to reproductive freedom, which is the right to make and carry out decisions about all matters relating to reproductive health care, including prenatal care, childbirth, postpartum care, birth control, abortion care, miscarriage care, and respectful birthing conditions.
However, Missourians remain unable to exercise their constitutional right to abortion under Amendment 3 at Planned Parenthood clinics after Jackson County Circuit Court Judge Jerri Zhang issued a mixed decision that leaves in place numerous abortion restrictions. The court enjoined the state’s abortion bans, including the total ban, and the vast majority of laws known as Targeted Regulations of Abortion Providers, which were restrictions put in place before the fall of Roe that made health regulation compliance so expensive for abortion clinics that they went out of business. The TRAP laws plaintiffs challenged included the 72-hour mandated delay period, biased information requirements, and hospital admitting privileges.
The judge left in place a law that dictates size requirements for hallways, rooms, and doors—and no health centers can comply with an equally irrelevant, invasive vaginal exam for patients seeking a medication abortion. Plaintiffs will continue to fight to see that these restrictions are enjoined.
In 2019, for example, the Department of Health and Senior Services used facility licensure as the tool to target the last remaining abortion facility in the state in an attempt to eliminate all abortion access. The State’s Administrative Hearing Commission later rejected the effort, according to a news release from Planned Parenthood. During this process, the Department invented a new requirement that patients seeking medication abortion must submit to a medically unnecessary invasive vaginal exam. It was revealed during that litigation the Health Director maintained a spreadsheet of Planned Parenthood patients’ menstrual cycles.
The health care providers who filed the challenge, Comprehensive Health of Planned Parenthood Great Plains and Planned Parenthood Great Rivers–Missouri, would have been able to immediately resume abortion care if the court had granted the requested preliminary relief. Plaintiffs are evaluating their legal options as they vow to continue fighting to fulfill the promise of Amendment 3 and restore abortion access in Missouri.
“It is unacceptable that tomorrow, just like for the past two weeks, Missourians will have a constitutional right that cannot be realized in their home state,” said Emily Wales, president and CEO of Comprehensive Health of Planned Parenthood Great Plains. “We’re relieved the court recognized and enjoined many oppressive laws on the books that serve no purpose except to put abortion out of reach. Unfortunately, a key tool weaponized by anti-abortion politicians — the licensure process — remains in effect, and we are unable to restore care. We stand ready to begin providing access to abortion in Missouri and will keep fighting to ensure Missourians' rights are fully realized as soon as possible.”
Courts and legislatures. Ballot initiatives are great and necessary. You still need both courts and legislatures to fulfill the promises of a ballot measure, as we had in Michigan, in order to make the changes necessary to support the will of the voters. First though, we had to pass voting rights ballot measures, including one that established a nonpartisan redistricting commission that (while not perfect) did a lot to repair gerrymandering in our state. It got us a Dem trifecta in 2022 (sadly, we lost our state house majority again this year) that overturned our zombie 1931 abortion ban and managed to do a whole lot to support access in our state. So it’s possible! But it’s definitely multi-layered. Much like TRAP laws, they make it so on purpose to make it as difficult as possible for people to get the care they need and deserve.