ST. LOUIS — Abortions are not yet available in Missouri clinics, despite a judge’s ruling that appeared to clear the way two weeks ago.
Jacky, right, a sidewalk counselor from Coalition Life, hands the driver of an arriving car literature about alternatives to abortion as a volunteer clinic escort from Abortion Action Missouri, left, waves him through the entrance to Planned Parenthood Central West End health center on Monday, Feb. 17, 2025. The state’s two Planned Parenthood affiliates say they are preparing limited access at a few clinics, for abortions only up to 12 weeks. But they still need key plans approved by the state, haven’t heard back from state officials on the plans submitted, and have no idea when they will. “We didn’t get any time frame from them about when this would be reviewed, in 48 hours or two weeks or two months,” said Dr. Margaret Baum, interim medical director for St. Louis-based Planned Parenthood Great Rivers. “That’s the part we don’t know.” The Missouri Department of Health and Senior Services did not respond to requests for comment on this story.
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The delay largely centers around medication abortions, performed via two pills taken up to two days apart. The clinics, Great Rivers in St. Louis and Great Plains in Kansas City, believed they needed to submit a “complication plan” to the state health department for approval before providing medication abortions. The plan requires providers of medication abortions to have a written contract with an obstetrician who is “on-call and available twenty-four hours a day” to treat complications. “Our legal team and also the legal team of Planned Parenthood Great Plains both interpreted that as needing to provide that to the state,” Baum said. “So based on their legal advice, that’s what we’ve done.” The issue has its roots in state rules. After Missourians approved Amendment 3 in November, protecting the right to an abortion up to fetal viability, multiple regulations remained in place that made it too difficult, abortion providers said, for them to restart abortions. Planned Parenthood Providers and the ACLU of Missouri filed a lawsuit in Jackson County Circuit Court seeking to strike down the regulations. In December, a judge paused many of the restrictions while the case plays out, including one that required two appointments 72 hours apart to have an abortion. And on Feb. 14, the judge also temporarily halted several licensing rules — such as pelvic exams and building specifications — which providers said were the last major hurdles preventing them from providing abortions. “Abortion care will be restored immediately,” said Emily Wales, CEO of Comprehensive Health of Planned Parenthood Great Plains. “The people voted, the court responded, and we will do our part: serving Missourians in their home state.” “Our health center staff,” said Great Rivers CEO Margot Riphagen, “are quickly readying to restart this critical care in the coming days.” The next day, staff at Great Plains’ midtown Kansas City clinic
said they provided the first elective abortion since the Supreme Court ruling. But, since then, the restart hasn’t arrived. And critics have blasted the two agencies. “It is certainly confusing for the community at-large when press releases are sent out stating abortion services have resumed in Missouri, but the reality we hear on the ground is contradictory to that,” said Alison Dreith, director of strategic partnerships for
Midwest Access Coalition , an abortion fund that helps people traveling to, from, and within the Midwest to access abortion.
What’s Next , a coalition of activists working to track the impact of Missouri’s abortion laws, released a statement asking Planned Parenthood providers “to prioritize patients, not publicity.” “They need to appropriately and honestly communicate about appointment availability, and the limits to care a patient might experience,” the statement read. “It’s dangerous to mislead pregnant people who need time-sensitive care.” Planned Parenthood officials blame the “complication plans,” and lack of state response, for the delay. Baum said Great Rivers submitted its plan on Feb. 21 to the Missouri Department of Health and Senior Services and is waiting on approval. It’s unclear, however, that Planned Parenthood really needs the plans approved.
The judge’s ruling said, when complications arise, patients would “seek emergency care at the nearest hospital emergency room, as with any other medical emergency.” And
St. Louis School of Law professor Jamille Fields Allsbrook , a former policy analyst for Planned Parenthood Federation of America with expertise in reproductive health, said it appears to her, based on the judge’s rulings, that a complication plan is not required. “It’s unclear to me, to be frank with you, why Planned Parenthood still felt the need to submit complication plans,” Fields Allsbrook told the Post-Dispatch. “Maybe they’re just playing it safe. I don’t know.” Planned Parenthood Great Plains says it will begin offering procedural abortions — which do not need “complication plans” — on a limited basis next week at two clinics in midtown Kansas City and Columbia. Great Plains is still determining which days it will offer the procedure because of adjustments to physician schedules that had already been set prior to the court ruling, a spokesperson stated in an email. Patients must call to make an appointment; online scheduling is unavailable. The procedure is also only available to patients up to 12 weeks gestation. Both Great Plains and Great Rivers, with locations in St. Louis, Rolla and Springfield, also said they were ready to begin providing medication abortions, which account for 63% of all abortions in the U.S., and can be taken up to 12 weeks gestation. Great Rivers will initially only offer medication abortions at its St. Louis clinic. Baum said that’s because Missouri requires physicians to provide such abortions, as opposed to nurses or physician assistants, which are allowed to do the work in other states. “I don’t have physicians to send out to Springfield and Rolla and all of our other clinics, so right now we are starting in with Central West End” in St. Louis, she said, which is where physicians also provide other gynecological surgeries and vasectomies. Great Rivers will not immediately provide procedural abortions in Missouri for similar reasons, Baum said. “We have plans to resume procedural abortion in Missouri,” Baum said. “But that’s just going to take a little bit of time.”
