KANSAS CITY, Mo. — Nearly all abortion is now banned in Missouri following the U.S. Supreme Court decision Friday ending the federal right to the procedure that marks the culmination of a decades-long campaign by Missouri abortion opponents to restrict – and one day eliminate – the lawful ability to end a pregnancy.
The U.S. Supreme Court opinion overturns the federal right to abortion established by the 1973 Roe v. Wade decision. Missouri has a “trigger law” prohibiting abortions except those necessary because of medical emergencies in the event Roe is overturned.
The sole clinic in the state offering surgical abortions —in St. Louis— is almost certain to immediately stop performing the procedure.
The decision is a historic moment not only for the country but for Missouri, ending nearly half a century of legal abortion in a state with deep anti-abortion roots. Missouri law barred abortion as early as 1825 – a prohibition that only ended with Roe 49 years ago.
The opinion ushers in a new, chaotic era in the fight over reproductive rights in Missouri, as lawmakers clash over how far to go in eliminating the procedure and weigh whether they can punish those who help Missouri residents get abortions out of state. Prosecutors, including Missouri Attorney General Eric Schmitt, will face new choices about whether to charge individuals with abortion-related crimes.
The decision may not be the final word on abortion in Missouri. In the future, a ballot initiative could force a statewide vote on legalizing the procedure. A lawsuit could also be brought that argues the Missouri Constitution guarantees the right to an abortion.
“The battle is not over. It’s just that the battleground has shifted,” said Samuel Lee, a lobbyist for Campaign Life Missouri. “I expect lots more work for the pro-life movement over the coming years to protect the unborn and help women who are risk for abortions.”
Even before Friday’s decision, access to abortion was already very limited in Missouri. By 2020, fewer than 200 surgical abortions were performed, a drop of several thousand over the past two decades.
In 2020, Yamelsie Rodríguez, president and CEO of Reproductive Health Services of Planned Parenthood of the St. Louis Region said that “the reality is, abortion has essentially become a right in name only in Missouri.”
Missouri residents often traveled to Kansas, where a clinic in Overland Park offers the procedure, or to a clinic in Fairview Heights, Illinois, near St. Louis. In 2021, for instance, 3,458 Missouri residents received abortions in Kansas — 44% of all abortions performed in Kansas that year.
Abortion is likely to remain legal in Illinois, but in Kansas, voters will decide in August whether to approve an amendment to their state constitution that would clear the way for state legislators to approve a ban.
The one clinic in Missouri offering abortions, called Reproductive Health Services of PPSLR, will stop offering abortions. Instead, it will refer patients to a nearby clinic in Illinois.
“We will have to stop providing abortions at our clinic in St. Louis immediately,” Bonyen Lee-Gilmore, a spokesperson for Planned Parenthood of the Saint Louis Region (PPSLR), said in an interview on Tuesday. “It comes with criminal penalties.”
Trigger law set stage for ban
Republicans set the stage for halting legal abortion in Missouri three years ago, when lawmakers embedded a trigger ban in a 2019 anti-abortion bill signed by Republican Gov. Mike Parson. The law requires either Parson or Schmitt to issue statements that Roe has been overturned to implement the ban.
Schmitt, a Republican running for U.S. Senate, had promised to immediately release the necessary document. Within minutes of the U.S. Supreme Court decision, his office announced he had signed a legal opinion implementing the abortion ban.
“Following the SCOTUS ruling overturning Roe v. Wade, Missouri has just become the first in the country to effectively end abortion with our AG opinion signed moments ago. This is a monumental day for the sanctity of life,” his office tweeted.
Parson had also said recently he would be ready to act, telling reporters his office would have an executive order already prepared.
“I’m a pro-life guy. I’m fine with that. That’s what I believe in, I’ve said that all along,” Parson said Thursday when asked about what the trigger law would mean for his legacy as governor.
But Parson also said people would continue to have access to abortion.
“The one about it is, you’re not doing away with it, either. We may be in the state, but there’s other places to go if people want to do that in time,” Parson said. “But right now, this is something a lot of us have worked real hard for.”
At the time of the bill’s passage in 2019, the “trigger” provision was overshadowed by the legislation’s ban on abortion after the eighth week of pregnancy. The law was blocked by a federal court before it could go into effect, however.
For years, Missouri lawmakers, many of whom saw abortion as an evil akin to murder, chipped away at access to the procedure. They required women seeking an abortion to wait 72 hours and blocked the use of telemedicine in abortion. And again and again, they tried to stop Planned Parenthood from receiving public funds, even though federal law already prohibited the dollars from paying for abortions.
State Rep. Mary Elizabeth Coleman, an Arnold Republican and a staunch abortion opponent, has often described her goal as making abortion not just illegal, “but unthinkable.”
Coleman this spring offered a preview into the possible next frontier of the anti-abortion movement, when she proposed allowing lawsuits against anyone helping Missouri women obtain abortions even if the procedure took place out of state. Her measure didn’t advance in the legislature.
Abortion rights supporters have cast access to the procedure as a key element of healthcare for women. Ending a pregnancy, they often said, was such an important decision that it was best left to women themselves, in consultation with their doctor and possibly their clergy—and out of the hands of the government.
“Those protections may soon be a thing of the past and the rights our grandmothers fought for and our mothers enjoyed will no longer apply to our generation,” Emily Wales, CEO of Planned Parenthood Great Plains, told reporters shortly after the leaked draft opinion was published in May.
If legal abortion isn’t an option in Missouri, abortion rights supporters may at the very least focus on persuading prosecutors not to go after doctors and others who help women obtain abortions. The 2019 trigger law doesn’t allow prosecutions of those who get an abortion.
Some prosecutors have already made clear they won’t pursue abortion-related cases. Jackson County Prosecutor Jean Peters Baker released a statement in May calling the threat of criminal sanctions for reproductive health care “an injustice.”
But Missouri law appears to give Missouri Attorney General Eric Schmitt at least some authority over abortion-related crimes, potentially setting up clashes because the Republican official and local Democratic prosecutors.
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(The Kansas City Star’s Kacen Bayless and Natalie Wallington contributed reporting.)
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