Background: A Missouri and American flag fly outside Planned Parenthood in St. Louis, June 24, 2022. (AP Photo/Jeff Roberson, File). Inset: Former U.S. Attorney Catherine Hanaway speaks to reporters after Missouri Gov. Mike Kehoe announced her appointment as the state”s next attorney general on Tuesday, Aug. 19, 2025, at the governor’s Capitol office in Jefferson City, Mo. (AP Photo/David A. Lieb).
Abortions can continue at Planned Parenthood facilities in Missouri, as a state appeals court has upheld a lower court’s ruling on the matter. The appeals court determined that the initial court order was within its legal boundaries.
In a detailed 40-page decision, the Western District Court of Appeals delivered a setback to the Missouri Attorney General’s Office, which had sought to reinstate several abortion restrictions. The appellate court’s task was to assess whether Judge Jerri Zhang of the 16th Judicial Circuit had “abused its discretion” with her preliminary injunction, and it concluded that the circuit court had acted appropriately.
This legal battle traces its origins back to November 2024, when Missouri voters approved the Right to Reproductive Freedom Initiative, embedding reproductive rights into the state constitution.
Despite this constitutional amendment, the state government enacted several restrictions on reproductive healthcare. These included bans on telemedicine consultations for medication abortions and a mandate for patients to make two in-person visits to the same physician with a minimum 72-hour interval. In response, Planned Parenthood filed a lawsuit, asserting that these regulations contradicted the newly established constitutional protections.
The case was brought before Judge Zhang, who issued a preliminary injunction against these restrictions, effectively overturning years of limitations. This ruling enabled Planned Parenthood clinics in Columbia, Kansas City, and St. Louis to resume offering procedural abortions, as reported by the Missouri Independent.
Former Attorney General Andrew Bailey opposed the injunction, contending that it was unwarranted. The state’s argument hinged on the claim that no “irreparable harm” existed since Missouri residents could travel to neighboring states to obtain abortion services if needed.
Western District Court of Appeals Judge Mark D. Pfeiffer saw this argument as “disingenuous,” as residents of the state voted to avoid that specific outcome. He wrote:
In essence, the State does not deny that Missouri citizens adopted Section 36 to the Missouri Constitution so that Missouri residents would not have to travel to a different state to receive abortion care; but, during the pendency of this litigation the State proposes that that is precisely what Missouri residents should be required to do, so that Missouri statutes prohibiting elective abortion care in Missouri will override the Missouri Constitution during the pendency of this litigation. This argument lacks any precedential support.”
“As the circuit court discussed in its ruling below, the irreparable harm flowing from a denial of abortion care within the confines of the Missouri Constitution Article I, Section 36, are unique because an abortion decision by an expectant mother ‘simply cannot be postponed, or it will be made by default with far-reaching consequences,’” he added.
Bailey is no longer the state’s attorney general; that position is held by Catherine Hanaway. But the state has forged ahead with its legal strategy. Hanaway’s office said Tuesday’s ruling “puts women in danger and undermines Missouri’s ability to protect patients,” per the Missouri Independent.
A bench trial to consider making the preliminary injunction permanent is set for January. Zhang is also considering a separate request from Planned Parenthood concerning other state regulations, specifically medications used for abortion procedures.
