Missouri could become the first state without a clinic that performs abortions, Planned Parenthood officials warned Tuesday, saying they are suing the state to allow their clinic in St. Louis to continue offering the procedure.

Planned Parenthood officials said the state’s health department is threatening not to renew the organization’s license to offer abortions in St. Louis, the only place in Missouri that provides the procedure.

The license expires Friday, and if it isn’t renewed, Planned Parenthood president Leana Wen said, “this will be the first time since 1974 that safe, legal abortion care will be inaccessible to people in an entire state.” Planned Parenthood said the closure of the St. Louis clinic would leave “more than a million people in a situation we haven’t seen since Roe v. Wade.”

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The St. Louis clinic planned to file a lawsuit in state court Tuesday seeking permission to keep providing abortions if its license expires, Planned Parenthood said in a statement. The nonprofit said the clinic “has maintained 100 percent compliance” with the law.

“What is happening in Missouri shows that politicians don’t have to outlaw abortion to push it out of reach entirely,” Jennifer Dalven, director of the ACLU Reproductive Freedom Project, said in a statement.

The facility in St. Louis will continue to provide other services if its license to perform abortions is not renewed, Planned Parenthood spokeswoman Emily Trifone said in an email.

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The Missouri Department of Health and Senior Services performed a routine, annual investigation of the clinic in March and found “numerous violations of state laws,” Gov. Mike Parson (R) said Wednesday at a press conference.

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The health department told Planned Parenthood about the alleged violations and asked to interview seven doctors performing abortions at the St. Louis facility, Parson said. He said five of those doctors declined to participate.

Missouri still has “serious health concerns” about the clinic, Parson said, including its compliance with requirements that patients get a pelvic exam 72 hours before an abortion and that the same doctor who obtains a patient’s informed consent be the one to perform the abortion.

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The Planned Parenthood facility in St. Louis will get its annual license if it addresses the state’s complaints by Friday, Parson said. It would be “reckless” for a judge to issue a temporary restraining order allowing the clinic to keep performing abortions before the state acted on the license renewal, he said.

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“No judge should give special treatment to Planned Parenthood in this instance,” Parson said. "If you break the law, there are serious consequences. If you don’t provide a standard of care that supports the safety of women, you shouldn’t be able to operate.”

The governor signed a bill last week that criminalizes abortion at eight weeks of pregnancy, following a wave of similar laws across the country. He had said the bill provided Missouri “the opportunity to be one of the strongest ‘pro-life’ states in the country."

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As The Washington Post’s Lindsey Bever reported:

The vote came just hours before the state’s legislative session was set to end, and was preceded by an emotional debate in the House, during which some lawmakers recounted their own experiences with abortion. Aside from some outbursts from spectators in the gallery and quiet sobbing at times that appeared to come from the House floor, the chamber was largely silent during the arguments about the bill.
Supporters said the bill would protect unborn children’s lives, but opponents argued it would also put the mothers’ lives at risk, forcing them to either suffer or go underground to seek illegal and unsafe procedures.

The ban on abortions at eight weeks, when some women do not know they are pregnant, provides exceptions for medical emergencies. The law defines these emergencies as “a condition which, based on reasonable medical judgment, so complicates the medical condition of a pregnant woman as to necessitate the immediate abortion of her pregnancy to avert the death of the pregnant woman or for which a delay will create a serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman.”

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Rape and incest are not exceptions under the state law, called the Missouri Stands for the Unborn Act. The legislation says a doctor who performs an abortion could be charged with a Class B felony that is punishable by 5 to 15 years in prison. Doctors could also lose their professional licenses.

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Although five clinics in Missouri performed abortions in 2008, that number fell to two by 2018. It dropped to one facility in October after Planned Parenthood’s Columbia Health Center could not meet new state requirements that abortion providers receive admitting privileges at hospitals within 15 minutes of their clinics, according to NPR.

According to the Guttmacher Institute, which advocates for abortion access, five other states have just one clinic that performs abortions: Kentucky, Mississippi, North Dakota, South Dakota and West Virginia.

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Eleven states have passed laws limiting access to abortion this year, and restrictions in three other states are pending. New York and Vermont passed laws that protect abortion access, and Illinois is debating an expansion of abortion rights.

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Conservative-leaning states hope to prompt the Supreme Court to reconsider its ruling in Roe v. Wade now that two justices appointed by President Trump sit on the court.

“I have prayed my way through this bill,” Alabama state Rep. Terri Collins (R), who sponsored that state’s abortion ban, previously said. “This is the way we get where we want to get eventually.”

Emily Wax-Thibodeaux contributed to this report.

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