Abortion rights supporters take part in a protest in St. Louis on May 30. A judge ruled Monday that Missouri's only abortion clinic can continue performing abortions and said the state Department of Health and Senior Services must decide whether it will renew the clinic’s license by June 21. (Jeff Roberson/AP)

The last abortion clinic in Missouri has at least another 10 days.

A judge ruled Monday that the St. Louis clinic, which is operated by Planned Parenthood, can continue performing abortions while it fights the health department’s attempts to shut it down. The decision is a temporary victory for the abortion rights movement in a state that is on the brink of becoming the only one in the country without access to the procedure.

Missouri’s Department of Health and Senior Services must decide whether it will renew the clinic’s license by 9 a.m. June 21. The department has so far refused to do so, citing health concerns officials say they found during an annual inspection. But the preliminary injunction that Circuit Court Judge Michael Stelzer granted Planned Parenthood prevents its license from expiring until he makes another ruling.

“Today’s ruling gives doctors like me the ability to wake up tomorrow and continue providing safe, legal abortion in the last health center in the state that provides abortion care,” Colleen McNicholas, a doctor at the clinic, said in a statement. “For patients, that means for now, they can continue to make decisions about their bodies, lives, and future in their home state.”

Health department officials did not respond to a request for comment on the ruling.

Stelzer has delayed the clinic’s fate before, ordering last month that the state could not simply let its license lapse on June 1, as the agency had intended. On Monday, Stelzer directed the health department to make a clear decision — one way or another — about the clinic’s license.

“The Court does not believe that an ‘official action’ can include non-action,” he wrote.

The ruling, Stelzer stressed, is not an opinion on whether the license should be approved or denied. That authority, he wrote, “rests exclusively with the Department of Health and Senior Services.”

Last month, the department said its inspection found concerns over patient safety, including what the agency called “failed surgical abortions.” Officials also asked to interview current and former physicians about the problems it found, but Stelzer ruled last week that testimony from the clinic’s nonstaff doctors isn’t necessary.

The health department director, Randall Williams, said Planned Parenthood has demonstrated an “unprecedented refusal” to cooperate, and Gov. Mike Parson (R) said it shouldn’t get any “special treatment.”

Planned Parenthood, meanwhile, said its clinic “has maintained 100 percent compliance” with the law and has accused the health department of using its regulatory authority to further the governor’s antiabortion policy agenda.

If the clinic loses its license, the health center would remain open, offering testing for sexually transmitted diseases, cancer screening and other services. But the end of abortion services there would mark a milestone in the state-by-state battle over abortion rights, one that has intensified in 2019 as conservative lawmakers across the country have pushed increasingly strict bans on the procedure. Advocates worry that Missouri could be a harbinger of future efforts to close clinics, especially in the handful of states that have only one abortion facility left.

Like many other states, Missouri already had restrictive laws on its books. Last month, Parson signed into law a measure that bans abortions after eight weeks of pregnancy. It provides no exceptions for victims of rape or incest, only for medical emergencies. He said on Twitter that the bill would make Missouri “the most Pro-Life state in the country!”

Antiabortion activists and groups have applauded the governor’s efforts.

“While abortion supporters continue to scramble to play the victim and blame others for their deficiencies, Missouri state leaders are standing firm and fighting for the protection of women and their babies, both born and unborn,” Susan Klein, the executive director of Missouri Right to Life, said in a statement last month.

If the St. Louis health center stops providing abortions, the next nearest facility is just across the Mississippi River in Granite City in Illinois, a state that has moved in the opposite direction, passing more abortion protections. Missouri patients who travel to Granite City will likely drive there on a highway that illustrates the deep divide in the abortion debate. This spring, the Granite City facility, Hope Clinic, bought a billboard along Interstate 55 that reads, “Welcome to Illinois, where you can get a safe, legal abortion.”