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 will be allowed to continue at Planned Parenthood clinics in Missouri, a state appeals court has ruled, finding that a lower court’s original order was not out of bounds.
The 40-page decision by the state’s Western District Court of Appeals handed the Missouri Attorney General’s Office a loss as it seeks to have several abortion regulations reinstated. The appeals court made clear its assignment was to consider whether 16th Judicial Circuit Judge Jerri Zhang’s preliminary injunction “abused its discretion” — and it found that the circuit court did not.
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The case can most aptly be charted back to November 2024, when Missouri voters approved the Right to Reproductive Freedom Initiative and enshrined reproductive rights in the state constitution.
However, when the state government passed several restrictions on reproductive care — such as prohibiting telemedicine appointments for a medication abortion and requiring patients seeking an abortion to make two in-person visits to the same physician at least 72 hours apart — Planned Parenthood sued. The organization argued that these regulations violated the new constitutional amendment.
The case landed in front of Zhang, and her preliminary injunction on the restrictions overturned years of limitations. As the Missouri Independent reported, the order allowed Planned Parenthood clinics in Columbia, Kansas City, and St. Louis to offer procedural abortions for the first time in years.
Former state Attorney General Andrew Bailey challenged the injunction, arguing that it wasn’t necessary. There was no risk of “irreparable harm,” the state argued, because Missouri residents who wanted an abortion, for example, could travel to neighboring states to get one.
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.
