Missouri’s abortion rights trial concludes, but a decision is still months away

A recovery room at the Planned Parenthood Great Plains office is pictured on June 21, 2024, in Overland Park, Kansas (Anna Spoerre/Missouri Independent)

KANSAS CITY — After 10 days of often emotion-filled testimony, a trial dissecting Missouri’s abortion regulations under the new constitutional right to reproductive health care concluded Monday.

In closing arguments, attorneys from both the Missouri Attorney General’s Office and Planned Parenthood brought the focus back to the crux of the case: are Missouri’s abortion regulations necessary safeguards for women or discriminatory road blocks for patients?

In a final attempt to cast doubt on the validity of the case, Peter Donohue, deputy solicitor general for Missouri, argued that Planned Parenthood had not met Missouri’s high legal burden needed to nullify state laws in total.

Jackson County Circuit Judge Jerri Zhang gave both parties until April 10 to file post-trial briefs. She urged them to opine on the burden-of-proof argument, which was recently addressed by the Missouri Supreme Court in a separate constitutional case on the state’s gender-affirming care ban for minors.

The outcome of this month’s trial will determine the accessibility of abortion across the state before Missourians are asked to vote on whether they want to again ban the procedure in November.

Donohue defended the regulations as protecting women from unsafe abortion providers, which he accused of having a history “fraught with harms to women.”

Even if current Planned Parenthood clinics provided safe care, as they testified, he said the state must think about any provider who might provide abortion care in the future.

“If they’re safe,” he argued, “these requirements don’t burden them.”

But attorneys for Planned Parenthood spent days of testimony laying out how each regulation left clinics hamstrung to provide abortions. These regulations, introduced over the past few decades, increasingly drove Missourians out of state to get abortions.

Planned Parenthood providers and staff recounted the toll the regulations took on patients left unable to access abortion quickly and close to home.

These few dozen targeted regulation of abortion, or TRAP, laws are currently in state statute. Planned Parenthood and the ACLU of Missouri filed a lawsuit asking a judge to deem the laws unconstitutional after voters approved the abortion rights amendment in November 2024. Some were temporarily enjoined last year, allowing procedural abortions to resume.

“All these laws target abortion in a unique way,” Vanessa Pai-Thompson, an attorney with Planned Parenthood Federation of America, said in her closing argument. “And a unique way that is now also an unconstitutional way.”

These regulations include required distribution of Missouri’s informed consent booklet prior to an abortion; a 72-hour waiting period between an initial appointment and an abortion; abortion facility licensing requirements; a ban on prescribing medication abortion via telehealth, and mandatory pelvic exams prior to a medication abortion.

Pai-Thompson said although abortion is essential health care, it remains regulated by state laws that are now discriminatory under the new amendment. Pai-Thompson then pointed back to a timeline showing decades of Missouri’s restrictions that have limited access.

Two decades ago, several thousands abortions were performed in Missouri annually, according to state health department data. By 2021, the year before abortion was outlawed in Missouri, there were only 151, as a result of the TRAP laws. But many women still have abortions. In 2024, nearly 12,000 women went to Kansas and Illinois to end their pregnancies.

The state was the only side to call women to testify about their abortions, most of whom said they went on to regret them. This included a woman on Monday who said she obtained two medication abortions from the Planned Parenthood clinic in Columbia in 2012 and 2015, the second of which was followed by an emergency surgery to remove fetal tissue. The exact details of her medical issue were not detailed during her brief testimony.

Pai-Thompson in closings characterized the state’s expert witnesses — which included a parade of doctors who oppose abortion — as unreliable advocates. She underscored the medical consensus among leading medical organizations that abortion is safe, telling the judge that abortions pose less risk than pregnancy or childbirth.

Testimony from Planned Parenthood earlier in the trial detailed that roughly 1% of the more than 53,000 Missourians who received abortions over the last 10 years in Illinois and Kansas experienced complications, ranging from infection to incomplete abortions to hemorrhaging.

Planned Parenthood began the trial with Dr. Margaret Baum, chief medical officer with Planned Parenthood Great Rivers. She returned to the stand Monday to dispute the state’s characterization of women seeking abortions as being uncertain about their decision and easily coerced into abortion.

“I find that infantilizing of my patients and of women in general,” Baum said. “Most of my patients who present for abortions already have been pregnant or already have children. They know exactly what it means to be pregnant.”

Baum also disagreed with assertions from state witnesses that women often regret their abortions. She said her patients most frequently express relief. And when she tells people about her work in social settings, she hears abortion stories from other women, who express gratitude.

“The most common thing people have said to me is ‘thank you,’” Baum said. “‘My abortion saved my life.’”

Missouri Independent is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: info@missouriindependent.com.