A trial over Missouri’s new reproductive rights amendment begins Monday, putting the state’s numerous abortion regulations under scrutiny and drawing attention from across the country.
The case, filed by Planned Parenthood and the ACLU of Missouri after voters approved broad abortion protections in November 2024, will include testimony from abortion providers, anti-abortion doctors, and Planned Parenthood leadership. Advocates for abortion rights argue that many regulations are unconstitutional under the amendment, while the state contends the rules are necessary for patient safety.
Missouri’s amendment, one of the strongest in the nation, prohibits most restrictions on abortion before fetal viability unless justified by a compelling governmental interest using the least restrictive means. Currently, many targeted regulations, including the 72-hour waiting period and facility licensing requirements, are temporarily paused, allowing clinics in Kansas City, Columbia, and St. Louis to provide in-clinic abortions.
However, doctors remain unable to prescribe medication abortions using mifepristone and misoprostol due to regulations requiring complication plans and supplemental insurance. Medication abortion accounts for about two-thirds of abortions nationwide.
Experts say the trial’s outcome could influence abortion access in other states facing legal challenges, including Arizona, Michigan, and Ohio. “Missouri is a test case for what happens when the people have spoken and passed the constitutional amendment with the strongest possible protections, but the state still decides to stand in their way,” said Amy Myrick, senior attorney at the Center for Reproductive Rights.
Anti-abortion advocates argue repealing the regulations could threaten patient safety. “The amendment was the first step, opening the door for the abortion lobby to tear down all of the health and safety standards,” said Katie Glenn Daniel of SBA Pro-Life America.
Missouri’s ongoing federal litigation over medication abortion further complicates the landscape, with potential limits on mifepristone access and telemedicine prescriptions.
Legal experts caution that politics may continue to influence the courtroom. Former Missouri Supreme Court Chief Justice Michael Wolff noted, “The courts have always been solicitous of what the voters were voting on It’s not a matter for the courts to decide whether the voters were dumb or smart when they did this.”
The trial is expected to last two weeks, and its impact could reshape abortion access across the Midwest and South.
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