Why Missouri Could Soon Be Down To Just One Abortion Clinic

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For women in the state of Missouri, abortion access may become significantly more challenging, thanks to a new court ruling. On Monday, a federal appeals court moved to uphold a law which would require that abortion clinics be, among other things, licensed as ambulatory surgical centers. As part of that classification, abortion-performing doctors would also have to obtain permission to perform surgeries at a nearby hospital.

Originally, these requirements were blocked as part of a 2017 injunction. Monday's decision in the 8th U.S. Circuit Court of Appeals in St. Louis overturned that injunction, according to Reuters, allowing Missouri to begin enforcing those rules.

“Look no farther than Missouri to see what kind of harm courts can inflict on women’s rights and freedoms," Dawn Laguens, the executive vice president of the Planned Parenthood Federation of America, says in a statement provided to Bustle. She continues:

The Eighth Circuit Court of Appeals once again ignored Supreme Court precedent and what is already settled law. Despite a Supreme Court ruling striking down virtually identical restrictions in Texas, judges in the Eighth Circuit continue to re-write the books on abortion access. Today’s ruling threatens to eliminate abortion access at all but one health center in the state.

The laws that were upheld on Monday also require that abortion-providing facilities maintain expensive, hospital-grade equipment and architectural requirements. While this could place financial and logistical burdens on abortion-providing facilities, there is reportedly a pilot waiver program in place wherein people who run abortion clinics may apply for exemption from certain requirements, according to ThinkProgress.

By and large, per ThinkProgress, the more complicated law is the one that requires abortion-providing clinics be classified as ambulatory surgical centers. That law dictates that "all doctors who perform abortions... must be ‘privileged to perform surgical procedures in at least one licensed hospital in the community.’”

These rules are stricter than average. Sometimes, abortion-performing doctors are required to have admitting privileges at a nearby hospital, but requiring that those doctors also be able to perform surgeries at those hospitals would make the vetting process all the more challenging for abortion clinics.

The Guttmacher Institute reports that, as of 2014, there were two abortion-care providing facilities in Missouri. And prior to Monday's ruling, the state already had a lengthy set of abortion access restrictions in place. Among those, according to Guttmacher, are a 72-hour waiting period, mandatory counseling, and only providing public funding for abortions in cases of rape, incest, or life endangerment.

While it's not clear whether the Missouri ruling will definitively cause one of the state's two abortion-providing facilities to close, it is a very legitimate possibility. This means that women who are seeking abortions could be required to travel long distances to obtain services, or else travel out of state entirely. This can pose an undue financial burden in a state where public funding for abortions is already limited.

Planned Parenthood affiliates originally sued Missouri over the ambulatory surgical center requirements in 2016. The lawsuit came shortly after the Supreme Court struck down a similar law in Texas, ruling it unconstitutional.

"The surgical center requirement, like the admitting-privileges requirement, provides few, if any, health benefits for women, poses a substantial obstacle to women seeking abortions, and constitutes an ‘undue burden’ on their constitutional right to do so,” Justice Stephen Breyer wrote for the majority, The Washington Post reported at the time.

However, the ruling only applied to the laws as they existed in Texas, and if other states were to impose similar restrictions, they would have to be dealt with separately. Given that the Supreme Court struck down the law in Texas, it's highly likely that Monday's ruling will soon be challenged. Until then, however, abortion access in the state stands to be severely legally restricted.