AILSA CHANG, HOST:
One of the country's strictest abortion bans may be on the verge of ending. Missouri bans abortion in any stage of pregnancy, even in cases of rape or incest, with some medical exceptions. But last month, voters approved a state constitutional amendment that allows abortion until fetal viability. That's usually around the 24th week of pregnancy. The amendment was supposed to take effect today, but abortion access has been held up after a court hearing this week. NPR's Elissa Nadworny was at that hearing and joins us now. Hi, Elissa.
ELISSA NADWORNY, BYLINE: Hello.
CHANG: OK, so what exactly is this holdup in the courts right now?
NADWORNY: So even though voters supported abortion rights on Election Day, the old laws that restrict access are still on the books.
CHANG: OK.
NADWORNY: And it's not just the near-total ban that's in play here. There are actually a number of laws and regulations in Missouri, some going back decades, that aim to restrict abortion. So some examples include a 72-hour waiting period, a law that requires only doctors, and not certified midwives or nurse practitioners, to perform abortions. There's a ban on using telehealth to access abortion medication - things like that.
I was at a hearing this week in Kansas City where abortion rights advocates, including Planned Parenthood, which runs three clinics in the state - they don't perform abortions, but they do offer other health care. They sought to stop the state from enforcing these restrictions. But the Republican attorney general aims to keep enforcing some of them. Now, one of the state's arguments is that the right to reproductive freedom includes the right to childbirth, so preventing abortions is part of that. They argue, without these restrictions, like the waiting period, it may infringe on a woman's right to give birth.
CHANG: Huh. Well, I know that you also visited a Planned Parenthood clinic in St. Louis. How was the staff there preparing for whatever happens?
NADWORNY: Right. They're kind of in limbo right now. You know, they're ready, and they're waiting. Planned Parenthood says that if the judge gives a green light to resuming abortions without restrictions, then three of their Planned Parenthoods in the state will start to offer medication abortion and procedural abortions. And I will say, you know, the amendment is on the books. Planned Parenthood is kind of afraid of going afoul of the law, so they want to make sure they have that all-clear from the judge, which is why they're not starting abortions now. But, you know, when we visited the clinic in St. Louis, the staff were stacking up abortion medicine that just came in, for example. They're sorting them, putting them in the cabinets, getting consent forms ready. I talked with Dr. Colleen McNicholas, the chief medical officer for Planned Parenthood Great Rivers and an OB-GYN at the clinic.
COLLEEN MCNICHOLAS: We will be open and available for folks if they want to just walk in to have that appointment. Or if they can call the call center and get on the schedule, get to us in the same day, we'll be here to do that.
NADWORNY: McNicholas said they are getting ready to perform abortions again. It feels kind of like they're opening a time capsule - you know? - 'cause, the past several years, that area has mostly sat empty.
CHANG: Wow. Well, I heard that, while you were inside that clinic, there were also antiabortion demonstrators outside. I mean, what was that scene like?
NADWORNY: Well, out on the sidewalk, there were about two dozen protesters. Many of them were part of a group called Coalition for Life (ph). They told us they, you know, think of themselves as the last line of defense, and they spent a lot of time praying as cars rolled into the parking lot.
UNIDENTIFIED PERSON: Our father, who art in heaven, hallowed be thy name. Thy kingdom come, thy will...
NADWORNY: People from the group are handing out flyers advertising an abortion reversal hotline. They have information on crisis pregnancy centers. And back before the total ban, protesters came every day. That stopped, you know, during the ban, and now they're back.
CHANG: Well, earlier, you mentioned that Republicans have controlled state politics there for quite some time, and you mentioned all these restrictions on abortion that had been on the books for decades in that state. What's been the overall impact of that?
NADWORNY: So even before the near-total ban here, and even before the U.S. Supreme Court overturned federal protections that made abortion legal across the U.S., Missouri was making it very difficult to get one, as you said, and you can see kind of the evolution of that. In 2021 - this is a year before the Dobbs decision...
CHANG: Yeah.
NADWORNY: There were only about 150 abortions statewide...
CHANG: Wow.
NADWORNY: ...And only one clinic, here in St. Louis, that performed abortions. Dr. McNicholas was the OB-GYN at the clinic.
MCNICHOLAS: When I was born, the state of Missouri had more than two dozen places to get an abortion. By the time I started my medical training at the university here, there were less than a handful. And by the time I was fully practicing as an OB-GYN, there was two. For the couple of years before the Dobbs decision, there was one, and you're standing in it.
NADWORNY: You know, Ailsa, Republican lawmakers here say the rules make it safer for women to get care, and they fear women are pressured to get abortions when there are fewer regulations.
CHANG: So when the judge in this case does rule, what comes next in the legal process?
NADWORNY: Well, this is not the end. After the judge rules, this case goes to trial.
CHANG: Ah.
NADWORNY: Both sides expect this legal fight to continue, perhaps all the way to the state Supreme Court, and Republican lawmakers have proposed holding another referendum to undo the one that passed last month - so essentially taking this question again to voters as soon as next year.
CHANG: Wow. That is NPR's Elissa Nadworny. Thank you so much, Elissa.
NADWORNY: Thank you. Transcript provided by NPR, Copyright NPR.
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