Missouri’s only abortion clinic gets to keep serving patients who want to terminate their pregnancy, a judge decided Friday.

The St. Louis Planned Parenthood clinic was set to lose its license to perform abortions on Friday, which would have made Missouri the only state with no abortion clinics since the Supreme Court legalized the procedure in Roe. v. Wade in 1973. State officials would not renew the clinic’s license, saying it did not meet additional regulations that the state imposed last week. Planned Parenthood filed a lawsuit on Tuesday so its clinic could continue to provide abortions.

St. Louis Circuit Judge Michael Stelzer issued a restraining order on Friday, temporarily prohibiting Missouri from withholding the clinic’s license as litigation continues. The ruling allows the clinic’s current license to remain in effect until the lawsuit is heard again on June 4. Patients can continue to get abortion care in the St. Louis clinic, at least for now. 

The last week has been especially challenging for the St. Louis clinic, as staff weighed workarounds and fielded questions from patients. Had the court not intervened, patients would have had to go to clinics in nearby states to access care. Already more than half of the patients who go to Hope Clinic for Women, an Illinois clinic across the Mississippi River from St. Louis, are Missourians.  

The chaos was prompted because the abortion clinic failed to meet one of three new regulations, which the state notified the clinic of only last week. Missouri officials wanted to interrogate seven doctors at the clinic, but Planned Parenthood maintains that the matter is out of its hands, since the clinic doesn’t employ all of them directly. Planned Parenthood said the new regulation amounted to intimidation, as the investigation subjected providers to criminal proceedings and board reviews.

Last week, Missouri also enacted a six-week abortion ban — banning the procedure before many women and gender minorities even know they are pregnant. The law is scheduled to go into effect in August, but expected to be blocked in court before then.

Red tape has shuttered abortion clinics before, and other states with just one abortion provider have been on the brink of having none at all.

Two years ago, Kentucky officials threatened to pull the license of the state’s last abortion clinic. A judge ultimately struck down the state’s new condition, saying “scant medical benefits… are far outweighed by the burden on Kentucky women seeking abortions.”

Given the trend, abortion providers say it’s clear these regulations are not about providing safe medical care but closing clinics.

“The folks who oppose abortion are looking for and using every tool in their toolbox, whether that’s outright bans, six-week bans, eight-week bans, [procedure bans], let’s get the state involved, let’s inspect, let’s not renew a license — doing anything and everything that they can to stop legal abortion,” said Tammi Kromenaker, director of Red River Women’s Clinic, North Dakota’s only abortion clinic.

“We know that doesn’t stop abortions from happening, that just makes it much more unsafe,” Kromenaker added.

Closing clinics means blocking safe access for low-income people, because wealthier patients can afford to leave the state to get abortions. Some patients who can’t access abortion in a clinic setting have the means to terminate their own pregnancies. Aid Access mails abortion pills to people living in the United States. Already, Aid Access wrote prescriptions for nearly 2,600 patients last year, but the federal government is threatening to shut it down.

While self-managed abortion can be a medically safe and effective way to terminate a first-trimester pregnancy, laws in several states can be used to punish women or gender minorities who self-manage their abortions — including in Missouri. Patients of color could be disproportionately criminalized, since they are likelier to be targeted by law enforcement.