Most Missouri Abortion Laws Ruled Unconstitutional by County Judge — A Crucial Moment for Missouri Voters

Kansas, City, MO — A Missouri county judge issued a ruling on Friday, June 19, 2026, that declared most of that state’s abortion safety laws unconstitutional. This ruling opens the doors for chemical abortions to commence there for the first time since 2018.

While the State Attorney General’s office plans to appeal the ruling, that will not stop the dispensing of abortion chemicals in a way that the Missouri Department of Health and Senior Services (DHSS) previously found to be laden with risks to women.

Planned Parenthood facilities in St. Louis and Kansas City wasted no time capitalizing on the ruling by dispensing abortion drugs on Monday. A third Planned Parenthood in Columbia is not currently conducting medication abortions.

“This court ruling has literally declared it unconstitutional to enforce laws that protect women and their babies from shoddy and dangerous abortion practices,” says Operation Rescue President Troy Newman. “Disgracefully, that makes subjecting women to back-alley style abortion procedures a new constitutional right in Missouri.”

How did this happen?

How did Missouri go from being one of the most pro-life states to one that is now abandoning legal protections for vulnerable women and their babies?

In the years prior to the U.S. Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization, thoughtful pro-life legislation was passed into law that included numerous patient safety requirements like clinic licensing, pre-abortion reflection periods, a rule that required abortionists maintain nearby hospital privileges, and other common-sense regulations.

Those laws, in part, were enacted due to a large spike in medical emergencies at the Reproductive Health Services Planned Parenthood in St. Louis. Operation Rescue documented 77 abortion-related medical emergencies there that required the emergency ambulance transport of women to area hospitals. At least four of those women suffered documented life-threatening abortion complications.

Among those laws was also a provision that ended abortions in Missouri once the Supreme Court overturned the 1973 Roe v. Wade Supreme Court decision, which decriminalized abortion in all fifty states. When the Dobbs decision was issued on June 24, 2022, that law took effect, making Missouri one of the first abortion-free states in America.

Abortion organizations responded by placing an initiative on the November 2024 ballot that amended the state constitution to include the “right” to abortion for any reason throughout all nine months of pregnancy. It passed by a narrow margin, allowing abortions to resume in Missouri.

However, state abortion statistics revealed that very few women sought out abortions. In January through October 2025, the months following the abortion amendment’s narrow win, only eighty abortions were committed in Missouri according to preliminary Health Department data.

Pro-life regulations that remained on the books continued to prevent Missouri abortionists from dispensing abortion causing drugs, which are now responsible for at least 63 percent of all abortions done in the U.S. The loss of revenue from their lack of involvement in this burgeoning market was certainly of concern to Planned Parenthood, the only business offering abortions in Missouri.

Planned Parenthood Great Plains and Planned Parenthood Great Rivers filed suit in Jackson County, Missouri, seeking to overturn those and other pro-life regulations as being in conflict with Amendment 3, which states in part, “The Government shall not deny or infringe on a person’s fundamental right to reproductive freedom…The right to reproductive freedom shall not be denied, interfered with, delayed, or otherwise restricted unless the Government demonstrates that such action is justified by a compelling government interest achieved by the least restrictive means…”

In January 2026, a ten-day bench trial was held in the Kansas City courtroom of Judge Jerri Zhang, who issued her final ruling on the case last Friday.

Abortionists “self-regulated”

Zhang’s ruling found that abortionists are “self-regulated and have significant training and safeguards in place to provide medical care in all health care scenarios.”

“Allowing abortionists to self-regulate is like letting the fox guard the henhouse,” says Newman. “I doubt that many of the seventy-seven women who required ambulance transport after suffering botched abortions would concur that abortion facilities have adequate safeguards — even when the pro-life safety regulations were in effect. There is a huge body of documentation that proves abortions were never safe in Missouri.”

Newman is referring to documents obtained by Operation Rescue over the years that clearly show the safety failures and resistance to compliance at Missouri abortion facilities. The following are just a small sampling.

• A report detailing a failed inspection at RHS Planned Parenthood, dated May 25, 2017. Planned Parenthood’s medical director was observed not washing his hands between patients before donning latex gloves. When the inspector called him on the longstanding handwashing requirement, the abortionist questioned whether it was a new standard.
• Repeated failures of clinic inspections dating back to 2009.
• Photos of a rusty, bloody, and moldy suction machine that was used in that condition to conduct approximately fourteen surgical abortions per month at the Columbia Planned Parenthood facility, according to a DHSS Deficiency Report.
• DHSS intended not to renew RHS Planned Parenthood’s clinic license based of a 62-page deficiency report that was so bad, it was sealed by a court shortly after Operation Rescue obtained a copy of it. (View OR’s extensive archive of reports with astonishing details about the licensing case.)
• Seven RHS Planned Parenthood abortionists were subpoenaed in a DHSS investigation into serious abortion injuries but refused to cooperate with state officials, according to a 4-page letter from the DHSS.

Abortion safety laws now unconstitutional

According to Zhang’s newest ruling, the following abortion laws are now unconstitutional in Missouri based on their “conflict” with Amendment 3:

• The prohibition on all abortions that automatically went into effect after the Dobbs decision.
• Any gestational limits on abortion.
• 72-hour reflection period before an abortion.
• In-person visit requirement to receive abortion-inducing drugs.
• Abortion-inducing drugs must be taken in presence of a physician, which eliminates prescribing them via telemedicine.
• Medication complication plan to ensure women suffering abortion pill complications receive speedy and competent care. (Nearly 11 percent of women taking abortion-inducing drugs suffer complications, according to latest study.)
• Abortion facility licensing requirements specifically directed at abortion facilities and ambulatory surgical centers.
• Requirements that abortionists maintain hospital privileges near the facility where the abortions occur.
• Transfer agreement with a local hospital required in the event of a medical emergency.
• Tissue removed during an abortion must be sent to a pathologist for analysis and to ensure the abortion was complete.
• Interference with medical assistance. (For example, when an abortion employee requests that ambulances run without lights or sirens when responding to an abortion-related medical emergency — an act that slows response time and delays care.)
• Abortion reporting requirements.
• Informed consent law that required an abortion business to inform women that “[t]he life of each human being begins at conception… [and a]bortion will terminate the life of a separate, unique, living human being.”

Solution: A new Amendment 3

As mentioned, the State Attorney General plans to appeal Judge Zhang’s dangerous ruling, which Operation Rescue enthusiastically supports. However, the true solution is a new initiative that will appear on Missouri ballots on November 5.

This initiative is also titled “Amendment 3.” It would repeal the 2024 amendment that enshrined abortion as a new “right” under the Missouri Constitution and created a more dangerous and unaccountable state abortion industry.

Known as the “Prohibit Abortion and Gender Transition Procedures for Minors Amendment,” if approved, it will not only remove abortion as a special “right,” but will insert language that will protect pre-born babies and their moms.

Also, the new amendment would protect children under eighteen from harmful gender transition procedures and puberty blocking drugs.

This amendment is a permanent solution to protect children, whether in the womb or in danger from gender transition mutilation.

“I urge every Missourian to vote on November 5 in favor of Amendment 3: Prohibit Abortion and Gender Transition Procedures for Minors,” says Newman. “Make Missouri abortion-free again!”

This article was originally published by Operation Rescue, a leading pro-life, Christian activist organization dedicated to exposing abortion abuses, demanding enforcement, saving innocent lives, and building an abortion-free America. The author, Cheryl Sullenger, is Operation Rescue Sr. Vice President Emeritus.