Missouri was the first state to mandate that abortion clinics meet the same stringent patient care standards as facilities performing other outpatient surgeries, protecting women from an increasingly substandard and predatory abortion industry and setting the “gold standard” for other states to follow. However, the state provides little protection to human embryos outside the womb, having amended the state constitution to allow cloning-for-biomedical-research.
- The legislature has found that the life of each human being begins at conception.
- As applied to its abortion-related laws, Missouri maintains a narrow definition of “medical emergency”: A medical emergency is deemed to exist only in situations where a woman’s life or a “major bodily function” is at risk.
- Missouri prohibits partial-birth abortion.
- Missouri has a post-viability abortion ban that allows an abortion only when the life of the mother is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, or when continuation of pregnancy will create a serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman. The law also requires determination of gestational age according to specified standards, includes specific reporting requirements, and requires a second physician to concur that an abortion is “medically necessary.”
- At least 24 hours prior to abortion, a woman must be advised of the risks of abortion, given information about the development of her unborn child, and provided information on resources available to assist her in bringing her child to term. The law also requires that she be informed that abortion ends the “life of a separate, unique, living human being.
- Abortion providers must offer an ultrasound to every woman seeking an abortion.
- Women seeking abortions at or over 22-weeks gestation must be counseled on fetal pain.
- Abortion clinics must provide a woman with confidential access to a telephone and list of protective resources if she indicates that she is being coerced by a third party into seeking an abortion.
- A physician may not perform an abortion on an unemancipated minor under the age of 18 without the informed, written consent of one parent or a court order. Further, only a parent or guardian can transport a minor across state lines for an abortion.
- Missouri requires abortion clinics to meet the same patient care standards as other facilities performing surgeries in an ambulatory setting.
- Only physicians licensed by the state, practicing in Missouri, and having surgical privileges at a hospital that offers obstetrical or gynecological care may perform abortions. The Eighth Circuit Court of Appeals has upheld this requirement.
- A physician performing abortions must have admitting privileges at a hospital within a 30-mile radius of the facility where the abortion is performed.
- Missouri law provides that no person shall perform or induce a “medical abortion” unless such person has proof of medical malpractice insurance with coverage amounts of at least $500,000.
- The state has an enforceable abortion reporting law, but does not require the reporting of information to the Centers for Disease Control (CDC). The measure pertains to both surgical and nonsurgical abortions and requires abortion providers to report short-term complications.
- Missouri follows the federal standard for Medicaid funding for abortions, only permitting the use of federal or state matching Medicaid funds for abortions necessary to preserve the life of the woman or when the pregnancy is the result of rape or incest.
- Missouri law provides that it is unlawful for any public funds to be expended for the purpose of performing or assisting an abortion not necessary to save the life of the mother or for the purpose of encouraging or counseling a woman to have an abortion not necessary to save her life.
- The state has an extensive list of additional limitations on abortion funding, including the following: public facilities may not be used for performing, assisting in, or counseling a woman on abortion unless it is necessary to preserve her life; a state employee may not participate in an abortion; no school district or charter school or personnel or agents of these schools may provide abortion services or permit instruction by providers of abortion services; family planning services may not include abortions unless it is certified by a physician that the life of the mother is in danger; “Missouri Alternatives to Abortions Services Program” funding may not be granted to organizations or affiliates of organizations that perform or induce, assist in the performance or induction of, or refer for abortions; research grants may not be used in research projects that involve abortion services, human cloning, or prohibited human research, and cannot share costs with another prohibited study; and no money from the legal expense fund may be used to defend abortion.
- Private health insurance policies are prohibited from including coverage for abortion unless an abortion is necessary to preserve the life of the woman or an optional rider is purchased. Missouri also prohibits abortion coverage for state employees except in cases of life endangerment. Further, Missouri protects individual and group insurance consumers from paying for insurance coverage that violates their moral or religious beliefs.
- State health insurance for uninsured children cannot be used to encourage, counsel, or refer for abortions, with exceptions for life endangerment or in cases of rape or incest.
- Insurance companies participating in the state insurance Exchanges established pursuant to the federal healthcare law cannot offer policies that provide abortion coverage within the Exchanges, expect in cases of life endangerment. There is a state constitutional amendment prohibiting the establishment, creation, or operation of a health insurance Exchange unless it is created by a legislative act, a ballot initiative, or referendum.
- Missouri has appropriated federal and state funds for women “at or below 200 percent of the Federal Poverty Level” to be used to encourage women to carry their pregnancies to term, to pay for adoption expenses, and/or to assist with caring for dependent children.
- Missouri requires that the initial dose in an abortion-inducing drug regimen be administered in the presence of a physician. The physician or an agent of the physician must also make all reasonable efforts to ensure that the woman comes back for a follow-up appointment.
- Missouri provides direct taxpayer funding to pregnancy resource centers and prohibits organizations that receive this funding from using those funds to provide abortion counseling or to make referrals for abortion.
- Missouri also provides tax credits for donations to pregnancy resource centers that do not perform or refer women for abortions.
Legal Recognition and Protection of Unborn and Newly Born:
- Under Missouri law, the killing of an unborn child at any stage of development is defined as a form of homicide.
- The state allows a wrongful death (civil) action when an unborn child at any stage of development is killed through a negligent or criminal act.
- Missouri has enacted AUL’s “Pregnant Woman’s Protection Act,” which provides an affirmative defense to women who use force to protect their unborn children from criminal assaults.
- The state has created a specific affirmative duty of physicians to provide medical care and treatment to infants born alive at any stage of development.
- Missouri has a “Baby Moses” law, establishing a safe haven for mothers to legally leave their infants at designated places and ensuring that the infants receive appropriate care and protection.
- The state funds drug treatment programs for pregnant women and newborns.
- In November 2006, Missouri voters approved a ballot initiative amending the state constitution to allow cloning-for-biomedical research (while banning cloning-to-produce-children) and destructive embryo research. This constitutional amendment may mean that the state’s ban on public funding relates only to cloning-to -produce-children.
- The state’s prohibition on fetal experimentation applies only to a fetus aborted alive.
- Missouri has created a program funding the establishment of umbilical cord blood banks. The state Department of Health and Senior Services is to post resources regarding umbilical cord blood on its website including information on the potential value and uses of cord blood. State law authorizes a licensed physician giving care to a pregnant woman to provide information about this website.
- Missouri maintains no laws regarding human egg harvesting or assisted reproductive technologies.
End of Life Laws:
- In Missouri, assisted suicide constitutes manslaughter.
Healthcare Freedom of Conscience:
Refusal to Participate in Abortion:
- A physician, nurse, midwife, or hospital is not required to admit or treat a woman for the purpose of abortion if such admission or treatment is contrary to religious, moral, or ethical beliefs or established policy. Protection is also provided to medical and nursing students.
- A law requiring insurance coverage for obstetrical and gynecological care provides: “Nothing in this chapter shall be construed to require a health carrier to perform, induce, pay for, reimburse, guarantee, arrange, provide any resources for, or refer a patient for an abortion.
Participation in Research Harmful to Human Life:
- Missouri currently provides no protection for the rights of healthcare providers who conscientiously object to participation in human cloning, destructive embryo research, or other forms of immoral medical research.
What Happened in 2013:
- With the assistance of AUL’s state director, Missouri enacted a measure allowing contributions to pregnancy resource centers to be eligible for tax credits. Similarly, the state considered a measure specifying that the constitutions and laws of the United States and Missouri must protect the rights of “alternatives-to-abortion agencies,” as well as a measure ensuring that pregnancy resource centers can freely engage in religious practices.
- Missouri enacted a law requiring that the initial dose in an abortion-inducing drug regimen be administered in the presence of a physician, and requiring that the physician or an agent of the physician make all reasonable efforts to ensure that the woman comes back for a follow-up appointment after a chemical abortion.
- Missouri considered legislation prohibiting sex-selection abortions, delineating qualifications for individual abortion providers, involving abortion reporting, and restricting abortion funding and insurance coverage of abortion.
- Missouri also considered legislation allowing or regulating destructive embryo research.
- Legislators considered measures offering limited conscience protection for healthcare providers, but it also considered legislation that would force pharmacists and/or pharmacies to stock and dispense so-called “emergency contraception” without regard to conscience objections.
Recommedations for Missouri
Women’s Protection Project Priorities:
- Women’s Health Defense Act (5-month abortion limitation)
- Abortion-Inducing Drugs Safety Act
- Parental Involvement Enhancement Act
- Abortion-Inducing Drugs Safety Act
- Component of the Child Protection Act mandating evidence retention
- Prenatal Nondiscrimination Act
- Defunding the Abortion Industry and Advancing Women’s Health Act
- Joint Resolution Commending Pregnancy Resource Centers
Legal Recognition and Protection for the Unborn:
- Law criminalizing nonfatal assaults on the unborn
- Assisted Reproductive Technologies Disclosure and Risk Reduction Act
Healthcare Freedom of Conscience:
- Healthcare Freedom of Conscience Act