Updated at 4:22 p.m. ET
Missouri health officials on Friday refused to renew the license of the state's last remaining clinic that provides abortions, but the St. Louis facility will continue to provide abortions for now because a judge's order remains in place.
In a letter to the clinic, state health official William Koebel wrote that the decision to not renew the license was "based on the serious, extensive unresolved deficiencies."
The letter said the clinic has addressed some concerns outlined by state regulators but not others, leaving the facility out of compliance with state law.
Earlier this month, a St. Louis Circuit Court judge granted Planned Parenthood's request to temporarily prevent state officials from revoking the clinic's license to provide abortions in the face of health officials attempting to revoke the license of the state's sole abortion provider.
It was the latest in a series of short-term legal reprieves for the clinic.
At a court hearing on Friday, Judge Michael Stelzer said it is not clear when the court will reach a final decision on whether the state can stop abortion services at the clinic, which is run by Planned Parenthood, NPR member station St. Louis Public Radio reported.
A spokeswoman for the St. Louis facility said the license issue would impact only part of the clinic, meaning that even if abortion services were to end, other gynecological and reproductive health services would continue.
Critics of the state's decision not to renew the license say top officials in Missouri are using the state regulatory process as a means of pursuing an anti-abortion-access political agenda.
"Missouri would have its residents return to the days when abortion was outlawed, when women seeking abortions had to risk a loss of fertility or their life when trying to end an unwanted pregnancy," Toni Van Pelt, president of the National Organization for Women, said in a statement.
"These dangers," she added, "are especially prevalent for people in vulnerable populations, such as women living in poverty and women of color, who may not have the resources necessary to travel out-of-state to access abortion care."
If the state's efforts are successful, Missouri will become the only state in the U.S. without a legal abortion provider.
Health officials in the state have cited concerns about operations and the quality of care at the facility. As NPR has previously reported:
"In March, state officials cited a number of deficiencies in their inspections of the clinic as part of the annual license renewal process. One problem they noted was that not all of the staff had participated in a fire drill. Then in April, Missouri officials announced an investigation of an unspecified complaint from a patient.
"State officials asked to interview seven physicians associated with the clinic, some of whom were employed by Washington University Medical School and were not part of the clinic's full-time staff. Because of that relationship, the clinic argues it cannot force the doctors to be interviewed. It also says the state has not revealed the scope of the questioning, which the clinic's legal team says could include criminal referrals."
Koebel, the state health official, wrote in the letter that clinic staff has addressed problems highlighted by the state, including better reporting of "failed abortions." He also said clinic officials have improved record-keeping rules and taken steps to make sure the physician who received informed consent from a patient is the same doctor who performs an abortion.
But Koebel said there are numerous other areas in which the clinic has not taken action. State officials say the clinic is still undermining its investigation into patient care by refusing to make available for interviews some physicians who provide abortions.
The letter stated that some patients had "failed abortions" likely because of physician missteps during examinations. "The Department has no assurance that such instances would not be repeated," Koebel wrote.
Abortion-rights advocates say Missouri is "weaponizing" state health law in an effort to eliminate the procedure from the state. The short-term win on Friday was cautiously applauded by Leana Wen, president and CEO of Planned Parenthood.
"This fight is far from over — we will continue to do everything we can to maintain, protect, and expand access to safe, legal abortion care for our patients," Wen said.
Missouri is one of about a dozen states that have passed laws this year seeking to restrict abortion access. Supporters of some of the bills have said the new laws are an attempt to prompt a Supreme Court review of the 1973 Roe v. Wade decision legalizing abortions nationwide.
In Missouri, Republican Gov. Mike Parson signed a bill in May that criminalizes almost all abortions in the state after eight weeks of pregnancy — which is often before many women are aware they are pregnant.
Under the law, any person who performs an abortion after eight weeks could be charged with a Class B felony punishable by five to 15 years in prison.
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