Dr Erin King felt a weight lift off her shoulders – at least for a few minutes.

The executive director of Hope Clinic in Granite City, Illinois had spent a week “scrambling” to prepare for an influx of patients from St Louis – just about a 10-minute drive across the Mississippi River – as Missouri threatened to close its last legal abortion provider by the end of the week at midnight.

In a ruling on Friday afternoon, circuit judge Michael Stelzer issued a temporary restraining order keeping Missouri from allowing the St Louis Planned Parenthood’s license to expire – keeping the clinic in operation at least until Tuesday.

It didn’t remove the stress for King, but it at least allowed her, her staff, and Planned Parenthood officials in Missouri a few more days to prepare for the worst.

“It does not give me comfort,” King said of the ruling Friday afternoon. “But it is good news for the very short term.”

Abortion rights in Missouri have been under “aggressive” attack for more than two years now. But earlier this month, the Republican governor, Mike Parson, signed a restrictive bill prohibiting the procedure after eight weeks and even criminalizing doctors who perform it.

The state has also been using administrative maneuvering to stamp out abortion here, women’s rights advocates say. The department of health and senior services is declining to renew the St Louis clinic’s license unless it grants the state interviews with all seven physicians who practice at the clinic, including trainees – something Planned Parenthood has described as “harassment” and an excuse to roll back reproductive rights.

If the St Louis Planned Parenthood were to be closed for the procedure, Missouri would become the first state in the country in close to 50 years without a legal abortion provider. That would force clinics like King’s, in neighboring states near the Missouri border, to pick up the slack.

Illinois has passed legislation to expand abortion access – a move cheered by King, who finds herself straddling two different worlds.

“We’re sitting literally on this cusp of what could potentially be one of the worst days for abortion rights in this region, and one of the best – separated by a river,” King said.

Anticipating attacks on abortion rights, the Hope Clinic has already doubled the number of its doctors, increased its staff, and added additional appointment days to its schedule to accommodate the influx in patients.

Signs on the wall of the Hope for Women Clinic in Granite City, Illinois. Photograph: Troy Swanson/EPA

But the latest wave of threats against reproductive rights has been “scary” – and put both staff and patients on edge, King said in an interview.

“We’ve seen a significant increase in patient stress in the last two weeks,” King said in her office. “It is very clear there is a lot of anxiety. A lot of tension.”

Hope Clinic is located near a large healthcare campus on the ragged edge of this manufacturing town. On the sidewalk leading up to its door, protesters have scribbled out anti-abortion messages in chalk. “GOD KNIT YOU IN YOUR MOTHER’S WOMB,” one square of sidewalk read Friday morning. “ABORTION SCARS UTERUS + WEAKENS CERVIX,” read another.

Inside the busy clinic, King has fostered a calming presence. She comes off as upbeat, even on a day like Friday, when her home state – she lives across the river in St Louis with her husband, Dr David Eisenberg, the co-medical director of Planned Parenthood of the St Louis region – was hours away from losing its last abortion clinic.

She’s good at brushing off the anti-abortion demonstrators who gather outside the clinic on a near daily basis. She’s good at focusing on the positive feedback the clinic gets from patients, some of which is posted on a cork board outside her office: “Thanks for all you do on a daily basis,” reads one message from a former patient.

Still, even King is exasperated by Republican attacks on reproductive rights – so much so that she has, at times, considered leaving Missouri.

“I feel like I am dehumanized,” she said. “We’re going backwards in time.”

Ultimately, Judge Stelzer granted the St Louis Planned Parenthood a temporary stay in what Eisenberg said in a press conference outside the clinic on Friday was a “huge victory” for Missourians. A massive banner on the clinic read: “Still here.”

Outside the Planned Parenthood in St Louis. Its fate remains uncertain. Photograph: Saul Loeb/AFP/Getty Images

For abortion rights supporters outside the clinic on Friday, the judge’s ruling was merely temporary “breathing room” – and provided little relief.

“The fight’s not over,” said Peg O’Malley, who stood outside the clinic holding a sign reading: “Pro-Choice Catholic.”

“It’s just unbelievable,” another Planned Parenthood supporter, Kathy Turner, said outside the embattled clinic. She was there with her husband and small child to show her support. “I never thought it would get this bad.”

It’s not clear what will ultimately happen to the clinic. Stelzer ruled on Friday that “immediate and irreparable injury will result if petitioner’s license is allowed to expire”, allowing the clinic to continue providing abortions past midnight on Friday, when its license was due to expire.

But it’s not clear what its fate will be past Tuesday, when another hearing is scheduled. Even if it is allowed to continue operating, though, reproductive rights in Missouri are in peril – with only one abortion clinic for a state with a population of more than 3 million women and reproductive rights under threat from Republicans in the state legislature.

“This is a crisis,” King said. “This is happening.”