A decision about whether Missouri’s last abortion clinic can remain open is “imminent”, advocates involved in the case have said.

Last summer Republican state officials refused to relicense the state’s last clinic, a Planned Parenthood in St Louis. If it shuts, Missouri will be the first state in the US to have no abortion clinic since abortion was legalized in 1973 in the Roe v Wade supreme court decision.

Advocates have argued that the state’s decision not to relicense the clinic is a political move to end abortion in a state long hostile to reproductive rights. The same year the clinic’s license was denied, the state passed a restrictive eight-week abortion ban.

Efforts to close the clinic in Missouri come in the context of a nationwide effort to restrict abortion. Last year, state lawmakers across the south and midwest passed “heartbeat bills”, which restrict abortion at six weeks.

A judge’s ruling on the Missouri case is expected soon as Monday was the last day for attorneys representing the state and Planned Parenthood to file legal briefs.

Already, state statistics have shown women are leaving Missouri to obtain abortions. “Abortion access is so difficult in Missouri that the majority of people choose to cross state lines instead of accessing care in their home state,” said Yamelsie Rodríguez, CEO of the St Louis Planned Parenthood clinic.

Only three women obtained abortions at the St Louis clinic in February, according to state data records analyzed by NPR. That is down from 174 the year before. More than 300 Missouri women crossed state lines into Illinois to obtain abortions. Rodríguez cited 72-hour waiting periods for an abortion, state-mandated counseling and, at one point, medically unnecessary pelvic exams as driving women to other states.

In addition, court hearings revealed state officials had tracked women’s menstrual cycles in an effort to find incomplete abortions at the clinic, and that the abortion clinic is the state’s only outpatient facility inspected annually and that inspectors did not find an unsafe environment. State officials have claimed they revoked the license for alleged safety violations.

Even more extreme measures have been introduced, though not passed, in other statehouses across the US. A group of Ohio lawmakers introduced a bill to make “abortion murder” a crime and requiring doctor to try to “reimplant” ectopic pregnancies, an impossible feat. One Missouri lawmaker introduced a bill to try to give due process rights to fetuses, and to then have local law enforcement to stop women from having abortions.

The case also comes in the context of the most high-profile reproductive rights case to come before the supreme court in decades. The court heard oral arguments this month on whether Louisiana could legally restrict abortion access. If upheld, the case could have severe nationwide implications.

“No one should be forced out of their home state just to access healthcare,” said Planned Parenthood’s CEO, Alexis McGill Johnson, about statistics showing more women were seeking abortions in Illinois. “What’s happening in Missouri could soon be the reality for many more states and millions of other people. It is no coincidence that just over a week ago, we were rallying in front of the supreme court – the right to control your body, life, and future is on the line.”