The wide-ranging proposal also would exempt alternatives-to-abortion agencies from a new St. Louis ordinance barring discrimination against women on the basis of whether they take birth control or have had an abortion.

“This is the most important bill in my short time as a legislator. There is a clear and present danger to the health and safety of Missouri women and to the free speech rights of pregnancy care centers,” said Republican Sen. Bob Onder, an abortion opponent from Lake Saint Louis.

The vote left Democrats seething after they had worked to send the House a less restrictive version of the legislation last month. The House rejected that proposal and sent the Senate a version containing tougher mandates against abortion clinics.

Democrats and a handful of Republicans had sought to force a compromise with the House. But Republican leaders used the so-called “nuclear option” to end debate on the measure.

Three Republicans bolted from party leaders to vote against forcing a vote on the bill, including Sens. Bob Dixon of Springfield, Gary Romine of Farmington and Doug Libla of Poplar Bluff.

Sen. Jill Schupp, D-Creve Coeur, said she would have filibustered the issue last month had she known Senate Republicans would allow the House bill to make it to Greitens’ desk.