Signed into law by Gov. Mike Parson (R) in May, the gestational age bans make it a crime to perform an abortion at or after eight, 14, 18, and 20 weeks of pregnancy, as measured from the first day of a patient’s last menstrual period.

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The fight over legal abortion in Missouri intensified Tuesday as reproductive rights advocates filed a federal lawsuit challenging several pre-viability abortion bans set to take effect at the end of August.

The lawsuit, filed by the American Civil Liberties Union (ACLU) and Planned Parenthood, targets four bans that the Missouri legislature lined up like dominos in HB 126. Signed into law by Gov. Mike Parson (R) in May, the gestational age bans make it a crime to perform an abortion at or after eight, 14, 18, and 20 weeks of pregnancy, as measured from the first day of a patient’s last menstrual period. HB 126 is written in such a way that the later gestational age bans are intended to remain in effect if any of the earlier ones are struck as unconstitutional. In other words, if Missouri’s eight-week ban is struck down, language in the measure would trigger another ban on abortions at 14 weeks. If that 14-week ban is overturned, the state would have an 18-week ban take effect. If that 18-week ban is struck down, abortions would be illegal after 20 weeks.

Finally, if the U.S. Supreme Court overturns Roe v. Wade, abortions would be banned in all circumstances except for medical emergencies.

Advocates also challenged HB 126’s ban on abortion at any stage of pregnancy if the provider “knows” that the patient’s decision to terminate their pregnancy is based on the sex or race of the embryo or fetus, or a “prenatal diagnosis, test, or screening” indicating Down syndrome or the potential for it.

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“For years, anti-abortion politicians in the Missouri General Assembly have been pushing abortion care further and further out of reach,” said Tony Rothert, acting executive director and legal director of the ACLU of Missouri, in a statement. “Until now, they’ve used medically unnecessary and politically-motivated restrictions as a cudgel. H.B. 126, Missouri’s extreme and unconstitutional abortion ban, shows us just how far they’ll go. This dangerous bill criminalizes abortion at nearly every stage of pregnancy.”

“The ACLU will not stand by while politicians emboldened by President Trump’s anti-abortion agenda exploit our health and our lives for political gain,” Rothert continued.

Legal abortion is under siege in Missouri. Earlier this summer, Missouri health officials refused to renew the license of a Planned Parenthood reproductive health-care clinic in St. Louis, citing alleged violations of state laws. But a judge blocked that decision in June, deciding the clinic could stay open until at least August while the fight over its license continues. Advocates are also hoping to let voters weigh in on Missouri’s eight-week ban, and they have sued to move forward with a referendum petition to put repealing the measure on the ballot for Missouri’s general election this fall.

“Gov. Parson and anti-abortion politicians are on a mission to end access to safe, legal abortion in Missouri,” said Dr. Colleen McNicholas, chief medical officer at Planned Parenthood of the St. Louis Region, in a statement Tuesday announcing the lawsuit.“This law passed in May, just as Gov. Parson launched a failed attempt to end abortion in Missouri through the state’s health center licensing process. We are in the fight of our lives to protect abortion for 1.1 million Missouri women of reproductive age in our state.”

Advocates claim that if the challenged provisions are allowed to take effect, those bans—combined with the myriad of abortion restrictions already in place in the state—would have the effect of preventing the “vast majority” of patients in Missouri from being able to access abortion there. Missouri’s complex web of abortion restrictions already means many must travel out 0f state to places like Illinois for care. Any patient wishing to have an abortion must first visit a provider at least 72 hours before the procedure. At that appointment, the state requires providers to give patients misleading information designed to dissuade them from having an abortion. The patient must then return for a second visit. That means each patient, with extremely limited exceptions, must make at least two separate visits to a clinic or a hospital, at least three full days apart.

“Unless they are blocked by the court, these extreme laws would outright ban the vast majority of abortions in Missouri,” said Andrew Beck, senior staff attorney at the ACLU Reproductive Freedom Project, in a statement. “The impact would be devastating for Missourians seeking abortion care and would be felt most acutely by low-income patients and people of color,” Beck said. Missouri already has some of the worst health outcomes for Black women in the country, with Black maternal mortality rates 230 percent higher for Black patients in the state than for white.

“These dangerous and illegal bans put people’s health and lives at risk. We are living in a terrifying world where politicians are doing all they can to overturn Roe v. Wade—no matter how many people’s lives they put at risk,” said Alexis McGill Johnson, acting president and CEO of Planned Parenthood Federation of America, in a statement.

Missouri is one of nine states in 2019 to pass a law either banning abortion before viability or re-criminalizing abortion entirely, with more states like Tennessee considering similar bans. So far no federal court has allowed any of these restrictions to take effect.

Attorneys for Missouri have not yet responded to the lawsuit. Absent a court order blocking the restrictions, they will take effect August 28.