JEFFERSON CITY, Mo. (AP) -- Missouri is down to one clinic providing abortions Wednesday, after the only other clinic in the state that performs the procedure failed to adhere to new state requirements and its license expired.
The Columbia clinic's abortion license expired Tuesday, Planned Parenthood Great Plains spokeswoman Emily Miller said.
Federal appeals court judges also ruled last month that Missouri can enforce a requirement that doctors must have admitting privileges at nearby hospitals before they can perform abortions. The judges issued a mandate Monday for that rule to officially take effect.
The Columbia Planned Parenthood clinic has been unable to secure physician privileges or find a doctor with those privileges after a panel of medical staff at University of Missouri Health Care voted to stop offering those privileges altogether in 2015 amid a Republican-led legislative investigation on abortion in the state.
Miller said the clinic cancelled abortions scheduled for Wednesday in Columbia, which would have been the first since the mandate was issued. The clinic continues to provide other health care services.
"We are unable to provide abortion services now, so we've been working with patients who were on the schedule for today for abortion appointments to let them know what their alternatives are," Miller said.
Women seeking abortions can go to Planned Parenthood's St. Louis clinic --- which is now the only facility in Missouri where abortions can be performed --- or travel to neighboring states, she said. Planned Parenthood has argued in court filings that the additional distance women will need to travel to the clinic on the far eastern border of the state to receive abortions will be burdensome and could make the procedure inaccessible to some.
Miller said they're hoping the state will issue another abortion license soon.
Planned Parenthood attorneys also had asked U.S. Western District Court Judge Brian Wimes to temporarily exempt the Columbia clinic from the hospital privileges requirement before Wednesday. Wimes hasn't yet ruled on that request.
If Wimes does decide to grant a temporary restraining order on the law, abortions could resume at the clinic if it also receives another license.
Planned Parenthood affiliates with Missouri health centers filed the underlying lawsuit to block state requirements on admitting privileges and mandates that clinics meet hospital-like standards for outpatient surgery. The U.S. Supreme Court in 2016 struck down similar rules in Texas.
The Missouri Attorney General's Office, which is defending the regulations, in court documents argued that the admitting privileges requirement "provides substantial benefits, such as ensuring that women have access to a treating physician, ensuring continuity of care, reducing the likelihood of unnecessary treatment, and providing women and the State with greater, more accurate information."
Attorneys with the attorney general also wrote that the requirement "is strongly justified by Missouri-specific circumstances, such as the deeply troubling health-and-safety record of Missouri abortion facilities and their long, flagrant violation of statutory reporting requirements."
The office cited a Sept. 26 health inspection that found the clinic was using equipment with tubing that contained "black mold and bodily fluid."
Miller said Planned Parenthood takes issue with that description, and said the tubing has been replaced and other concerns raised in the Sept. 26 inspection have been addressed.
U.S District Judge Howard Sachs in May 2017 issued a temporary restraining order to block the admitting privileges rule. But his action was undone in September by judges on the 8th U.S. Circuit Court of Appeals, who argued Sachs didn't do enough to weigh the cost benefits of Missouri's rules and sent the case back to the lower court.
The underlying challenge to the Missouri abortion regulations is still pending.