Missouri’s only abortion clinic was in a regulatory standoff with the state Friday as a judge weighed whether to grant an order allowing it to continue performing abortions as its license neared its expiration.

The annual license for Planned Parenthood’s St. Louis abortion clinic was due to lapse at midnight Friday, which would make Missouri the only state without a functioning abortion clinic.

St. Louis Circuit Judge Michael Stelzer heard arguments Thursday on Planned Parenthood’s request for a temporary restraining order that would prohibit Missouri from allowing the clinic’s abortion license to end. It wasn’t clear when Stelzer would rule.

The Missouri Department of Health and Senior Services has cited concerns with “failed abortions,” compromised patient safety and legal violations at the St. Louis clinic. Agency officials also want to interview additional physicians who have worked at the clinic as part of their investigation.

But Planned Parenthood has said five of the seven doctors are contractors — not staff members — and can’t be compelled to speak to the state. The two staff doctors did talk with state officials.

“If we could meet with these doctors on these clinical issues, we really think we could get to a resolution very quickly,” health department Director Randall Williams said Friday.

The department wants to satisfy concerns “about some patients that had bad outcomes,” he said. “We need to make sure, by our statutorily required duty, that those aren’t going to happen again.”

Williams said there is no option for the department to grant a temporary extension of the license.

Planned Parenthood officials have said Missouri is “weaponizing” the licensing process.

“Planned Parenthood, with the exception of the interviews, has bent over backward” to work with the state, organization attorney Jamie Boyer said at the court hearing Thursday.

Tensions over abortions have been running high in Missouri.

St. Louis police said 16 people were arrested Thursday while protesting in support of abortion rights after refusing to leave a building where Republican Gov. Mike Parson has an office. Those arrested included an alderwoman and Planned Parenthood board members.

Planned Parenthood officials have said that if the St. Louis clinic’s license is not renewed, Missouri would become the first state without an abortion clinic since the U.S. Supreme Court’s 1973 Roe v. Wade decision that legalized the procedure nationwide.

The fight over the clinic’s license comes as lawmakers in conservative states across the nation are passing new restrictions that take aim at Roe. Abortion opponents, emboldened by new conservative justices on the Supreme Court, are hoping federal courts will uphold laws that prohibit abortions before a fetus is viable outside the womb, the dividing line the high court set in Roe.

Louisiana, Georgia, Kentucky, Mississippi and Ohio have enacted bills barring abortion once there’s a detectable fetal heartbeat, as early as the sixth week of pregnancy. Missouri lawmakers recently approved an eight-week ban on abortion. Alabama’s gone even further, outlawing virtually all abortions, even in cases of rape or incest. None of the bans has taken effect, and all are expected to face legal challenges.

The number of abortions performed in Missouri has declined every year for the past decade, reaching a low of 2,910 last year. Of those, an estimated 1,210 occurred at eight weeks or less of pregnancy, according to preliminary statistics from the state health department.

If the St. Louis clinic loses its license, women seeking abortions in the area could travel to a clinic across the Mississippi River in Granite City, Illinois, which is less than 10 miles (16 kilometers) from the Planned Parenthood facility in St. Louis. Planned Parenthood’s abortion clinic in the Kansas City area is in Overland Park, Kansas, just 2 miles (3 kilometers) from the state line.

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