Missouri’s last remaining licensed abortion clinic might no longer be permitted to perform abortions as of Friday, May 31 — and all because the Missouri Department of Health and Senior Services is reportedly “refusing” to renew their license, even though abortion is still legal in all 50 states.

According to CBS News, the DHSS’s refusal to renew the license would severely limit people’s ability to access abortion services even further than the state’s already restrictive laws. As Refinery29 notes, people seeking abortion care must allow an ultrasound to be performed on them, wait 72 hours between their first appointment and their procedure, and obtain parental consent if they are under 18; the state also bans abortion after 24 weeks, and has banned telemedic abortions.

If the St. Louis-based clinic’s license is not renewed, it would only be allowed to offer Planned Parenthood services not related to abortion, making Missouri the first state without a single licensed abortion clinic.

The clinic’s license is set to expire on May 31; on May 20, the state health department had raised issue with three areas of the clinic, Planned Parenthood said. The organization agreed to comply with the state’s request to perform pelvic exams on abortion patients and to change who provided state-mandated counseling to patients. However, a third request, which Planned Parenthood told CBS News was “out of its control” required a state department investigation into reported “deficient practices” at the clinic. The St. Louis Post-Dispatch also notes that Planned Parenthood claims the state wanted to “interrogate” its doctors as a means of “intimidation.”

In order to comply with the needs of the investigation, Planned Parenthood was asked to provide seven employees that the Missouri Department of Health and Senior Services could interview. Planned Parenthood told CBS News that only two of the requested employees were employed with Planned Parenthood. The other five clinic employees are “residents in training” not working through Planned Parenthood and they declined to be interviewed, a clinic spokesperson told CBS News.

In a written letter, reported on by CBS News, the Missouri Department of Health and Senior Services confirmed the license would expire without completion of an investigation. Responding to the potential closure, Planned Parenthood said it was a filing a restraining order that would potentially halt the close, the Associated Press reported.

Dr. Leana Wen, the President & CEO of Planned Parenthood Federation of America, called the possible loss of licensed abortion access in Missouri a “public health crisis.”

“Missouri would be the first state in the country to go dark—without a health center that provides safe, legal abortion care,” she said in a statement. “More than a million women of reproductive age in Missouri will no longer have access to a health center in the state they live in that provides abortion care.”

News of the closure comes after Missouri Governor Mike Parson signed a bill that would ban an abortion after eight weeks. The law, scheduled to go into effect on August 28, would only allow for an abortion after eight weeks in cases of “medical emergencies,” but not in cases of sexual assault or incest. Any abortion carried out after eight weeks could potentially lead to prison time, NPR reported.

On the same day that Planned Parenthood announced their restraining order, the American Civil Liberties Union of Missouri filed a referendum petition with the Missouri Secretary of State, the Kansas City Star reported. Filed in response to Parson’s bill, the petition, if approved, would allow the ACLU to secure the signature support of 100,000 people who wanted the state to revote on the bill. Once 100,000 signatures are collected, passage of the bill would be halted until a vote was taken.

Planned Parenthood pointed to the bill as a possible reasoning for the closure. “Missouri’s governor just signed an extreme ban into law, but he is not waiting until the law goes into effect: his administration is ending access to safe, legal abortion care,” Dr. Wen said.

Missouri is the latest state to pass abortion bans. Reports published by Planned Parenthood indicate that the United States has seen a 63 percent increase in the introduction of anti-abortion bills over the last year. Lawmakers have filed at least 250 bills that would aim to restrict abortion across state legislatures in 2019 so far.

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