In 20 years at Planned Parenthood Great Plains, Vicki Casey said she's suffered a wide range of harassment, both physical and verbal.
She said she's been verbally berated by protesters as she walked to her car and was even physically assaulted. In 2019, someone set fire to the Columbia Planned Parenthood clinic where she worked.
As Casey, a facilities operations manager, sat at the witness stand, she told attorneys on behalf of Planned Parenthood that even the act of testifying, something incredibly public, brought her great anxiety.
"I've been followed and confronted at the grocery store, and someone in this courtroom today came to my house on this past Mother's Day," she said.
Casey recalled one particular moment when she was trying to escort a provider from one spot to another in her car.
"I accompanied (the provider) and we were chased through the streets of Columbia with three vehicles by people I can only assume were anti-abortion," Casey said.
This environment made hiring and retaining staff incredibly difficult and, in many cases, chased away women who needed health care services, she said. Burdensome regulations imposed on abortion providers further complicated the situation, something Planned Parenthood leaders and staff testified to during the first five days of a trial in Jackson County Circuit Court.
Although Missourians passed a constitutional amendment in November 2024 enshrining the right to an abortion up to fetal viability, many abortion regulations are still in effect. Planned Parenthood and the American Civil Liberties Union of Missouri are suing to get these laws off the books, but attorneys for the state argue the laws are necessary to give women time to make an informed decision and protect them from bad actors.
Judge Jerri Zhang temporarily halted many of these laws, allowing procedural abortions to resume, but medication abortion remains blocked. Now, a trial will determine whether these laws will be officially stricken. Beyond the total abortion ban, these regulations include requirements that:
- the same doctor who meets the patient during the initial appointment be the one to provide the abortion,
- clinics meet certain physical requirements, like hallway and door size or the type of changing room available,
- pelvic exams be performed before every procedure, even medication abortions,
- restrict the use of telemedicine for medication abortions,
- a complication plan be created for medication abortions,
- providers offering medication abortion carry tail insurance effective for 21 years after an abortion takes place.
Wendy Stamilio, a lead nurse for Planned Parenthood Great Rivers, said in her testimony that a required 72-hour waiting period between the initial appointment and an abortion was a major detriment to patients.
Some travel long distances only to be told to come back in three days, presenting challenges with child care, work and other scheduling factors. Sometimes it delayed care for weeks.
State attorneys argued this restriction ensures women aren't forced into a process they are unsure about. Stamilio, who is in charge of training for many nurses, said if a woman is unsure, they would never be rushed or pressured by staff.
"What I always tell patients is they can't take it back so we need to be sure," she told state attorneys. "You can be sad and sure. You can be scared and sure. But being unsure, it's not OK to move forward."
During that initial meeting, doctors are required to provide an informed consent packet written by the state Department of Health and Senior Services. It's another step the state believes will protect women. But outside experts brought in by Planned Parenthood said much of this packet contains questionable information that would undermine trust between patients and their clinicians.
Dr. Daniel Grossman, an obstetrician-gynecologist at San Francisco General Hospital, also called into question a requirement that clinics providing abortion be located within 30 miles or 15 minutes of a hospital where the clinic's doctors have admitting privileges. He said that many hospital requirements for admitting privileges go far beyond what these clinicians could meet, like the number of patients that need to be admitted in a given timeframe.
Emily Wales, the CEO and President of Planned Parenthood Great Plains, said this requirement has been especially cumbersome on the Columbia clinic.
In 2012, the facility had two providers with these privileges, but both stopped working due to harassment, she said. By 2015, they were able to relicense, but a state inquiry and request for documents caused the hospital to revoke these privileges.
Eventually, they acquired admitting privileges, but in 2017, the state passed new regulations requiring their medication abortion complication plan to have an OB/GYN on call around the clock. Once again, abortions ceased. The constant stop-start limited the number of abortions they could provide, and the threat of criminal penalties should they accidentally break a law caused great distress for providers, Wales said
"I felt under a microscope. I felt targeted," clinic staff told Wales, she testified. She added that their experiences with regulations imposed on clinics offering abortion were far more restrictive and punitive than those for any other health care facility.
A higher obligation
While Planned Parenthood laid out an argument they felt was sufficient to sway the judge, state attorneys on Friday sought to have Zhang end the case early.
Assistant Solicitor General Alex Buttram argued evidence presented by Planned Parenthood did not meet the evidentiary standard.
"It is the burden of the plaintiff to prove that the challenged statutes are invalid in all circumstances," he said, adding that testimony from Planned Parenthood witnesses acknowledged "that many of the regulations at issue like prohibiting smoking, requiring sanitation, infection control are the standard of care."
Attorneys on behalf of Planned Parenthood disagreed with this standard, and Zhang ruled against the early verdict, suggesting they do have sufficient evidence to, at the very least, have their claim heard.
Now, the state will take the next five days to lay out its argument before the judge.
Dr. Ingrid Skop, a vice president of the national anti-abortion Charlotte Lozier Institute, was the first witness called by the state late Friday. She set the basis last week for the state's position that existing regulations don't inherently prevent providers from offering abortions. Instead, she suggested they give women the time and information necessary to make an informed decision.
"Considering an abortion is a highly emotional event," Skop said. "In a situation like that, the obligation to make sure a woman understands everything about the decision is much higher."
Skop also suggested that complications from abortion are more common than data suggests, something the state is expected to hit on further in the coming days. Complications occur in approximately 2% of elective abortions, with about 1 in 4 of those requiring hospitalization, according to National Institutes of Health data.
Copyright 2026 KCUR
