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Missouri Omnibus Abortion Bill (SB 5)

This law was last updated on Oct 23, 2017

This law is Anti–Choice




SB 5




Jun 12, 2017


Primary Sponsors: 2
Total Sponsors: 2


Conscience and Refusal Clauses, Fetal Tissue, Omnibus (multiple topics), Physicians Reporting Requirements, Religious Freedom, Reporting Requirements, Targeted Regulation of Abortion Providers

Full Bill Text

SB 5 would modify provisions relating to abortion, including tissue reports, local abortion policies, employee disclosure policies, and inspections of abortion facilities.

Forced Counseling/Waiting Period

The bill would require a physician to inform the pregnant person, orally and in-person, at least 72 hours prior to the procedure of:

  • Immediate and long-term medical risks to the patient, including, but not limited to, infection, hemorrhage, cervical tear or uterine perforation, harm to subsequent pregnancies or the ability to carry a subsequent child to term, and possible adverse psychological effects associated with the abortion, and
  • Immediate and long-term medical risks in light of the anesthesia and medication that is to be administered, the gestational age of the fetus, and the patient’s medical history and medical condition.

Existing law allows the information to be provided to the woman either by the physician who is to induce or perform the abortion or a qualified health professional. SB 5 would require the information be provided in person by the physician who is performing the abortion.

 Fetal Organs and Tissue Reporting Requirements

The bill would require that all fetal organs and tissue removed at the time of an abortion be sent to a pathologist within three days for gross and histopathological examination. The pathologist would need to provide a copy of the tissue report to the abortion facility or hospital within 72 hours. If the pathological examination does not reveal the presence of a completed abortion, the pathologist must notify the abortion facility within 24 hours.

The department would need to reconcile each notice of abortion with its corresponding fetal organs and tissue report.

If the department does not receive either a notice or a report, the department would be required to conduct an investigation and, if a deficiency is discovered, must perform an unscheduled inspection of the facility to ensure such deficiency is remedied. If the deficiency is not remedied, the department must suspend the abortion facility’s or hospital’s license for at least one year, subject to applicable licensure procedures.

The bill would require the department, beginning January 1, 2018, to make an annual report to the General Assembly. The report would need to include all reports and information received by the department under this law, the number of any deficiencies of each abortion facility in the year and whether such deficiencies were remedied, and the following for each abortion procedure reported:

  • The termination procedure used with a clinical estimation of gestation;
  • Whether the department received the fetal organs and tissue report for that abortion; and
  • The existence and nature, if any, of any inconsistencies or concerns between the abortion report and the fetal organs and tissue report.

Attorney General

The bill would grant the Attorney General power to have concurrent original jurisdiction throughout the state for actions for any violation of the state’s abortion laws.

Local Abortion Policies

The bill would preempt political subdivision authority regarding abortion in certain circumstances.

The bill would prohibit a political subdivision from enacting, adopting, maintaining, or enforcing any order, ordinance, rule, regulation, policy, or other similar measure that:

  • prohibits, restricts, limits, controls, directs, interferes with, or otherwise adversely affects an alternatives to abortion agency (crisis pregnancy center) or its staffs’ operations or speech;
  • has the purpose or effect of requiring a person to directly or indirectly participate in abortion if such participation is contrary to their religious beliefs or moral convictions;
  • requires a real estate broker, appraiser, property owner, or any other person to buy, sell, exchange, purchase, rent, lease, advertise for, or otherwise conduct real estate transactions for, to, or with an abortion facility or for, to, or with a person for the purpose of performing or inducing an abortion not necessary to save the life of the pregnant individual if such requirement is contrary to their religious beliefs or moral convictions; and
  • requires an employer, employee, health-care provider, health-plan provider, health-plan sponsor, or any other person to provide coverage for or to participate in a health plan that includes benefits that are not otherwise required by state law.

The bill provides that a court may order injunctive relief with specified damages for any violations. The Attorney General may also bring a cause of action to defend the rights guaranteed under this act.

Whistleblower Protections

The bill would require each hospital, ambulatory surgical center, pathology lab, medical research entity, and any other facility involved in elective abortions to establish and implement a written policy to protect employees who disclose information concerning actual, potential, or alleged violations of applicable federal or state laws.


The bill would require the department to conduct annual, unannounced, on-site inspections and investigations of abortion facilities. These inspections must address certain areas of interest including:

  • Compliance with all statutory and regulatory requirements for an ambulatory surgical center, including requirements that the facility maintain adequate staffing and equipment to respond to medical emergencies;
  • Compliance with the requirement that all fetal organs or tissue removed at the time of abortion be submitted to a board certified or eligible pathologist;
  • Compliance with the provisions prohibiting the use of public funds, facilities, and employees to perform or to assist a prohibited abortion or to encourage or to counsel a woman to have a prohibited abortion; and
  • Compliance with the requirement that continuous physician services or registered professional nursing services be provided whenever a patient is in the facility.

Inspection, investigation, and reports would need to be made available to the public.


The bill defines “abortion facility” to mean:

[…]any establishment operated for the purpose of performing or inducing any second- or third-trimester abortions or five or more first-trimester abortions per month, and which does not provide services or other accommodations for patients to stay more than twenty-three hours within the establishment.

The bill would require an abortion facility to provide affirmative evidence that each person authorized to perform abortions is a physician currently licensed to practice in Missouri in order to receive a license to operate the facility.

The bill modifies several other provisions of law to include references to or replace references to “ambulatory surgical centers” with the newly-defined “abortion facilities”, including provisions relating to infection control, licensure standards, staff training, and whistleblower protections.

Medication Abortion Complication Plans

The bill would prohibit a physician from prescribing or administering to a patient any abortion-inducing drug or chemical without first obtaining the Department of Health and Senior Services’ approval of a complication plan if the FDA label of such drug includes a clinical study “in which more than one percent of those administered the drug or chemical required surgical intervention after its administration.”

The bill would allow the department to develop rules and regulations governing complication plans to ensure that patients undergoing medication abortions “have access to safe and reliable care.”

Medical Interference

The bill would create the offense of “medical interference with medical assistance” if a person, while serving in their capacity as an employee of a medical facility:

  • knowingly orders or requests medical personnel to deviate from any “applicable standard of care or ordinary practice” while providing medical assistance to a patient for reasons unrelated to their health or welfare; or
  • knowingly attempts to prevent medical personnel from providing medical assistance to a patient in accordance with all “applicable standards of care or ordinary practice” for reasons unrelated to their health or welfare.

Such an offense would be a class A misdemeanor.

Related Legislation

Similar to HB 456/SB 67 and HB 602, all of which failed to pass during the regular 2017 legislative session.

Similar to SB 1.

Similar to the attorney general provision found in HB 6.

The local abortion policies provision is similar to HB 9/SB 6.


This bill was introduced during the 2017 special session.

Truly agreed to and finally passed on July 25, 2017.

Signed by Gov. Eric Greitens (R) on July 26, 2017.


Primary Sponsor