U.S. District Judge Ortrie Smith on Monday extended a temporary restraining order blocking a Missouri law (SB 370) that would designate facilities performing second- or third-trimester abortions or more than five first-trimester abortions each month as "ambulatory surgical centers," the St. Louis Post-Dispatch reports. Smith at a hearing said he is extending the order to allow more time for evidence and testimony to be submitted (St. Louis Post-Dispatch, 9/11).

Ambulatory surgical centers are subject to increased regulation from the state Department of Health and Senior Services. The law would require hallways at the facilities to be at least six feet wide and doors at least 44 inches wide. The clinics must also have separate male and female changing rooms for staff and a recovery room with space for a minimum of four beds with three feet of clearance around each bed. The health department has said the law requires that three clinics in the state be licensed.

Planned Parenthood of Kansas and Mid-Missouri last month filed a federal lawsuit alleging that the new regulations are unnecessary and are not meant to improve safety, but rather to interfere with a woman's constitutional right to abortion. Smith last month issued a temporary restraining order blocking implementation of the law, which was scheduled to take effect Aug. 28. Last week, Smith ruled that physician Allen Palmer -- who operates the Women's Care Gynecology clinic in Bridgeton, Mo. -- can join the lawsuit (Kaiser Daily Women's Health Policy Report, 9/10). Smith on Monday said he would rule on issuing a preliminary injunction on the law by Sept. 24.

Hearing Comments
Donna Harrison, a gynecologist and president-elect of the American Association of Pro Life Obstetricians and Gynecologists, at the hearing said the regulations were reasonable steps to protect women from complications of medical and surgical abortions, the Kansas City Star reports. Paul Blumenthal, a gynecologist and professor at Stanford University's School of Medicine, said the regulations are unnecessary (Morris, Kansas City Star, 9/10). Palmer in court documents argued that the same restrictions do not apply to other private physicians who performed minor surgeries in the offices. In addition, Palmer said he performed only early-term abortions at his office (St. Louis Post-Dispatch, 9/11).

Architects at the hearing testified that the three clinics would incur substantial costs to comply with the new law, but they said they did not estimate the cost of renovations if the state were to waive some of the requirements. Dean Linneman, an administrator for DHSS, said it is possible the department would permit waivers (Kansas City Star, 9/10).