ST. LOUIS — Missouri’s only abortion clinic could be closed by the end of the week because the state is threatening to not renew its license, Planned Parenthood officials said Tuesday.

Planned Parenthood officials said in a teleconference that the current license for the St. Louis facility expires Friday. If not renewed, the organization said Missouri would become the first state without a functioning abortion clinic since the 1973 Roe v. Wade Supreme Court decision.

“This is not a drill,” said Dr. Leana Wen, president and CEO of Planned Parenthood Federation of America. “This is not a warning. This is real and it’s a public health crisis.”

Planned Parenthood said the state told officials it was investigating “a large number of possible deficiencies.” The state wanted to interview seven physicians, but the organization said only the two staff physicians agreed to be interviewed. Those interviews will take place later Tuesday.

Phone and email messages left for the Missouri Department of Health and Senior Services and Gov. Mike Parson’s office haven’t been returned.

Missouri is among half a dozen states that have passed sweeping anti-abortion measures. Parson, a Republican, signed a bill Friday banning abortions on or beyond the eighth week of pregnancy, with no exceptions for rape or incest.

Under the Missouri law that comes into force Aug. 28, doctors who violate the eight-week cutoff could face five to 15 years in prison. Women who terminate their pregnancies cannot be prosecuted.

Wen said a lawsuit has been filed to try and keep the St. Louis clinic open. If it closes, the nearest clinics performing abortions are in a Kansas suburb of Kansas City and in Granite City, Illinois, across the Mississippi River from St. Louis.

Wen said Missouri has “illegally weaponized the licensing process.” Colleen McNicholas, an OB-GYN at the Planned Parenthood office in St. Louis, called it the “natural consequence of several decades of restriction after restriction.”

“This is precisely what we’ve been warning of,” McNicholas said.

Alabama’s governor signed a bill on May 15 making performing an abortion a felony in nearly all cases. Supporters have said they hope to provoke a legal challenge that will eventually force the U.S. Supreme Court to revisit its landmark 1973 Roe v. Wade ruling that legalized abortion nationally.

Unlike Alabama’s near-total abortion ban, lawmakers who helped draft the Missouri bill say it’s meant to withstand court challenges instead of spark them. If the eight-week ban is struck down, the bill includes a ladder of less-restrictive time limits at 14, 18 or 20 weeks.

Missouri’s bill also includes an outright ban on abortions except in cases of medical emergencies, but that would kick in only if Roe v. Wade is overturned. Missouri Right to Life called it “the strongest pro-life bill in Missouri history.”

Kentucky , Mississippi , Ohio and Georgia also have approved bans on abortions once fetal cardiac activity can be detected, which can occur in about the sixth week of pregnancy. Some of those laws already have been challenged in court, and similar restrictions in North Dakota and Iowa have been struck down by judges. Nonetheless, the rash of new legislation has left abortion providers in some of those states uncertain about what they can now do.

Even before the latest legislation, Missouri already had some of the most restrictive abortion regulations in the nation, including a requirement that doctors performing abortions have partnerships with nearby hospitals.

A total of 3,903 abortions occurred in Missouri in 2017, the last full year for which the state Department of Health and Senior Services has statistics online. Of those, 1,673 occurred at under nine weeks and 119 occurred at 20 weeks or later in a pregnancy.

A total of 2,910 abortions occurred in 2018 in Missouri, according to provisional data provided by the health agency. That includes 433 abortions at eight weeks of pregnancy and 267 at six weeks or earlier.

McNicholas said there is “a tremendous amount of confusion” among women who come to the Planned Parenthood clinic because of all of the recent laws.

Meanwhile, the ACLU of Missouri is seeking a statewide vote on Missouri’s new abortion law. The ACLU said Tuesday that it has submitted a referendum petition to the secretary of state’s office as a first step toward blocking and potentially repealing the law.

If the petition is approved for circulation, the ACLU would need to gather more than 100,000 signatures to block the law from taking effect on Aug. 28 and force a referendum in 2020.

A similar tactic was used in 2017, when opponents of a law limiting union powers submitted enough signatures to block it from taking effect. Missouri voters overwhelmingly rejected that law in 2018.

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