CNN  — 

Missouri moved closer Friday to becoming the first state without an abortion clinic when its health department rejected a license renewal for the St. Louis Planned Parenthood location.

A judge had ordered the Missouri Department of Health and Senior Services to decide by Friday whether it would renew a license for Reproductive Health Services of Planned Parenthood of the St. Louis Region. Judge Michael Stelzer relayed the health department’s decision Friday in court.


Refusal of the license renewal is only for abortions and does not include other services that Planned Parenthood offers, said Randall Williams, director of the Department of Health and Senior Services.

And, at least for now, the clinic may continue performing abortions, Stelzer added – until further court order. Should that change, Missouri could become the first state without an abortion clinic in almost 50 years.

The battle has been brewing for weeks as states across the country move to restrict access to the procedure.

The St. Louis Planned Parenthood clinic sued the state’s health department for refusing to renew its license, which was set to expire May 31. Stelzer granted a preliminary injunction that let the facility keep performing abortions while state officials decided on the license.

Williams said his department did not renew the abortion license because Planned Parenthood failed to correct 26 of 30 deficiencies found by regulators.

Williams said that doctors involved in the investigation of these deficiencies refused to cooperate.

In one case, a patient had three abortion-related services in three days, first a surgical that was unsuccessful, then a medical that was unsuccessful, and then a surgical again, Williams said. In another case, a patient had an abortion that failed, according to Williams.

Dr. Colleen McNicholas, a physician at the facility, told CNN the department is trying “to distort the safety record” to distract from its true goal of shutting down abortions.

McNicholas said she couldn’t discuss individual cases because of patient confidentiality laws, but said the St. Louis Planned Parenthood clinic had a complication rate lower than 1% among the 3,000-5,000 abortions it performs in a year.

“The risk of complications is incredibly low,” McNicholas said.

A study published in 2015 in the journal Obstetrics & Gynecology looking at more than 54,000 abortions in 2009-2010 found the risk of complications was 2.1% overall.

Planned Parenthood’s M’Evie Mead praised the judge Friday for keeping the clinic open for now.

“We will continue to fight for our ability to deliver high-quality, patient-centered health care, and that includes the full range of reproductive health care,” she said.

As for the state’s complaints, she said, “They restated a number of their other issues that Planned Parenthood has responded to with medically accurate, thorough responses; they continue to restate things that are already resolved as far as we’re concerned.”

Also at issue between the two sides was the state’s intention to require a woman to undergo a pelvic exam 72 hours before the procedure.

Mead said the exam was “weaponizing” the administrative process and was not in a woman’s best interests.

Williams said Friday he would allow Planned Parenthood to determine when that 72-hour window was not necessary.

Abortion remains legal in all 50 states under Roe v. Wade, the 1973 Supreme Court ruling.

States have approved numerous challenges to that decision this year. The most restrictive is Alabama’s, which bans virtually all abortions and could send doctors to prison for life if they perform the procedure. That law, slated to go into effect in the fall, is being challenged in court.

Missouri’s Republican governor this year signed a bill into law banning abortions at eight weeks, including in cases of rape and incest; it includes exceptions in cases when a mother’s life is at risk or she faces a serious permanent injury. It is scheduled to take effect August 28.

CNN’s Marlena Baldacci, Hollie Silverman, Sheena Jones and Theresa Waldrop contributed to this report.