By Nate Raymond

(Reuters) – A federal appeals court on Monday cleared the way for Missouri to enforce state laws requiring doctors who perform abortions to be affiliated with hospitals and abortion clinics to be licensed as ambulatory surgical centers.

The 8th U.S. Circuit Court of Appeals in St. Louis overturned a 2017 ruling that blocked enforcement of those laws and opened the door for more abortion providers to operate in the state, which at the time had only one.

Monday’s decision comes in a 2016 lawsuit filed by affiliates of the women’s health organization Planned Parenthood in the wake of a U.S. Supreme Court ruling that year that struck down similar abortion restrictions in Texas.

The Missouri laws require doctors who perform abortions to have admitting privileges at local hospitals, which can be difficult to obtain, and for abortion clinics to have costly hospital-grade facilities to be licensed as ambulatory surgical centers.

The court said it did not have enough information to determine how easily abortion clinics could obtain waivers from the licensing rules and whether those requirements posed an undue burden on clinics.

U.S. Circuit Judge Bobby Shepherd, who wrote the opinion, said the lower-court judge also erred by not considering the state’s arguments about the benefits of the provision requiring doctors who perform abortions be affiliated with hospitals.

“Invoking the Constitution to enjoin the laws of a state requires more than ‘slight implication and vague conjecture,'” Shepherd wrote. “At a minimum, it requires adequate information and correct application of the relevant standard.”

The lawsuit was filed by Comprehensive Health of Planned Parenthood Great Plains and Reproductive Health Services of Planned Parenthood of the St. Louis Region.

Planned Parenthood in a statement said the ruling threatens to shut down abortion services at one of Missouri’s two clinics that can provide it.

Missouri’s attorney general did not respond to a request for comment.

Abortion and the landmark 1973 ruling Roe v. Wade that legalized the procedure have been a central issue in the U.S. Senate confirmation process for Republican President Donald Trump’s U.S. Supreme Court nominee Brett Kavanaugh.

Some states are passing restrictive abortion laws in anticipation they will be upheld by an increasingly conservative Supreme Court.

“Look no farther than Missouri to see what kind of harm courts can inflict on women’s rights and freedoms,” Dawn Laguens, executive vice president, Planned Parenthood Federation of America, said in a statement.

(Reporting by Nate Raymond in Boston, Editing by Alexia Garamfalvi and Cynthia Osterman)