Missouri's health department announced Monday that it will immediately being enforcing state laws regulating abortion clinics and doctors, after a US appeals court ruled that the state may do so.

The 8th US Circuit Court of Appeals ruled Sept. 10 in Comprehensive Health v. Hawley to overturn a 2017 decision which blocked enforcement of state laws that required abortion clinics to have the same standards as similar outpatient surgical centers, and mandated that doctors who perform abortions have hospital privileges.

"In its opinion, the court noted that the good faith of state officers and the validity of their actions are presumed," Randal Williams, director of the Missouri Department of Health and Senior Services, stated.

"As the Director of DHSS, a board-certified obstetrician/gynecologist for thirty years, and a defendant in the case, my commitment and that of the department is to act in good faith to follow the law and protect the health and safety of all women in Missouri, including those seeking abortions."

The health department stated: "now that the injunction has been vacated, DHSS will immediately begin enforcing the hospital privileges and physical plant requirements for abortion facilities."

The appellate court ruling comes in a case filed by Planned Parenthood affiliates in 2016 after the US Supreme Court struck down similar abortion restrictions in Texas.

In April 2017 a federal judge issued an injunction against the Missouri law, citing the Supreme Court's Whole Woman's Health v. Hellerstedt decision.

The appeals court vacated that preliminary injunction, saying that Hellerstedt "did not find, as a matter of law, that abortion was inherently safe or that provisions similar to the laws it considered would never be constitutional," and that the undue burden standard requires a weighing of regulations' benefits and burdens.

In its 2017 decision the district court "explicity refused to 'weigh [] the asserted benefits'", Judge Bobby Shepherd wrote for the appellate court, and thus "in light of Hellerstedt the district court erred in so ruling."

The appeals court judges remanded the case to the district court, saying it "should, at the very least, weigh the state's 'asserted benefits.'"

It added that the Hellerstedt decision did not find that provisions similar to those in Texas would never be constitutional, precisely because its analysis of the purported benefits of the law at issue related to abortion in Texas, and that "no such determination about abortion in Missouri was made."

"Perhaps there was a unique problem Missouri was responding to," the appeals court wrote. "Such a problem may required a different response than what was needed in Texas, and the Hospital Relationship Requirement may be appropriate given '[Missouri's] legitimate interest in seeing to it that abortion, like any other medical procedure, is performed under circumstances that insure maximum safety for the patient,'" quoting Hellerstedt, which was in turn quoting Roe v. Wade.

"Invoking the Constitution to enjoin the laws of a state requires more than 'slight implication and vague conjecture,'" the appeals court wrote. "At a minimum, it requires adequate information and correct application of the relevant standard. Because we conclude that the preliminary injuction in this case was entered based on less than adequate information and an insufficient regard for the relevant standard, we vacate the preliminary injunction and remand."

Planned Parenthood currently provided abortion services at only two locations in Missouri, in St. Louis and Columbia.

In 2017, Missouri passed further regulations which granted the attorney general more power to prosecute violations, and required stricter health codes and proper fetal tissue disposal.