Missouri's restrictive abortion ban does not include exceptions for pregnancies caused by rape or incest.
Missouri's Republican-led House on Friday passed sweeping legislation designed to survive court challenges, which would ban abortions at eight weeks of pregnancy.
If enacted, the ban would be among the most restrictive in the US. It includes exceptions for medical emergencies, but not for pregnancies caused by rape or incest. Doctors would face five to 15 years in prison for violating the eight-week cutoff. Women who receive abortions wouldn't be prosecuted.
Republican Gov. Mike Parson is expected to sign the bill.
Abortion-rights supporters in the House chanted, "when you lie, people die" and "women's rights are human rights" before being escorted from the chamber. Outside, they shouted "shame, shame, shame" after lawmakers voted 110-44 for the bill.
Several women dressed as characters from the "The Handmaid's Tale" watched the debate silently. The Margaret Atwood book and subsequent Hulu TV series depicts a dystopian future where fertile women are forced to breed.
The Missouri legislation comes after Alabama's governor signed a bill on Wednesday making performing an abortion a felony in nearly all cases.
Supporters say the Alabama bill is meant to conflict with the 1973 Roe v Wade decision that legalised abortion nationally in hopes of sparking a court case that might prompt the current panel of more conservative justices to revisit abortion rights.
Missouri Republicans are taking a different approach.
GOP Rep. Nick Schroer said his legislation is "made to withstand judicial challenges and not cause them."
"While others are zeroing in on ways to overturn Roe v Wade and navigate the courts as quickly as possible, that is not our goal," Schroer said. "However, if and when that fight comes we will be fully ready. This legislation has one goal, and that goal is to save lives."
Kentucky, Mississippi, Ohio and Georgia also have approved bans on abortion 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 previously were struck down by judges.
Missouri's bill also includes an outright ban on abortions except in cases of medical emergencies. But unlike Alabama's, it would kick in only if Roe v Wade is overturned.
If courts don't allow Missouri's proposed eight-week ban to take effect, the bill includes a ladder of less-restrictive time limits that would prohibit abortions at 14, 18 or 20 weeks or pregnancy.
"Laundry bleach, acid bitter concoction, knitting needles, bicycle spokes, ballpoint pens, jumping from the top of the stairs or the roof," Democratic Rep. Sarah Unsicker told colleagues on the House floor. "These are ways that women around the world who don't have access to legal abortions perform their own."
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.
About 2,900 abortions occurred in 2018, according to the agency.
The wide-ranging bill also bans abortions based solely on race, sex or a diagnosis indicating the potential for Down Syndrome.
It also requires a parent or guardian giving written consent for a minor to get an abortion to first notify the other parent, except if the other parent has been convicted of a violent or sexual crime, is subject to a protection order or is "habitually in an intoxicated or drugged condition." A change was made after hours of late-night negotiations in the state Senate to also remove the requirement when the other parent lacks legal or physical custody.