St. Louis (AFP) - A US court on Thursday weighed the fate of the last abortion clinic in Missouri, which risks becoming the first state in 45 years without access to the procedure amid a nationwide push to curtail reproductive rights. 

As a judge heard arguments, crowds of protestors took to the streets of Missouri's largest city St. Louis, warning of dire consequences if the state of six million loses its sole abortion provider.

"No one should decide what women do with their bodies," said Jane Wees Martin, a 70-year-old painter who was among the hundreds holding up signs reading "My vagina, My choice," and "Reproductive autonomy is a human right." 

Denouncing a "war against women," health management student Neha Hanumanthiah, 19, said "I did not realize how conservative my state was."

The state is pursuing a case against Planned Parenthood, which provides women's reproductive services throughout the United States, arguing that the group failed to make its contract doctors cooperate with an investigation into its practices.

John Sauer, Missouri's solicitor general, told Thursday's hearing the non-profit had "washed its hands of the issue."

Planned Parenthood's attorney Jamie Boyer argued meanwhile that Missouri was acting in bad faith, with "shifting interpretations of its regulations."  

She said the organization could not "in good conscience ask doctors to sit for an interview on wide-ranging (subjects) in an investigation which might result in criminal charges."

It will be up to Judge Michael Stelzer to decide whether to grant Planned Parenthood's request for a restraining order, or allow its license to perform abortions in the state to expire on Friday night.

Concerted strategy

The Missouri case comes as more than a dozen US states -- including recently Alabama, Georgia, Mississippi and Louisiana -- passed laws restricting abortion as part of a concerted strategy to push the issue before the Supreme Court.

The top US court, now dominated by a conservative majority, enshrined a woman's right to have an abortion in 1973, allowing for conditions to be placed on it only after the first trimester of pregnancy.

The states restricting abortion access have generally sought to roll back when the procedure is permitted, to as early as when a heartbeat is first detected -- around six weeks of gestation when many women do not yet know they are pregnant.

Most of the measures are expected to face legal challenges -- and eventually end up before the Supreme Court.

On Thursday, Louisiana Governor John Bel Edwards signed into law his state's measure prohibiting abortions of fetuses with a "detectable heartbeat." 

Earlier this month Missouri lawmakers passed a bill banning abortion after eight weeks of pregnancy, including in cases of rape and incest. 

Planned Parenthood alleges in its lawsuit that the state has sought to use its regulatory powers to deny it a license.

It says the state's health department is attempting to shut down its abortion service by "unlawfully conditioning a decision on its routine license renewal application on completion of a supposed 'investigation' of a patient complaint."

Appearing on a local Fox affiliate, obstetrician-gynecologist Colleen McNicholas said that "by continuing to change the way that they are interpreting their own rules, it makes it impossible for us to be able to comply because we are just guessing what they think."

Religion

Missouri Governor Mike Parson, who recently signed the state's new abortion law, on Wednesday accused Planned Parenthood of "actively and knowingly violating state law on numerous occasions."

"Regardless if you support abortion or not, Planned Parenthood should be able to meet the basic standards of health care under the law," he said.

Many of the protesters in St. Louis disagreed, with some arguing the governor was motivated by his Christian Baptist faith.

"He is trying to put his religion into law in Missouri," said Sara Sullivan, a 32-year-old mother of two daughters.

In front of the Planned Parenthood clinic in St. Louis, opponents of abortion encourage patients to continue their pregnancies, as they do every day.

"These people harass patients who go in," 37-year-old mother of three Nicki Island said.

She held a poster with an image of a hanger -- a symbol of clandestine abortions to which women resorted when the procedure was illegal -- and the words: "We will not go back!"