Missouri voters may overturn one of nation’s strictest abortion bans

KANSAS CITY, Mo. – In the two years since Missouri’s near-total abortion ban took effect, obstetrician Laura Parisi has had several patients there turned away from chain pharmacies as they tried to get a medication often prescribed after a miscarriage.

“It’s heartbreaking,” she said, with some pharmacies reluctant to provide misoprostol for fear it would be used illegally for abortions. “For a patient to have the worst day of their life, just having had a miscarriage, and then to be made to feel like a criminal, it’s devastating.”

Parisi, 39, was part of a group of doctors going door-to-door in Missouri cities on Saturday in support of Amendment 3, the question on the state ballot that would overturn one of the nation’s strictest abortion bans. The law here only allows the procedure to save a woman’s life, with no exceptions for rape or incest.

The citizen-led measure – which survived a months-long court battle – seeks to enshrine in the state constitution “the right to make and carry out decisions about all matters relating to reproductive health care,” including abortion care. Missouri is one of 10 states with abortion-related initiatives going before voters on Nov. 5, including some in battleground states that will be key to deciding control of the White House and Congress.

Organizers for Missourians for Constitutional Freedom said they are cautiously optimistic given recent polls trending more favorably toward the amendment’s passage. A survey conducted by St. Louis University and YouGov found 52 % of voters for the amendment, 34 % against it and 14 % undecided. That was an eight percentage-point increase since the same question was asked in February, the pollsters said.

Proponents have raised far more money than opponents – as is the case in other states – bringing in nearly than $30 million from such high-profile backers as media mogul Mike Bloomberg and Missouri-raised model Karlie Kloss. By contrast, recent campaign disclosures show, the Vote No on 3 backers raised $1.6 million.

Opponents contend the amendment’s wording is far too broad. Lawyers representing the opposition in court argued that the amendment’s reference to “all matters relating to reproductive health care” could be interpreted far beyond abortion. With no limiting language, they say, judges will be forced to allow everything related to the reproductive system, including technologies currently banned in Missouri – such as cloning and gender transition surgeries for minors.

“Missourians do not want to permanently commit to supporting every reproductive technology, now and in the future,” said Mary Catherine Martin, senior counsel for the anti-abortion legal group the Thomas More Society.

Martin said the law’s backers have not given voters a clear picture of its long-term legal implications, likely triggering a blizzard of court cases if passed. “If you’re going to vote on a law, it’s your obligation to try and determine what the law would do,” she said. “It’s not an answer to just simply say, ‘Let a judge decide.’”

In recent days, Republican conservatives such as Gov. Mike Parson and Sen. Josh Hawley have falsely claimed that the proposed amendment would legalize gender-affirming care for young people. Billboards urging a “no” vote to “STOP Child Gender Surgery” have appeared.

Marcia McCormick, a St. Louis University law professor who specializes in sexuality and the law, disputed those characterizations, saying the amendment’s wording is “narrowly tailored” to matters of pregnancy. “It is really framed around the rights of autonomy of the person making the decision and the people who support them in exercising the right,” she said.

Since the U.S. Supreme Court overturned Roe v. Wade in 2022, voters have routinely supported abortion protections in ballot measures, even in red states like Kansas and Ohio. Should Missouri and other states follow suit, anti-abortion forces could be forced to retrench.

“If you have a truly red state like Missouri vote for a pretty expansive abortion amendment, that’s going to cause a lot of soul-searching, and it should,” said Patrick Brown, a fellow at the conservative Ethics and Public Policy Center in Washington. He has long argued that abortion opponents should focus their energy on support for maternal and infant health care, rather than pouring money into potentially losing court battles.

“Failure is a teacher, and we’ve gone 0-7 on these ballot initiatives,” Brown said. “There are definitely people who have said we need to meet the voters where they are rather than try and be prophetic voices right now. But there are still people who are full-throated antiabortionists who think any compromise is a deal with the devil.”

National anti-abortion groups are focusing hard on Florida, he noted, thinking that the state’s tough threshold – with passage for Amendment 4 requiring 60 % of votes cast – might give the movement the “shot in the arm we need.” Brown is not optimistic: “The deck is stacked against us.”

Floridians Protecting Freedom, the group behind the abortion rights amendment there, reported Friday that it had raised more than $100 million for the campaign. Reports show that an effort launched by Republican Gov. Ron DeSantis has only raised $6.3 million.

Abortion has been illegal in Missouri since a trigger law took effect immediately after Roe fell. Amendment 3 would permit the procedure until fetal viability at about 24 weeks, the point in a pregnancy when a fetus can survive outside the womb.

Missouri has a long history of anti-abortion sentiment; in 1825, it became the first state to ban the procedure. After abortion became legal nationally in 1973, GOP legislators here tightened laws until the state effectively had only one abortion clinic by 2022. It also had a 72-hour waiting period, restrictions on insurance coverage and a parental consent requirement.

David Mehr, 74, a professor emeritus in family and community medicine at the University of Missouri, remembers the days before abortion was legalized, when women had to travel elsewhere to get abortions and botched procedures by nonstandard practitioners were common. The current ban in Missouri “takes the decision-making out of the realm of doctors and patients and puts it in the hands of politicians, creating situations where people are not getting good care,” he said.

Doctors say that even if the measure passes, it may take months or years for hospitals and clinics to staff up and reopen. Leaders at Planned Parenthood Great Plains, which is based in Kansas, have said they hope to resume offering abortions in two Missouri cities.

Devika Maulik, 47, a high-risk-pregnancy specialist, said she decided to canvass last weekend because she has seen firsthand how current state law has delayed care for some pregnant patients, including some carrying fetuses with fatal anomalies.

Yet overturning the abortion ban ‘won’t make things better right away,” Maulik told voters she encountered during the door-knocking. “This is just the first step in a long process to restore abortion rights.”