Missouri voters reject Amendment 3, preserving abortion rights approved in 2024

Two years after becoming the first state to overturn an abortion ban at the ballot box, Missouri voters rejected an attempt Tuesday to reinstate the ban, instead preserving the reproductive rights protections they approved in 2024.

The defeat of Amendment 3, which won only 44% of the vote, leaves in place a constitutional right to abortion up to the point of fetal viability and rejects an effort by Republican lawmakers to reverse the narrow abortion rights victory two years ago.

“Politicians thought they knew better than voters,” Dr. Margaret Baum, chief medical officer of Planned Parenthood Great Rivers, said as she stood before a few hundred abortion-rights supporters late Tuesday evening in St. Louis. “They thought we weren’t smart enough to know what we voted for in 2024. They thought they could trick voters into the ballot box in 2026. But we are not new to this fight, so we saw their dirty tricks coming, and more importantly, we know our values.” 

The proposed amendment would have banned nearly all elective abortions, with exceptions for medical emergencies, fetal anomalies and pregnancies resulting from rape or incest if an abortion was sought within the first 12 weeks.

It also would have placed a constitutional ban on gender-affirming care for minors.

Instead, Missouri became the first state to defeat an attempt to overturn an abortion rights measure and the first state to reject an attempt at a constitutional ban on gender-affirming care for minors.

“We didn’t ask for this,” said Mallory Schwarz, executive director of Abortion Action Missouri, after the race was called. “And yet, for 18 months we have fought harder than ever to protect our fundamental rights to our own bodies, lives and futures.” 

The result is a setback for Missouri’s anti-abortion movement, which spent two years rebuilding its campaign after narrowly losing the 2024 vote.

“We came up short today, but this is a battle in a war, and so we are definitely going to keep on going forever,” Tom Estes, with Her Health, Her Future, the campaign behind Amendment 3, told reporters in Columbia after the final results came in. “We are never going to stop until every child is protected in the state of Missouri.”

Estes said he was proud of the coalition that spanned the state. This time, unlike in 2024, the effort to reinstate an abortion ban had significant and organized support from Republican lawmakers, Gov. Mike Kehoe’s office and many of the state’s largest churches.

Kehoe, who campaigned across Missouri for Amendment 3 on Monday, told supporters during a stop in Chesterfield that its defeat would be “a sad day for Missouri.”

The proposal also faced opposition from some anti-abortion activists who argued its exceptions went too far.

Among them was Republican state Sen. Mike Moon, who publicly criticized the amendment for allowing abortions in cases of rape, incest and medical emergencies.

The campaign to pass Amendment 3 also focused heavily on gender-affirming care for minors, which has been restricted under state law since 2023.

The statutory ban on puberty blockers and cross-sex hormones is scheduled to expire in 2027, while the prohibition on gender-affirming surgeries for minors is permanent. Both remain in place.

Proponents argued a constitutional prohibition was necessary to make those restrictions permanent. Opponents said the proposal was designed to attract voters who supported restrictions on gender-affirming care but might otherwise oppose an abortion ban.

Shira Berkowitz, senior director of public policy and advocacy at PROMO, a Missouri-based LGBTQ+ advocacy group that also sits on the Stop the Ban coalition, said Amendment 3 sought to vilify and dehumanize trans children. 

Instead, they said, Missourians sent a different message to trans youth: “You belong right here in Missouri.” 

National anti-abortion leaders had pointed to Missouri’s amendment as a possible model for reinstating abortion bans in other states by pairing abortion restrictions with a ban on gender-affirming care for minors.

“What happens in Missouri, right here, this year in this election, is not going to stay just in Missouri,” David Bereit, executive director of the Virginia-based Life Leadership Conference, said during a virtual fundraising event in October. “When Missouri wins, every other state will learn that these bad amendments can be reversed and undone. But if it loses, no other state will likely try this again for a long time, perhaps for a generation.”

Missouri has been at the center of legal and legislative battles over abortion in recent years.

Missouri was the first state to enact a trigger law banning nearly all abortions after the U.S. Supreme Court struck down Roe v. Wade in June 2022. Thousands of Missouri women subsequently traveled to clinics in Illinois and Kansas to obtain abortions. Others ended pregnancies using medication obtained through telehealth providers in states where abortion remained legal.

In 2024, 51.6% of Missouri voters approved a citizen-led reproductive rights measure spearheaded by organizations including the ACLU of Missouri, Abortion Action Missouri and local Planned Parenthood affiliates.

Following its passage, abortion access slowly returned to Missouri. Five of the state’s Planned Parenthood clinics have resumed providing the procedure amid ongoing litigation over dozens of abortion restrictions that were later found unconstitutional under the reproductive rights amendment.

The campaign supporting Amendment 3, Her Health, Her Future, raised more than $7 million, but was significantly outspent by abortion rights advocates.

Ahead of Election Day, Stop the Ban had raised more than $27 million.

The abortion rights campaign drew small donations from thousands of Missourians, but much of its financial support came from wealthy out-of-state donors and progressive nonprofit organizations that are not required to disclose their donors.

Among them was the Fairness Project, a Washington, D.C.-based nonprofit and the campaign’s largest contributor.

The Independent’s Steph Quinn contributed reporting.

This story was updated at 12:35 a.m. to include comments from both campaigns.