Missouri’s Amendment 3 marks a crossroads for abortion rights in the state.
If voters approve the proposed constitutional amendment on Nov. 5, it could provide a stunning rebuke to Missouri Republicans who fought to restrict abortion access for decades — culminating in a nearly total ban on the procedure after the fall of Roe v. Wade.
A win for the measure could also show that voters are willing to enshrine protections for abortion rights in states that regularly vote for Republicans on a national and state level.
“Missourians don't want politicians telling them what to do,” said state Rep. Crystal Quade, the Democratic gubernatorial nominee. “And folks may not totally be aligned on this issue, but they're aligned on the fact that they want that personal freedom.”
Even though proponents of Amendment 3 managed to raise tens of millions of dollars and attracted thousands of volunteers, opponents of abortion rights aren’t letting the measure pass without a fight.
They’re contending the proposal goes too far and could have unintended consequences. And they also say the GOP-controlled legislature, not the Missouri Constitution, is the better place to make changes to the state’s abortion ban.
Foes of Amendment 3 are also banking that the state’s voters, who have a history of backing candidates who oppose abortion rights, will mobilize on Election Day to keep the state’s near-total ban on the procedure.
“The ‘Your body, your choice’ type of stuff — that's just not something that aligns with me,” said St. Clair resident Jamie Keem. “And I feel very strongly about that issue. That's probably my top issue in this election.”
A long journey
Amendment 3 would place language in the Missouri Constitution that would allow abortion up to fetal viability, which is usually around 24 weeks. Currently, Missouri bans abortion except in the event of medical emergencies. Some amendment proponents have said that without exceptions for rape or incest, the law is too restrictive.
Fetal viability is defined in the proposal as the point in pregnancy when, "in the good faith judgment of a treating health care professional and based on the particular facts of the case, there is a significant likelihood of the fetus’s sustained survival outside the uterus without the application of extraordinary medical measures.”
If Amendment 3 passes, it wouldn’t legalize abortion in Missouri right away. But it would provide the legal backbone for lawsuits over the state’s abortion restrictions — including the near-total ban that went into effect in 2022.
Backers of the initiative had to wade through a slew of lawsuits and disagreement among abortion rights activists over the measure’s language. They also had to contend with a failed effort from the Missouri legislature to make the state’s constitution harder to amend — which Republicans said was squarely aimed at making it more difficult to legalize abortion through the initiative petition process.
“The thing that drives me absolutely insane is that the will of the voters seems to be something that the politicians just don't give a rat's patootie about,” said Kirkwood resident Lisa Aydt, who supports Amendment 3.
Ultimately, backers of Amendment 3 were able to gather more than enough signatures to make the ballot — including in historically Republican parts of the state. And a pro-Amendment 3 campaign committee has raised more than $30 million, dwarfing the amount of money available to groups opposed to the measure.
Some of the more notable supporters of Amendment 3 are medical professionals like St. Louis OB-GYN Jennifer Smith. During a conference call with reporters, Smith said the state’s abortion ban doesn’t provide exceptions for fatal fetal abnormalities unless a woman’s life or permanent physical health is in danger. That means she’s had to send patients who have dire complications during pregnancies to Illinois, where abortion is legal.
“This should not be happening in Missouri,” Smith said. “But that’s the reality when politicians force their beliefs on patients and doctors.”
Can money beat ideology?
Public polling has shown Amendment 3 above the 50% mark needed to pass. Backers are hoping for strong support in suburban and urban areas, including parts of St. Louis County that typically vote for Republican candidates.
Even some GOP lawmakers who don’t like Amendment 3 have conceded it may be difficult to defeat, especially since supporters have significantly more money.
“If I were to bet, I'd say it will pass,” said state Rep. Ken Waller, R-Jefferson County.
Religious groups and churches that believe abortion is morally wrong have spoken out against the proposal. And they’re banking that Missouri voters who typically back GOP candidates who oppose abortion rights will vote against the measure.
Stephanie Bell, who’s with the group Missouri Stands with Women which is opposing Amendment 3, said the measure is much more expansive than proponents are letting on. She said the language could be read to allow abortion up to eight or nine months of pregnancy.
“There are lots of provisions within this that would be enshrined into our constitution that I think are causing lots of Missourians very real concerns,” Bell said.
She also said judges could interpret the language to legalize gender transition surgery for minors.
Backers of Amendment 3 say opponents are mischaracterizing what the measure could actually do and have pointed out that abortions later in pregnancy almost always involve catastrophic health complications.
The amendment allows the legislature to restrict abortion after fetal viability as long as the government doesn’t “deny, interfere with, delay, or otherwise restrict an abortion that in the good faith judgment of a treating health care professional is needed to protect the life or physical or mental health of the mother.”
“In these late-term scenarios, [Amendment 3] allows the state to regulate the practice of abortion,” said Kelly Gillespie, director of the Center for Health Care Studies at the St. Louis University School of Law.
Amendment 3 proponents have also pushed back against interpretations that the amendment will legalize gender transition surgery for minors, especially since some transgender people don’t pursue procedures that affect reproduction. And Gillespie also said statements of advocacy groups describing gender-affirming care as reproductive health care are irrelevant to courts interpreting Amendment 3’s text.
National implications
Missouri is one of 10 states this year deciding whether to enshrine abortion rights protections in the state’s constitution. And these ballot items are getting national attention.
Karlie Kloss, a fashion model and entrepreneur who has lobbied for abortion rights nationally, recently went door-knocking in St. Louis County with backers of the measure. The Webster Groves native said she encountered strong support for Amendment 3.
“I'm really hopeful, not only because of the doors that I knocked on, but because of many polls that are showing that there's an overwhelming majority of Missourians, Republicans and Democrats, who do support this right to choose,” Kloss said.
Kloss is referring to how GOP-leaning states have either enshrined abortion rights in the constitution — or rejected restrictions.
“Twenty-five million women across this country live in a state with an abortion ban,” Kloss said. “This critically touches their life.”
But Amendment 3 opponents like Republican Bob Onder said if the measure passes, it will have less to do with support for abortion rights and more to do with the fact that it only requires a majority vote to place a measure in the Missouri Constitution.
“I think if Amendment 3 passes, it will be a combination of really bad structural problems we have here in the state of Missouri,” Onder said.
Onder, the GOP nominee in Missouri’s 3rd Congressional District, noted that prognosticators counted anti-abortion rights activists out in 2006 when they tried to defeat a proposal that enshrined protections for embryonic stem cell research. Voters approved it, but by a much more narrow margin than expected.
“And I think it [Amendment 3’s results] will be very close,” Onder said.
