Just two years after Missouri voters enshrined the right to reproductive freedom in the state constitution, abortion is once again on the ballot.

On November 3, Missouri residents will vote on Amendment 3, a measure that, if passed, would prohibit abortion with exceptions only for medical emergencies, fetal anomalies, rape, or incest. For cases of rape or incest, the procedure must occur no later than 12 weeks of gestation.

The proposed Amendment 3 aims to repeal the 2024 amendment that had established reproductive freedom, including abortion access through fetal viability, typically between 24 and 26 weeks. If approved this time, the amendment would also grant state lawmakers the authority to regulate abortions and access to care, potentially including requirements for physicians to have hospital admitting privileges and licensing for abortion facilities.

Supporters of the amendment argue it is essential for protecting women and children and aligns better with the state's values than the previous measure. State Sen. Adam Schnelting, who sponsored the legislation leading to Amendment 3, stated that the amendment offers a measure more in line with voters' values.

Opponents, however, contend that Amendment 3 is an attempt to mislead voters and reinstate abortion bans. They point to the inclusion of language restricting gender-affirming care for minors, arguing it is a tactic to obscure the amendment's primary goal of limiting abortion access. Gender-affirming surgeries and medical treatments for minors are already prohibited in Missouri by statute.

This vote comes after the Supreme Court's June 2022 decision overturning Roe v. Wade, which led 13 states to cease most abortion services and four to implement six-week bans. Missouri enacted a trigger ban following the Supreme Court's ruling, but in November 2024, voters approved a different Amendment 3, overturning the near-total ban with approximately 52% of the vote.

Mallory Schwarz, executive director of Abortion Action Missouri, expressed concern that politicians are seeking to undo the will of the people shortly after the previous amendment was passed. She highlighted that voters must now re-protect abortion rights that were previously secured through a constitutional amendment.

The ACLU of Missouri echoed these sentiments, with Tori Schafer, director, stating that politicians are trying to trick voters into banning abortion again. The inclusion of gender-affirming care restrictions is seen by opponents as a diversionary tactic.