One year ago today, Missourians voted to enshrine abortion rights into the state Constitution.
But access remains fragmented as court battles and proposed abortion bans introduce more confusion into an already complicated situation.
Procedural abortions are sporadically available at three Planned Parenthood clinics in Missouri as numerous legal fights unfold, including a question over whether restrictions on medication abortion will remain in place. Medication abortion, which accounts for about two-thirds of abortions nationwide, is completely unavailable in Missouri.
The exact number of abortions provided since the passage of Amendment 3 is not yet available. But Sam Lee, a longtime anti-abortion advocate with Campaign Life Missouri, said it seems to be “nowhere near what we had anticipated or what the supporters of Amendment 3 had anticipated.”
While the last 12 months have seen a pitched battle over abortion rights in Missouri, the next 12 months will likely see some conclusion.
The outcome of a multi-week trial slated for January will determine which of Missouri’s longstanding abortion regulations will be upheld and which are unconstitutional under the abortion-rights amendment. Any decision will likely end up before a higher state court.
Outside the courts, lawmakers placed a new constitutional amendment on the November 2026 ballot seeking to reinstate Missouri’s abortion ban.
“They rushed to put an abortion ban, that reads like a pro-choice amendment, back on the ballot––and they don’t think Missourians are smart enough to notice,” Mallory Schwarz, executive director of Abortion Action Missouri, said in a statement. “We know better. This time next year, Missourians will again vote against banning abortion. Hey Jeff City, it’s time you learned, no means no.”
The abortion rights amendment broadly protects reproductive health care. It also prohibits the legislature from regulating abortion prior to the point of fetal viability, which is generally the point at which a fetus can survive outside the womb without extraordinary measures.
When 52% of 3 million Missouri voters supported the amendment, it opened the doors not only for broad abortion access in Missouri but also began to lay the groundwork for access for women in nearby states with bans, including Iowa, Arkansas, Oklahoma and Texas.
But the road to widespread access is complicated, in large part thanks to the state’s long history electing anti-abortion lawmakers and their focus on crafting some of the more restrictive laws in the country, known as “targeted regulation of abortion providers,” or TRAP, laws.
These regulations are the reason for the dramatic dip in abortion in Missouri before it was outlawed. And these regulations remain among the reasons abortion isn’t yet widely accessible.
A decade ago, more than 5,000 abortions were performed in Missouri, according to data from the Missouri Department of Health and Senior Services. By 2020, that number dropped to 167 as the legislature enacted more abortion regulations.
In 2019, the Missouri legislature passed a “trigger law” that would go into effect if Roe v. Wade ever fell. When the U.S. Supreme Court overturned the constitutional right to abortion in June 2022, Missouri enacted its trigger law, becoming the first state to ban nearly all abortion.
In the first 25 months after Roe was overturned, 74 abortions were performed in Missouri under the state’s emergency exemption, according to health department data. But data shows the ban didn’t prevent thousands of other Missourians from getting elective abortions.
In 2023, approximately 2,860 Missourians traveled to Kansas last year for abortions, and 8,710 traveled to Illinois, according to the Guttmacher Institute, a reproductive rights research group that closely tracks abortion data.