A critical health-focused ballot measure on the November 5 election ballot is Amendment 3, or the “Right to Reproductive Freedom Initiative.” The amendment would establish the constitutional right to an abortion. Since the overturning of Roe v. Wade in June 2022, nearly all abortions became illegal in Missouri, with few exceptions for the health of the pregnant person.
To achieve our vision of zero health disparities, the Community Heatlh Commission of Missouri prioritizes achieving health equity. The passing of Amendment 3 would support and improve maternal health outcomes by removing barriers to access to necessary health care and reinforcing the belief that everyone in our state should have the opportunity to determine if, when, and under what circumstances to get pregnant.
In addition to abortion, the amendment would also solidify other reproductive rights into the constitution, such as in-vitro fertilization and birth control. In-vitro and birth control are still legal in Missouri, but the amendment would enshrine them into the Missouri Constitution.
If the Amendment passes, the General Assembly will have the opportunity to regulate abortion after the point of fetal viability. When a pregnancy reaches fetal viability, it means the fetus could survive outside of the womb. The government will not be allowed to delay or restrict an abortion past that point if a health care provider deems an abortion necessary. The proposed amendment eliminates penalties for pregnancy outcomes, including miscarriage, stillbirth, and abortion. The government will also not be allowed to “discriminate against persons providing or obtaining reproductive health care or assisting another person in doing so.”
Ballot Summary Lawsuit
The Secretary of State created a summary of the amendment designed to mislead voters. As a result, abortion-rights activists challenged this summary, claiming that voters were being misled.
A Missouri judge agreed with the activists and ruled that the summary was unfair and created unnecessary confusion about the amendment. The initial summary led voters to believe the amendment would allow medical professionals to perform abortions negligently or criminally.
In reality, the proposed amendment aims to eliminate criminal penalties for providers who perform abortions and for patients who are seeking them. Physicians in Missouri currently face penalties of up to 15 years in prison if they perform an abortion.
Maternal Health Cost in Missouri
Many birthing people struggle to afford abortions, especially those without health insurance. The Hyde amendment was introduced at the federal level in order to restrict funding for abortion access. The Hyde Amendment requires that federal funds cannot be used to cover abortions unless the pregnancy is a result of rape or incest, or if the pregnancy endangers the mother’s life. This means that abortions in Missouri are only funded by Medicaid if their abortion meets those specific requirements. However, the majority of people who tend to seek abortions are covered under Medicaid, and this lack of funding due to the Hyde Amendment often leads to devastating consequences, both physically and financially.
Restricting reproductive health care, such as abortions, has far-reaching consequences. If abortion was completely banned in the United States, the overall number of maternal deaths would rise by 24%. Maternal deaths among Black birthing people would rise by 39%. The US currently has one of the highest maternal mortality rates among industrialized countries.
Missouri already presents a high risk for unfavorable reproductive health outcomes. These outcomes are primarily due to inadequate access to quality reproductive health services, which is driven by socioeconomic determinants, limited access to primary healthcare, lack of mental health support, and substance use. The abortion-restriction in Missouri only exacerbates the maternal, perinatal, and neonatal mortality rates. 39% of the counties in Missouri are maternity care deserts, meaning birthing people must travel farther to see providers.
Abortion-Access Data
The point of Fetal Viability is considered to be around the 24th week of pregnancy. In 2022, the majority of abortions were performed prior to the 24 week mark (just over 99%). The bulk of abortions are typically performed before the 9 week mark (59%). This data is based on recorded abortions in 2022, and does not take into account the trigger ban that went into effect after Roe was overturned. The Guttmacher Institute has recorded that in 2023 over 10,000 Missouri women sought reproductive care in Kansas and Illinois. Self-managed medication abortions have increased by 26,000 across the country.
The Bottom Line
When abortions and reproductive health care are restricted, people die of preventable causes. Thousands of women across Missouri have been facing struggles since the abortion ban. Many struggle to find a provider to care for their basic needs. Others are struggling with unplanned pregnancies. Abortion bans do not help women and birthing people, but a “yes” on Amendment 3 helps all Missourians achieve health equity.
We know that access to reproductive healthcare is critical for health equity. Restricting abortion disproportionately affects marginalized groups, including low-income women, women of color, and those with limited access to healthcare, exacerbating existing health disparities. By safeguarding abortion rights, the measure would ensure that all women, regardless of socioeconomic status, have the ability to make informed decisions about their health, reducing barriers to comprehensive care and promoting overall reproductive justice.
I am in favor of amendment 3. However, I do not believe that abortion should be a form of birth control. Why is there not a bigger push on educating and providing birth control? This would help eliminate the birth control abortions. I think this is a huge problem, not just in Missouri, but the whole country.
Thank you for your thoughtful comment and for supporting Amendment 3. We share your belief that comprehensive education and access to birth control are essential in addressing reproductive health needs and reducing the need for abortion. At the core of Amendment 3 is the protection of reproductive freedom, ensuring that people retain control over their health care decisions. Supporting both access to birth control and the right to choose are essential parts of a broader reproductive justice framework, and we will continue advocating for both.
The point of visibility? If aborted is murder. Right? What are the reasons a person would wait until the fetus can survive outside of the womb? That is why I want to vote in the negative
Thank you for your comment and for sharing your perspective. We recognize that this is a complex issue that evokes strong feelings on all sides, especially when it comes to defining and understanding medical milestones like viability.
At its core, we believe that access to abortion is an equity issue. The ability to choose when and how to receive medical care, including abortion, is fundamental to ensuring that everyone has control over their body, livelihood and future. While we respect the importance of nuanced discussions around topics like reproductive health care, our support will always stand by the belief that reproductive freedom includes the right to make deeply personal decisions without interference, including abortion.
I feel woman should be able to get n abortion in the case of : rape,incest, or the life of the mother is at stake. Abortion shouldn’t be used as birth control. Past the 1st month is too late for one.
Hi Teri, thank you for your comment and sharing your perspective! As we have shared in other comments, we strongly support access to all reproductive health care, including birth control, and believe that Amendment 3 ensures individuals maintain control over their healthcare choices. Advocating for both access to birth control and the right to choose is a key aspect of a broader reproductive justice approach, and we remain committed to supporting both.
Why shield healthcare providers from accountability? Paragraph 5 is a get-off-the-hook clause for healthcare providers regardless of the services provided. That doesn’t seem very equitable or even remotely woman-friendly. It sounds to me like women are being exploited so that those profiting from providing services can make more money without the threat of lawsuits.
Hi Joy, thank you for your thoughtful comment and commitment to health equity! We understand your concerns, but it’s important to clarify the intention and impact of Missouri Amendment 3. Right now, under current law, performing or receiving an abortion in most cases is illegal in Missouri, which can lead to severe legal consequences for both healthcare providers and patients. Amendment 3 seeks to change this by protecting the right to abortion and ensuring it’s treated as a legitimate medical procedure, governed by the same rigorous clinical and evidence-based standards that apply to other healthcare services. Rather than making abortion lawless or unregulated, Amendment 3 restores abortion as a protected medical service and empowers providers to make decisions based on science and the health of their patients, rather than politics. Ultimately, this helps ensure that anyone seeking an abortion in Missouri receives safe, medically sound care.
None of the comments were clear if the amendment is rejected will women have the ability to have an abortion that through incest or rape and special medical health issues yes or no
Thank you for your question! Current Missouri law does not provide exceptions for rape or incest. The only exceptions are for medical emergencies that endanger the life of the pregnant individual or pose a serious risk of significant and irreversible damage to a major bodily function. If amendment 3 is rejected, current Missouri law will remain in place, which outlaws non-medically necessary abortions.
Abortion in any case beyond 12 weeks is murder in my opinion but should be allowed in a few circumstances/exceptions before the 12 weeks. It seems to me a yes vote on this amendment is removing all restrictions and that’s just not acceptable. I also don’t feel that the responsibility should fall onto the taxpayer. I do feel Missouri law should be changed to include rape and incest but this amendment does more harm than that little bit of good. Of course this blog shows the few worst case scenarios but statistics for rape and incest abortions are very low as well. The fact remains we are a mobile society and since abortions are provided in states all around us I am not persuaded that supporting Amendment 3 is the best thing for Missouri.
Thank you for sharing your perspective! We understand your concerns about the balance between protecting certain exceptions and maintaining restrictions on abortion.
We would like to clarify that the amendment does not remove all restrictions on abortion. In fact, it allows for regulations that are consistent with widely accepted clinical standards and evidence-based medicine. This framework ensures that abortion remains a safe, medical procedure, while still permitting reasonable regulations. The amendment also explicitly permits restrictions on later-term abortions after the window of fetal viability, consistent with the health and safety of the pregnant person. While it’s true that cases involving rape and incest are statistically less common, the impact of these exceptions is profound for those affected. Currently, Missouri law lacks adequate protections for survivors or birthing people generally, and this amendment would allow for care in traumatic or complicated circumstances without criminal penalties for providers or patients. It is also worth considering that not everyone has the resources to travel to another state for care, and many face significant burdens when trying to access essential healthcare services, particularly in emergency situations.
Ultimately, we believe that Amendment 3 is about restoring access to safe, equitable health care.
“Restricting reproductive health care, such as abortions, has far-reaching consequences. If abortion was completely banned in the United States, the overall number of maternal deaths would rise by 24%” But we are not wanting to completely ban abortions. As you mentioned, “If amendment 3 is rejected, current Missouri law will remain in place, which outlaws non-medically necessary abortions.” So we will still allow abortions when it comes to the safety of women. The only thing that changes with this amendment is now we will allow people to use abortion as a back up for birth control.
Thank you for sharing your thoughts! While it’s true that Missouri law allows for abortions in cases where a woman’s life is in danger, Amendment 3 focuses on improving access to reproductive healthcare and addressing health disparities across the state. As highlighted in the blog, the Community Health Commission of Missouri prioritizes achieving health equity, and part of that vision includes ensuring everyone has the opportunity to make decisions about their reproductive health, including if, when, and under what circumstances to get pregnant. Amendment 3 would remove barriers to necessary healthcare, which can have a demonstrably positive impact on maternal health outcomes. By allowing birthing people more control over their reproductive choices, we can support better health outcomes and ensure that everyone has access to the care they need based on their unique circumstances, not just in medical emergencies.
Thank you for taking such an important and thoughtful stance. This amendment is not only essential in securing our most fundamental right-to control what happens within our own bodies, but also paves so many pathways for improving maternal and child health across the state.
Thank you so much for your support and for recognizing the importance of this amendment, Emily! We agree that the right to make personal healthcare decisions is fundamental, and it’s encouraging to hear that others appreciate the broader impact its passage will have on improving maternal and child health in Missouri.