Missouri residents voted overwhelmingly to maintain protections for reproductive healthcare on Tuesday.

All protections put in place by 2024’s Amendment 3 remain in place, “including but not limited to prenatal care, childbirth, postpartum care, birth control, abortion care, miscarriage care and respectful birthing conditions.”

“In 2024, Missourians made history by becoming the first state in the nation to defeat an abortion ban at the ballot box, and tonight we made history again with more than a million Missourians voting to defend that victory from politicians who tried to take our power away,” said Luz María Henríquez, executive director of the ACLU of Missouri.

Amendment 3 was a legislative effort intended to ban access to abortion care for the first 12 weeks of gestation except in the case of rape or incest.

The amendment promised care for ectopic pregnancies, miscarriages, the life of the mother and fetal anomalies throughout the pregnancy. The fetal anomaly provision only referred to cases where the fetus would not survive outside of the womb.

Amendment 3 was defeated by 55.3% of Missourians, a higher percentage than the 51.6% who backed enshrining reproductive rights in the Missouri Constitution in 2024. All the numbers are unofficial results.

This decision comes following a contentious history of access to abortion in the state.

After the 2022 U.S. Supreme Court decision to return the right to abortion to the states, Missouri enacted a trigger ban on abortion previously passed by the legislature.

The trigger ban placed a near-total ban on abortion in the state, with criminal and civil consequences for providing or receiving an abortion.

A citizen-led initiative in 2024 restored the right to reproductive healthcare in the state. It was decided by a 51.6% to 48.4% vote.

Republican legislators Rep. Ed Lewis, R-Moberly, and Sen. Adam Schnelting, R-St. Charles, led initiatives in both chambers to get abortion back on the ballot this fall.

They included an additional provision intended to enshrine an existing state ban on gender-affirming care for minors in the Missouri Constitution, including access to puberty blockers, hormone drugs and sex change surgeries. That provision was seen as an effort to attract more votes for the potential abortion ban.

In 2023, the Missouri General Assembly passed a law banning transgender care for minors; however, it is set to expire in August 2027 unless the legislature removes the sunset date. Legislators are expected to be voting on these provisions in 2027.

Most of the advertising in favor of Amendment 3 focused on the gender-affirming care issue.

“We’ve said it before, voters said it again tonight, and we’ll continue fighting until we are heard fully: Missourians do not want politicians interfering with our health care decisions,” said Margot Riphagen-Dunn, president and CEO of Planned Parenthood Great Rivers Action. “Not with our abortions. Not with our gender-affirming care. Never with our bodies, our families or our futures.”

Looking forward

All protections that were put in place in 2024 remain intact.

Lewis anticipates future legislation on abortion in the state. He said that either citizens or lawmakers will almost certainly continue the fight.

Anti-abortion activists were devastated by the loss and signaled intentions to carry on the fight. Some opposed to abortion were reluctant to support the amendment because it did not totally ban the procedure.

Voters reject new congressional map, strengthen voter power

By Jordan Davis and Emily Skidmore, Missouri News Network

Missouri voters elected Tuesday to deny a Republican-friendly congressional map and to strengthen protections for voter-approved laws.

The map referendum — known as Proposition A — saw roughly 62% vote “no,” while the voter protections — known as Amendment 6 — saw approximately 60% vote “yes.”

Prop A

Voters defeated Prop A in Tuesday’s election, meaning Missouri will continue to use the congressional map approved in 2022.

The referendum was prompted by Missouri Republicans, who in 2025 redrew the state’s congressional maps in an attempt to gerrymander a Kansas City-area seat out of Democratic control.

Tuesday’s vote came after back-and-forth from state and federal court rulings, which left uncertainty about whether Prop A would appear in front of voters until relatively late in election season.

Proposition A was put on the ballot through an initiative petition from activist group People Not Politicians, which gathered over 300,000 signatures. Secretary of State Denny Hoskins then attempted to block the referendum and preserve the use of the 2025 map, a move that was reversed by the Missouri Supreme Court in September. This allowed the ballot measure to be voted on by Missouri residents rather than having Missouri legislators decide which map would be used.

People Not Politicians Executive Director Richard Von Glahn spoke Tuesday night in a social media post, two hours before the Prop A election was called.

“(Prop A is) about a much larger question, about who democracy needs to focus on and who it belongs to,” Von Glahn said. “And the answer is us.”

Had the 2025 map been approved, Kansas City’s 5th District was set to be redrawn to include a dozen deep-red counties. This would have jeopardized Democratic Rep. Emanuel Cleaver’s odds for reelection if he chose to run again in 2028.

Prior to the election, several Republican lawmakers voiced support for another redistricting attempt in advance of the 2028 election. It is unclear whether or not those rumblings could gain steam in Missouri’s upcoming legislative session.

Republicans initially set out to make a map the favored the GOP in seven of the state's eight congressional districts. By the end of the night Tuesday, Democrats had swung the balance to 5-3 — Democrat Fred Wellman defeated incumbent Rep. Ann Wagner, a Republican, in suburban St. Louis's 2nd District.

Amendment 6

Missouri voters approved Amendment 6 on Tuesday to place in the state’s constitution higher restrictions on repeals of citizen-led initiatives.

The amendment establishes a higher threshold for legislators to overturn voter-approved laws by requiring an 80% vote in both chambers of the legislature and a statewide vote of the people to change or undo any law that is passed through the initiative process.

Additionally, the amendment requires that ballot summaries, summary statements and fiscal notes have clear and easily understandable language.

The amendment will maintain the current signature requirements and voting threshold for citizen-initiated petitions.

Under current Missouri law, the Missouri General Assembly needs just a simple majority to initiate the repeal of a constitutional amendment approved by voters.

With the passage of Amendment 6, Missouri’s protections on voter-approved laws are some of the strongest in the country.

The passage of this amendment comes after attempted repeals of citizen-led initiatives by legislators, with the two most recent examples including reversals of both abortion and paid sick leave in May 2025.

Respect MO Voters, the main group in support of Amendment 6’s passage, celebrated the result in a news release Tuesday night.

“Missourians from every corner of this beloved state said the time for these political games is over and the time for holding politicians accountable and protecting our constitutional rights are here to stay,” Jack Cardetti, spokesman for the Yes on 6 campaign, said in the release.

In August, Hoskins attempted to prevent the proposed amendment from going on the ballot due to claims of it having more than one subject.

Respect MO Voters sued Hoskins for the decision, making way for the Missouri Supreme Court to reverse the decision and place Amendment 6 in front of voters.

The next legislative session, set to begin in January, will determine the impact that Amendment 6 will have on the state’s legislature. Several Republican officials have suggested creating more restrictions on other aspects of the petition process in response.