Abortion is on the ballot in 10 states this year. Here's why that matters.

A record number of abortion access-related ballot initiatives are before voters this fall. It’s the next stage in an ongoing battle to protect abortion rights after the U.S. Supreme Court gave states back the power to regulate abortion two years ago, experts say. 

Eleven ballot measures will be decided on by voters in 10 states in November. All but one proposal would establish state constitutional rights to an abortion.  

In Missouri, which has voted for a Republican president since 2000, voters will decide whether to overturn the state’s current near-total ban on abortion, which has been in effect since June 2022. Missouri was one of 13 states that enacted trigger laws to automatically ban the procedure with few exceptions like rape or incest if Roe v. Wade were overturned.

Stories of how bans have affected pregnant women and their families have been “shocking to the general public,” said Sheela Ranganathan, an associate with the Health Policy and the Law Initiative at Georgetown University.

In Georgia, for instance, 28-year-old Amber Nicole Thurman died in August 2022, two months after the Dobbs v. Jackson Women's Health Organization ruling ended the federal constitutional right to abortion. Thurman had sought treatment at an Atlanta hospital for a procedure to remove fetal tissue that remained in her uterus after taking abortion pills. 

But the state had recently banned the operation, with few exceptions; performing it could land a provider in prison for up to 10 years. Doctors waited 20 hours to operate on Thurman, a delay that played a major role in her death, ProPublica reported. 

“More people are likely thinking about how their pregnancy or their daughter or wife’s pregnancy would be impacted by the health care they are able to receive, particularly in emergency situations,” Ranganathan said. “These issues are becoming our reality instead of a theory, so I think that is definitely motivating people a lot more than it would have” before the Dobbs decision.

If Missouri voters overturn their state’s abortion ban, they would continue a trend across other conservative states where people have voted in favor of abortion rights. Last year, Ohio voters decided in favor of establishing a state constitutional right to abortion. And in 2022, voters in Kansas and Kentucky voted against proposals that would have restricted abortion rights.  

A June 2024 study from Wichita State University found that the abortion ballot measure in Kansas, which 59% of voters voted against, generated more participation from younger voters, female voters and first-time voters during the primary election in August 2022.

“Given that a majority of the voters in the primary were registered Republicans, some significant minority of them bucked the legislature’s party line and voted against the amendment,” researchers wrote. “This should be concerning to Republican lawmakers and anti-abortion activists in conservative states across the country.”

A poll by Saint Louis University of 900 Missourians conducted in August, for instance, found that 52% of respondents said they support overturning the ban. However the majority of respondents still said they would vote for former President Donald Trump and the Republican candidate for governor, Lt. Gov. Mike Kehoe.

Last month, Kehoe expressed his support for the abortion ban during a debate with the Democratic candidate, state Rep. Crystal Quade. “I think that Missourians and elected officials, number one, protect innocent life, the life of those who can’t speak for themselves, and I have had that conversation about exceptions, and I understand there are some people who think we need to work on that, but this law goes way too far. It’s very extreme,” Kehoe said.

Missouri’s ballot question “probably won’t make a difference to how the state votes in the presidential election,” said Shaun Bowler, a political science professor at the University of California Riverside. The Wichita State University poll, for instance, also found a decline in voter participation when it came to the general election. Nearly 55% of those who voted in the primary election did not return to the polls in November.

Like other red states with abortion propositions, Missouri as a whole is unlikely to “suddenly go blue,” he added. “The exceptions are going to be Arizona and Nevada, which are swing states.”

In addition to Arizona, Missouri and Nevada, other states with abortion on the ballot this election season are Colorado, Florida, Maryland, Montana, Nebraska, New York and South Dakota. 

It’s hard to say if Republicans who vote in favor of abortion rights will switch parties to vote for Vice President Kamala Harris, Bowler said. But it is likely that Harris will attract young, female and first-time voters given she has advocated for reproductive rights throughout her political career. Conservative voters, even if they do support abortion rights, may still commit to Trump, who has traditionally supported anti-abortion. As president, for instance, he appointed more than 200 federal justices and judges with conservative views on abortion.

But in recent months, Trump has expressed a more tolerant take on the issue. In a post yesterday to X, formerly Twitter, he said, “EVERYONE KNOWS I WOULD NOT SUPPORT A FEDERAL ABORTION BAN, UNDER ANY CIRCUMSTANCES, AND WOULD, IN FACT, VETO IT, BECAUSE IT IS UP TO THE STATES TO DECIDE BASED ON THE WILL OF THEIR VOTERS (THE WILL OF THE PEOPLE!).” 

EVERYONE KNOWS I WOULD NOT SUPPORT A FEDERAL ABORTION BAN, UNDER ANY CIRCUMSTANCES, AND WOULD, IN FACT, VETO IT, BECAUSE IT IS UP TO THE STATES TO DECIDE BASED ON THE WILL OF THEIR VOTERS (THE WILL OF THE PEOPLE!). LIKE RONALD REAGAN BEFORE ME, I FULLY SUPPORT THE THREE…

— Donald J. Trump (@realDonaldTrump) October 2, 2024

The general public was largely unprepared for Trump to win the 2016 election, Ranganathan said, and many were shaken by the quick undoing of abortion rights at the federal and state levels that followed his win. 

“I’m not sure if [abortion] sentiments are changing necessarily,” she said. “Maybe it’s that people are starting to wake up to what is happening in their state and in states near them because they’re really starting to feel the direct impacts of these laws.”