Voters in Missouri, Nevada, Idaho, and Virginia will decide abortion-related ballot measures in the November general election, continuing a wave of state-level votes on reproductive rights that began after the U.S. Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization eliminated federal abortion protections.
Missouri presents a unique situation as the only state voting to remove abortion protections already enshrined in its constitution. Just two years after voters approved Amendment 3 in 2024 to guarantee abortion access through fetal viability, the state’s Republican-dominated legislature is asking voters to repeal that protection and replace it with a ban allowing abortions only in cases of medical emergencies, fetal anomalies, and pregnancies from rape or incest, with the latter restricted to before 12 weeks. Missouri was the first state to implement an abortion ban following the Dobbs decision and had previously restricted the procedure through regulations over three decades, reducing abortions from 5,772 in 2011 to just 150 by 2021.
Nevada is also voting on abortion protections for the second time, as state law requires two consecutive voter approvals to enshrine constitutional amendments. A 2024 measure protecting abortions up to 24 weeks received 64% support, and voters must reaffirm that backing in November for it to take effect. The measure would require voter approval for any future abortion bans. Idaho voters will decide whether to establish abortion rights through fetal viability, approximately 24 weeks, while the state currently maintains one of the nation’s strictest bans. Virginia voters will determine whether to amend their state constitution to codify existing abortion access through 28 weeks.
The patchwork of state-level abortion policies has created confusion for both patients seeking care and providers attempting to deliver services. The repeated Missouri votes exemplify this uncertainty, with the state only resuming medication abortion access nearly two years after voters approved protections in 2024. Advocates and opponents on both sides of the abortion debate have highlighted concerns about the ongoing volatility in state policies and constitutional standing.
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