Missouri's abortion rights opponents came close to defeating a measure two years ago that dismantled some of the restrictive laws governing the procedure in the nation.
With less than two months until the November election, they're trying to navigate difficult national headwinds and tricky political dynamics to pass Amendment 3 – which would institute a near-total ban on the procedure and also enact constitutional prohibitions against gender-affirming care for minors.
"I really don't think that speaking for innocent life should be or is a political thing," said Gov. Mike Kehoe at a rally late last month in Fenton. "It's either who you are to your core and in your soul, or it's who you're not."
Missouri lawmakers placed Amendment 3 on the ballot last year as a way to repeal the 2024 abortion rights initiative, which was also called Amendment 3. The 2024 measure ended up knocking out the state's near-total ban on abortion, as well as scores of laws that made it difficult, if not impossible, for clinics to operate in the state.
This ballot whiplash has many Missourians asking why they're voting on this issue again. The answer comes from people like Attorney General Catherine Hanaway, who opposes abortion rights and is not going to abandon her advocacy despite a statewide vote not going the way she wanted.
"I've been pro-life since Roe v. Wade was decided," said Hanaway, referring to the U.S. Supreme Court decision that legalized abortion. "And I was in a Catholic grade school, and we were wearing these little buttons because our school was failing that said 'Save Our School.' And the nuns told us: 'No, as of today, it stands for Save Our Souls.'"
Hanaway touched on an important reason why abortion rights opponents in Missouri remain quite active, even after their political setback from two years ago. The state has a large population of residents who identify as Catholic or as evangelical Christians. And for the most part, those religious groups are involved in efforts against abortion rights in Missouri.
"Church involvement is even better this time than it was last time," said Tom Estes, a state Senate staffer and pastor who is working to pass Amendment 3. "We have already seen leaders from the Catholic Church, the Missouri Baptists, Assemblies of God and other charismatic denominations joining in. Their leadership has said we are all in for Amendment 3. And think about all the church involvement we had last time around. We never had that."
Gender-affirming care is campaign focus
In addition to a near-total ban on abortions, Amendment 3 includes another provision: It would ban gender-affirming care for minors. And some anti-abortion rights activists are banking on the inclusion of that issue to help get the proposal approved.
In fact, a TV ad on Amendment 3 doesn't use the word abortion once. It instead focuses on how it would ban gender-affirmation surgery for minors, which is already illegal under state statutes. The ban is set to expire in 2027, and proponents want to enshrine it in the constitution so it wouldn't need another vote from the legislature.
Amendment 3 detractors contend that the gender-affirming care provisions were placed in the measure for a specific reason: misleading voters into thinking they're not voting for stricter abortion laws. Rep. Keri Ingle, D-Lee's Summit, said this strategy is cynical.
"And they knew that they would not be able to go back to their trigger ban or to just let the abortion issue stand on its own," Ingle said. "And so they had to marry these two issues together in order to sow fear and distrust in Missourians to get them to ban what they had just voted for."
Former House Speaker Tim Jones, an Amendment 3 supporter, defended the inclusion of the gender-affirming care ban.
"You have to point out the big things that this proposal does, and it deals with both abortion and the transgender issue," Jones said. "Everybody knows Amendment 3 deals with abortion. I don't know if folks know if it definitely will address the transgender issue or not. So, I think that's why folks lead with that too."
Big money again
Even the strongest supporters of Amendment 3 acknowledge they have a challenging road to win in November.
Amendment 3 in 2024 only passed by about 3 percentage points, even though opponents were vastly outspent. That's going to be the case this time around too, since a campaign committee called Stop the Bans has raised millions of dollars in single donations over $5,000 since the beginning of the year.
Margot Riphagen-Dunn of Planned Parenthood Great Rivers Action says abortion rights opponents are misjudging the mood of Missourians.
"What we hear over and over again on the doors is that folks are tired of this," Riphagen-Dunn said. "They say we've already voted for this. We want abortion access in our state. We are clear on this. Voters are clear that these are more games coming out of Jefferson City and from our elected officials, and they're tired of it."
One of the problems for abortion rights opponents is that the 2024 version of Amendment 3 received 338,000 more votes than Democratic presidential nominee Kamala Harris. That means Donald Trump voters played a role in legalizing abortion in Missouri.
And Trump has never been particularly passionate about embracing abortion bans. Back in 2024, he repeatedly said that Florida's ban on abortion after six weeks of pregnancy was "too strict." That's a less restrictive law than what's being proposed under the 2026 version of Amendment 3.
"What we see over and over again is this is not an issue about the left or the right, Democrats or Republicans," Riphagen-Dunn said. "This is a real issue that impacts people's lives, regardless of who they voted for, regardless of their political positioning, and we see that at the polls."
Jones, the former House speaker, said the 2026 version of Amendment 3 addresses concerns of Trump voters who may be less doctrinaire on abortion by including exceptions for rape, incest and medical emergencies. And while putting those exceptions in the proposal caused some backlash among abortion rights opponents, Jones said it's important to not let the perfect be the enemy of the good.
"We didn't ban abortion overnight in Missouri," Jones said. "We're not going to get back to that situation. I think this is a perfect position that I would argue the majority of Missourians, right, left and center, would be in favor of."
Amendment 3 will be on the ballot in the Nov. 3 election.
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