Justice Gatson, a longtime reproductive justice activist based in Kansas City, opposed Missouri’s Amendment 3, saying it didn’t go far enough in ensuring abortion access for everyone (Anna Spoerre/Missouri Independent).
Supporting Amendment 3 was never an option for Justice Gatson.
As the leader of the Reale Justice Network, a reproductive justice organization based in Kansas City, she had a simple explanation for her decision: the amendment didn’t go far enough in expanding abortion access.
So when voters approved Amendment 3 — which lifts Missouri’s near-total abortion ban but allows legislators to regulate the procedure after viability — Gatson didn’t stand by.
The day after the election, she was among a number of organizers and activists who released an accountability plan called “What’s Next.”
The initiative demands a comprehensive legal strategy to dismantle as many barriers to abortion access as possible before Donald Trump moves back into the White House, and it calls on the community to help fund abortion access across the state.
“‘What’s Next’ is really about holding the space of accountability and pushing and demanding that a legal effort is made to close these holes,” Gatson said.
Chief among the group’s concerns are current parental notification requirements for minors trying to access abortion and a ban on Medicaid funding for abortion.
“We really want access for anybody who needs it in our state,” Gatson said, “No matter what.”
Less than 24 hours after voters approved Amendment 3, Planned Parenthood Great Plains and Planned Parenthood Great Rivers, two leaders in the campaign behind the amendment, sued the state in the hopes of quickly bringing back abortion access to statewide clinics.
The Planned Parenthoods did not respond to any of the specific concerns outlined in the “What’s Next” plan. Instead, they reiterated in a joint-statement that “Missourians have been living under severe restrictions and outright bans on abortion care for several years.”
“As expert providers of comprehensive sexual and reproductive health care,” the statement continued, “We are focused on making the necessary preparations to realize the people’s right to access abortion in Missouri again as soon as possible.”
The reproductive justice ballot initiative that never was
On the 50th anniversary of Roe v. Wade in January 2023, Gatson stood before more than 50 people in Kansas City and announced her intentions to draft an initiative petition aiming to lift every restriction on abortion.
It had been six months since Missouri enacted a trigger law that banned nearly all abortions, with exceptions only for medical emergencies.
Emblazoned across the shirts of those standing beside Gatson were five words: “I am more than Roe.”
In the coming months across the nation, similar refrains were growing louder as several states, like Missouri, announced campaigns to protect or restore reproductive rights with viability provisions that divided abortion-rights groups.
Fetal viability is the time in pregnancy when a fetus can survive on its own outside the womb without extraordinary medical interventions. While viability is generally considered to be about the mid-point in pregnancy, between 20 and 24 weeks, there is no exact gestational definition.
Abortions later than 20 weeks account for fewer than 1% of all abortions in the United States, according to the Centers for Disease control and Prevention. Often, they are the result of diagnoses of fetal anomalies, growing health complications with the mother or an inability to access an abortion sooner, an issue that’s increasingly become commonplace in the south, where bans force women to travel states away to access the procedure.
Those opposed to viability language say it continues to create barriers for the most vulnerable people, often those in rural areas, those living in poverty and those with medical complications that arise later in pregnancy. Access to earlier abortions remained particularly tenuous for many communities of color, where people are more likely to be uninsured or underinsured and where there remains a distrust in medical professionals due in part to the history of medical exploitation of minority communities in the U.S.
“The courts didn’t protect us,” Gatson said. “Reproductive justice advocates have been saying that the whole time.”
The term reproductive justice was coined in 1994 when 12 Black women joined together to voice concerns that reproductive rights were not extending to under-represented communities. Their work has since grown into a national movement that dreams of a future beyond the typical Roe-centered goals of reproductive-rights leaders who are typically tied to more established organizations like Planned Parenthood.
Pamela Merritt, a longtime reproductive justice organizer based in the St. Louis area, was part of the initial conversations that eventually evolved into what became Amendment 3.
At the time, Merritt said she was the only Black woman at the table, and she encouraged the other coalition members to involve Gatson, who had already announced her own initiative petition effort.
A partnership never emerged, and the coalition — headed by the ACLU of Missouri, Abortion Action Missouri, Planned Parenthood Great Plains and Planned Parenthood Great Rivers — remained majority white-led.
Merritt eventually stepped away from the coalition when the organizations decided to move forward with an initiative petition that included viability language. Merritt said before she left, she was told she was trying to make perfect the enemy of good in her push for language that would have legalized abortions at any point in pregnancy.
“The language of inclusion and diversity and equity is very much at the forefront of progressive organizations, leadership and their strategies,” said Merrit, who now serves as executive director of Medical Students for Choice. “The actual work of it isn’t.”
At the end of the day, coalition leaders said they chose the initiative petition they felt had the best chance of both expanding reproductive rights and passing with majority approval in Missouri.
Amendment 3 ultimately passed with 51.6% of the vote. Of the nearly 3 million votes cast, more than 95,000 yes votes edged out those hoping to defeat it.
Merritt said she didn’t want Amendment 3 to fail because of the optics and political legacy that would follow in the wake of a loss. But she reiterated that Roe didn’t serve women of color or those living in poverty in the same way it served others.
It’s those stories that fuel the reproductive justice fight.
“Black leaders like [Gatson] are being asked to fall in line for the good of their community,” Merritt said “It feels like an absolute repeat of every issue of erasure in power, resource-guarding behavior, and it’s frustrating because we’re being put in this ethical fix.”
Gatson said she was blind-sided by the initiative petition chosen by the coalition. She didn’t attend the coalition’s signature-gathering launch party that took place at a community center in one of Kansas City’s historically Black neighborhoods. Nor did many people of color.
The Reale Justice Network in a February press release announced its reproductive justice workers could not support the measure, which followed in the footsteps of Roe by “offering up the most impacted people as a sacrifice for others.”
Had it not passed, Gatson was preparing to bring forward an initiative petition that has been a few years in the making, with the guidance of the national Ballot Initiative Strategy Center: one that didn’t include gestational limits on abortion. Instead, she said, the Amendment 3 win felt like an “erasure” of grassroots reproductive justice efforts.
Sandra Thornhill, a reproductive justice advocate and social justice doula based in St. Louis, said it felt as if the lessons of Roe were being swept under a rug.
“We have to shoot beyond the moon. We gotta shoot for the next galaxy,” Thornhill said. “Because what we know is that the enemies out there who don’t want us to have our autonomy, who don’t want us to have access, who don’t want us even have choice, they are going to do what they have always done.”
A different landscape under Trump
The initial lawsuit filed Nov. 6 by the Planned Parenthoods is ambitious, with the goal of immediately striking down more than a dozen of the state’s current abortion restrictions, commonly referred to as TRAP laws.
During a press conference the day of the lawsuit filing, Richard Muniz, interim President and CEO of Planned Parenthood Great Rivers, did not specifically say whether parental notification will be challenged in the future, but implied there are more lawsuits to come.
Planned Parenthood officials have said if a judge grants their emergency injunction, they hope to start providing abortions at three clinic locations across the state again after Dec. 5, when the amendment goes into effect.
But there are still many barriers standing in their way. This includes a tight timeline of court hearings and the impending legislative session where Republicans have vowed to continue to attempt to restrict access and even put forward a second amendment seeking to again ban the procedure.
“Anti-abortion, anti-democracy politicians are going to try to stomp us out,” Mallory Schwarz, executive director with Abortion Action Missouri, told a crowd gathered in St. Louis following Amendment 3’s win on election night. “They’re going to try and fight us in court, they’re going to file new attacks in Jefferson City.”
The coalition now faces two Republican trifectas: one in Washington, D.C., and the other in Jefferson City, all but guaranteeing an uphill battle to restore access in a timely manner.
And while the coalition will be watching the GOP administrations, Gatson will be among those watching the coalition.
“It’s going to require tight and aggressive legal strategy, period,” she said. “And they owe it to the community.”
After the election, Monica Simpson, executive director of SisterSong, the Women of Color Reproductive Justice Collective, said on a national press call that the labor of reproductive justice workers was not over.
It was an urging to recognize and uplift people of color in the abortion space.
“We must trust Black women to build an intersectional movement until the principles of reproductive justice become a reality,” Simpson said. “A world where we go beyond restoring the federal right to abortion and achieve a future where everyone has the human right to maintain personal, bodily autonomy: Have children, not have children and parent the children that we do have in safe and sustainable communities.”
Black families continue to suffer higher rates of infant and maternal mortality in Missouri where Black mothers are 2.5 times more likely to die within a year of pregnancy than white mothers.
Merritt said these outcomes are part of the reason she is speaking up.
“For 50 years, the reproductive health rights and justice movement has held a lot of our tension in our disagreements behind closed doors because we had a well-funded, vicious opposition coming at us,” she said.
But times have changed.
This year, it was the Amendment 3 campaign — backed by more than $31 million in donations — that far out-fundraised the anti-abortion opposition. This time, Merritt said, it was the establishment reproductive rights groups holding the power.
“Reproductive justice is the path to liberation,” Merritt said. “… If it isn’t centering the people most impacted by oppression, that’s not reproductive justice, that’s political theater, and we need to call it out.”