The Missouri state flag is seen flying outside the Missouri State Capitol Building on Jan. 17, 2021 in Jefferson City (Michael B. Thomas/Getty Images).
Missourians will likely vote on an alternative abortion amendment in 2026.
This amendment will be drafted and summarized by the Republican-controlled Missouri legislature, which aims to roll back provisions in Amendment 3 and further restrict abortion access.
Instead of repeating past mistakes that endangered women and babies, Republicans should offer a commonsense abortion amendment.
In 2024, Missourians for Constitutional Freedom spent $30 million on a reproductive freedom amendment that narrowly passed at the ballot box. In the same election cycle, Missouri Democrats leaned heavily into pro-abortion messaging in statewide and legislative races yet failed to gain a single seat.
Republicans still hold every statewide office and a legislative supermajority. Despite implementing an extreme anti-abortion agenda that made reproductive health care tenuous in Missouri, Republicans faced no electoral consequences.
Emboldened by a decisive Trump victory in Missouri, anti-abortion Republicans now believe they can push through a constitutional amendment banning abortion. The legislature has already begun moving forward with this plan.
Lawmakers debate new constitutional amendment banning abortion in Missouri
On Tuesday, the Missouri House heard testimony on state Rep. Melanie Stinnett’s proposed constitutional amendment, which bans abortion except in rare cases. While it may appear to be a departure from the total ban Missourians rejected at the ballot box, in practice, its language creates so many barriers to care that abortion — including life-saving medical treatment — would remain virtually inaccessible.
This is clear for three reasons.
First, to qualify for an abortion in cases of rape or incest, a woman would be required to report the assault to law enforcement with jurisdiction to investigate the crime. It is well-documented that many survivors do not report sexual assaults to the police. This requirement is not only punitive but unnecessary.
Abortion providers, including Planned Parenthood, are already mandatory reporters under Missouri law and must report incidents involving pregnant minors. There is no need to duplicate this law in a constitutional amendment. If the legislature insists on a reporting condition for adults, lawmakers should explore less punitive alternatives that acknowledge the realities of sexual violence.
Second, some women choose to terminate a pregnancy due to fetal abnormalities — when the baby will not survive outside the womb due to a catastrophic developmental condition. While Stinnett’s bill includes an exception for fetal abnormalities, its wording makes it virtually impossible to meet.
Under the proposed criteria, a patient must be carrying a baby with a fetal abnormality and the abnormality must present a serious physical risk to the mother. In reality, many women carrying doomed pregnancies can physically continue the pregnancy but seek to terminate earlier as part of their grieving process or to preserve future fertility.
Third, the medical emergency exception is so narrowly written that it would be nearly impossible for physicians to act. The bill, which pulls the language directly from the previous total ban, allows an abortion only to avert death or if a delay “will” result in both “substantial” and “irreversible” harm.
But physicians cannot predict the future with certainty, and such restrictive language forces doctors to wait until a woman is critically ill before they can legally intervene. In fact, the way the amendment is written, a woman could arguably only prove to qualify for the medical emergency exception if she actually died.
Obviously, that’s absurd.
The medical emergency exception as written is particularly problematic, as its ambiguity has already led to Missouri women being denied care. In 2023, a pregnant woman in Joplin was refused emergency treatment despite arriving at the ER with premature rupture of membranes. Missouri women and families should have legitimate concerns that reinstating this medical emergency clause could further deter providers from delivering necessary care.
The best way to avoid these pitfalls while still protecting life in Missouri is to legalize elective abortion up to a gestational marker — such as 12 weeks. After that point, physicians should have the discretion to determine the necessity of an abortion on a case-by-case basis. This approach would not restrict the legislature’s ability to enact commonsense regulations and limits on abortion, an inevitability with an anti-abortion legislature.
Missourians for Constitutional Freedom chose to put forth a progressive, gender-neutral catch-all abortion amendment that failed to secure a decisive victory that would have fended off future attacks like this one. Now, Missouri Republicans hold all the cards.
But they should remember: Missourians already rejected a total abortion ban. They do not want a new law that amounts to the same thing in practice.