Voters in Missouri overturned one of the nation’s strictest abortion bans on Nov. 5, delivering a major win for abortion rights advocates. However, efforts to expand protections fell short in Florida, Nebraska and South Dakota, leaving restrictions intact in those states.
Missouri’s constitutional amendment allows abortion up to fetal viability, typically around 21 weeks. The measure marks the first successful reversal of a total abortion ban through a statewide vote. Advocates celebrated the victory as a turning point in the post-Roe v. Wade era.
“This is a turning point for reproductive freedom,” said Mary Wilson, a reproductive rights advocate with Missourians for Freedom. “It proves the power of citizens to push back against unjust laws.” Opponents, including Missouri Right to Life members, argued the measure “threatens unborn children,” according to a statement released on Nov. 5.
In Florida, voters rejected Amendment 4, a proposal to enshrine abortion rights in the state constitution — even though a majority in favor of the proposed amendment. According to Florida law changes to the constitution require a 60% approval, and Amendment 4 received only 57%.
The measure’s failure leaves in place Florida’s 6-week abortion ban, which Gov. Ron DeSantis has defended as a “common-sense protection for unborn life.” Speaking to supporters after the election, DeSantis said, “Floridians have made their voices heard.”
Abortion rights advocates expressed disappointment. “This is a huge setback for access to care,” said Dr. Julia Clarke, a Miami-based OB-GYN. Clarke warned the decision would drive more patients from nearby states with stricter laws to seek care in already-overburdened clinics in Florida.
“It’s devastating for women and families across the South,” she said.
Elsewhere, abortion rights measures passed in Arizona, Colorado, Maryland and Montana, continuing a trend of direct voter action on the issue. In Nevada, voters approved a similar amendment, but it must clear a second vote in 2026 to take effect. In New York, a broad anti-discrimination amendment prohibiting bias based on “pregnancy outcomes” was approved by a wide margin.
These results come amid ongoing fallout from the Supreme Court’s 2022 decision overturning Roe v. Wade, which ended nearly 50 years of federally protected abortion access and shifted regulatory power to the states. Advocacy groups on both sides have since launched ballot measures to shape abortion policy in their states.
Former President Donald Trump, who won re-election earlier this month, has taken varying stances on abortion but has consistently argued it should remain a state issue. However, experts say federal policies and judicial appointments under his administration could significantly influence the future of abortion access nationwide.
Missouri’s vote highlights the growing influence of citizen-led initiatives in challenging restrictive abortion laws. “This is a testament to the power of democracy,” said Karen Mitchell, a legal analyst with the Center for Reproductive Justice. “Voters are rejecting extreme policies and demanding a balanced approach.”
Florida’s rejection of Amendment 4, however, underscores the resilience of anti-abortion movements in Republican-controlled states. Groups like Florida Family Policy Council applauded the outcome, stating it was “a victory for protecting life at every stage.”
Healthcare providers say the stakes remain high, particularly in the South, where abortion access is increasingly limited. “We’re seeing the ripple effects of these laws,” said Dr. Erica Hall, a physician in Georgia. “Women are traveling further, waiting longer and facing greater risks.”
As advocates gear up for future battles, the mixed outcomes in Missouri and Florida reflect a deeply polarized nation grappling with one of its most divisive issues.