Published September 24, 2026 at 4:00 PM CDT

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For pregnant Missourians seeking an abortion, in-clinic procedures are available in Kansas City, St. Louis, Columbia and Springfield.

The procedure is legal because Missourians enshrined the right to abortion until the point of fetal viability in 2024.

But if voters pass Amendment 3 at the ballot box in November, abortion will again become highly restricted.

Missourians will decide Nov. 3 whether to repeal the abortion rights amendment passed in 2024 and reinstate a ban on the procedure, except in cases of emergency, fetal anomalies and rape or incest under 12 weeks’ gestation.

If passed, Amendment 3 would also constitutionally ban gender-affirming care for minors. There is already a permanent ban on gender-affirming surgeries for trans youth in state statute, and a ban on puberty blockers and hormones that will sunset in 2027.

The ballot measure reads as follows:

“Shall the Missouri Constitution be amended to:

• Repeal the 2024 voter-approved Amendment providing reproductive healthcare rights, including abortion through fetal viability; 
• Allow abortions for rape and incest (under twelve-weeks’ gestation), emergencies and fetal anomalies; 
• Allow legislation regulating abortion;
• Ensure parental consent for minors’ abortions;
• Prohibit gender transition procedures for minors?

State governmental entities estimate no costs or savings. Greene County estimates it may experience an unknown increase in tax revenue. Other local governmental entities estimate no costs or savings.”

A “yes” vote supports amending the state constitution to repeal the 2024 abortion rights amendment, reinstate a ban except in cases of emergency, rape or incest and fetal anomalies, and ban gender-affirming care for minors.

A “no” vote opposes amending the state constitution and keeps the 2024 abortion rights amendment in place.

Missouri was the first state to enact its near-total “trigger ban” on abortion when the U.S. Supreme Court overturned Roe v. Wade in 2022.

Missourians voted to legalize the procedure up to the point of fetal viability in 2024. That measure, which was also called Amendment 3 and was sent to voters through the state’s initiative petition process, passed with 51.6% of the vote.

But abortion was not immediately accessible after the vote, as several legal fights over the procedure moved through the court system. A Jackson County judge earlier this year ultimately struck down several restrictions, opening up abortion access across Missouri more broadly.

In May 2025, the state’s Republican supermajority referred another amendment to the voters asking them to reinstate the ban.

Millions of dollars have been raised on both sides of the Amendment 3 campaign, and the vote is again expected to be tight, said Anna Spoerre, who covers reproductive healthcare for the Missouri Independent.

August polling from Saint Louis University and YouGov showed that 43% supported Amendment 3, while 44% opposed it and 13% were unsure, with a 4.09% margin of error.

Campaigns are working hard to convince those who don’t know how they’ll vote. Even after a massive 2024 campaign, energy is still high on both sides.

“No one seems tired,” Spoerre told KCUR’s Up To Date.

But the two sides are sometimes taking different approaches to try to win undecided voters.

Advertising and yard signs from Her Health Her Future, a political action committee whose treasurer is Missouri First Lady Claudia Kehoe, is largely centered on the amendment’s gender-affirming care provisions.

Meanwhile, campaigns like Stop The Ban Missouri, which opposes Amendment 3, center support of reproductive freedom and their view that state lawmakers want to “overturn the will of the people.”

“We’re seeing both sides really play into what we’re seeing reflected in polling,” Spoerre said.

February results from the SLU/YouGov poll show that a majority of Missourians support abortion access, while they also oppose gender-affirming care for minors.

• Anna Spoerre, reproductive healthcare reporter for the Missouri Independent