Ohioans United for Reproductive Rights field staff member Carlos Ortiz delivered boxes of petitions to the secretary of state’s office in Columbus on July 5, 2023. Advocates behind abortion initiatives often look to votes in Kansas and Ohio as harbingers of success. (Graham Stokes/Ohio Capital Journal)

After abortion rights were upended federally in June 2022, Kansas voters got a chance to weigh in on a ballot measure that was something of a test balloon just a couple of months later. Defying expectations, nearly 60% of voters rejected an anti-abortion constitutional amendment.

Since then, voters in states with both conservative- and liberal-leaning electorates have either rejected abortion restrictions or secured the right to an abortion. The majority of these successful campaigns were spearheaded by coalitions of doctors, advocates and everyday people who disagreed with the Supreme Court’s decision to upend federal abortion rights.

The issue was on the ballot in five states in November 2022. Americans in California, Michigan and Vermont enshrined the right to a host of reproductive health care services into their state constitutions during the midterms, while voters in Montana defeated a measure containing anti-abortion rhetoric and Kentucky voters soundly rejected an amendment seeking to declare that nothing in the state constitution guaranteed abortion rights.

Then, last year, faced with a Republican trifecta in state government where many lawmakers harbored anti-abortion positions, Ohio reproductive rights advocates took matters in their own hands and launched an effort to codify the right to abortion, contraception, fertility treatments, miscarriage management and pregnancy care.

Despite roadblocks thrown up by GOP officials who tried to increase the threshold for an amendment to be added to the Ohio Constitution, Issue 1 succeeded in November. Nearly 57% of Buckeye State voters cast ballots in favor of reproductive rights.

Elected officials elsewhere are playing a role in thwarting abortion ballot petitions, too. Missouri’s attorney general tried to push the state auditor to inflate the estimated cost of an initiative, and the secretary of state offered up ballot summaries that judges dismissed as partisan last year. (Abortion-rights proponents are suing again over the same issue, Missouri Independent reported.)

In Arkansas, Republican Secretary of State John Thurston refused to count all of the signatures for an abortion-rights ballot petition, citing technical paperwork errors, according to Arkansas Advocate. After a five-week legal battle — on the day of the deadline for Thurston to distribute certified ballots to counties — the state Supreme Court affirmed his position. Arkansans for Limited Government, the group behind the ballot measure, said the justices’ recent 4-3 ruling silenced more than 102,000 people who signed on to the effort, the Advocate reported.

Another strategy being deployed by opponents: “decline-to-sign” campaigns popped up in Arkansas, Arizona, Missouri and South Dakota.

Democrats have pledged to restore the right to an abortion nationally if they retain the White House and gain seats in Congress in the coming election, and Republican leaders have said they don’t support a national ban.

Still, as things stand today, 10 states have confirmed abortion-rights questions for Nov. 5 ballots. Lawsuits to invalidate them are pending across the nation.

Arizona?

Abortion is illegal after 15 weeks in Arizona, unless the patient’s life is at risk. There are no exceptions for rape, incest or genetic abnormalities.

Proposition 139 will ask voters if they want to allow abortion up to fetal viability with exceptions later in pregnancy for the patient’s life, or physical or mental health. The amendment would also prevent any penalties for someone who helps a person get an abortion. Arizona for Abortion Access is behind the initiative.

Colorado

Abortion is legal throughout pregnancy in Colorado, but the state enacted a ban on public funds being used for abortions in 1984. Government employees’ insurance does not cover abortion care.

Initiative 89, titled “Right to Abortion,” could effectively repeal that 40-year-old coverage ban if 55% of voters approve the amendment. Coloradans for Protecting Reproductive Freedom is leading the effort.

Florida?

Abortion is illegal after six weeks in Florida with exceptions for rape, incest and to save the patient’s life.

Amendment 4 would bar government interference in abortion access before fetal viability or when a provider deems the procedure necessary to save a person’s health. Sixty percent of voters have to approve the measure, which wouldn’t remove the parental notification requirement for minors seeking abortions. Floridians Protecting Freedom is behind the campaign.

Maryland?

In March 2023, the Democratic-controlled Legislature voted in favor of a referendum that put the “Right to Reproductive Freedom Act” before voters this fall. Abortion is broadly legal in Maryland.

Question 1 would reify the right to “reproductive freedom,” including the right to make “decisions to prevent, continue, or end” a pregnancy. The proposed amendment would also prevent the state from interfering in the right for the most part.

Missouri?

Abortion is only permitted in Missouri for medical emergencies. Restrictions on clinics and providers hindered access in the state before the Dobbs decision, Missouri Independent reported.

Amendment 3, if approved by a simple majority, would legalize abortion up to fetal viability with exceptions later in pregnancy to protect the life or physical or mental health of a pregnant person. It also states patients and providers cannot be prosecuted for abortion. Missourians for Constitutional Freedom is the political action committee behind the initiative.

Montana?

A 1999 Montana Supreme Court ruling solidified abortion access based on the state’s constitutional right to privacy, and a 2023 decision reaffirmed the precedent, while also ruling that advanced practice nurses can provide abortions. Still, the Republican-controlled legislature advanced abortion restrictions, which are largely blocked by the courts, Daily Montanan reported.

CI-128 asks voters to further enshrine into the state’s constitution the right to make decisions about one’s pregnancy, including abortion up to fetal viability, without government regulation. The amendment would include exceptions later in pregnancy to protect the life or health of the patients, as determined by providers. Montanans Securing Reproductive Rights headed the ballot effort.

Nebraska?

A 12-week abortion ban was enacted last year. Protect Our Rights launched a campaign in November for an amendment that would expand access up to viability, as determined by a provider, with later exceptions for a mother’s health.

Protect Women and Children announced a counter-effort in the spring for a competing constitutional amendment that would ban abortions after the first trimester (12-14 weeks), with later exceptions for rape, incest or the life of a mother. It would allow the legislature to pass stricter bans in the future.

If both questions make it to the ballot and both are approved by voters, the one with the most votes wins, Nebraska Examiner reported.

Nevada?

In 1990, Nevada voters secured the right to an abortion through 24 weeks of pregnancy, or later if the mother’s life is at risk. Question 6 will ask voters to ensure similar rights constitutionally — making them harder for lawmakers to modify. If passed, this amendment would protect abortion access up to fetal viability, or later to protect the life or health of the patient, Nevada Current reported.

The coalition Nevadans for Reproductive Freedom is behind the proposal, which will have to be approved twice — once this year and again in 2026.

New York

Abortion is legal in New York up to 24 weeks of pregnancy, and abortions after that point must be approved by providers who decide whether a fetus is viable, or if a patient’s life or health is at risk.

Proposal 1, a legislatively referred referendum, asks voters if they want to add an equal rights amendment to the constitution. If approved, it would bar discrimination based on sex, including “pregnancy, pregnancy outcomes and reproductive health care and autonomy.” Supporters say this would add protection for the right to an abortion.

South Dakota?

Abortion is banned in South Dakota unless it’s necessary to save a patient’s life. Dakotans for Health led an effort to expand access.

Amendment G asks voters whether to ban legislators from regulating abortion until the end of the first trimester, allow regulations during the second trimester “in ways that are reasonably related to the physical health of the pregnant woman” and let the state prohibit abortion in the third trimester unless the procedure is necessary to save the life or health of a pregnant patient.