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Inside the Struggle to Restore Abortion Rights in Red State Missouri

Missouri was the first state to enact a near-total abortion ban after the overturning of “Roe v. Wade” in 2022.

Thousands of demonstrators march in support of Planned Parenthood and pro-choice as they protest a state decision that would effectively halt abortions by revoking the license of the last center in the state that performs the procedure, during a rally in St. Louis, Missouri, on May 30, 2019.

Kansas City, Missouri — On a sunny Saturday in October, Johanna Kelley set out to canvass for two ballot propositions personal to her: one that would raise the minimum wage and create paid sick leave and another that would establish a constitutional right to abortion in the state of Missouri, which for more than two years has been under a near-total abortion ban.

Kelley, a licensed social worker and therapist, was motivated to canvass by her own experiences of becoming a mother. She and her husband, Michael, who was also out canvassing that day, got pregnant with their first daughter with the help of fertility treatment. After experiencing a complicated pregnancy and birth, she went back to work just six weeks later.

“That’s when I was like, if I didn’t so desperately want this baby, I don’t think I could have gone through with it,” she said. “That’s when I really became passionate about this issue.”

Voters in the neighborhood located in the northern part of the Kansas City suburbs, were wary of opening their doors to strangers. Many houses had “no soliciting” signs; Kelley left information, but didn’t knock. Some of those who did engage in conversation didn’t know about the two measures but were open to hearing Kelley’s pitch. At a few homes where Kelley came looking for a woman voter, it was men who responded, telling her that they opposed abortion or didn’t vote. At others, she found strong support.

“I believe that everyone should make their own decisions,” Susan Campagna told The 19th while standing outside her house by her mailbox. “Government doesn’t need to be involved in health care decisions, and that’s about it.”

Missouri was the first state to enact a near-total abortion ban, with no exceptions for rape or incest, after the U.S. Supreme Court overturned Roe v. Wade in 2022. A dozen other states immediately followed suit, enacting similar bans. Now, Missouri voters could be among the first nationwide to overturn a strict ban by a vote of the people.

The fight in Missouri to restore abortion rights, which GOP lawmakers had significantly eroded for years before the fall of Roe, is as much a fight to preserve democracy as a battle to secure health care. The deep-red state has long relied on direct democracy to circumvent its ultraconservative elected lawmakers. The ballot measure that voters will decide on is the most recent — and consequential — instance.

“I don’t think we’re going to solve the problem in the legislature, but I think we could certainly send a message to them that they should stay in their lane and stay out of people’s private lives,” said Emily Wales, CEO of Planned Parenthood Great Plains (PPGP) and PPGP Votes. “If we saw any easing of the attacks on individual rights, that would be a tremendous win.”

Emma Brooke, a marketing professional who lives in Kansas City and has canvassed for abortion rights in Kansas and Missouri, said the initiative process allows voters to break through what can be an intractability divided political climate in the state.

“By separating it from party vote, it does allow people to truly vote their conscience,” she said. “I think Missourians are much closer to purple than might seem.”

Voters just across the border in Kansas proved abortion was a highly galvanizing issue weeks after the fall of Roe, when they showed up in droves to defeat an anti-abortion constitutional amendment. After that first victory, abortion rights advocates have won ballot measures in seven states so far. Ten more states will be voting directly on abortion in November.

“Kansas lit the spark a little bit,” said Rachel Sweet, who ran the winning campaign in Kansas and is the campaign manager to pass Amendment 3 in Missouri. “I’m just really glad Kansas worked out. It might be a different national conversation had that not happened.”

While advocates in Kansas were working to preserve the access to abortion guaranteed in the state constitution, the Missouri initiative would create an affirmative right to the procedure, which had been out of reach for citizens of the state even before the 2022 ban. “I think that does change the tenor on the ground, and it definitely raises the stakes a bit,” Sweet said.

“In Kansas, the legislature sent this to the voters, and so we just didn’t necessarily feel like we knew where people were,” Wales said. “But in Missouri, 380,000 people signed petitions. I feel really, really good going into the vote. I really do.”

Amendment 3, backed by the group Missourians for Constitutional Freedom, would create a right in the state constitution to abortion and other forms of reproductive health care, including contraception and miscarriage management. The amendment requires a simple majority of over 50 percent of the vote to pass. Despite the supermajority Republican legislature, Missourians have long used the citizen initiative process to pass progressive policies, from expanding Medicaid to legalizing recreational marijuana.

But the effort to take those wins further with abortion has been met with significant resistance. Republican elected officials, including Secretary of State Jay Ashcroft and Attorney General Andrew Bailey, fought hard to keep the measure off the ballot and to influence the language used to describe the measure on the ballot and its estimated cost, part of a larger pattern of GOP-led attacks on abortion ballot measures.

Anti-abortion groups have also spread mis- and disinformation about the amendment process. Missouri Stands with Women, a group whose leaders have close ties to top GOP politicians in the state, led a “decline to sign” campaign during the signature-gathering process that included sending text messages to voters baselessly claiming that signing initiative petitions could expose them to identity theft.

After months of legal delays and setbacks, Missourians for Constitutional Freedom was finally cleared to start gathering signatures in January, only three months ahead of a May deadline. Even in such short time frame, the institutional knowledge and on-the-ground infrastructure from years of past successful ballot measure campaigns allowed the group to get 380,000 signatures — twice the number needed.

“Missourians are competitive like anybody would be. And I do think they feel frustrated that you can go to Illinois or Kansas and get care you can’t get here,” Wales said. “And increasingly, people who may not have identified as pro-abortion access do know someone who’s been affected.”

The majority of Missourians — 59 percent — believe abortion should be legal in most or all cases while 11 percent believe it should be illegal in all cases, according to the nonpartisan Public Religion Research Institute.

During the sprint to get Amendment 3 on the ballot, paid and volunteer signature gatherers fanned out across the state, spreading the word about its abortion ban and generating momentum. When the campaign beat back an 11th-hour court challenge in September to get the amendment thrown off the ballot, Sweet said, it generated an “infusion” of donations and volunteers signing up to make calls and knock on doors.

“I think it got people really fired up,” she said. “And despite those attacks, we don’t think it’s depressed people’s enthusiasm.”

The energy on the ground now, Sweet said, is “infectious.”

“And it’s great to see so many people who are engaging in politics, sometimes for the first time,” she added.

The abortion rights movement is also joining forces with organized labor, a key political force in Missouri. “That might not have happened five or six years ago,” Sweet said.

That Saturday, multiple local labor and reproductive rights organizations gathered outside a United Auto Workers local in Pleasant Valley, a Kansas City suburb, for a rally and canvass kickoff for Amendment 3 and Proposition A, which would create paid sick leave and raise the minimum wage to $15 an hour.

“Trust me, it won’t stop with taking away the women’s right of choice. They won’t stop there. They’ll continue to pull away all of our civil liberties if we let them get away with that,” Terrence Wise, a leader of Stand Up KC and board member of the Missouri Workers’ Center, told the crowd.

At the time of the Dobbs decision, Missouri was one of just four states without any independent abortion providers, which meant that it had experienced life with virtually no access to the procedure before much of the country. By 2018, just one Planned Parenthood clinic in St. Louis provided abortions. Even as providers in Kansas and Illinois have opened new clinics and expanded their hours, they’re unable to meet the demand from abortion-ban states, including Arkansas, Missouri, Oklahoma and Texas.

Restoring access to abortion in Missouri “won’t be overnight,” Wales cautioned. But to go from a state “where very little really changed the day of Dobbs decision” to one with abortion rights enshrined in the constitution would be “life-changing for Missourians,” she said.

The campaign for Amendment 3, which is nonpartisan, is centering personal stories and testimonials with an underlying message of freedom and getting the government out of personal health care decisions.

“However you feel about abortion, this ban goes too far and hurts women,” a woman named Whitney, sitting in a church pew, says in one Yes on 3 ad. “I’m voting Yes on 3 because Missourians should have faith, family and freedom guiding their personal decisions.”

The campaign’s messaging is also highlighting the lack of exceptions in Missouri’s abortion ban. Kelley, who previously worked as a counselor in Kansas City public schools, said the prevalence of rape, incest and trauma also deepened her support for reproductive rights.

Diann Williams, a voter whom Brooke canvassed in a majority-Black neighborhood in Southland Kansas City, said she was conceived as a result of rape. She wants women today who find themselves in a similar situation as her mother faced to make the choice right for them.

“I’m a rape baby,” she said. “And I just feel that it ain’t my body.”

Missourians for Constitutional Freedom has raised over $22 million, campaign finance filings show, significantly outraising and outspending its opposition. A survey conducted by Emerson College/The Hill in mid-September showed 58 percent of likely voters supporting the ballot measure with 30 percent opposing it and 12 percent undecided. An earlier poll from St. Louis University and YouGov found 52 percent of voters in support, 34 percent opposed and 14 percent undecided.

Anti-abortion groups argue the measure would go too far and infringe on parental rights to be involved in their children’s health care. Some have also invoked anti-transgender arguments, claiming without evidence that the amendment would pave the way for children accessing gender-affirming surgeries. Organizations opposing the ballot measure, including Missouri Right to Life, Missourians Protecting Women and Children and Coalition Life did not respond to interview requests.

Missouri, a once-purple state, is now solidly Republican, backing former President Donald Trump by 15 points in 2020. To get above 50 percent of the vote, the Yes on 3 campaign will need the support of many of Trump’s voters.

“Sometimes, you hear people say it’s a turnout game, or we just need to get our base out to the polls. I don’t think that’s true for abortion,” Wales said.

Aly Bennett, who lives in the St. Louis area, is a registered Republican who plans on voting for Trump and Republicans on the federal level. But she’s voting for Amendment 3 and supporting Democrats at the state level due to the issue of abortion.

“I never thought that anything related to reproductive rights would ever get overturned,” she said. “And so that’s why I had no problem saying that I was a Republican.”

Bennett, a mother of four boys, was done having children by the time Roe v. Wade was overturned and didn’t initially think the loss of reproductive rights would personally affect her. But she realized “the world is wider” than her and the full spectrum of reproductive health goes beyond abortion.

“I don’t think five years ago, politics or women’s rights would have come up at a dinner conversation or at a happy hour or a travel hockey tournament, and now it seems to have become more mainstream,” she said. “It seems so ridiculous that these things are being questioned. I have friends, even though I disagree with them, who are pro-life, but they still are believers in the choice and the access to reproductive rights.”

Bennett’s message to other self-identified Republicans is, “By voting on Amendment 3, you can still do what you want. You’re just allowing everybody else to have that same choice.”

Missouri’s lawmakers have succeeded first in eliminating the access, then the right to abortion. But the Yes on 3 campaign wants to lay down a marker that democracy and the will of the people is alive — and stronger than ever.

To check your voter registration status or to get more information about registering to vote, text 19thnews to 26797.

Editor’s note: The 19th has removed the name and story of someone a campaign erroneously identified by her full name, due to concerns for her safety.

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