Long before the Supreme Court overturned the historic Roe v. Wade decision that granted Americans the Constitutional right to abortion, advocates for reproductive freedom faced tremendous attacks from abortion opponents who passed more than 1,300 abortion restrictions since 1973. Extreme anti-abortion laws created barriers to accessing abortion by imposing big burdens on providers, by making abortion more expensive and time-consuming, and by requiring patients to jump through hoop after hoop in order to access the care they need.
For decades, reproductive health advocates have worked to stop these attacks on patient rights, backed by research demonstrating that denying people access to timely and safe abortions has tremendous legal, economic and health consequences for women and their families. These efforts are more critical now than ever as abortion bans sweep the nation in the wake of the Supreme Court’s Dobbs decision, leaving millions of people without basic access to abortion care.
Fortunately, elected leaders, healthcare providers, patient advocates and many others are rising to the challenge by escalating efforts to restore legal rights to abortion, driving efforts to increase access for people in state after state. Abortion rights advocates are making big progress by taking their case directly to the voters via ballot measures that give average Americans the choice to enact Constitutional rights and guarantee people the freedom to decide for themselves when and if to increase the size of their families.
The proliferation of ballot measures to increase and ensure abortion rights over the last several years mark a historic reversal in the nation’s abortion rights debate and signal a marked increase in voter support for reproductive freedom in states after the Supreme Court overturned that right federally. While ballot measures about abortion aren’t new, the dominance of ballot measures that increase rights and access over those that restrict abortion certainly is a departure from the recent past.
Since 1970, over half the states have voted on an abortion-related ballot measure. Some of these were early measures to establish the right to abortion even before the Supreme Court established the Constitutional right to abortion in America in 1973. In the forty years between 1980 and 2020, however, the vast majority of abortion questions that made it to ballot were driven by anti-abortion groups trying to restrict people’s freedom to access abortion on their own terms. During this period there were 54 abortion-related ballot measures: 80% of these were supported by abortion opponents while only 20% were supported by abortion rights supporters.
Historically, voters rejected the greatest share of measures designed to restrict access and approved two thirds of those that protected or expanded reproductive rights. In particular, voters defeated extreme bans and “personhood” measures that would have endowed fetuses with more rights than the people who carry them. This track record makes sense given that a majority of Americans have supported legal abortion for the last 50 years. Today, support for abortion rights and access is at an all-time high.
Increased support for reproductive rights, largely spurred by the Supreme Court’s reversal of Roe, has fueled the new trend toward expanding abortion rights and access via ballot measures that put decisions about laws directly in the hands of voters. Patient advocates and supporters seeking to restore the civil right to abortion have spearheaded efforts to protect access by modifying state Constitutions and some have even sought to increase access by reversing bans on Medicaid funded abortion for the first time.
Following the Supreme Court’s June, 2022, Dobbs decision, California, Michigan, and Vermont became the first states to successfully ensure abortion rights in state constitutions via ballot measure. In three other states–Louisiana, Kansas, Kentucky–ballot measures that prohibited abortion-related changes to the state Constitutions prevailed. In Kansas, the Supreme Court subsequently ruled that the state Constitution already supports the right to abortion and the procedure remains legal there. In fact, Kansas is the only state in the region that retains the legal right to abortion and now has a health clinic where people from multiple states can access abortion.
In 2023, voters in Ohio approved a measure that provides more expansive rights over reproductive health decisions in the state constitution. The new law enables Ohioans to “make and carry out one’s own reproductive decisions, including but not limited to” decisions about abortion, contraception, fertility treatment, miscarriage care, and continuing pregnancy.
In 2024, this strategy to protect and expand reproductive rights will culminate in a record number of ballot measures on the November ballot and the dominance of these “pro-choice” measures over the extremist anti-abortion efforts that used to be more numerous in the past.
This fall, there are measures pushing to codify or expand abortion rights, a lynchpin to reproductive freedom, in 10 states. See a summary here. These measures are a critical step to ensure that women can make their own decisions about reproductive health in the future and will have big implications for the future health and economic security of millions of women and their families over time. Moreover, the winning track record of measures that guarantee reproductive rights and access continue to evidence that average Americans support safe, legal abortion as a basic American liberty despite the extremist decisions coming from the Supreme Court and some legislative bodies.