Missouri voters rejected a Republican-backed proposal Tuesday, November 3, 2026, to restore a ban on most abortions and add restrictions on gender-affirming medical care for minors to the state constitution, preserving reproductive rights they approved two years earlier.
Amendment 3 failed by approximately 55% to 45%, according to preliminary election results. Missouri voters had overturned the state's near-total abortion ban in 2024, becoming the first state to reverse such a prohibition through a statewide vote after the U.S. Supreme Court overturned Roe v. Wade.
Republican lawmakers sought to undo that decision with a measure that would have restricted abortion to medical emergencies, certain fetal anomalies, and pregnancies resulting from rape or incest during the first 12 weeks. The proposal also required parental or judicial consent for minors seeking abortions and would have allowed lawmakers to regulate abortion providers.
Voters approved reproductive freedom as a fundamental right under the Missouri Constitution with approximately 52% support in 2024. Six months later, Republican lawmakers advanced a new constitutional amendment that would repeal those protections, returning the issue to the ballot under the same Amendment 3 designation.
The proposal also sought to prohibit gender-transition surgeries, puberty blockers, and hormone treatments for minors, with exceptions for certain medical conditions. Missouri already bans transition-related surgeries for minors and restricts new prescriptions of puberty blockers and hormones. Those medication restrictions are scheduled to expire in August 2027, while the surgical prohibition has no expiration date. The defeated amendment would have placed the restrictions in the state constitution.
The effort to restore abortion restrictions faced a legal challenge before reaching voters. In December 2025, the Missouri Court of Appeals ruled that language prepared by Secretary of State Denny Hoskins failed to adequately explain that the proposal would repeal the reproductive rights amendment adopted in 2024.
Judges ordered revised wording explicitly informing voters that approval would eliminate Article I, Section 36 of the Missouri Constitution, which protects decisions involving abortion, contraception, miscarriage care, and childbirth. The new description appeared on Tuesday's ballot.
The 2024 amendment had already prompted litigation over Missouri's abortion laws. Planned Parenthood challenged restrictions on providers after voters established constitutional protections for reproductive health care, leading courts to block enforcement of several requirements.
In June 2026, a Jackson County judge permanently blocked numerous abortion restrictions, including a mandatory 72-hour waiting period, certain informed consent requirements, and licensing rules for abortion facilities. The ruling followed earlier court orders that allowed abortion services to resume in Missouri.
The state's Department of Health and Senior Services currently advises that Missouri is prohibited from enforcing most abortion-specific laws and regulations under the court's judgment. The permanent injunction leaves those restrictions unenforceable while the ruling remains in effect.
