On November 5, 2024, as much of the country watched Donald Trump regain the presidency, abortion advocates in Missouri celebrated. Amendment 3, a ballot proposition to repeal Missouri's total abortion ban, had passed. Missouri was one of seven states that enacted amendments to protect abortion rights on November 5. And in a state that Donald Trump won by over 18 points, voters had somehow simultaneously restored the right to abortion by a narrow margin of 52 to 48 percent. For abortion advocates, passing Amendment 3 was a hard-fought but undeniable victory.
Then, the question became: "What's next?"
For rural Missourians, the answer is complicated. Over the past few decades, Missouri has severely limited abortion access. Hit hardest were women in rural communities. For years, there were only three abortion clinics in Missouri, which has a population of over 6 million. By 2017, a Planned Parenthood in St. Louis was the only place in the entire state you could get a medical abortion. And in 2022, Missouri passed the "Right to Life of the Unborn Child Act," a trigger ban that months later became the first in the nation to go into effect when Dobbs v. Jackson overturned the constitutional right to an abortion.
This was the landscape framing desperate efforts to restore medical access to abortion in Missouri. But celebrations fell quiet in weeks after the election as anti-abortion advocates began to respond. Elected officials in Missouri pledged to "vigorously defend" abortion bans in the state. On January 16, 2025, U.S. Senator Josh Hawley (R-MO) introduced federal legislation to defund Planned Parenthood. I felt my own stomach churn when my little sister, a veterinary student at the University of Missouri, texted me: "I'm getting anxious. About living [here]."
One-third of Missourians live in rural areas. But even those in urban counties have felt the effects of the decades-long effort to restrict access to abortion. Columbia, Missouri, where my sister lives, has a population of 130,000. But it's over a two hour drive to St. Louis, where the sole abortion provider in Missouri is located. Rural Ozark County — which has a 29.6 percent poverty rate, the highest in the state — is a four hour drive from St. Louis. Not to mention travel costs, medical expenses, and scraping together time off work — all challenges exacerbated by rurality.
While Amendment 3 granted abortion access until the point of fetal viability, the St. Louis Planned Parenthood cannot legally resume providing abortions. This is, in part, due to a December ruling by Jackson County Judge Jerri Zhang which upheld licensure requirements for abortion clinics — meaning that though Missourians have a renewed right to abortion, there is no place for them to obtain one. This leaves rural women in Missouri vulnerable, particularly those in the southern half, where the nearest abortion clinic might be several states away.
However, progress was made: In the same opinion, Judge Zhang struck down other restrictive laws, including a 72-hour waiting period and a requirement that physicians who perform abortions have admitting privileges in all hospitals that provide obstetric or gynaecological care within "30 minutes or a 15-minute drive." Judge Zhang considered rural Missourians in the decision, writing that:
[A] person who travels three hours to get a medication abortion and then returns home, would not benefit from [these restrictions]. If complications arise after taking the medication, the individual would need to seek emergency care at the nearest hospital emergency room, as with any other medical emergency.
Aside from the judiciary, what else can be done? In a state like Missouri, where only 28.9 percent of statewide legislators are women, many will turn to grassroots organizing. "What's Next?," an organization dedicated to improving abortion access in Missouri, has advocated for Know-Your-Rights Trainings and other local initiatives. In a 2024 study by the Kaiser Family Foundation, over 35 percent of rural women reported they wouldn't know where to go or where to find abortion information. This post by Rooney Debutts details other statewide legislative efforts to improve abortion access.
One thing is clear: The fight for abortion access in rural Missouri is far from over.
2 comments:
I wonder whether women in rural Missouri or any state like it, will ever have true abortion access. After Dobbs, it seems that rather than allow abortion to remain a contested matter in their states, legislatures took further steps to enshrine restrictions/protections on abortion that prevent future action on the issue. For example, California took steps to cement the right to abortion within our state's constitution--making it nearly impossible for that right to be overturned or contested in the future. Alternatively, states restricting abortions passed similar measures, making it more difficult for future contenders to change abortion laws.
Additionally, recent news from this past week, where a Louisiana grand jury indicted a New York doctor for prescribing abortive medication to a resident of that state, will have a chilling effect on access for restrictive state residents. Presumably, abortion providers will think twice before helping their patients out of fear of prosecution. Additional laws providing for civil damages against out-of-state abortion actors likewise have a chilling effect.
Tragically, it seems that any abortion access that did exist in restrictive states died with Dobbs. Thus, I do not believe the question is "when" but "if."
Post-Dobbs, it certainly seems that many states have had to accept and celebrate these kinds of small wins, regardless of whether abortions are truly accessible to the most vulnerable. Rather than rely entirely on the judiciary, I appreciate that your post highlights grassroots organizing and legislative efforts. Particularly in rural areas where communities are close-knit and may not have faith in the legal system or know their rights, grassroots organizing could act as a kind of first-response for women who need abortions and do not know how to access them.
Post a Comment