MARIES COUNTY — Missourians will decide Nov. 3 whether to allow more specific regulations on abortions in the state Constitution.

A yes vote on Amendment 3 repeals and replaces the 2024 Amendment 3, which added a constitutional right to “reproductive freedom.” The new section allows the legislature to regulate abortions and prohibits transgender procedures for minors. A no vote keeps the 2024 language in place, allowing regulations on abortion after fetal viability.

While pro-abortion advocates believe that this measure removes a woman’s right to make decisions, pro-life advocates believe it protects children.

The measure says that the state’s duty is to protect the health and welfare of the public and that it has an interest in regulating areas of medical uncertainty or ethical concern.

As a result, the amendment allows the legislature to pass laws regarding the provision of abortions, abortion facilities and abortion providers to keep the mother safe. Abortions cannot be performed on minors without parental consent.

The measure’s language also protects health care access for miscarriages, ectopic pregnancies and other medical emergencies.

The legislature can also require that an abortionist has admitting privileges to a nearby hospital, that the facilities are licensed and inspected, that physicians sufficiently examine the woman, and that only physicians and licensed medical technicians perform ultrasounds.

The ballot measure allows abortions for medical emergencies and fetal anomalies throughout the pregnancy. Abortions for rape and incest can occur up to 12 weeks’ gestation. However, abortions cannot occur because of a disability diagnosis or screening.

A medical emergency is defined as a condition that requires an abortion to prevent the mother’s death or “substantial and irreversible physical impairment of a major bodily function.” This is determined by the “reasonable medical judgment” of a “reasonably prudent physician,” considering other medical conditions.

A fetal anomaly is defined as a “structural or functional abnormality” that prevents the child from living outside the womb.

The amendment also prohibits using public funds for abortions, except in the cases of rape, incest and medical emergencies. Fetal organ harvesting is also prohibited.

The measure also prohibits physicians from providing minors with transgender surgeries, cross-sex hormones and puberty-blocking drugs. But the text allows drugs, surgeries and hormones for conditions unrelated to gender transitions.

The 2023 state Senate Bill 49, the Missouri Save Adolescents from Experimentation (SAFE) Act, includes similar protections. But the prohibition on puberty blockers and cross-sex hormones is set to expire Aug. 28, 2027. Amendment 3 would enshrine these protections into the state Constitution, and it would eliminate the exception for those on such drugs prior to Aug. 28, 2023.

The current text of Article I, Section 36, is known as The Right to Reproductive Freedom Initiative. This section, passed by voters in November 2024, prohibits the government from infringing on one’s “fundamental right to reproductive freedom.”

The legislature may regulate abortion after fetal viability, except to protect the “life or physical or mental health” of the mother. But people can’t be penalized for receiving or performing actions related to an abortion, stillbirth or miscarriage.

Fetal viability is defined as the point when a physician believes the child can likely survive outside the uterus “without the application of extraordinary measures.”

While there is no definitive point of fetal viability, a child has a higher likelihood of surviving outside the uterus in between weeks 24 and 25, according to the American College of Obstetricians & Gynecologists.

Virginia Staabs, Democratic candidate for 16th state Senate District, opposes Amendment 3 and believes it will be difficult for women to receive medically necessary procedures. Her biggest concern is that the maternal death rate will increase.

Furthermore, Staabs believes that pro-life policies are not small government because they interfere with women making the best decision with a medically trained physician. Even with the exemptions, she believes the amendment does not cover every situation.

“Which means that families with children already lose mothers, and we create single-parent families where we didn’t need to,” she said.

Staabs gave the example of a pregnant woman with early kidney disease who needs an abortion to survive. She said the physician must wait until the woman is certain to die before performing an abortion because the amendment doesn’t say at which stage the procedure is allowed.

She also shared about when her son’s girlfriend was pregnant. A few weeks later, tests showed that her hormonal levels were abnormal. After testing every other day for 1 ½ weeks, the results showed that the child was not developing.

Further testing determined that she did not have a viable pregnancy, but it took another two weeks to obtain the necessary medications for her body to absorb the tissue.

“Can you imagine carrying around something in your body that was no longer or hadn’t been living but could make you sick because insurance companies or government regulations were arguing that it might still grow?” Staabs said. “But it was never going to grow.”

Staabs also clarified that the incident didn’t occur in Missouri, but it was still under a “save every pregnancy” mindset.

Regarding the maternal mortality rate, Staabs said that in states with similar restrictions on abortion, such as Texas, the maternal death rate has increased by 40 percent.

“That’s ridiculous. We should never create a law that is going to create more deaths when they could be saved,” she said.

According to an April 2026 JAMA Network study, titled “US Abortion Bans and Pregnancy-Associated Mortality,” nationwide or state-specific pregnancy-associated mortality did not significantly increase after U.S. Supreme Court ruled in 2022 in Dobbs v. Jackson Women’s Health Organization. However, the data would have to be analyzed further.

According to a study published in May 2026 by AJPH, pregnancy-associated and pregnancy-related mortality may increase from abortion bans. While the study found an increase in pregnancy-associated deaths among 14 states with abortion bans, it didn’t find a “detectable increase” in maternal mortality. The study also recognized limitations in the data and variations that could affect the “certainty of these and other findings.”

As for Texas, after the 2021 abortion ban in early pregnancies, infant deaths increased by 12.9 percent statewide compared to 1.8 percent nationwide, using data from 2018 to 2022. The June 2024 study from JAMA Pediatrics also said that this ban may increase trauma and medical costs from increased infant mortality, but more research is necessary.

The Advocate did not find a study, showing that maternal mortality increased 40 percent from abortion bans after Roe v. Wade was overturned.

For transgender procedures, Staabs said that she understands prohibiting surgeries for minors. But she also said she doesn’t because a physician wouldn’t recommend the procedure because there isn’t enough tissue to perform the surgery until people are in their 20s.

Staabs also initially said that there aren’t exemptions for treating conditions unrelated to transgender surgeries. But after reading the text, she questioned the cost of proving the procedures are for unrelated conditions.

“Again, we’re putting government in the middle of something they don’t need to be in,” she said.

In response to pro-life advocates, who say that abortion is murder, Staabs challenged them to define when life begins. She referenced Genesis 2:7, which says that God breathed into man’s nostrils, and he became living. She also said that Jews don’t believe that life begins until the child starts breathing.

For those who reference other passages to indicate that life begins at conception, Staabs questions when a child can live outside the womb. For example, she said that a pie isn’t ready to eat before it is cooked, and a sweater isn’t wearable until it’s finished.

Mary Frances Mier, Staab’s campaign treasurer, also said that the unborn aren’t biologically children until the 23rd or 24th week of pregnancy.

“Sixty percent of fertilized eggs never implant. So, what does that mean? That 60 percent of life just vanished?” Staabs said. “There’s too many what ifs.”

Staabs also said that many pro-life advocates are simply “pro birth,” wanting a child to be born without helping to care for the child.

But if a pro-life advocate says there is available support, such as adoption, Staabs said that many of those organizations are overwhelmed. She said that the foster care system is overwhelmed because there aren’t enough homes in which to place children.

But Staabs also said that if the child is viable, then delivery is an option. But there are often cases in which there is a fetal anomaly such as having no brain stem or underdeveloped lungs.

“If delivery is an option, and you can save both; save both,” she said.

As for the cases of rape and incest, she said if a woman is “mentally capable,” she will have the child. Otherwise, she will probably have an abortion. But the laws don’t consider the mental health of the woman.

“That’s why the medical professionals are the ones who should be making the decision with the patient,” she said.

Stephen Neubert, chair of the Maries County Republican Party, supports Amendment 3 because it keeps the community’s children safe.

For transgender procedures, he believes the ballot measure keeps parents in charge of their children and prevents life-changing decisions before adulthood.

“If you’re under 18, you can’t buy alcohol. You can’t buy tobacco. You can’t vote,” he said. “Why would you want to make such life-altering decisions in youth?”

Instead, minors should focus on having fun and “being a kid,” not which gender they are. But for those that do struggle with that question, Neubert said that they can speak with a mental health provider rather than chemically changing their anatomy.

For issue of abortion, Neubert, a Christian conservative, believes that lives of babies matter. Since they can’t speak for themselves, they should be protected. Even for those who aren’t Christians, he believes that Christian values are a “good thing.”

“It breaks my heart to think of infants in the womb not being able to see childhood. That’s a big concern for me,” he said.

Neubert also said that rape and incest are horrible, but he believes “a life is a life.” He also understands why a woman would consider an abortion. But he said it takes maturity to create life.

“If you create life, then you have to take care of it, right?” he said. “It’s hard, and it’s an important decision.”

For women considering an abortion, Neubert said that there are other options. For example, a woman can obtain a free ultrasound and see her child’s heartbeat. He believes that once she sees her child, she will realize that the child is living and deliver the baby.

But whether she raises her child or chooses adoption, Neubert believes that decision is personal.

If a woman is unsure how to take care of her child, Neubert, a father of four children, understands. He said that while raising a child is difficult, it “takes a village,” and there are community programs, churches and neighbors willing to help.

“Just because something is hard to do doesn’t mean it’s not worth doing,” he said. “Don’t think you do it alone.”

For concerns about maternal mortality rates increasing, he said that he would have to see factual and empirical numbers, and he believes those claims are sometimes “straw man arguments.”

As for the claim that Amendment 3 doesn’t cover every scenario, he isn’t sure which scenarios those are, but he thinks that the text was written well. And if a child dies in the womb, he said that situation doesn’t end a life and is medical care — not abortion.

For situations like the girlfriend of Staabs’ son, he isn’t sure what would have caused the delay without being familiar with the case. He also said that he believes that Missouri doctors are good and that a lot of these scenarios are hypothetical.

“I don’t know why an abortion law would apply to a medical procedure that is not abortion,” he said.