Missouri voters enshrine abortion rights in a state that has a near-total ban

JEFFERSON CITY, Mo. — Missouri voters enshrined abortion rights in their constitution Tuesday, positioning the state to undo one of the nation's most restrictive abortion bans.

''Tonight, through the sheer will and power of the people, Missouri becomes the first state to end a total abortion ban at the ballot box,'' Abortion Action Missouri Executive Director Mallory Schwarz said in a statement.

Missouri currently allows abortions only in cases of medical emergencies. There are no exceptions for rape or incest. The amendment guarantees people's right to make decisions about their reproductive health, such as whether to get an abortion, take birth control or get in vitro fertilization.

But the amendment does not explicitly undo the law, meaning abortion-rights advocates will need to sue to overturn the ban.

The campaign against the amendment, Missouri Stands with Women, pledged Tuesday to continue fighting it.

''Life supporters will not sit back and watch as Big Abortion works to dismantle all the health and safety protections put in place to protect women and babies,'' Missouri Stands with Women spokesperson Stephanie Bell said in a statement.

Voters in eight other states decided Tuesday whether to add the right to abortion to their state constitutions.

The Missouri measure allows the state legislature to enact restrictions or bans on abortion after viability — a sticking point for some abortion-rights supporters. The term ''viability'' is used by health care providers to describe whether a pregnancy is expected to continue developing normally or whether a fetus might survive outside the uterus. Though there's no defined time frame, doctors say it is sometime after the 21st week of pregnancy.

Advocates had worried that failing to include such limits would sink their chances of passing abortion protections. But others cautioned against giving the state's Republican-controlled Legislature the power to enact regulations that could effectively end access to the measure.

The campaign ultimately made room for restrictions to late-term abortions in the Missouri amendment.

Just getting on Missouri's ballot was an uphill battle. The Republican attorney general and auditor fought publicly over the estimated cost of the amendment.

Attorney General Andrew Bailey argued the amendment would cost $51 billion in lost tax revenue because allowing abortions could mean fewer residents. The auditor and judges disagreed, instead setting the cost estimate closer to $51,000.

And a Missouri appeals court last year ruled against Republican Secretary of State Jay Ashcroft's summaries of the ballot measures, which described proposed amendments as allowing ''dangerous and unregulated abortions until live birth.'' Judges ruled Ashcroft's language was politically partisan.

Republicans nationwide have been trying for years to raise the bar for voter-referred constitutional amendments to be put on the ballot, as well as raise the threshold for those amendments to be enacted.

GOP infighting and a record-breaking, 50-hour Democratic filibuster in May killed the latest Republican push to make amending Missouri's constitution harder, an effort that in part had been aimed at thwarting an upcoming ballot measure on abortion-rights.

Missouri requires a simple majority to pass constitutional amendments.

The latest challenge to the amendment was raised by abortion opponents and Republican state lawmakers who argued that voters were not informed about the list of abortion laws it could repeal. The Missouri Supreme Court disagreed, requiring Ashcroft to place the measure on the ballot.

Missouri voters also approved measures to prohibit ranked-choice voting and to raise the minimum wage gradually from $13.75 to $15 an hour and require paid sick leave. Other measures on the state ballot that were too early to call include measures to legalize sports betting and allow a casino at the Lake of the Ozarks.