Medication abortion access restored in MO ahead of Amendment 3 vote
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- A Missouri judge cleared the path for residents to access medication abortion statewide.
- The ruling occurred more than 18 months after Missouri voters legalized abortion access.
- Advocates urged voters to oppose Amendment 3 in November to keep abortion rights intact.
A Missouri judge on Thursday cleared a path for residents to access medication abortion, a key decision more than 18 months after voters legalized abortion access.
The 20-page ruling from Jackson County Circuit Court Judge Jerri Zhang marks a major win for abortion rights supporters and also struck down a series of longstanding restrictions on the procedure. But the order comes as voters are gearing up for another abortion rights fight at the ballot box in November.
In a news release Thursday, Gillian Wilcox, director of litigation for the ACLU of Missouri, said the ruling is a “monumental win for reproductive freedom.”
“Today’s decision is a reminder that politicians are trying to strip us of our right to reproductive freedom, and Missourians must reject Amendment 3 at the ballot box this November, or we could lose the access we gained today,” Wilcox said.
The ruling restores access to medication abortion, the most common form of abortion, across the state as early as next week for the first time since 2018, the ACLU said.
“For too long, politicians forced patients to leave the state for an evidence-based and trusted form of abortion care,” said Emily Wales, president and CEO of Comprehensive Health of Planned Parenthood Great Plains. “Now, that care is coming home and with it, we move closer to fulfilling the promise of reproductive freedom Missourians demanded.”
The ruling officially solidified Missouri as the first state to reverse a near-total abortion ban and restore access to both procedural and medication abortion after the fall of Roe v. Wade in 2022.
In Thursday’s ruling, Zhang found that “most of Missouri’s complex web of abortion restrictions violated Missouri’s Right to Reproductive Freedom,” referencing the state’s 2024 vote that enshrined abortion rights in the state Constitution. The ruling came after a nearly two-week trial in January.
Zhang’s ruling blocked a cluster of TRAP laws, or “targeted regulation of abortion providers,” that lawmakers enacted over the years. Those restrictions included a requirement that women wait 72 hours between seeing a doctor and having an abortion.
Missouri, led by staunch anti-abortion politicians, had for decades built a fortress of regulations that whittled away at access, culminating in the near-total abortion ban in 2022.
Abortion rights advocates moved to strike those restrictions in a lawsuit filed in 2024, arguing that they violated the amendment voters approved.
The patchwork of regulations, providers argued, severely restricted services and reduced abortion access to one clinic in St. Louis before the 2022 ban took effect.
The number of abortions performed in Missouri also plummeted from 6,163 in 2010 to 150 in 2021, according to statewide data.
Missouri Attorney General Catherine Hanaway, a Republican whose office fought to keep in place the ban on medication abortion and other restrictions, said her “heart is broken by today’s ruling.”
“This radical decision gives abortion providers a free pass to police themselves,” Hanaway said, offering a preview of how abortion opponents plan to campaign on a measure to ban abortions again in November.
Zhang’s decision comes just months ahead of a statewide vote on Amendment 3, a new abortion ban measure that state lawmakers placed on the November ballot. The abortion rights measure that nearly 52% of voters approved in 2024 was also called Amendment 3.
As abortion rights supporters celebrated the ruling, they also emphasized the stakes of the upcoming fight over abortion in November.
“Thanks to November 2024 voters, Missourians have a constitutional right to abortion,” said Maggie Olivia, the director of policy and external affairs for the advocacy group Abortion Action Missouri. “This November we will vote to keep it when we vote NO on 3 and stop another abortion ban.”
This story was originally published June 18, 2026 at 8:07 PM.
