Abortion supporters divide over post-Roe strategies

In all his decades on the job, Missouri pro-life lobbyist Sam Lee hasn’t seen the pro-abortion movement in his state as divided as it is now.

Lee got his first hint of an internal struggle among Missouri pro-abortion groups when he came across an April article from Politico with the headline, “Democrats want to restore Roe. They’re divided on whether to go even further.”

That came out the month after a St. Louis–area physician filed 11 versions of a proposed initiative petition that would add a right to abortion to the state constitution. Currently, Missouri law prohibits abortion in all cases except when it threatens the mother’s life or bodily health. The proposed amendment language would undo that and many other pro-life laws in the state. But most of the proposals would still allow state lawmakers to regulate abortion.

As the Politico article outlined, not all abortion supporters in the state are happy with the options. “We would never advocate for a false or politically determined limit on abortion,” Missouri abortion supporter Pamela Merritt, the executive director of Medical Students for Choice, told Politico.

After repeated pro-life losses at the ballot box since summer 2022, ballot measures adding a right to abortion to state constitutions seem like a reliable path forward for pro-abortion groups. That’s especially the case in states like Missouri where pro-life laws have shut down abortion facilities since the overturn of Roe v. Wade. But while some supporters want an unlimited right to abortion, other groups support language more popular among voters that would purportedly allow for some pro-life protections. The conflict exposes a weakness among abortion supporters that could hamper their efforts to put one of these proposed amendments on the 2024 ballot—both in Missouri and in other states.

Each of the 11 versions of the ballot measure from St. Louis-area Dr. Anna Fitz-James asserts the “fundamental right to reproductive freedom,” which includes “abortion care.” Some clarify the language does not require government funding of abortion procedures—others that the legislature can require parental consent for minors to get abortions. And eight of the 11 say the government can still regulate abortion after 24 weeks or “fetal viability,” as long as it allows for abortions to protect the life or physical or mental health of the woman.

In August, a former staffer for Republican lawmakers filed six additional initiative petitions that also assert the right to abortion but with more limited language. Some only allow for abortions in cases including rape, incest, or risk to the health or safety of the mother. Others would also allow abortions for any reason up to 12 weeks.

Only one of the 17 proposals doesn’t include any exceptions. Last month, pro-life lobbyist Lee saw a petition circulating on social media that called for pro-abortion voters to support this so-called “clean” version—the only one that will ensure “full bodily autonomy for ALL people without government interference.”

But Lee said any of the proposals would create a right to abortion throughout pregnancy. Even the versions that allow for restrictions still include an undefined health exception, which courts have historically taken to include emotional and familial health, and even the age of the woman pursuing the abortion. “That’s wide-open abortion,” Lee said. “And the legislature would be incapacitated from passing a real health exception.”

Some pro-abortion groups seem to recognize this. “These policies would restore a level of access that the state hasn’t seen, ever,” said Mallory Schwarz, executive director of Abortion Action Missouri, in a September article at Mother Jones, speaking in support of the original 11 proposals. (She elsewhere opposed the six Republican-filed proposals as “an anti-abortion trap.”)

Polling also suggests that policies with restrictions are more likely to pass. According to an August 2022 survey from Saint Louis University and YouGov, 58 percent of respondents agreed that abortion should be legal in Missouri during the first eight weeks of pregnancy while 40 percent agreed it should be legal up to 15 weeks. Only 32 percent supported legal abortion whenever a woman wants one and for any reason. Gallup poll results released in June show that, nationally, 69 percent of voters support legal abortion in the first three months of pregnancy. Meanwhile, only 37 percent support it in the second trimester and only 22 percent in the third trimester. Some abortion supporters point at numbers like these to argue that allowing for some regulations could earn the support of more voters.

But not all abortion advocates buy this strategy.

“I don’t care if the polling shows that parental notification and viability show the ballot winning with 90 percent of the vote,” Merritt told Mother Jones. According to that news outlet, Merritt “stepped back” from the coalition behind the Missouri ballot effort in July. Her take was that if voters didn’t support a right to abortion without restrictions, it wasn’t the right time to pass any amendment.

According to Mother Jones, Planned Parenthood of the St. Louis Region and Southwest Missouri similarly “paused its work on the ballot effort” this spring over a disagreement about what ballot language to pursue. Chief Medical Officer Colleen McNicholas told the outlet that the proposed language would “recreate the very system” that resulted in fewer than 200 abortions occurring in the state per year. The affiliate’s political action arm wrote in a February memo that “the Roe framework and any legislative, policy, or political interference in reproductive health care including abortion will not get our support.”

Even before the Dobbs v. Jackson Women’s Health Organization decision, Missouri’s one remaining surgical abortion facility performed very few abortions and was on the brink of closure for years due to licensing issues. Local pro-lifers pointed to repeated ambulance visits to the facility and patient safety concerns, but pro-abortion groups blamed it on burdensome requirements targeting abortion facilities

“Their take is, ‘give those anti-choicers an inch, they’ll take a mile,’” said Lee. He acknowledged that, even before Dobbs, pro-life lobbyists and lawmakers in states including Missouri passed health exceptions that limited post-viability abortions to mothers who faced severe threats to their physical health. But from his perspective as a pro-lifer in Missouri, he’s looking at these proposed ballot measures anticipating “a worst-case scenario.” Michigan voters in November approved similar language for their constitution. Michigan’s pro-abortion lawmakers are now working to undo remaining pro-life laws, including safety requirements for abortion facilities and a ban on partial-birth abortion.

While the conflict appears to be the strongest in Missouri, abortion groups in other states are also divided over the best post-Roe strategy. Some abortion supporters are frustrated by pro-abortion ballot language in Ohio, Florida, South Dakota, and Arizona that allows for restrictions on abortion later in pregnancy, even though each has broad health exceptions. The Planned Parenthood affiliate in South Dakota told The Nation that it doesn’t believe the proposed ballot language there “will adequately reinstate the right to abortion in South Dakota.”

Of the amendment in Ohio—the only state that will vote on an abortion amendment this year—the American College of Obstetricians and Gynecologists told Mother Jones the language is “not completely in line” with its support for “access to abortion without restrictions.” But ACOG’s Ohio chapter still came out in support of the amendment, saying it would restore “the vital reproductive rights that were guaranteed by Roe v. Wade for fifty years.”

“One of the things pro-lifers need to realize is just that, [as] there are differences of opinion within the pro-life movement, there is also in the pro-abortion movement,” Lee said. Even pro-abortion groups have their pragmatists and their purists: those who are willing to compromise the ideal for incremental gains and those that aren’t. Lee said this division among abortion supporters only helps pro-lifers: “If there’s division among the pro-abortion people, that means there may be some of them who won’t vote for it.” Disagreements among supporters could also mean less outside money. Powerful out-of-state pro-abortion groups, for instance, may look at the situation in Missouri and decide it might not be worth putting their money into.

“I’m grateful for this division,” Lee said. Referring to Psalm 55:9, he pointed out that David called upon the Lord to confuse the speech of his enemies. “I mean, that’s a legitimate prayer,” said Lee. “Whatever it takes to defeat this that’s honest and true and sincere is what we should pursue.”