Abortion-Related State Constitutional Amendment Measures in the 2024 Election

Since the Supreme Court’s Dobbs decision overturning Roe v. Wade, the availability of abortion has largely become a matter of state law. Voters in 16 states have weighed in on constitutional amendments regarding abortion. This year, voters in 10 states considered ballot initiatives that would amend state constitutions to protect abortion. In 2024, 10 states voted on abortion measures that sought to affirm that the state constitution protects the right to abortion. Prior to the 2024 election, the side favoring access to abortion prevailed in every state that voted on abortion constitutional amendment ballot measures.

2024 Election Outcomes

In 2024, 11 statewide ballot measures related to abortion were certified in Arizona, Colorado, Florida, Maryland, Missouri, Montana, Nebraska, New York, Nevada, and South Dakota for the general election ballot on November 5 — the most on record for a single year. Ten of the ballot measures addressed state constitutional rights to abortion. Voters approved seven of them in Arizona, Colorado, Maryland, Missouri, Montana, New York, and Nevada, while three measures were defeated in Florida, Nebraska, and South Dakota.

Measures protecting abortion rights succeeded in 7 states – Arizona, Colorado, Maryland, Missouri, Montana, Nevada, and New York – and failed in 3 – Florida, Nebraska, and South Dakota. In one state, Nebraska, voters considered competing measures: one that would limit abortion access and one that would expand it. Nebraska voted on two measures: one seeking to protect abortion and the other seeking to ban abortion after the first trimester. The measure constitutionally prohibiting abortions after the first trimester passed in Nebraska. And in Nebraska, voters approved a measure that would prohibit abortion after 12 weeks of pregnancy. One, in Nebraska, to limit the timeframe for when an abortion can be performed was approved.

Voters in Nevada also approved an abortion-rights state constitutional amendment, but ballot measures must receive public approval twice in Nevada before becoming law. The same initiative will appear again for final approval on the 2026 ballot. A measure in Florida fell shy of the 60 percent threshold needed there to amend the state constitution. An abortion-rights amendment failed to receive a majority of the vote in South Dakota.

In 2022 and 2023, people in California, Michigan, Ohio, and Vermont voted to amend their constitutions to enshrine abortion rights, while voters in Kansas, Kentucky, and Montana defeated anti-abortion amendments.

Comparison of Pro-Life vs. Pro-Choice Ballot Measure Outcomes (1970-2024)

From 1970 to 2024, there were 65 abortion-related ballot measures. 44 (68%) of these had the support of organizations that described themselves as pro-life. Voters approved 12 (27%) and rejected 32 (73%) of these 44 ballot measures. The other 21 abortion-related ballot measures had the support of organizations that described themselves as pro-choice or pro-reproductive rights. Voters approved 15 (71%) and rejected six (29%).

How Measures Are Placed on the Ballot

There are two routes a measure may be placed on the ballot: citizen initiative and legislative referral.

• Legislatively-referred measures are introduced and approved by lawmakers before they appear on the ballot for citizens to vote on.
• Citizen-initiated measures are written by citizen groups and are placed on the ballot if they receive enough signatures.

From 1970 to 2024, 47 of 65 (72%) abortion-related ballot measures were citizen-initiated as statutes, constitutional amendments, or veto referendums. Legislatures referred 17 (26%) to the ballot, and a state constitutional convention referred one (2%).

History of Abortion Ballot Measures

Since the 1970s, abortion-related policies have been a topic for statewide ballot measures across the U.S. Before Roe v. Wade in 1973, three abortion-related measures were on the ballot in Michigan, North Dakota, and Washington, and each was designed to allow abortion in its respective state.

The first abortion-related measure to appear on a ballot was Washington Referendum 20, which was approved. In 1970, Referendum 20 legalized abortion in the state of Washington — three years before Roe v. Wade. Measures to legalize abortion were proposed in Michigan and North Dakota in 1972; both were defeated. After the U.S. Supreme Court decided Roe v. Wade in 1973, there were no abortion-related ballot measures until 1978. Oregon Measure 7, which was defeated, was the first of several ballot measures designed to prohibit the use of public funds on abortions.

States with the Highest Number of Abortion-Related Ballot Measures

The states with the highest number of abortion-related ballot measures were Colorado (10), Oregon (six), California (four), and Washington (four). These states have an initiative and referendum process. Abortion has been on the ballot in 30 states, including 21 states with an initiative and referendum process.

The average number of measures in states with an initiative and referendum process is 2.15, whereas the average number in states without initiatives or referendums is 0.38. States without an initiative and referendum process have never had more than one abortion-related ballot measure.