Last month, Missouri’s trial court largely sided with groups challenging the constitutionality of most of the state’s abortion regulations, including blanket bans, multi-pregnancy bans, targeted regulation of abortion providers, mandatory counseling and waiting periods, and a ban on telemedicine. State officials have already appealed the ruling, but the early victory marks a turning point, given that Missouri is the first state to enact a near-total abortion ban following a 2022 Supreme Court ruling. Dobbs v. Jackson Women’s Health Organization It declared that there is no federal constitutional right to abortion.
What has changed in these four years? In 2024, Missouri voters enacted an amendment codifying the right to reproductive freedom into the state constitution, and advocates immediately sought to enforce it through litigation. Missouri is one of the 10 states. Dobbsvoters enacted a constitutional amendment by ballot measure to protect abortion and reproductive rights. Two more states plan to do the same this November. The two states where the amendment passed the first of two votes needed in 2024 are Nevada and Virginia.
Over the past two and a half years, advocates have primarily invoked these reproductive freedom amendments in lawsuits seeking to block abortion restrictions. So far, challenges to bans and restrictions on abortion care have been successful in winning injunctions in lower courts, but no state Supreme Court decision has yet considered questions regarding the merits of the claims or the constitutional meaning or interpretation of the new amendments. Therefore, how this amendment will shape constitutional doctrine in these states, especially beyond the context of abortion, is still being developed.
However, nine court decisions to date have addressed the constitutionality of various abortion restrictions under the new amendment.
Opponents won both in states that had few legal restrictions on abortion before the amendment was passed (Arizona, Michigan) and in states that had almost complete bans after the amendment passed. Dobbs (Missouri, Ohio). Several types of abortion bans and laws that impede patient access were found to be in violation of the new amendments. The types of laws that courts have broadly ruled unconstitutional under the proposed amendments include pregnancy restrictions. Prohibition on seeking abortion for reasons related to race, gender, or fetal diagnosis. Mandated waiting period. Laws requiring biased counseling and ultrasound examinations. Ban on telemedicine abortion care. and laws requiring specific methods for the disposal of fetal remains.
In contrast, courts have reached different conclusions in cases challenging laws that restrict doctors’ ability to perform abortions. A Michigan trial court found such a law violated the state’s Reproductive Freedom Amendment, while a Missouri trial court upheld similar restrictions. Both states’ amendments require the application of rigorous scrutiny and only recognize the government’s compelling interest in protecting the health of pregnant patients based on evidence-based medicine and clinical standards of care. However, the difference in results reflects the Michigan court’s focus on how physician-only laws interfere with patients’ abortion rights, whereas the Missouri court was persuaded by testimony that physicians, rather than advanced clinicians, are needed to provide abortion care. Both decisions are being appealed, but the lower court’s decisions are a reminder that even with clear constitutional protections for abortion, courts can reach different conclusions about whether the restrictions are supported by sufficient evidence to justify restricting access to abortion care.
Courts are also asked to consider how the amendments apply to minors seeking access to reproductive health care. So far, challenges to Missouri’s parental consent and notification requirements have been dismissed without prejudice on the grounds that the plaintiff organizations lack standing. A similar challenge in Colorado is still in the early stages of litigation.
At the same time, opponents of reproductive freedom actively create debates and lawsuits regarding minors to advance their arguments. In Michigan, anti-abortion groups sought to overturn the state’s Reproductive Freedom Amendment with a legal challenge, arguing that it would undermine parental rights in terms of both abortion and gender-affirming care. (The case was dismissed on standing grounds.) And in Virginia, anti-abortion groups challenged the amendment as misleading because it would repeal Virginia’s parental consent law for both abortions and gender-affirming care. Meanwhile, a judge in the Ohio Department of Juvenile Services is trying to circumvent the state’s Reproductive Freedom Amendment, arguing that it conflicts with his duty to adjudicate abortion requests by minors, a process known as judicial bypass.
These are not the first examples of efforts to undermine the Reproductive Freedom Amendment. Opponents unsuccessfully challenged ballot language explaining the amendment in several states. And in Missouri, just two years after passing the amendment, opponents put a new one on this year’s ballot that would repeal the state’s current amendment protecting abortion care and create a 12-week pregnancy ban. The proposed amendment would also ban gender-affirming care for minors. Additionally, anti-abortion legislators continue to introduce anti-abortion bills in Arizona, Michigan, Montana, and Ohio, despite the clear intent of voters in these states to protect and expand access through ratification of constitutional protections for abortion. And opponents are devising additional strategies to eradicate constitutional protections for abortion.
Litigation over abortion care is not the only path to enforcing the amendment and leveraging it to build state constitutional jurisprudence. Most amendments include language that protects a number of rights related to pregnancy, childbirth, and reproductive autonomy generally. Courts across multiple states are currently defining the scope of these protections.
In Vermont, advocates invoked the state’s reproductive freedom amendment in a lawsuit alleging that the state’s child welfare system violated a pregnant woman’s reproductive rights by conducting an illegal evaluation of her parental capacity, obtaining a court order for custody of her unborn child, forcing her to perform an involuntary C-section, and then retaining custody of her newborn for seven months. The plaintiffs challenged this practice under the proposed amendment, arguing that the state’s actions were part of Vermont’s practice of monitoring a list of pregnant women it deemed “high risk.” The trial court dismissed those claims as ineligible because the plaintiff did not allege that she was on the “high risk” list, but held that the amendment was self-executing, meaning people could bring independent actions to enforce it.
The Maryland Supreme Court cited the state’s Reproductive Freedom Amendment in its decision to overturn the conviction of a woman convicted of murder related to a stillbirth. In this criminal case, prosecutors presented evidence that the woman searched for information about abortion during her pregnancy, but the court ruled that the search was inadmissible, citing a Maryland amendment and noting that the defendant has a constitutionally protected right to search for information about abortion.
And a state trial court in Michigan has ruled that a law that denies pregnant women the right to make decisions about end-of-life care, including a prohibition on forgoing life-sustaining care, violates the fundamental right to reproductive freedom codified in a state amendment.
These cases are less visible in the legal and public press.Dobbs State constitutional litigation over reproductive rights. However, they are important examples of how invoking these amendments outside the abortion context and in states where laws are less hostile to reproductive rights could positively shape judicial understandings of reproductive autonomy, equality, and justice in the years to come.
Kathren Cohen is a staff attorney in UCLA Law’s Center for Reproductive Health, Law, and Policy.
Recommended citation: Kathleen Cohen How are advocates using state reproductive freedom amendments?Sᴛᴀᴛᴇ Cᴏᴜʀᴛ Rᴇᴘᴏʀᴛ (July 23, 2026), https://statecourtreport.org/our-work/analysis-opinion/how-are-advocates-using-state-reproduction-freedom-amendments
