Voters Thought They Were Overturning An Abortion Ban. They Got This Headache Instead.
A report from the frontlines of abortion access in Missouri
GUEST COLUMN BY ROBIN FRISELLA, COMMUNITY ENGAGEMENT DIRECTOR FOR MISSOURI ABORTION FUND
“You must be so relieved abortion is legal again.”
It’s a comment I hear often. In November of 2024, Missourians voted to overturn the total abortion ban in our state, making abortion legal for some. This was a hard fought win for abortion advocates, who believed Amendment 3 would return abortion access to the state. However, as Community Engagement Director for Missouri Abortion Fund, I can tell you that it has not been that simple.
Since we funded our first abortion in 2016, abortion access in Missouri has shifted yearly, monthly—sometimes daily. We’re proud to say that through all those uncertain times, MOAF has provided abortion care for over 14,000 patients.
Funding abortion in Missouri requires constant adaptability. One day we are working after hours to help a patient get funding hundreds of miles away; another, we are responding to subpoena from our state's Attorney General, as we were in April. We are no strangers to difficult landscapes, but this year has been especially challenging.
When our amendment went into effect in December 2024, Missouri politicians didn’t waste a minute before working to undo the will of the voters—and it played out like a courtroom drama. Abortion is legal! Abortion is banned! Abortion is legal again! Even as someone who professionally and personally absorbs abortion news, it was hard to keep up.
The confusion became an additional barrier for patients. Our inboxes were soon seeing emails from patients who thought they were going to a Missouri clinic when they were actually scheduled at a clinic in Illinois. Patients faced not only the challenge of affording care, but also the fear that abortion might be banned again before their appointment. Our coalition partner, Right By You, an organization that runs a confidential text hotline, reinforced what we were seeing: Patients were unsure of how or where to access care.
Traveling for health care is an all too familiar reality for Missourians where 51.3% of counties are maternity care deserts.
We rank 44th in maternal mortality rates, and due to health disparities, Black women are 2.5 times more likely to die from pregnancy-related causes than white women. Despite the legal turmoil, our organizations mobilized quickly to counter misinformation and support patients seeking clarity.
Fighting for abortion access in Missouri doesn’t come with many wins. Which is why it’s so hard to remind folks that despite abortion being ‘legal’ for now, we still have harmful abortion bans. Missouri’s restrictions on Medicaid and insurance, for example, means patients have to pay out of pocket; young people are still subject to parental consent and notification laws. And because the amendment restricted abortion after ‘viability’—a non-medical, arbitrary standard—vulnerable patients later in their pregnancies are also denied legal care.
Later abortion care is expensive; the average cost for an abortion later in pregnancy is over $2,000, but it can cost upwards of $10,000 or more. Having to travel out of the state presents an additional cost to later abortion patients, many of whom have limited financial resources. This also creates higher financial expenses for abortion funds, who often piece together thousands of dollars just for one patient.
Throughout all this, our focus remains on funding care, because every pregnancy can come with variable circumstances and expenses at any stage. When you add in travel, lodging, loss of income, childcare, and insurance bans, abortion becomes unaffordable for many Missourians.
Our fund has provided over $3.3 million dollars since our founding. We have assisted in covering procedures that have costs anywhere between $350 and $17,000 per patient. We regularly fund patients whose care exceeds $5,000. Through our social media platforms we try to reassure abortion seekers, “We are here for you and we are not going anywhere.”
Our work is essential to abortion access. Yet like abortion funds across the country, we are experiencing a funding crisis.
The same year we were forced to cut funding for clinics—hurting patients who needed abortions—more than $30 million poured in to pass Amendment 3. Even with that outcome, the reality is that abortion access is still out of reach for too many. We fought to make abortion legal in our state. But what good does that do if people can’t afford care?
This funding crisis has real and serious impacts. Funds are stretched thinner than ever, and the need for sustained, increased funding has never been more urgent. A recent survey conducted by the National Network of Abortion Funds found that since Dobbs, the demand for abortion has increased dramatically: Requests for support have risen by 56% from 2023 to 2024.
Despite our best efforts, abortion funds are still unable to meet this overwhelming and growing need. While funds were able to support 70% of patients in 2022, by 2024 that number had dropped by over 16%.
More demand and fewer resources mean that more people will be forced to remain pregnant. We know from the landmark Turnaway Study, that women denied abortions have worse financial, health and family outcomes. Without increased funding, the gap in abortion access will continue to grow.
It’s time we broaden the way we think about abortion access. This is not solely about the failings of red state politics— because state lines don’t erase income barriers. Real access includes funding and logistical resources regardless of zip code.
Right now, some Planned Parenthood affiliates in Missouri have set gestational limits on when they can perform procedural abortions due to facing staffing shortages. Data shows that medication abortion accounted for 63% of All US Abortions in 2023, but in Missouri, legal restrictions prevent clinics from prescribing it.
Abortion may be legal, but the patients we hear from are still leaving the state for care.
While the law and funding climate may change, our commitment doesn’t. We remain fully rooted in our mission and our community. We’re still here. We’re not going anywhere.
If you are a Missourian needing financial assistance, you can learn more about how we can help you at MOFund.org, or connect with Right By You, by texting their confidential text line at 855-458-0886.
Our priority is remaining sustainable so we can meet the immediate needs of Missourians. With the help of our monthly supporters, we are able to plan ahead, even when the future of abortion remains uncertain. To become a recurring donor you can support us here.
As someone who lives near the state line between Kansas and Missouri I’m well aware (and deeply disgusted) at the way MO politicians constantly try to overturn the will of the voters when they pass these amendments. They further insult their constituents by pretending that people didn’t know what they were REALLY voting for when what they really mean is voters didn’t agree with THEM so they must be wrong and make them vote on it again! This is their excuse for bringing the abortion issue back to the ballot under the guise of “protecting women” and even using the same amendment name on the ballot in the hopes to confuse voters. This isn’t the first time they’ve done this either (look up the puppy mill amendment) and it won’t be the last until these morons are voted out of office.
As a MO resident and member of Abortion Action MO, thank you for covering this