Americans in 10 states cast votes on ballot measures to protect or expand abortion access, and in seven, the measures for abortion rights won. That brings the total to 14 states approving abortion rights referendums since Roe v. Wade was overturned in 2022.

Ballot proposals sailed through on Tuesday not only in blue states like New York and Maryland, but also in red and purple states like Arizona, Nevada, Colorado, and Montana. Missouri, which was the first state to completely ban abortion after Roe fell, is now the first state to overturn a ban. All told, the pro-abortion rights measures passed on Tuesday will expand access for millions of women of reproductive age who live in those states, as well as thousands of others traveling from more restrictive areas for care.

The biggest loss of the night was undoubtedly in Florida, where advocates had raised more than $100 million to reverse the state’s near-total ban on abortion. The ban, which took effect this past spring, has decimated access not only for residents living in the third most populous state but also for people across the South who had been traveling to Florida since Roe was overturned. While a majority of Florida voters backed the proposal, which would have restored abortion rights up to the point of fetal viability — typically between 22 and 24 weeks of a pregnancy — Florida law requires at least 60 percent of voters to approve a ballot measure to pass.

This 60 percent “supermajority” threshold is simply a high bar for any referendum, and Florida’s earned 57 percent. Of all the winning abortion rights ballot measures that have passed in red or purple states since Roe’s overturn, none have reached that 60 percent level. In 2023, Republican lawmakers tried to raise Ohio’s ballot measure threshold to 60 percent precisely to make it harder for a pending abortion rights proposal to pass, and voters rejected the move. Ohio voters ultimately approved their abortion rights measure by 57 percent.

The other losses Tuesday night were in red states, like Nebraska, where voters were confronted with two (intentionally confusing) constitutional measures, and South Dakota, where reproductive rights groups didn’t help campaign for a ballot measure that would have overturned the state’s total ban. The ballot measure failed.

Ballot measures have become a powerful tool over the past 2.5 years, giving voters a direct way to challenge abortion bans and often cutting across partisan divides. Measures in red and purple states have won precisely because they’ve earned votes from individuals who otherwise cast ballots for Republicans, libertarians, or no candidate at all. On Tuesday, for example, voters in Arizona, Missouri, and Montana elected Donald Trump, but still cast their ballots in favor of abortion rights.

Anti-abortion groups were determined to end the clean winning streak of the abortion rights movement this year. The 2022 midterms were “a wake-up call that taught us we have a ton of work to do,” Kelsey Pritchard, the state public affairs director for Susan B. Anthony Pro-Life America, told Politico in the spring of 2023. “We’re going to be really engaged on these ballot measures,” she promised.

And indeed, anti-abortion leaders did lean in much harder this cycle, leveraging a range of new tactics. In Florida, for example, Republican Gov. Ron DeSantis actively attacked the proposed ballot measure for months, using his state agencies to help, including by threatening local television stations with criminal penalties if they aired ads in support of the abortion rights measure.

“Florida Governor Ron DeSantis deserves special recognition for taking the abortion industry head on and setting a new standard for what it means to be a Pro-Life Champion as a state’s chief executive,” said Carol Tobias, the president of National Right to Life, in a statement after Florida’s measure failed.

Still, in the end, proponents for abortion rights nationwide raised nearly six times as much as their opponents, according to a recent campaign finance analysis by the Associated Press. Abortion rights advocates spent more than three times as much as anti-abortion activists on TV, streaming services, radio, and websites, according to the AP.

“While we are disappointed with the Florida ballot measure election results not meeting the 60% threshold, we still saw the majority of Floridians voting in support of abortion access,” said Nourbese Flint, president of the pro-abortion rights group All In Action Fund. “This outcome is a direct result of anti-democratic tactics designed to undermine the will of the people and Floridians’ access to life-saving medical care.”

While organizers for abortion rights ballot campaigns have a lot to feel proud of, even in states that have approved measures, rights will not be restored immediately, and in some cases litigation is likely to follow. In Nevada, voters will need to reapprove their measure in 2026 to formally amend their constitution. Moreover, restoring legal rights is not the same as restoring access, and even in states with favorable laws many women still struggle to afford their abortion care.

The abortion rights ballot measures and their results

1) Arizona: Proposition 139

Establish abortion as a “fundamental right” up to fetal viability, and permit abortion beyond that if a doctor deems it necessary to protect the patient’s life, physical or mental health.

It passed.

Know more: Abortion is currently banned after 15 weeks in Arizona with no exceptions for rape or incest. “Next time the nation wonders how much government interference in reproductive healthcare is acceptable, or what type of arbitrary abortion ban is popular, they can look at Arizona and know the answer is ‘none’,” said Chris Love, a spokesperson for the YES on 139 campaign and a senior advisor to Planned Parenthood Advocates of Arizona.

2) Colorado: Amendment 79

Bar any state or local government regulation from interfering with an individual’s right to an abortion, and eliminate the state’s ban on public funding for abortion.

It passed.

Know more: Colorado is one of seven states without limits on when an abortion can occur. It barred state funding for abortion for 40 years. Overturning that ban means Colorado could start covering abortion for people on Medicaid and state employees.

3) Florida: Amendment 4

Establish state constitutional protection for abortion up to fetal viability, or when necessary to protect the patient’s health, as determined by their doctor.

It failed.

Know more: Three executive agencies within the Ron DeSantis administration aired and distributed ads against Amendment 4. The ACLU of Florida filed a lawsuit alleging the misuse of taxpayer funds, though their case was dismissed.

4) Maryland: Question 1

Establish an individual’s “fundamental right to reproductive freedom” including the ability to prevent or end a pregnancy.

It passed.

Know more: Maryland has very supportive abortion rights laws, and has become a destination for pregnant patients traveling from the South, especially those from North Carolina, Texas, Florida, and Virginia. According to the Guttmacher Institute, the state experienced a 26.7 percent increase in clinician-provided abortions between 2020 and 2023.

5) Missouri: Amendment 3

Establish a right to reproductive freedom, including contraception, and abortion through fetal viability, with exceptions thereafter to protect the life or health of the patient.

It passed.

Know more: Missouri was a leader in restricting abortion. In 1825, it became the second state to ban abortion, after Connecticut in 1821. “All people deserve the freedom to access abortion, to access all reproductive health care, throughout our lives, on our own terms, and with dignity and respect. That’s what we proved today … And today’s win is just the beginning,” said Mallory Schwarz, the executive director of Abortion Action Missouri.

6) Montana: Constitutional Initiative-128 Establish a state right to abortion through fetal viability, with exceptions to protect the life or health of the pregnant patient.

It passed.

Know more: After Roe v. Wade was overturned, Montana’s Republican-led legislature passed several bills to restrict abortion, but the courts blocked them, citing a state Supreme Court precedent dating back to 1999. Abortion remains legal up to viability.

7) Nebraska: Initiative 434 Ban abortion in the second and third trimesters, with exceptions for sexual assault, incest, or medical emergencies.

It passed.

Know more: Abortion is already banned after 12 weeks in Nebraska, and this proposal would not prevent further restrictions. Anti-abortion activists sponsored this measure and have been clear that they plan to keep pushing to entirely ban the procedure in the state.

8) Nebraska: Initiative 439

Establish a state constitutional right to abortion up to fetal viability or when necessary to protect the “health or life” of the pregnant patient.

It failed.

Know more: The two dueling ballot measures were confusing to voters, and many signed the petition for the anti-abortion measure thinking they were supporting expanding access. Over 300 Nebraskans later filed affidavits to remove their names, the most in state history.

9) Nevada: Question 6

Establish a constitutional right to abortion through viability, and after when deemed medically necessary to protect the life or health of the patient.

It passed.

Know more: Abortion is already legal in Nevada until 24 weeks of pregnancy, but advocates want to secure that right in the state constitution. Voters will need to approve the measure again in two years to formally make the change.

10) New York: Proposition 1

Amends New York’s existing Equal Rights Amendment by adding “sex, including sexual orientation, gender identity, gender expression, pregnancy, pregnancy outcomes, and reproductive healthcare and autonomy,” to its list of protected classes.

It passed.

Know more: Anti-abortion activists started running ads claiming the abortion rights measure would create “special rights for illegal immigrants” and could block local efforts from dealing with the migrant crisis.

11) South Dakota: Constitutional Amendment G

Grants the right to abortion for any reason in the first trimester, allows second trimester abortion only for health reasons, and permits third trimester abortions to protect the patient’s life or health.

It failed.

Know more: Nearly all abortions are banned in South Dakota, with no exceptions for rape or incest. However, as we reported earlier this year, the state’s measure faced criticism from both local and national reproductive rights advocates, who argued it didn’t go far enough to truly restore access.

Abortion rights looked potent, but it will take time to get a clear sense of what happened

Going into election night, it wasn’t clear how much abortion rights would matter to voters, compared to issues like the economy and immigration and crime. While it was clear it mattered to voters in the midterms, election experts say those voters — known as “high propensity” or “frequent” voters — tend to prioritize different issues from those who vote only once every four years. Roughly 160 million Americans cast ballots in the 2020 election, or 67 percent of the voting-eligible population. By contrast, just 112 million people voted in 2022, or 46 percent of those eligible.

It was also unclear how much ticket-splitting there would be this cycle, as polarization tends to ramp up in presidential elections compared to midterms. We still don’t yet know the gender or racial breakdown for Election Day voters, although early results indicated that women were turning out in higher numbers than men. Women voters make up a slight majority of the voting population, and advocates were banking on women being particularly motivated to protect abortion rights this cycle. We’ll continue to update our coverage as we get more information about how the votes broke down.

The 2024 election certainly won’t end the national debate around abortion. The election of Donald Trump to the White House, and Republican control of at least the US Senate, are setbacks for abortion rights advocates, who had hoped to restore access to care. However, the success of abortion rights ballot measures offers more hopeful signs and reaffirms the unpopularity of many state restrictions, even in states where referendums lost.

“Abortion rights are winnable in pretty much any state at this point,” said Joey Teitelbaum, a pollster with Global Strategy Group who has worked on nine state abortion rights ballot measure campaigns over the last three years. “People have been very clear about what side they are on, and just because a candidate or a ballot measure loses, it does not change that fact.”