In the U.S., abortion rights supporters won seven ballot measures and lost three in Tuesday’s elections.

These are the first statewide abortion ballot measures to lose in the U.S. after the Supreme Court reversed Roe v. Wade 2022. This ruling overturned the almost 50-year right to abortion nationwide, proving abortion opponents’ ability on ballot measures.

The other side also had some firsts: three amendments called for the rollback of abortion bans. One in Missouri, for example, prohibits it at any stage of pregnancy, with only limited exceptions to save the woman’s life.

Takeaways from these results

Missouri’s abortion ban is being challenged in court

Missouri is the state with the largest population where a vote could overturn a ban on abortions in all stages of pregnancy.

The work isn’t finished there.

Affiliates of Planned Parentshood that are located in Missouri have filed a lawsuit in state court on Wednesday to invalidate Missouri’s abortion law and other laws that regulate health care.

The Missouri Amendment, which will take effect on Dec. 5, doesn’t override state laws. The measure instead left it up to advocates to ask the courts to overturn bans they believed would now be unconstitutional.

On a Zoom call Wednesday with reporters, Planned Parenthood officials said they would offer abortions at their clinics in Columbia Kansas City and St. Louis once they receive the judicial ruling that they are requesting.

“This is just the first step in realizing and fully implementing Amendment 3’s protections.” Richard Muniz is the interim president and CEO at Planned Parenthood Great Rivers.

Even before Missouri’s ban on abortions took effect in 2020, clinics stopped performing them. The clinics said that a long list of regulations prevented them from operating. Planned Parenthood’s affiliate in the majority of the state, which covers a large part of the state, said that the requirements were onerous. They included that clinicians providing abortions must have surgical licenses as well as that they perform pelvic examinations on all patients – even if only offering medication abortions.

In a legal document, Dr. Selina Sandoval, associate medical director at Planned Parenthood Great Plains said that some of these patients chose medication abortion because they did not want instruments placed in their vagina. “I will not and cannot subject my patients unnecessary exams.”

Planned Parenthood is also against laws that require clinicians to be admitted to nearby hospitals and to a 72-hour wait period before abortions. They are also against the ban on telemedicine abortions. The group wants to repeal other laws that ban abortions after 8, 14, 18, and 20 weeks.

Voters are in favor of abortion rights

Abortion right advocates hailed victories at ballot boxes as a sign of widespread support for the abortion rights even in conservative state.

In the three states that have voted down abortion laws, there are special circumstances not present in any of the other two.

Florida has a 60% threshold to pass a constitutional change, while the majority of states require a simple majorit. The majority of voters supported the addition of abortion rights, but they fell short.

There, Gov. Ron DeSantis a Republican of national prominence, presented a challenge for proponents as well by directing state GOP funds towards countering the measure and defending an agency that published a website attacking it, amongst other government efforts.

South Dakota’s measure was different because it allowed the state to regulate the abortion during the second trimester, but only under conditions that protected the woman’s health. Due to this provision, many national abortion rights organizations did not spend money promoting the measure, which may have contributed to its failure in conservative states.

Both sides in Nebraska had questions on their ballots. The voters approved the measure that bans abortions after the first twelve weeks of pregnancy, which is in line the current state law. They also allowed for more strict restrictions. The measure to include in the state constitution a right to abortion up to viability was also rejected. This is usually considered to be after 21 weeks, but there is no fixed time.

Abortion advocates have condemned the anti-abortion group’s novel strategy of placing a competing measure at the ballot box in an effort to confuse voters. Anti-abortion organizations elsewhere considered the approach.

Trump’s return as president could influence abortion policy

Donald Trump, the Republican candidate for president, won despite his constantly shifting positions on reproductive rights.

The passage of a nationwide ban could be possible if Republicans gain the House. This would add to their wins in the Senate and White House.

Trump said that he would veto any national ban despite refusing to answer previous questions.

Republicans are accused of trying to distort the truth by referring to federal abortion restrictions in the form of “minimum standards for national policy” to try and gain political support.

The national abortion landscape has already been shaped by judicial appointments. Trump has claimed credit for appointing the three U.S. Supreme Court justices who formed the majority to overturn Roe v. Wade. Not just the Supreme Court. Trump’s nominee for U.S. district judge Matthew Kacsmaryk issued rulings that had nationwide implications, including one affecting access to the abortion drug mifepristone.

A president could also use executive power to restrict abortion pills sent by mail, and declare that doctors are not required to perform abortions if they must stabilize patients in emergency rooms. A new administration may also withdraw from a federal suit that challenges certain aspects of Idaho’s abortion ban.

The results show that voters are willing to divide their votes on abortion issues

Some ballot measures were placed on the ballot to encourage Democratic voters to vote in the candidate elections.

It didn’t appear to affect other races in the state if that was indeed the plan.

Montana and Missouri, both dominated by Republicans, passed laws protecting abortion rights and elected GOP candidates to the U.S. Senate, governorship and president.

In Montana, Republican Tim Sheehy beat incumbent Senator Jon Tester who had been in office for three terms and tried to combine his campaign with an abortion rights campaign.

Three Republican states — Florida Nebraska and South Dakota — also rejected the abortion ballot measures.