Missourians will pass a historic amendment on Tuesday night that will codify the right to abortion access until fetal viability in the state constitution, according to projections.

Amendment 3 will repeal the state’s near-total abortion ban and restore access until around 24 weeks of pregnancy ― a monumental win for abortion rights advocates in the deep-red state. The passage of Amendment 3 marks the first time that voters have overturned an abortion ban with no exceptions for rape or incest in the current post-Roe v. Wade landscape.

The measure will protect the right to make decisions about other reproductive health issues as well, including birth control, prenatal care, childbirth, postpartum care, miscarriage care and “respectful birthing conditions.” It will also protect Missourians from being prosecuted for their pregnancy outcomes, such as miscarriage, stillbirth and abortion.

“Today, Missourians made history and sent a clear message: decisions around pregnancy, including abortion, birth control, and miscarriage care are personal and private and should be left up to patients and their families, not politicians,” Rachel Sweet, the campaign manager for Missourians for Constitutional Freedom, wrote in a press release.

“By passing Amendment 3, Missourians have put the power to make personal health care decisions back where it belongs — in the hands of Missourians, their families, and their health care providers,” Sweet continued. “I am incredibly proud of the tireless work from our coalition and grassroots supporters who made this day possible. This win is proof that Missourians are ready for a future where everyone has access to the health care they need.”

The initiative is counter-intuitive for a Republican stronghold with a long anti-abortion history. Missourians who voted to repeal a near-total abortion ban also overwhelmingly supported extreme anti-choice Republicans. Voters in Missouri supported Donald Trump for president by a 16-point margin, and sent Sen. Josh Hawley (R) back to the Senate with an 11-point margin.

Missourians for Constitutional Freedom ran a nonpartisan campaign, focusing on personal liberties and freedom to bridge the gap for voters who may identify as conservative or independent in the state. Sweet told reporters last month that the campaign employed new strategies to reach Republican voters, such as tapping pro-choice clergy and faith leaders as messengers for more conservative circles.

The campaign also used the power of storytelling to show voters that the state’s near-total abortion ban doesn’t just impact people who need elective abortions.

“There are a lot of Missourians, especially folks who may be more conservative, who would never see themselves as someone who would choose to have an abortion, but they might be able to see themselves as someone who has struggled with a miscarriage,” Sweet said last month.

The state had only three abortion clinics in 2017 after years of targeted restrictions on abortion providers. The last clinic in the state closed shortly after Roe v. Wade, the 1973 ruling that established a national right to abortion, was overturned in June 2022.

Although the amendment is a historic win for abortion rights advocates in Missouri, the lack of brick-and-mortar clinics means abortion access in the state still has a long way to go. Many of the prior abortion regulations, including the 72-hour waiting period and the ban on telemedicine, will need to be litigated in court. The amendment will be in effect as soon as the vote is finalized, although anti-abortion groups will likely challenge the results in the coming months.

“This is an especially historic win for Missouri, one of a growing number of red, blue and purple states ― and the first with a total abortion ban ― to approve a constitutional amendment protecting abortion,” Nancy Northup, president and CEO of the Center for Reproductive Rights, said in a Tuesday night statement.

“In fact, the amendment goes even further, calling for ‘a fundamental right to reproductive freedom, defined to include abortion and all matters relating to reproductive health care,’” she continued. “By saying yes to this powerful language, voters have demanded the return of the essential human rights and freedoms they lost after Roe was overturned.”