Missouri voted to protect abortion access Tuesday, Decision Desk HQ projects, narrowly rejecting a ballot measure that would have reinstated a near-total abortion ban just two years after it was overturned.

Missouri in 2024 became the first state to use a ballot measure to overturn a near-total abortion ban and put a reproductive freedom amendment in the state constitution. That measure, also called Amendment 3, was approved by a narrow 51.6 percent majority. Nearly 54 percent of voters rejected the measure, with 15 percent of the vote reported. The GOP-dominated legislature, furious at the result, set out to change it. They used a legislative maneuver to place a question on the ballot that would rescind abortion rights, as well as restrict gender-affirming drugs and surgery for minors.

Opponents said Republicans tried to mislead voters by packaging an anti-transgender measure with the abortion ban — an effort critics called “ballot candy”— and recycling the same amendment name from the last election. In 2024, a “yes” vote on Amendment 3 repealed the state’s abortion ban. This year, a “yes” vote reinstated it.

The state’s 2022 law was the strictest in the country, with no exceptions for rape or incest. Supporters of the ballot measure argued that the new language is less restrictive and better reflects what voters intended in 2024. Unlike the law that was passed in the wake of the Dobbs decision in 2022, Amendment 3 includes limited exceptions for medical emergencies and fetal anomalies (birth defect or congenital disorder), and for survivors of rape or incest only up to the 12th week of pregnancy. The measure would also have enacted a constitutional ban on gender transition surgery for minors as well as the prescription or administration of cross-sex hormones or puberty-blocking drugs to minors — though both are already banned by law.