How abortion access map has been dramatically redrawn across US – after shock twists in deep red states

It wasn’t just Donald Trump or Kamala Harris on the ticket last night – there were also important referendums on abortion.

Americans in 10 states had their say on whether to enshrine abortion rights into their local constitutions, and the results have dramatically redrawn the map for abortion access across the US.

Voters approved the ballot measures in seven states – including in deep red areas like Missouri where women can now abort at up to around 23 weeks – while three rejected them, including South Dakota, where the only exception for an abortion is to save the life of the woman.

The new votes mean that 30 states and the District of Columbia allow abortion up to 18 weeks of pregnancy, while 20 states restrict the procedure in early pregnancy or ban abortion entirely. 

There are nine states with no limit on the gestational age including Oregon, Michigan and New Jersey, meaning doctors in these states are able to provide late-stage abortions. 

On the opposite end, there are 12 states with near-total bans on abortion, including Texas, Idaho and West Virginia. 

Dr Lisa Harris, an OB-GYN and professor at the University of Michigan told NPR that the changing landscape of laws is confusing for both providers and patients, and makes reproductive care more challenging overall. 

Dr Harris said: ‘It’s very frightening and confusing for physicians and the whole team that cares for patients to know, what can we do, what is OK and what’s not OK’ 

The issue of abortion was thrown to the states in 2022 when the Supreme Court overturned the national right to an abortion in the case of Dobbs v Jackson. 

The decision triggered a cascade of action by individual states either to protect or restrict abortion access. 

As the issue was taken to voters in state’s like Kansas, it became clear it doesn’t always fall along party lines. 

Experts say yesterday’s ballot measures were similarly surprising, we look at how all 10 states voted below:

Missouri – allowed up to 24 weeks

In The Show-Me State, when Roe v. Wade was overturned, a 2019 law that banned abortions except in cases of medical emergency went into effect. Violating the law was punishable by five to 15 years in prison. 

But on the 2024 ballot, Missourians approved an amendment to their constitution that guarantees ‘the right to make and carry out decisions about all matters relating to reproductive health care.’ 

This includes allowing abortions up to the point of viability, which doctors place around 24 weeks. 

Florida – despite majority vote, six-week ban remains

In the Sunshine state, abortion was made illegal by a ‘Heartbeat Protection Act’ which bans most abortions past six weeks of gestation. 

Advocates moved to expand access with a ballot initiative that would’ve codified the right to an abortion in the state’s constitution. 

But there was a threshold built into the initiative – which meant it needed to earn at least 60 percent of the vote to pass. 

So though a majority of voters, totaling 57 percent, were in favor of the initiative, it didn’t pass. 

Therefore, abortion is still illegal past six weeks, except in cases where the fetus has fatal abnormalities or the mother suffers from emergency complications. 

South Dakota – near-total ban 

In South Dakota, voters moved to reject an initiative that would’ve expanded abortion rights. 

After the Dobbs ruling in 2022, a trigger a law went into effect that banned all abortions except when the pregnant woman’s life is in danger. 

The 2024  measure would have enshrined the right to an abortion through the first trimester of pregnancy in the Mount Rushmore State’s constitution. A majority of voters, 59 percent, voted against the Amendment.

This means that the near-total ban on abortion in the state is upheld.  

Nevada – allowed up to 24 weeks

In 1990, Nevada passed a law that guaranteeing abortions up to 24 weeks of pregnancy, so that even after the Dobbs decision in 2022, citizens had access to the medical procedure. 

Still, abortion rights activists moved to put the issue to the voters in order to guarantee access to the medical procedure in the state’s constitution. 

Sixty-three percent of Nevadan voters approved the measure, enshrining the right to an abortion up to fetal viability, around 24 weeks. 

However, they will have to vote on the issue again in 2026 to officially amend the constitution, per state law. 

Arizona – allowed up to 24 weeks

Abortion rights in Arizona have been flip flopping over the past few years. In April 2024, the state supreme court upheld a total-ban on abortion that was originally created during the Civil War. 

State senators blocked the law from taking effect, but the situation mobilized abortion activists in the state, who added a ballot measure to 2024’s election. 

Arizonan voters approved the ballot measure, which approved an amendment to state constitution protecting abortion up to 24 weeks. 

Nebraska – 12-week ban

In Nebraska, there were two opposing ballot measures in 2024’s election. 

Initiative 439 would’ve add the right to abortion up to 24 weeks to the state’s constitution. 

Approximately 51 percent of voters were against the amendment, so it didn’t pass. 

By contrast, Initiative 434, which enshrines the state’s current 12 week ban into the constitution, won 55 percent of the voters.

The 12 week ban, which is within the first trimester, was originally signed into law in May 2023 by Governor Jim Pillen. 

This means that in Nebraska, abortions are prohibited after the first trimester, unless someone is in medical emergency or the pregnancy was the result of rape or incest. 

Montana – allowed up to 24 weeks

Montanans had the right to an abortion before the election because of a 1999 state Supreme Court ruling. 

However, state legislators have challenged that precedent a number of times since, passing laws that ban abortion and remove Medicaid coverage for the procedure. 

In the 2024 election, 58 percent of voters approved a ballot initiative to amend the state constitution. The amendment states it will: ‘expressly provide a right to make and carry out decisions about one’s own pregnancy, including the right to abortion.’ 

This protection extends to 24 weeks of pregnancy, but allows for medical professionals to perform one past that threshold in medically necessary cases. 

New York – allowed up to 24 weeks

Similarly to Nevada, New Yorkers haven’t had their abortion laws challenged in recent years. Still, reproductive rights groups moved to put the issue to the people with proposition one. 

The proposition added language to the equal protection clause of the state constitution about pregnancy. It states that someone may not be discriminated against or denied rights because of: ‘pregnancy, pregnancy outcomes, and reproductive healthcare and autonomy.’ 

Voters approved the addition, maintaining abortion rights in the state up to 24 weeks of pregnancy. The state also allows abortion after 24 weeks if the woman’s life is endangered. 

Maryland – allowed with no limits

In Maryland, 74 percent of voters approved of of a measure to add reproductive protections to their constitution. 

This cements the access that women in the state already had to abortion. 

The Old Line State has been progressive with it’s abortion protection in the past years, even enacting shield laws that protect abortion providers in the state from being prosecuted by other states. 

Colorado – allowed with no limits

In the Centennial State, abortion has been widely protected. Yet there was concern that local governments in more rural parts of the state were moving to restrict access to the procedure, according to NPR. 

So the issue was put to voters. Approximately 61 percent of voters in the Centennial state voted to approve Amendment 79, earning more that the 55 percent required. 

The Amendment essentially takes a 2022 law signed into law by Governor Jared Polis which enshrines the right to an abortion with no gestational limit and allows Medicaid to cover the procedure.