2 New Ballot Initiatives Would Expand ‘Health’ Definitions to Legalize Abortion on Demand
Elizabeth Troutman Mitchell /
Abortion initiatives in Missouri and Arizona will effectively ask voters to allow no restrictions on ending the lives of unborn children.
Missouri and Arizona on Tuesday joined the list of states with abortion initiatives on the Nov. 5 ballot. Now, voters will decide pro-abortion measures in a total of eight states, the most on record in a single year: Arizona, Colorado, Florida, Maryland, Missouri, New York, Nevada, and South Dakota.
The ballot measures in both Arizona and Missouri ask voters whether they wish to amend their state constitution to allow abortions. Both include a wide-ranging “health of the mother” clause—or in these cases, “health of the pregnant person” or “pregnant individual”—that would make it legally and practically impossible to pass laws restricting abortion.
Missouri’s ballot measure, titled “The Right to Reproductive Freedom Initiative,” would enshrine the right to abortion in state law if voters approve it. The measure would allow the state Legislature to pass laws regulating abortion after fetal viability, but also would prohibit lawmakers from restricting abortions “needed to protect the life or physical or mental health of the pregnant person.”
Arizona’s abortion amendment would establish a “fundamental right to abortion” and prohibit laws that deny, restrict, or interfere with abortions after fetal viability when the procedures are “necessary to protect the life or physical or mental health of the pregnant individual.”
Missouri and Arizona appear to refer to women by using the terms “pregnant person” and “pregnant individual,” respectively.
Both ballot measures, if approved, would leave the decision of what is necessary to protect a woman’s “health” to “health care professionals,” rather than medical doctors.
In the Supreme Court’s Doe v. Bolton decision, issued the same day in 1973 as Roe v. Wade, the justices defined “health” of the mother as referring to “all factors” affecting the pregnant woman.
In Roe v. Wade, the Supreme Court held that states could regulate first-trimester abortions and to some extent second-trimester abortions, but only for the purpose of protecting the “health” of the mother.
When the unborn child is viable during the third trimester, the Roe decision—which the high court overturned in June 2022—allowed states to make abortion illegal contingent on the existence of exceptions to protect the mother’s life and “health.”
Doe v. Bolton defined the “health” of the mother as “all factors” that affect the woman, including “physical, emotional, psychological, [and] familial” factors and “the woman’s age,” drastically expanding the allowable abortions under Roe.
Because the texts of the Arizona and Missouri constitutional amendments contain no limitations on what “health” means or definitions of “health care professional,” the measures if passed likely would legalize abortion at any stage of the pregnancy. That is, if anyone who claims medical expertise asserts that the mother would benefit physically, emotionally, or otherwise by killing the unborn child.
Arizona law defines a health care provider as “a person or organization that provides health care to prevent, diagnose, or treat illness or injury.” This includes those who work at a licensed health care institution or provide health care in a fieldwork setting, such as social workers.
According to Missouri law, a health care professional is a person who is licensed, accredited, or certified by the state to perform specific health services. This definition includes physicians, surgeons, dentists, podiatrists, pharmacists, psychologists, and nurses.
Although both statutes allow abortion restrictions after fetal viability, usually around 23 or 24 weeks’ gestation, the limitations would be rendered void by the proposed “health of the mother” clauses.
The ballot measures in both Arizona and Missouri would allow any health care provider, including a social worker or dentist, to determine that a woman’s mental health requires that she end the life of her unborn child.
As a result, if voters approve the amendments, legal experts say pregnant women in Arizona and Missouri would be able to get abortions for any reason up to the time of birth.