“Yes on 3” signs are seen outside the Missourians for Constitutional Freedom office on October 26, 2024. Credit – Arin Yoon for The Washington Post—Getty Images

Tthe majority of state ballot measures intended to protect abortion access this year was approvedand most of them were citizen-led initiativesmeaning organizers petitioned to get the measures on the ballot. That kind of action empowers everyday Americans to fight for abortion rights now that the issue has been left to the states. But not all states allow citizens to put state ballot initiatives, including some with the strictest abortion laws in the country, leaving reproductive rights advocates there with little recourse.

“It basically leaves us powerless when we’re talking about putting initiatives that people actually care about on the ballot,” said Chasity Wilson, executive director of the Louisiana Abortion Fund.

Since the US Supreme Court decision in 2022 i Dobbs v. Jackson Women’s Health Organization to overturned Roe v. Wadeadvocates have turned to the citizen-led initiative process to try to incorporate the right to abortion into state constitutions. Polls have found that the majority of Americans say that abortion should be legal in all or most situations, and when abortion has been on the ballot it is won most of the time.

Ballot measures can lead to tangible change – this year, Missouri made history like that first state then Dobbs decision to pass a citizen-led ballot measure expected to repeal its nearly total abortion ban. But only about half of all states allow citizens to propose state ballot measures; in other states, the legislatures would have to add measures to the ballot. And some of the states that do not allow this process are also states that have banned abortion in almost all situations, including Louisiana, Alabama, and Texas.

“I think this is something that was frustrating throughout the campaign when the conversation about abortion would come up and (Donald) Trump in particular would talk about how we just send it back to the states and give the voters and the states the ability (to decide this) , said Michelle Erenberg, the executive director of the reproductive rights organization Lift Louisiana. “It really ignored the fact that there are many states where citizen-led ballot initiatives are not possible.”

Read more: Why abortion rights won in three states that voted for Trump

Citizens elect their representatives, so in red states, legislators’ abortion restrictions remain a reflection of state-by-state political decision-making in a post-Rome landscape. But reproductive rights advocates in those states say restrictions don’t reflect how many voters feel about abortion. And seeing seven abortion rights measures pass in the 2024 election was also a chilling reminder to many advocates that they can’t try to do the same.

In Louisiana, a Democratic representative proposed placing a reproductive rights measure on the 2024 ballot, but the House Committee on Civil Rights and Procedure stop that effort in March. “We’re going to keep trying because we know this is something Louisiana voters support and really want,” Erenberg said. “The makeup of the committee is strongly anti-abortion and so it will take a lot of effort to either change the makeup of the committee or change the hearts and minds of the members of the committee.”

Year 2020, two years before Dobbs decision, Voters of Louisiana was approved a legislative amendment to reaffirm that nothing in the state constitution guarantees the right to abortion, with about 62% of voters supporting the measure. But support for abortion may have changed since then. Lift Louisiana, in partnership with other organizations, ordered one votingwhich found that of 1,000 likely Louisiana voters surveyed in April 2023, more of them—42%—would “strongly support” a constitutional amendment establishing a right to abortion than “strongly oppose” it—30%.

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Without a ballot measure, Wilson says the burden falls on advocates and local governments to help people get access to the care they need. The Louisiana Abortion Fund, for example, provides direct assistance to people in the Gulf South seeking abortions in states where it is legal, covering the cost of travel and connecting them to other resources they may need. The group also provides funding through pledges sent to clinics in states where abortion is legal. Lift Louisiana also provides informational resources, as well as pushing for reproductive rights legislation and offering legal support.

Jenice Fountain – the executive director of the Yellowhammer Fund, a reproductive justice organization serving Alabama, Mississippi and the Deep South—say not having the ability to put a measure on the Alabama ballot limits their ability to try to protect reproductive rights. “Honestly, the best thing we can do as advocates in the state is often to reduce some of the harm,” Fountain says. Yellowhammer Fund and other reproductive rights advocates is archived lawsuits against Alabama Attorney General Steve Marshall in 2023, arguing that he specified that groups that help people travel out of state to get abortions could be charged with conspiracy. The Yellowhammer Fund used to offer money to people seeking abortions, but stopped because of Marshall’s comments.

Now, the Yellowhammer Fund has distributed emergency contraceptives and other reproductive health items, such as condoms and pregnancy tests. “We just have to take baby steps,” says Fountain. “I think people want this big, sweeping move that restores access… I just don’t think there’s going to be any big sweeping moves; I think it just has to be very strategic.”

Raven E. Freeborn, the executive director of the Texas-based reproductive rights organization Avow, said they were encouraged to see other states pass ballot measures this year, adding that it could give Texans who travel out of state more opportunities to access care . But getting a measure on the ballot isn’t something Avow focuses on. “That’s a big jump,” Freeborn says. “But in the reality of what Texans are facing right now, the odds are stacked against us there, so we’re hopeful for different strategies, and that’s what we’re working towards.”

Freeborn emphasizes that there are still many other avenues for advocates to protect reproductive rights in Texas. Freeborn points to Amarillo, Texas, where the voters was rejected a local ballot initiative that would have increased abortion restrictions by essentially making it illegal to use local roads to travel out of state to obtain an abortion. Avow canvasses the state to raise awareness about abortion, and also works with legislators to push legislation to protect reproductive health care.

Renee Bracey Sherman, abortion activist and co-author of liberating abortion, says that not allowing these states to put forward citizen-led initiatives prevents people’s voices from being heard. “The organizers in these states are so amazing, and I have so much love and hope for all of them,” said Bracey Sherman. “I don’t have the same love and hope for the politicians in these states because they follow political winds … they don’t necessarily do right by the people.”

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