The Hidden danger of the 2024 Ballot initiatives: women losing access to justice

As the 2024 Presidential Election approaches, Americans are focusing not only on who will become the 47th President but also on key state ballot initiatives. Among the most consequential are those addressing abortion in ten states: Arizona, Colorado, Florida, Maryland, Missouri, Montana, Nebraska, Nevada, New York, and South Dakota.

 Though marketed as expanding women’s access to abortion, these initiatives, if passed, will have surprising consequences on women’s ability to hold medical practitioners accountable for any harm caused during abortion procedures. These amendments could remove critical protections for women, leaving those who experience harm without recourse.

 The 2024 abortion ballot initiatives aim to enshrine a “right to abortion” within their state constitutions. Many would allow abortion throughout all stages of pregnancy or restrict the ability of state legislatures to regulate or limit abortion access.

 What is less publicized—and deeply concerning—is that many of these amendments contain provisions shielding abortion providers from legal or regulatory action, even in cases of medical malpractice or negligence. These hidden clauses drastically limit accountability, creating significant barriers to justice for women harmed during abortion procedures.

 One concerning example is Amendment 3 in Missouri, which seeks to reverse the state’s abortion restrictions, permitting abortion until birth. A particularly problematic clause is Provision Five, which states:

 “No person shall be penalized, prosecuted, or otherwise subjected to adverse action based on their actual, potential, perceived, or alleged pregnancy outcomes, including but not limited to miscarriage, stillbirth, or abortion. Nor shall any person assisting a person in exercising their right to reproductive freedom with that person’s consent be penalized, prosecuted, or otherwise subjected to adverse action for doing so.”

This provision effectively shields abortion providers and anyone assisting them from penalties, prosecution, or adverse actions, regardless of the outcome—including in cases of gross medical malpractice.

 Montana’s CI-128 offers similarly sweeping protections for abortion providers:

 “CI-128 prevents the government from penalizing patients, healthcare providers, or anyone who assists someone in exercising their right to make and carry out voluntary decisions about their pregnancy.”

These broad protections remove accountability for medical practitioners, even if a woman suffers serious complications such as uterine perforation, infertility, hemorrhaging, sepsis, and even death.

Without accountability mechanisms in place, women who suffer harm during abortion procedures will have no path to seek justice. Regulatory agencies will also be powerless to hold abortion providers accountable for failing to meet basic medical standards.

 At the Center for Client Safety, our mission is to hold abortion providers accountable for failing to prioritize patient safety and well-being. We assist women who have experienced harm by documenting facility violations and pursuing justice through appropriate channels. However, if these ballot initiatives pass, our ability to help women will be severely restricted. State medical boards will lose critical tools needed to discipline providers, further insulating negligent abortionists from scrutiny and punishment.

 However, one ballot initiative stands out from the rest: Nebraska’s Initiative 434. Unlike the others, it introduces restrictions on abortion in the second and third trimesters, with exceptions for cases involving medical necessity, rape, or incest.

 If these ballot initiatives pass, women will lose more than just access to justice—they will lose the ability to hold negligent providers accountable. The stakes are too high to ignore. We must ensure that women retain the right to pursue action against medical practitioners when necessary—and that abortion providers are held to the same standards of accountability as all other healthcare professionals.