Reproductive rights activists in Missouri are facing a significant hurdle as they work towards getting a ballot measure before voters this fall to roll back one of the strictest abortion bans in the country. While there is a general consensus among activists about the need to ensure access to abortion, they have been divided on whether to include a provision in the measure that would allow the state to regulate abortions after the fetus is viable.

The debate over the viability clause has resurfaced long-standing fractures among reproductive rights advocates not only in Missouri but also in other states where abortion-rights measures are being planned this year, especially in Republican-leaning or closely divided states. Concerns have been raised that failing to include limits related to viability might jeopardize the chances of passing these measures.

The division over the viability clause has been particularly intense in Missouri, where different strategies have complicated efforts to push forward with a ballot measure seeking to reinstate the right to abortion. Bonyen Lee-Gilmore, the vice president of communications for the National Institute for Reproductive Health, which opposes viability clauses, acknowledges that "the movement is grappling with its value system."

The term "viability" typically refers to the phase when a fetus would be able to survive outside the uterus, which is around 23 or 24 weeks into pregnancy. However, experts argue that it creates an arbitrary dividing line and stigmatizes abortions later in pregnancy, which usually occur due to serious complications that put the life of the woman or fetus at risk.

Advocates like Pamela Merritt, executive director of Medical Students for Choice, oppose the viability clause, considering it to be a social construct and an arbitrary line in the sand. They argue that perpetuating such terms only serves to reinforce damaging ideologies.

Since the Supreme Court overturned the 1973 Roe v. Wade decision in 2022, activists have been determined to rebuild access to abortion, particularly for marginalized communities. However, measures proposed for this year's ballot in Missouri, Florida, Arizona, and Ohio have been adopting the viability framework established by Roe. This has raised concerns about the potential implications of such clauses.

In Ohio, a Black woman who miscarried in her bathroom was charged with abuse of a corpse, and the viability clause was cited as justification for the case to proceed. Although the grand jury ultimately dismissed the case, this incident has fueled fears that anti-abortion forces could misuse the viability clause to restrict abortion rights.

The divisions among reproductive rights advocates have also led to actions in other states. The local Planned Parenthood affiliate in South Dakota withdrew its support for a ballot measure that would allow lawmakers to restrict abortion after the first trimester, as it failed to protect abortion rights. In Oklahoma, discussions about a potential ballot measure to repeal the state's abortion ban have also centered around the issue of viability.

While some states, such as California and Vermont, have enshrined abortion rights in their constitutions without viability limits, proposed amendments in Maryland and New York also do not mention viability.

Missouri, with its contentious abortion debate, has become a focal point in the national discussion on reproductive rights. The state's abortion-rights groups have been split over which of the 11 versions of a proposed measure to support for the ballot. These petitions have faced legal challenges and have been tied up in court for months.

Adding to the complexity of the situation is another initiative petition proposed by Republican strategist Jamie Corley. This proposal would allow abortions up to 12 weeks into pregnancy with exceptions for cases of rape, incest, or to protect the life of the mother until viability.

Corley believes these restrictions are feasible to pass in Missouri, where Republicans have implemented strict abortion bans except in medical emergencies.