On November 3, 2026, midterm Election Day, abortion-rights campaigns won in Virginia and Missouri, while results in Idaho and Nevada were still undecided overnight. AP called the main results, as reported by the Idaho State Journal, NBC News and the Virginia Mercury. Across the country voters decided 145 ballot questions in more than three dozen states, according to AP.

Why It Matters

**Contraception and IVF are now constitutional rights in a Southern state.** Most post-Dobbs ballot measures have been about abortion alone. Virginia explicitly protects **birth control and fertility treatment**, which gives contraceptive brands, telehealth birth-control providers, fertility clinics and femtech companies operating there a legal floor that state legislators can't easily remove. That matters at a time when federal policy is going the other way: the US has [zeroed out international family-planning aid](/stories/trump-foreign-aid-contraception-cuts), insurers are still [illegally charging for some contraceptives](/stories/nwlc-aca-birth-control-coverage-denials), and courts keep revisiting IVF. **For Missouri operators, the status quo holds.** Abortion stays legal, and the state remains a test market for reproductive-health telehealth. Its Medicaid program still doesn't cover long-acting injectable PrEP ([our coverage](/stories/injectable-prep-insurance-barriers-idweek)), so access gaps continue outside abortion. If Idaho's Prop 1 fails as the overnight count suggests, the Mountain West stays the region where reproductive-health businesses face the tightest legal limits. We'll update when Idaho and Nevada are called.

Virginia's amendment covers more than abortion. Ballot Question 1 adds a "fundamental right to reproductive freedom" to the state constitution. According to the Virginia Mercury, it protects the right to obtain birth control medication or devices and fertility treatment, as well as abortion through the second trimester. It also drops the requirement for three physicians to approve later abortions; one is now enough. It passed with more than 61% in unofficial results at 10 p.m. Two other amendments also passed: one removes the state's defunct same-sex marriage ban (56%) and the other makes voting-rights restoration automatic for formerly incarcerated people (55%). Supporters pointed to Justice Clarence Thomas's 2022 suggestion that the Court revisit contraception precedents, and to state court cases challenging IVF, as the reason for writing contraception and fertility care in explicitly. "Never again will our reproductive rights be a political football in Virginia," said Han Jones, campaign manager of Virginians for Reproductive Freedom. Every Republican member of the General Assembly opposed the amendment.

Missouri kept its 2024 abortion-rights amendment. Voters rejected Amendment 3, which the Republican-led legislature had put on the ballot. It would have repealed the 2024 amendment and replaced it with a ban allowing exceptions only for medical emergencies, fetal anomalies, and rape or incest up to 12 weeks. NBC News projected the defeat just before midnight. The measure also would have written existing restrictions on gender-affirming care for minors into the constitution. AP reports that abortion-rights groups heavily outspent opponents.

The West was still counting. Idaho's Proposition 1, which would allow abortion up to fetal viability starting in January 2027, led early and then fell behind: 45.7% to 54.3% at midnight with 35 of 44 localities reporting, according to the Salt Lake Tribune. The Church of Jesus Christ of Latter-day Saints gave $1 million to the opposition PAC. Nevada's Question 6, the required second vote on writing existing abortion law into the state constitution, had no results posted overnight because long lines delayed counting.

Sources

Update — 2026-11-04

Initial entry — story first created.

Update — 2026-11-05

Final tally: three wins for abortion rights, one loss. By midday Wednesday, November 4, the two Western races that were undecided overnight had been called. Nevada's Question 6 passed. AP called it early Wednesday, adding a right to abortion to the state constitution. It still allows restrictions after fetal viability, except where needed to protect the pregnant person's life or physical health. This was its second approval, because Nevada requires a constitutional amendment to pass at two elections (Guttmacher). Idaho's Proposition 1 failed. AP called it with about 85% of votes counted and roughly 55% voting "No" (Boise State Public Radio). Idaho's near-total ban, in force since 2022, therefore stays. The two campaigns raised about $10 million combined. The LDS Church gave $1 million against Prop 1 and also opposed Nevada's measure.

Guttmacher summarised the night as "abortion rights win in three out of four states." It noted that Prop 1 would also have protected decisions about contraception and fertility treatments from government interference. Idahoans will keep relying on two routes. In 2025, 850 abortions were provided to Idaho residents through telehealth under other states' shield laws (up 16% on 2024), and 1,680 residents travelled out of state, mostly to Oregon and Washington. Unofficial totals reported by Boise State Public Radio: Missouri rejected Amendment 3 by 1,173,172 to 941,065, and Virginia passed Question 1 by about 2.1 million to 1.3 million.

What changed: The overnight "Idaho trailing, Nevada uncounted" uncertainty is gone. The result is two new constitutional protections (Virginia, Nevada), one reversal blocked (Missouri), and one total ban still in place (Idaho). For reproductive-health telehealth providers, the map hasn't moved much, but the Idaho figures show that shield-law telehealth is now a measurable channel into ban states, and it is growing.

New Sources