Intended for healthcare professionals


US midterm election results show that voters support the right to abortion

BMJ 2022; 379 doi: (Published 07 December 2022) Cite this as: BMJ 2022;379:o2928
  1. Terry McGovern, Harriet and Robert H Heilbrunn professor and chair
  1. Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, USA

The majority of Americans support the right to abortion—decades of polling have made this clear, and this was proved by the recent midterm elections.1 Interviews and exit polls show abortion was the top issue for many voters.

The five ballot initiatives related to abortion, which all went in favour of protecting abortion rights, also confirmed this reality. Voters in Kentucky, a state with more Republicans than Democrats, rejected a ballot proposal that would have amended the state constitution to explicitly state it does not protect a right to abortion.23 The Kentucky Supreme Court heard oral arguments recently on challenges to the abortion restrictions. Voters in Vermont, California, and Michigan endorsed ballot initiatives enshrining state constitutional protection for abortion.4 The Michigan ballot measure, called proposal 3, broke state records for signatures and campaign donations.4 In Montana, a deeply conservative state, residents voted down the state’s “Born Alive” measure, which would have criminalised healthcare providers if they did not take “reasonable actions” to save an infant born alive, including after an attempted abortion.5

Voters around the country rallied behind candidates pledging to protect access to abortion. Seven pro-choice Democrats held or won their governorships, including in Kansas where voters overwhelmingly rejected legislation to strip abortion rights from the state’s constitution earlier this year. Several Congressional races also illuminated voters’ commitment to protecting abortion access. Hillary Scholten, the pro-choice Democratic House candidate in western Michigan, defeated Trump backed candidate John Gibbs. The Democratic lieutenant governor John Fetterman—a steadfast supporter of reproductive rights—defeated Mehmet Oz in Pennsylvania’s critical Senate race. In Colorado, the incumbent Michael Bennet won his Senate re-election bid against Republican Joe O’Dea, and in New Hampshire, Democratic Senator Maggie Hassan bested Donald Bolduc, holding on to her seat. Defying all odds, Democrats have secured the Senate with Senator Cortez Masto’s victory clinching Democratic control.

Control of the House of Representatives was won by Republicans with a narrow margin. Republicans in the House have introduced abortion restrictions that will come to a vote now they have won the majority. But with such strong evidence of the unpopularity of banning abortion, one wonders whether Republicans will continue their attempts to roll back reproductive rights.

Poor maternal and child health record

One of the greatest flaws in the “pro-life” anti-abortion stance is the irrefutable fact that the states with the most aggressive laws against abortion have the worst health outcomes for women and children. The very politicians advocating for the sanctity of human life have consistently voted against measures that would shore up healthcare services and opportunities for women and children.

Anti-abortion lawmakers in Alabama and Mississippi have refused to expand Medicaid to extend postpartum care despite their states’ abysmal ratings for maternal and child health.6 And while anti-abortion politics are awash with rhetoric around saving the lives of infants and children, there is overwhelming evidence of dysfunction, neglect, and abuse in the foster care systems of Alabama and Mississippi, as well as in Louisiana, where at least three children have died in the past four months under the watch of the state’s Department of Children and Family Services.7 Courts in these states have found that the state programmes discriminate against young people with disabilities, provide unstable, unsafe care, and are responsible for extremely high rates of maltreatment.8910

In Oklahoma, Republican Governor Kevin Stitt has supported criminalising abortion but has not tackled some of the nation’s worst maternal and child health outcomes. When confronted with data about Oklahoma’s dismal maternal and child health outcomes, Stitt claimed that the federal government had skewed a report’s findings to make him look bad.

The truth is, a candidate’s stance of being “pro-life” by banning abortion does not signify support for children or mothers who are needlessly suffering or even dying. The midterms proved that voters see beyond this hypocrisy and recognise what supporting life should mean.


  • Competing interests: None declared.

  • Provenance and peer review: Commissioned, not externally peer reviewed.