Virginia Now Protects Third-Trimester Abortion With Doctor’s Note

Virginia voters on Tuesday approved Amendment 1, writing a “fundamental right to reproductive freedom” into the state constitution. The Associated Press called the race at 9:01 p.m. Eastern with the measure ahead 60.7% to 39.3%, with about 63% of ballots counted.

The new Section 11-A of the Bill of Rights, as published by the Virginia Department of Elections, covers “prenatal care, childbirth, postpartum care, contraception, abortion care, miscarriage management, and fertility care.” It says the right cannot be “directly or indirectly, denied, burdened, or infringed upon unless justified by a compelling state interest achieved by the least restrictive means,” and it defines a compelling interest as one with “the limited purpose of maintaining or improving the health of an individual seeking care.”

The fight is over the third trimester. The amendment says the state “may regulate the provision of abortion care in the third trimester,” but that “in no circumstance shall the Commonwealth prohibit an abortion” that “in the professional judgment of a physician is medically indicated to protect the life or physical or mental health of the pregnant individual,” or when a physician judges the fetus not viable.

Current law is stricter on process. Under Virginia Code 18.2-74, a third-trimester abortion requires the performing physician and two consulting physicians to certify, “based upon their best clinical judgment,” that continuing the pregnancy “is likely to result in the death of the woman or substantially and irremediably impair the mental or physical health of the woman.” The amendment’s language names the judgment of “a physician” and does not mention consulting physicians.

Opponents say the language reaches well past abortion. They argue the “sweeping” reproductive freedom wording and its strict-scrutiny test will invite litigation against medical safety laws, including rules requiring facilities to have lifesaving support available for a fetus born alive. Supporters of the measure say it protects access to abortion, contraception and fertility care and keeps those medical decisions private.

Opponents also have a court date. A challenge filed by the Founding Freedoms Law Center, the legal arm of the Family Foundation, seeks a preliminary injunction to block certification of the referendum results, arguing the ballot language was misleading. A hearing is set for Nov. 13, the Virginia Mercury reported.

Virginia performed nearly 40,000 abortions in 2025, roughly 8,400 of them on out-of-state residents, according to the pro-abortion Guttmacher Institute. Abortions after 21 weeks make up about 1% of the 1.1 million performed in the U.S. each year.