Voters in at least eight states will vote on ballot measures related to abortion access in November after officials in Arizona and Missouri certified proposed amendments in the states this week.

The measures are part of a strategy from abortion rights advocates who see direct voting on the issue as a way to elevate the issue and circumvent legislative gridlock on abortion. All seven state ballot measures considered following the Supreme Court’s 2022 Dobbs v. Jackson Women’s Health Organization decision have favored the side of abortion rights.

In addition to Arizona and Missouri, voters will weigh in on abortion-related measures in Florida, South Dakota, Nevada, Maryland, Colorado and New York. Additional measures in Arkansas, Montana and Nebraska could potentially be confirmed as well.

The measures have racked up some of the highest expenditures compared to other state ballot considered that year. Political contributions for and against Florida’s abortion rights amendment have topped $46 million, per state campaign finance records.

Missouri Secretary of State Jay Ashcroft certified a petition for a measure Tuesday that would amend the state constitution to include a right to an abortion. The state currently has one of the strictest abortion laws in the country, banning the procedure outside of medical emergencies.

”For too long, Missourians have lived under a total abortion ban with no exceptions for rape, incest or a woman’s health,” said Rachel Sweet, campaign manager Missourians for Constitutional Freedom in a press call Tuesday. “It is our turn to do something that no other state has done before. End a total abortion ban at the ballot box.”

She said the support includes signatures from 380,000 individuals from all 114 counties in the state.

Sweet would not disclose how much the coalition intends to spend on the campaign.

“As someone who has managed abortion rights ballot measures in other states, spending is dictated by a lot of factors. Our goal is just to make sure we have the resources to adequately communicate with Missouri voters,” she said.

SBA Pro-Life America called the Missouri measure “deceptive and extreme” and expressed concern it would infringe on parental rights and reduce current health protections.

Sue Liebel, the group’s Midwestern regional director, said the amendment would give “the abortion industry a free pass from operating under any health and safety requirements from the state.”

“The abortion lobby’s ballot measure would end thousands of lives,” said Liebel in a statement.

Arizona Secretary of State Adrian Fontes certified the state’s measure for inclusion on the November ballot on Monday. The state verified more than 577,000 signatures in favor of voting on the amendment, which is the highest total for a citizen initiative in Arizona’s history.

Arizona’s proposed amendment would guarantee the right to abortion until fetal viability. The state currently permits abortion until 15 weeks of pregnancy. 

But since the Dobbs decision, the state has grappled with enforcement of a 1864 law that prohibits almost all abortions. The Arizona Supreme Court upheld the law in April, prompting the state legislature to pass legislation repealing that ban.

“This is a huge win for Arizona voters who will now get to vote YES on restoring and protecting the right to access abortion care, free from political interference, once and for all,” said Cheryl Bruce, Arizona for Abortion Access campaign manager, in a statement.

Last week, an Arizona Superior Court judge also rejected a lawsuit alleging that the Arizona for Abortion Access had submitted fraudulent signatures to appear on the ballot. Arizona Right to Life is attempting to appeal that decision, arguing the amendment is misleading to voters.

“At every turn, opponents of reproductive freedom and the right of voters to decide for themselves have challenged this grassroots, hugely popular amendment,” said Kelly Hall, executive director of the Fairness Project, which has committed $15 million this election cycle to abortion rights measures including in Arizona and Missouri.