When Emma Burns, then a 19-year-old college student in Flagstaff, Arizona, found out she was pregnant with twins, she felt scared and alone. 

Abortion wasn’t openly discussed in the rural community where she grew up, where the sole clinic provided abortions just one day a week. Arizona’s mandatory 24-hour waiting period required two separate visits. Still, Burns was ultimately able to obtain a medication abortion, a decision she said saved her life. 

Now, Burns shares her experience as she gathers signatures for a proposed ballot measure that would enshrine a right to abortion in Arizona’s constitution. Telling her story, she said, puts a human face on the fight for abortion rights and has helped others in her community feel less alone. 

“When I speak in Flagstaff about abortion, the aftermath is always astounding to me,” she said. “I will tell my story and I won’t sugarcoat it. It was uncomfortable, it was painful, it was scary. But it was the best decision and I would make it again, and I would continue to make that decision if that’s what served my future.”

Abortion rights groups have been undefeated on similar ballot measures since June 2022, when the Supreme Court overturned Roe v. Wade and sent the issue to the states. Voters in up to 11 more states could weigh in directly on abortion this fall. Most proposed measures, including Arizona’s, guarantee a right to abortion to the point of fetal viability, which is determined by physicians but is usually around 22 to 25 weeks of pregnancy. 

But only one of those ballot measure campaigns, Arizonans for Abortion Access, is using the word “abortion” in its name.

The stakes are high. Since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health, Arizona patients and providers have been mired in the legal limbo and confusion caused by overlapping abortion bans. Of the states directly voting on abortion this year, Arizona is also the most closely politically divided, making it a critical battleground state in the 2024 presidential race. 

The name of a coalition working to pass a ballot measure may seem little more than a formality. But the Arizona coalition’s choice speaks to two factors: their focus on abortion as opposed to reproductive rights more broadly, and their desire to normalize public discussion of abortion. Since Dobbs, most abortion ballot measure campaigns, including those running this year, have used an iteration of “reproductive rights” or “reproductive freedom” in their names. 

Chris Love, a spokesperson for Arizona for Abortion Access, said the group’s decision to use “abortion” in its name was a deliberate choice. 

“We’re intentionally using ‘abortion’ as a word because that was the thing that we’re doing,” she said. “We don’t want to play ‘hide the ball’ with voters. We don’t want to insult voters’ intelligence by using poll-tested terms that don’t really mean anything. We want to say the thing.” 

Love said the group made a strategic and legal decision to limit the scope of the amendment to abortion and not other forms of reproductive care, in line with Arizona’s single-subject requirement for ballot initiatives. They also wanted to differentiate themselves from a previous, unsuccessful effort to put abortion on the ballot in 2022.   

But more than that, Love said, the coalition wants to be clear with voters about what the amendment would do — and to destigmatize the word “abortion.” Sixty percent of Arizonans believe abortion should be legal in all or most cases, while 8 percent believe the procedure should be illegal in all cases, according to polling by the nonpartisan Public Religion Research Institute.  

“Our messaging, our goal, our aim, is very popular across the political spectrum. That includes the independent voters and Republican voters,” Love said. “They understand…what abortion is, and it’s necessary to protect it. We shouldn’t treat voters like they aren’t intelligent or sophisticated enough to understand.”

In the red and purple states like Ohio, where abortion has won at the ballot box, advocates have successfully framed abortion rights as a matter of freedom from government interference in personal medical decisions, arguments the Arizona coalition is also making to voters. 

Nicole Walker, a professor of creative writing at Northern Arizona University who received an abortion as a child in the 1980s, believes the government shouldn’t have the authority to dictate that decision — a choice that determines the course of a person’s life. 

Walker decided to share her story in the summer of 2022 in a New York Times op-ed with a striking headline: “My Abortion at 11 Wasn’t a Choice. It Was My Life.” Now also working to support the ballot measure campaign, Walker said that stories like hers should be a part of the broader case for abortion rights in all circumstances, not only extreme ones. 

“It’s all the same narrative, which is, ‘I had to do this to be where I am now,’” she said. “And I think that’s true for every abortion story.”

Since Dobbs, Arizona’s abortion providers have contended with competing and contradictory state laws. While lawmakers have repealed a total abortion ban from 1864 that the state’s Supreme Court greenlit in April, it could still go into effect at some point later this year. In the absence of the total ban, the law defaults to a 15-week ban passed in 2022. 

The confusing laws and uneven access to care in Arizona stand to disproportionately affect women of color — a third of women between 18 and 64 in the state are Hispanic, according to estimates from the Kaiser Family Foundation. Arizona patients living in rural areas and those who are undocumented immigrants also face much steeper barriers to abortion.

While the proposed ballot measure pertains to only abortion, Love said it’s a necessary move to protect all kinds of reproductive health care, like fertility treatments and contraception, that GOP lawmakers could target in the future. 

“If we can’t say ‘abortion,’ then how are we really advocating for those other things and being truthful about what we’re advocating for?” Love said. “We need to be plain with folks right now. 2022 should have been a wake-up call … and the Band-Aid should be ripped off.”

Burns said she believes the abortion ballot measure has a strong potential to mobilize young voters who may feel disillusioned by party politics. 

“I’m really proud of the work that they’re doing because they’re saying the word ‘abortion,’” she said.  “We’re so scared of it because nobody talks about it.”

President Joe Biden is centering reproductive rights in his reelection campaign and running on restoring the protections of Roe v. Wade, though his relatively recent embrace of abortion doesn’t go as far as some activists would like. 

But Love distinguished between the Arizona ballot measure campaign’s efforts and the Biden campaign’s messaging of reinstating Roe, saying that her coalition wants to “create a framework that works for Arizona.” She also warned that Democrats can’t count on the abortion ballot measure to boost their candidates.

“The Democratic Party will need to do the work of getting voters excited to vote for Democrats,” she said. “We all have a role to play, but our roles are very different.”

Anti-abortion advocates have mounted fierce opposition to the proposed measure, including in a campaign, “It Goes Too Far,” and have discouraged voters from signing the petitions to make it eligible for the ballot. In April, Arizona for Abortion Access announced it had collected over 500,000 signatures in support of the measure, far more than the number needed to submit them by the July 4 deadline. 

Still, more challenges lie ahead. GOP lawmakers are also trying to kneecap Arizona’s long-standing tradition of direct democracy with a separate ballot measure this November that would make it harder for future citizen-led initiatives to get on the ballot. The effort is part of a larger pattern of attacks on citizen-led ballot initiatives by Republicans around the country. 

Advocates in Arizona, Colorado, Florida, Missouri, Nevada and South Dakota have submitted or acquired the necessary signatures to get their amendments on the 2024 ballot in those states, while organizers in Arkansas, Nebraska and Montana are still collecting signatures they plan to submit this summer. Campaigns in red states like Florida, Missouri and Montana have already overcome legal efforts by state officials to block abortion from getting on the ballot.

Burns said she’s now devoting her time and effort to educating college students on the health care resources available to them and to, more broadly, end the stigma surrounding abortion.  

“We’re going to create a whole generation of people who don’t even question whether or not it’s OK to have an abortion,” she said. “It’s something we can all do. And it’s not a crime and a bad thing.”