San Francisco, California, Proposition O, Local Reproductive Healthcare Including Abortion Policies Initiative (November 2024)

San Francisco County Proposition O
Election date November 5, 2024
Topic Local abortion
Status Approved
Type Initiative

San Francisco County Proposition O was on the ballot as an initiative in San Francisco County on November 5, 2024. It was approved.

A "yes" vote supported this ballot initiative to: Declare that San Francisco shall not "investigate or prosecute a person for having accessed or provided reproductive health care" or "assist or cooperate with such an investigation or prosecution," with certain exceptions for harms to the pregnant person; Require the Department of Public Health (DPH) to maintain a website listing "pregnancy services centers in the City that provide or offer referrals for abortions or emergency contraception, as well as limited service pregnancy centers" and a non-emergency telephone number "where members of the public can obtain information about where to obtain abortions and emergency contraception;"  Prohibit pregnancy services centers that receive municipal funding from "requiring abortion providers to possess or obtain additional medical qualifications beyond those required by state and federal law, in order to provide abortions;" Establish the Reproductive Freedom Fund, which would receive private donations, including grants, gifts, and bequests, and distribute the funds to support "access to abortions and emergency contraception in San Francisco;" and Create a new service class called Reproductive Health Clinics (RHCs) and amend zoning laws to allow RHCs throughout San Francisco, except that in residential districts, RHCs are only permitted in certain corner areas.

A "no" vote opposed this ballot initiative, known as the San Francisco Reproductive Freedom Act.

A simple majority vote was required for the ballot measure.

Election results

See also: Results for abortion-related ballot measures, 2024

San Francisco County Proposition O
Result		Votes	Percentage
Yes		312,914	83.84%
No		60,335	16.16%

Results are officially certified.

Source

Overview

Proposition O declared that San Francisco shall "serve as a safe and welcoming place for patients seeking reproductive health care, to protect the rights of pregnant persons to bodily autonomy and control over their private medical decisions, and to safeguard confidential health information between patients seeking access to reproductive health care and their providers."

The ballot initiative, among other provisions, declared that San Francisco shall not "investigate or prosecute a person for having accessed or provided reproductive health care" or "assist or cooperate with such an investigation or prosecution," excluding cases involving "the use of coercion or force against the pregnant person" or "criminal negligence that harmed the health of the pregnant person." Officials and employees of San Francisco, under this measure, were prohibited from sharing information with out-of-state or federal law enforcement about state-legal abortions, contraception use, in vitro fertilization, pregnancy status, or abortion decisions.

The ballot initiative required the San Francisco Department of Public Health (DPH) to maintain a website listing "pregnancy services centers in the City that provide or offer referrals for abortions or emergency contraception, as well as limited service pregnancy centers" and a non-emergency telephone number "where members of the public can obtain information about where to obtain abortions and emergency contraception." The DPH were permitted to install signs outside limited services pregnancy centers, defined as those that do not provide abortions or emergency contraception, stating that these centers do not provide abortions or emergency contraception and where those can be accessed.

Starting January 1, 2025, Proposition O prohibited centers that receive municipal funding from "requiring abortion providers to possess or obtain additional medical qualifications beyond those required by state and federal law, in order to provide abortions."

Proposition O established the Reproductive Freedom Fund, which received private donations, including grants, gifts, and bequests, and distribute the funds to support "access to abortions and emergency contraception in San Francisco."

Proposition O created a new service class called Reproductive Health Clinics (RHCs), defined as those that provide abortions or emergency contraction and specialize in reproductive health services. The ballot initiative amended zoning laws to allow RHCs throughout San Francisco, except that in certain residential districts RHCs are only permitted as Limited Corner Commercial Use.

Text of measure

Ballot title

The ballot title for Proposition O was as follows:

“

Shall it be City policy and law to support, protect, and expand reproductive rights and services?

”

Full Text

The full text of this measure is available here.

Support

Yes on O was the campaign in support of the initiative.

Supporters

Officials

• U.S. Rep. Nancy Pelosi (D)
• State Sen. Scott Wiener (D)
• Mayor London Breed (Nonpartisan)

Political Parties

• San Francisco Democratic Party

Organizations

• San Francisco Chamber of Commerce

Arguments

• San Francisco Mayor London Breed: "Prop O - the San Francisco Reproductive Freedom Act - ensures that everyone in our city has the autonomy to make decisions about their reproductive health. San Francisco is a city known for its progressive values, inclusivity, and unwavering commitment to individual rights. Prop O embodies these principles by protecting access to comprehensive reproductive healthcare, including safe and legal abortion services. At a time when reproductive rights are under attack nationwide, and Donald Trump and J.D. Vance have proposed a nationwide abortion ban, it is imperative that San Francisco stands as a beacon of freedom and compassion. Prop O affirms that we all deserve the right to make private health decisions without government interference. Prop O, the San Francisco Reproductive Freedom Act, will: - Guarantee that all residents, regardless of income, have access to necessary care, by ensuring continued funding for reproductive health services. - Protect healthcare providers who deliver these essential services from political and legal attacks. - Guarantee that education on reproductive health remains unbiased, factual, and available to all. Passing Prop O is not just about preserving rights; it's about protecting lives. Comprehensive reproductive care leads to healthier families and communities. Prop O ensures that women and all people who can become pregnant are not forced into dangerous or untenable situations. I urge you to join me in supporting Prop O- the San Francisco Reproductive Freedom Act. Let's ensure that San Francisco remains a leader in upholding the dignity and rights of all residents. Thank you for standing up for freedom and justice. Vote YES on Prop O."

Opposition

Opponents

Organizations

• Archdiocese of San Francisco
• Pro Life San Francisco

Arguments

• Melanie Salazar, executive director of Pro-Life San Francisco: This measure goes way beyond "pro-life versus pro-choice." Prop O will discriminate against life-affirming healthcare facilities that San Francisco citizens depend on and lessen the number of services they can provide to the community. A yes vote would: - Require signs to be installed outside of free pro-life medical clinics in the city of San Francisco to advertise abortion centers. Nothing of the sort would be installed outside abortion centers. - Create a designated coffer for soliciting grants, donations, and budgeted tax funds to pay for elective induced abortions up to 24 weeks gestation. - Create a new website to highlight abortion businesses and disparage "limited service" centers. Because of the falsehoods Mayor Breed spread at her Prop O press conference about SF's pregnancy resource centers, we feel this website will discourage people from interacting with those facilities and receiving quality care there. Rather than calling out material aid centers or clinics by name and citing negative reviews or violations of the law, governments have been increasingly castigating all PRCs categorically. - Limit city funding from going to health facilities that refuse to abort healthy fetuses or refuse to refer people to businesses that do. This special treatment limits the expansion of services that life-affirming facilities can make available to the public. - Let new companies purchase and operate in any property zoned for non-residential use, as long as they are an abortion business. - Create an "Abortion Provider Appreciation Day" for the city. Most people who self-identify as pro-choice believe that elective abortion should be available only in the 1st trimester, but this measure would applaud doctors harming older fetuses. Together, we must reject abortion extremism by voting NO on Prop O."

Path to the ballot

This measure was added onto the ballot by San Francisco Mayor London N. Breed.

How to cast a vote

See also: Voting in California

See below to learn more about current voter registration rules, identification requirements, and poll times in California.

How to vote in California

Poll times

All polls in California are open from 7:00 a.m. to 8:00 p.m. Pacific Time. An individual who is in line at the time polls close must be allowed to vote.

Registration

Check your voter registration status here.

To vote in California, an individual must be a U.S. citizen and California resident. A voter must be at least 18 years of age on Election Day. Pre-registration is available at 16 years of age. Pre-registered voters are automatically registered to vote when they turn 18.

Automatic registration

California automatically registers eligible individuals to vote when they complete a driver's license, identification (ID) card, or change of address transaction through the Department of Motor Vehicles. Learn more by visiting this website.

Online registration

See also: Online voter registration

California has implemented an online voter registration system. Residents can register to vote by visiting this website.

Same-day registration

California allows same-day voter registration.

Californians must be registered to vote at least 15 days before Election Day. If the registration deadline has passed for an upcoming election, voters may visit a location designated by their county elections official during the 14 days prior to, and including Election Day to conditionally register to vote and vote a provisional ballot, which are counted once county election officials have completed the voter registration verification process. The state refers to this process as Same Day Voter Registration.

Residency requirements

To register to vote in California, you must be a resident of the state. State law does not specify a length of time for which you must have been a resident to be eligible.

Verification of citizenship

See also: Laws permitting noncitizens to vote in the United States

California's constitution requires that voters be U.S. citizens. When registering to vote, proof of citizenship is not required. Individuals who become U.S. citizens less than 15 days before an election must bring proof of citizenship to their county elections office to register to vote in that election. An individual applying to register to vote must attest that they are a U.S. citizen under penalty of perjury.

As of November 2024, two jurisdictions in California had authorized noncitizen residents to vote for local board of education positions through local ballot measures. Only one of those jurisdictions, San Francisco, had implemented that law. Noncitizens voting for board of education positions must register to vote using a separate application from the state voter registration application.

All 49 states with voter registration systems require applicants to declare that they are U.S. citizens in order to register to vote in state and federal elections, under penalty of perjury or other punishment. Seven states — Alabama, Arizona, Georgia, Kansas, Louisiana, New Hampshire, and Wyoming — have laws requiring verification of citizenship at the time of voter registration, whether in effect or not. One state, Ohio, requires proof of citizenship only when registering to vote at a Bureau of Motor Vehicles facility. In three states — California, Maryland, and Vermont — at least one local jurisdiction allows noncitizens to vote in some local elections. Noncitizens registering to vote in those elections must complete a voter registration application provided by the local jurisdiction and are not eligible to register as state or federal voters.

Verifying your registration

The secretary of state's My Voter Status website allows residents to check their voter registration status online.

Voter ID requirements

California does not require voters to present identification before casting a ballot in most cases.

On September 29, 2024, Gov. Gavin Newsom (D) signed SB 1174 into law prohibiting any jurisdiction in the state from adopting a local law that requires voters to present ID before voting.

The federal Help America Vote Act requires that individuals who register to vote by mail and who have not voted previously in a federal election in their state must provide either their driver's license or a paycheck, bank statement, current utility bill, or government document showing their name and address. Individuals voting by mail must include a copy of one of those documents with their absentee/mail-in ballot.

These requirements do not apply if an individual submitted a copy of their identification, their driver's license number or the last four digits of their Social Security number when registering to vote.

The following list of accepted ID to comply with HAVA requirements was current as of October 2025. Click here for the California Secretary of State page to ensure you have the most current information.

“

Current and valid photo identification provided by a third party in the ordinary course of business that includes the name and photograph of the individual presenting it. Examples of photo identification include, but are not limited to, the following documents: driver's license or identification card of any state; passport; employee identification card; identification card provided by a commercial establishment; credit or debit card; military identification card; student identification card; health club identification card; insurance plan identification card; or public housing identification card. Any of the following documents, provided that the document includes the name and address of the individual presenting it, and is dated since the date of the last general election…: utility bill; bank statement; government check; government paycheck; document issued by a governmental agency; sample ballot or other official elections document issued by a governmental, agency dated for the election in which the individual is providing it as proof, of residency or identity; voter notification card issued by a governmental agency; public housing identification card issued by a governmental agency; lease or rental statement or agreement issued by a governmental agency; student identification card issued by a governmental agency; tuition statement or bill issued by a governmental agency; insurance plan card or drug discount card issued by a governmental agency; discharge certificates, pardons, or other official documents issued to the individual by a governmental agency in connection with the resolution of a criminal case, indictment, sentence, or other matter; public transportation authority senior citizen and disabled discount cards issued by a governmental agency; identification documents issued by governmental disability agencies; identification documents issued by government homeless shelters and other government temporary or transitional facilities; drug prescription issued by a government doctor or other governmental health care provider; property tax statement issued by a governmental agency; vehicle registration issued by a governmental agency; or vehicle certificate of ownership issued by a governmental agency.

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See also

Local measures

• Local measures in 2024
• Local abortion on the ballot

• San Francisco County measures

California

• California 2024 local measures
• Local ballot measures, California
• San Francisco, California

News and analysis

• State and local preemption conflicts
• Measures advancing national agendas