Washington (CNN) -- The failed referendum in Albuquerque, New Mexico, to ban abortions after 20 weeks of pregnancy is the first known instance of the issue being addressed at a local level, but it might not be the last.
"I think we'll see this more and more," said Mallory Quigley, communications director for Susan B. Anthony List, an anti-abortion group.
"We're constantly doing things on the local level in terms of outreach because those methods are very effective in bringing about social change in general," said Tara Shaver, who with her husband, Bud, is with the group Project Defending Life.
The Shavers call themselves "full-time pro-life missionaries." They moved to Albuquerque three years ago, after waging an anti-abortion battle in Kansas, because Albuquerque has one of the few abortion clinics in the country to perform abortions beyond 20 weeks.
Tara Shaver said the state legislature has repeatedly refused to take up a parental notification measure, one of the most basic steps for abortion opponents. The legislature "never gives our bill the time of day," she told CNN.
After watching a successful local campaign to place a minimum wage increase on the Albuquerque ballot in 2012, Shaver became inspired. She thought something similar could be done with abortion.
It worked. After collecting 27,000 signatures of support, the measure got its own special election.
While this is the first time a city has voted on whether to restrict abortions, the idea is not new.
Social movements often start at the grass-roots level as cities and localities often shift more quickly than the federal government.
That's where the movement to legalize marijuana got its start.
"Reformers have always used local referenda and initiative," Allen St. Pierre, executive director of the National Organization for the Reform of Marijuana Law, said.
Built on principles from the anti-Vietnam War protests, activists seized on a Nixon-era report that criticized the criminalization of marijuana. The report went nowhere at the federal level as Nixon was adamantly opposed to its findings, but activists used the report to organize in cities and towns in all 50 states, St. Pierre said.
University towns, especially in the Midwest, including Ann Arbor, Michigan, and Madison, Wisconsin, acted to decriminalize pot. It became a trend and is still happening today.
In this past election, three cities in Michigan voted to legalize pot. Although the vote was largely symbolic, it shows that local can still lead the way.
It's an effort "to get around recalcitrant legislators who don't want to even introduce bills," St. Pierre said.
Another Midwest town played a central role in the lesbian and gay movement as well. East Lansing, Michigan, was the first place in the country to prohibit discrimination based on sexual orientation. That was in the early '70s. Forty years later, Congress has still been unable to pass an LGBT workplace anti-discrimination bill.
Sarah Warbelow, state legislative director for the Human Rights Campaign, said her group "works with municipalities all the time" to pass and implement LGBT rights measures.
Pro-choice advocates, however, caution the anti-abortion activists from overstepping and trying to chip away at settled law.
"What we're actually seeing because of the groundswell of anti-abortion overreach, we're seeing the entire movement put into an offensive posture," said Ilyse Hogue, president of NARAL Pro-Choice America.
She added that Roe v. Wade is settled law and any attempt to roll back abortion access will get caught up in litigation. But the tactic also appeals to anti-abortion activists who hope the courts roll back Roe v. Wade.
"We are more than happy," Shaver said, "to assist... and encourage people in the cities who have problems with state legislatures."
And an activist has already begun the process to ban late-term abortions in Valencia, a county neighboring Albuquerque.