The Ohio Statehouse at night with lights on in the rotunda.
On November 7, will decide whether reproductive rights, including access to abortion, should be added to the state constitution. Credit: The Ohio Statehouse

This November, Ohio voters will decide whether reproductive rights, including access to abortion, should be added to the state constitution. This question appears on the ballot as Issue 1. 

The outcome of the election will have a significant impact on access to abortion in Ohio. The only state with an abortion rights amendment appearing on the fall ballot, Ohio is being watched closely nationwide. 

Here’s what access to abortion looks like today in Ohio

Currently, abortion is legal in Ohio up until 22 weeks of pregnancy. After that time, doctors can perform abortions if the pregnancy threatens the patient’s health or life.  

More than 18,400 abortions were reported to the Ohio Department of Health in 2022, according to a recent data report released by the state. Nearly 30% of abortion procedures took place in Cuyahoga County, according to state data. Sixty-seven percent of abortion procedures performed in Ohio were on women who were under nine weeks pregnant, according to the report. 

Beyond abortion care provided in hospital settings, Ohio currently has six full-service ambulatory surgical centers and three clinics that provide medication abortion services, according to the reproductive rights group Pro-Choice Ohio

How overturning Roe v. Wade affected abortion access in the state

Immediately after the U.S. Supreme Court overturned the landmark case,  which had prevented states from banning abortion, access to abortion temporarily changed in Ohio. 

The U.S. Supreme Court’s ruling cleared the way for Ohio’s 2019 “heartbeat law” to take effect. The law, which had been stalled by a legal challenge, banned doctors from performing abortion procedures once a fetal heartbeat can be  detected, which is around six weeks into pregnancy. The law made no exceptions for rape or incenst. 

It was in place for 11 weeks before Planned Parenthood, Preterm and other Ohio advocacy groups won a court ruling to temporarily block it again. It remains tied up in a Hamilton County court.

Even with some limitations on abortion services and a possible heartbeat bill looming, Ohio has become a destination for people seeking reproductive care from states with more restrictive options. 

Dr. Mae Winchester, a physician with Preterm Cleveland, a nonprofit abortion clinic in Cleveland, said the organization has seen an increase in out-of-state patients seeking services in the past year. 

Patients have traveled from surrounding states such as Indiana and Kentucky, where abortion services are banned, and Southern states such as Georgia, where abortions are severely restricted,  Winchester said. 

People have traveled very far to get the care they need,” Winchester said. “I’m really happy that Ohio can kind of be like a safe haven state for these people, even if it’s tentative for now.”

What abortion access will look like if Issue 1 fails 

The current state law,  which bans abortion procedures after 22 weeks, will remain in place until the challenge to the heartbeat law is resolved. 

If the heartbeat bill were to take effect, abortions could not be performed on patients after six weeks, which is before many people even know they’re pregnant. Physicians could face prison time, lawsuits and loss of their medical licenses for any violations if they operate on patients after six weeks.

Abortion rights advocates say that the heartbeat bill would in effect end abortion access in the state. 

Ohio abortion doctors worked under the state’s six-week ban for nearly three months in the summer of 2022, before the legal challenge resulted in an injunction. 

While surgical services at Preterm have resumed, Winchester said she is worried about patients who lack the resources and time to travel to receive abortion care if Issue 1 fails. 

Winchester said while the law will make it harder for people to get an abortion, there will be ways to get funding and community resources for patients to travel for care.

What abortion access looks like if Issue 1 passes 

The proposed amendment would allow the state to restrict access to an abortion after “fetal viability,” or when a fetus can survive outside the uterus, which is around 22 to 24 weeks into pregnancy. But it would also allow doctors to perform an abortion at any stage of pregnancy, regardless of viability, if the patient’s physician determines it is necessary to protect the person’s life and health. 

The proposed amendment would also guarantee that the state could not interfere in a person’s decisions about contraception, fertility treatment, miscarriage care and other reproductive care. 

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Health Reporter (she/her)
Candice, a Cleveland Documenter since 2020, has been a freelance writer whose reporting and digital media work have appeared in The Daily Beast, VICE, Cleveland Magazine and elsewhere. She has written about health, equity and social justice.