In a monumental victory for abortion rights, Ohio voters have chosen to enshrine reproductive freedom in the state constitution. Based on election returns, over 58% of voters supported the ballot initiative known as Issue 1, approving a constitutional amendment to protect abortion access in the Buckeye State.

The passage of Issue 1 marks a significant win for abortion rights advocates in a historically conservative Midwestern state. Ohio is the first state to amend its constitution to explicitly protect abortion since the overturning of Roe v. Wade by the Supreme Court in June 2022. The amendment will preclude the state legislature from enacting bans and restrictions on abortion care.

“This is one of the greatest moments of my life, working so hard with my team beside me to achieve reproductive rights and freedoms in Ohio,” said Kate Gillie, an Issue 1 supporter, amid emotional celebrations on election night. “We’ve got two little girls and this is about their future and their reproductive rights.”

The approved amendment will establish an individual right to reproductive healthcare, including abortion, within Ohio’s governing document. It blocks the state from prohibiting abortions prior to fetal viability, generally considered around 23–24 weeks gestation. After viability, abortions would remain legal if a doctor determines the procedure is necessary to protect the pregnant person’s life or health.

Passage Follows Months of Heated Campaigning

The passage of Issue 1 comes after months of contentious campaigning between pro-choice and anti-abortion groups. Supporters of the amendment contended it was necessary to forestall a total abortion ban in Ohio. Without constitutional protections, they warned the Republican-controlled legislature could outlaw abortion even in cases of rape, incest, or medical emergencies.

“Issue 1 will provide a safeguard in our state constitution to ensure that abortion care remains legal and accessible in Ohio,” said Iris Harvey, president of Planned Parenthood Advocates of Ohio, speaking to voters ahead of Election Day. “It will mean that blanket abortion bans proposed by extremist politicians cannot take effect.”

Opponents argued that Issue 1 was too extreme, incorrectly claiming it would allow unfettered access to late-term abortions. “Issue 1 would mean elective late-term abortions — abortions even minutes before birth — would be unrestrained and allowed,” said Molly Smith, president of Cleveland Right to Life.

In reality, the amendment only permits later abortions if a doctor confirms there are serious risks to the pregnant person’s health. According to the American College of Obstetricians and Gynecologists, abortions after 21 weeks represent just 1% of all procedures and often involve rare, severe fetal abnormalities or life-threatening medical complications.

Record Spending on Both Sides

The high-stakes campaign over Issue 1 sparked record spending, with pro-choice groups raising over $46 million to support the ballot measure. On the other side, anti-abortion organizations ponied up around $16 million to defeat it, according to campaign finance filings.

Much of the funding came from out-of-state donors and advocacy groups on both sides of the debate. The anti-amendment group Protect Ohio’s Children drew substantial contributions from anti-abortion organizations in Washington D.C. and other states.

“Our hearts are broken tonight not because we lost an election, but because Ohio families, women and children will bear the brunt of this vote,” Protect Ohio’s Children said in a statement after projections showed Issue 1 passing. “We stand ready during this unthinkable time to advocate for women and the unborn.”

Momentum Behind Abortion Rights Continues

The success of the Ohio amendment is the latest demonstration of voter support for abortion access heading into the 2024 elections. It extends an unbroken streak for pro-choice ballot initiatives in the wake of the Dobbs decision.

Voters in red states like Kansas and Kentucky have already rejected constitutional amendments designed to eliminate protections for abortion. Meanwhile, blue state voters in California, Michigan, and Vermont have voted to enshrine reproductive freedom in their state constitutions.

Political analysts say the victory for Issue 1 in Ohio — a perennial swing state — is an encouraging sign for Democrats. It suggests abortion could remain a galvanizing issue for liberal-leaning voters going into the next presidential race.

“If the ballot initiative passes really easily it will confirm that voters are still mad” about loss of abortion rights, said Mary Ziegler, an expert on reproductive law at the University of California. “But it won’t confirm abortion is a priority issue for them — that’s a different question.”

President Biden hailed the result as a rebuke of Republican officials pushing for abortion bans. “Ohioans and voters across the country rejected attempts by MAGA Republican elected officials to impose extreme abortion bans,” he said.

Outlook in Other States

The passage of constitutional protections in Ohio comes as abortion access hangs in the balance in neighboring states. In Kentucky, the fiercely contested gubernatorial race between Republican incumbent Andy Beshear and challenger Daniel Cameron will help determine whether the state’s last two abortion clinics stay open. Both clinics have temporarily halted services in anticipation of an immediate ban if Cameron wins.

Meanwhile in Virginia, Republican state lawmakers are poised to advance new abortion restrictions if the GOP wins control of the legislature on Tuesday. “If Republicans get the majority, they will definitely pass abortion restrictions,” said Tarina Keene, executive director of NARAL Pro-Choice Virginia. “Our reproductive freedom is on the line.”

With abortion rights now guaranteed at the state level, Ohio is likely to see an influx of patients traveling from states with bans or looming restrictions. Though abortion opponents succeeded in eliminating federal protections, Tuesday’s result shows most voters in the Buckeye State believe the decision should remain between a patient and their doctor.