Ohio voters resoundingly approved a ballot measure enshrining a right to abortion in the State Constitution, according to The Associated Press, continuing a winning streak for abortion-rights groups that have appealed directly to the public as they try to recover from the United States Supreme Court’s reversal of Roe v. Wade.

Issue 1, as the ballot measure is known, had become the country’s most-watched race in the off-year elections, as both parties try to gauge whether voter anger over the loss of the federal right to abortion could help Democrats in next year’s presidential and congressional races.

National groups on both sides of the debate poured money into Ohio in recent weeks, delivering a frenzy of ads and canvassers, arguments and misinformation.

While abortion-rights groups prevailed in six out of six state ballot measures last year, Ohio was considered the toughest fight yet. And the victory lifted the hopes of abortion-rights groups pushing similar measures next year in red and purple states, including Arizona, South Dakota, Missouri and Florida.

“Tonight’s results are not an outlier or a fluke. Seven times abortion has been put on the ballot across the country, and seven times voters have turned out overwhelmingly to defend it,” said Mini Timmaraju, president of Reproductive Freedom for All, formerly Naral. “Once again, voters sent a clear message to Republicans and anti-abortion extremists: We believe in the right to abortion, and we are the majority.”

Democrats facing tough odds next year quickly hailed the victory, suggesting how much their hopes are riding on popular support for reproductive rights. President Biden, who polls show remains largely unpopular in Ohio, issued a statement soon after the vote was called, declaring that voters across the country had “rejected attempts by MAGA Republican elected officials to impose extreme abortion bans” that are “out-of-step with the vast majority of Americans.”

Senator Sherrod Brown of Ohio, one of the Democrats’ most endangered incumbents in 2024, similarly warned that Republicans would “overrule Ohioans by voting for a national abortion ban” if they took control of the Senate.

Anti-abortion groups who had triumphed with the overturning of Roe 18 months ago now cast themselves as the underdog.

“The same pro-life movement that worked almost 50 years to undo the wrongs of Roe v. Wade will not be discouraged,” said Kristan Hawkins, president of Students for Life Action, calling the fight “a marathon, not a sprint.”

“Win or lose, our work continues,” she said.

Polls had consistently showed that nearly 6 in 10 voters supported the Ohio ballot measure. But anti-abortion groups had powerful allies among the Republicans who control the state government.

From the governor and attorney general on down, they had leaned on the power of their offices to try to thwart the measure. They called a special election in August to try to make ballot amendments harder to pass, and purged voter rolls in recent weeks. They rewrote the language that appeared on the ballot, adopting the terms of anti-abortion groups to play to voter unease that the measure would lead to more abortions late in pregnancy.

A coalition of abortion rights groups supporting the amendment had appealed to Ohioans’ — and Americans’ — suspicion of government interference. They urged voters to keep politicians out of decisions about their health and families.

That argument seemed to resonate with many “yes” voters, across party lines. Exit polls showed women in particular remain angry about the Supreme Court’s decision in Roe.

“It’s not up to the government to decide what we do with our bodies,” said Alissa Carver, 26, who lives outside Cincinnati and describes herself as an independent voter. “It’s for us to decide, it’s our experience.”

Wendy Pace, a 52-year-old independent, said she didn’t normally vote in off-year elections, but came out because she wanted to vote “yes” on Issue 1.

“I have a teenage daughter and I don’t like having my rights taken away from me,” she said. “I fear that this is just the beginning of rights being taken away, and I do fear for my daughter and what her rights would be going forward.”

In Shaker Heights, Maxine Williams, 82 and a Democrat, said she was “old enough to remember when women had to go underground and do these back alley abortions.”

“Aren’t the Republicans against government interference? Yet they’re doing that,” she said. “It boggles my mind they’re acting this way.”

Lauren Beene, a pediatrician and the executive director of Ohio Physicians for Reproductive Rights, said the victory was a credit to “giving the people the opportunity to use their voice.”

“Ohio has such a gerrymandered government that it’s disrupted the ability of Ohioans to voice their real opinions,” she said. “When you put democracy in the hands of the people and look to see what the majority opinion is, this is what happens.”

The measure had been initiated largely by doctors, and it was helped by public outrage over the consequences of an abortion ban that the legislature passed in 2019.

That ban, which prohibited abortion after roughly six weeks of pregnancy with almost no exceptions, was on hold pending a ruling from the State Supreme Court, but was in effect for 82 days after Roe’s reversal. In that time, the state drew national headlines when a 10-year-old rape victim had to travel to Indiana for an abortion because Ohio doctors said they could not provide one.

“I think mothers’ lives are important. I think babies’ lives are important. But if a little girl is raped at 10 years old, I don’t think she should have to carry the baby if she is pregnant,” said Delena Reed, 65, a registered Republican who considers herself “pro-life” for religious reasons, yet voted yes on Issue 1.

The results of Issue 1 will almost certainly require the court to invalidate the six-week ban.

Just as national polls showed that Democrats were more likely to turn out and vote on abortion in last year’s midterms, exit polls in Ohio on Tuesday suggested that Democrats had turned out in greater numbers than Republicans.

Returns showed more support for the amendment in metro areas including Cleveland and Columbus, with rural areas more likely to vote against the measure. But even in Mahoning County in northeastern Ohio, considered Trump country, the “yes” vote won.

The yes vote won with Republican support, and despite confusion among many voters about what a yes vote would mean — as well as the fact that voters have historically been more inclined to vote “no” on changing the Constitution.

The measure amends the State Constitution to say that individuals have the right to make their own reproductive decisions, including on abortion. The state may prohibit abortion when the fetus is viable outside the uterus — around 23 weeks — except when a pregnant woman’s doctor determines it is necessary to protect her health or life.

Abortion opponents argued that it was too extreme for Ohio, and would eliminate parental notification laws on abortion and allow children to get gender-transition care without input from their parents. Constitutional scholars said the amendment would do neither.

Greg Eubanks, a 58-year-old voter who described himself as “conservative, but pro-choice,” said he could have gone either way on the measure, but “those things concern me.”

“Issue 1 is so far that I voted no against it,” he said, “but I am going to lobby our Republican leadership to soften the language of the current abortion restrictions, which are ridiculous.”

The success of Issue 1 shows how much the debate and dynamic around abortion have changed since the Supreme Court overturned Roe last year. Immediately after the decision in June 2022, abortion rights groups seemed to have little way forward, and focused mostly on filing lawsuits to try to stop abortion bans that took effect in more than a dozen states.

Abortion opponents, on the wings of their victory at the court, pushed ballot measures saying there was no right to abortion in state constitutions in Kentucky and Kansas. But after those measures failed, and ballot measures to establish abortion rights succeeded, anti-abortion groups have been on the defensive.

In Ohio, they were far outspent by abortion rights groups.

“Issue 1 passed because abortion activists and outside Democrat donors ran a campaign of fear to Ohio voters: Vote for this ballot measure or women will die,” said Marjorie Dannenfelser, president of SBA Pro-Life America.

And Mari Urbina, the managing director of the Indivisible Project, the left-leaning group started in opposition to the election of President Donald J. Trump in 2016, said: “We’re taking notes from this win in Ohio. Now we look ahead to Arizona and so many other battlegrounds where voters will be the firewall for our democracy.”

Still, the power of ballot measures to restore abortion rights and to help Democrats may be limited. Roughly 10 states allow citizen-sponsored ballot measures and also restrict abortion. And support for abortion-rights measures in other states has not always translated into support for Democratic candidates.

Abortion opponents are looking to block future ballot initiatives. In states like Missouri and Arizona, they have begun “decline to sign” campaigns, hoping to persuade voters not to sign the petitions required to put the measures on the ballot.

Rachel Richardson and Daniel McGraw contributed to this story.

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