Tens of millions of dollars have poured into television advertising in the four states with major elections on Tuesday, a sign of the national implications of their outcomes.

Whether they are about state legislators in Virginia, a constitutional amendment in Ohio, or candidates for governor in Kentucky and Mississippi, the ads share a few themes.

Threats to abortion rights are prominent in ads for Democrats, even in states where the issue isn’t explicitly on the ballot. Since the overturning of Roe v. Wade last year, Democrats have found electoral success in galvanizing opposition to restrictive abortion laws.

Advertisements for Republican candidates, in turn, often hitch the Democrats to President Biden’s record, as well as to inflation, taxes and prevailing economic uncertainty. And if Republican candidates have been endorsed by former President Donald J. Trump, it is a good bet that will show up in their ads.

In Ohio, voters will be asked to vote “yes” or “no” on Issue 1, a ballot initiative that would enshrine a constitutional right to “carry out one’s own reproductive decisions” — effectively blocking the Republican-controlled legislature from enacting a strict anti-abortion bill.

But confusion about the language of the initiative, including what limits on abortion it would allow the state to impose, has been amplified by misinformation and exaggeration on and off the airwaves.

One ad put out by Protect Women Ohio — an anti-abortion group that has spent more than $6.7 million on advertising time, according to AdImpact, a media tracking firm — features the state’s Republican governor, Mike DeWine, and his wife, Fran, who says: “Issue 1 would allow an abortion at any time during a pregnancy, and it would deny parents the right to be involved in their daughters making the most important decision of her life.”

(The statement is misleading — the amendment explicitly allows the state to restrict the procedure after the point of fetal viability, around 23 weeks, unless the patient’s doctor finds the procedure necessary to protect the patient’s life or health.)

Most of the “vote no” ads speak to the discomfort among voters with late-term abortions, which data shows are very rare and are usually performed in cases where doctors say the fetus will not survive.

Ohioans United for Reproductive Rights, a coalition of abortion rights groups supporting the amendment, has spent $19.5 million on advertising since early September, the AdImpact analysis shows. The group’s ads, and the “vote yes” ads generally, frame the issue as government interference in personal health care decisions and in doctors’ abilities to make lifesaving decisions.

They also raise alarms about young girls being forced to bear the child of a rapist. In one ad, a man says: “The state is trying to ban abortion, even in cases of rape. When I hear that, all I can think of is — what if it’s my daughter?”

All 140 seats in Virginia’s General Assembly are up for election, and Gov. Glenn Youngkin, a Republican, is leading an effort to swing both chambers to G.O.P. control. The election will serve as a barometer of Mr. Youngkin’s popularity, gauge the local mood about Mr. Biden and test whether abortion continues to mobilize voters.

In all, about $72 million, including money from national groups, has been spent on advertising time in the state, with a dozen of the most competitive races accounting for about $50 million in ads.

Generally, Democrats have argued that if Republicans prevail, Virginia will join other Southern states in sharply restricting abortion rights, while Republicans’ ads have focused on tax cuts and job creation. Many of them feature Mr. Youngkin.

Some ads have featured pointed attacks, with accusations of racism, socialism and grift. But in the closest-fought races, some candidates have sought to find a middle ground — Democrats citing their gun ownership, or Republicans saying they want to protect women’s rights.

Gov. Andy Beshear, a Democrat, and committees supporting him have spent $46.9 million on advertising entering the election, according to AdImpact’s analysis, far exceeding the $28.6 million spent in support of his Republican opponent, Daniel Cameron, the state’s attorney general.

Nearly all of that spending has come from two entities — Mr. Beshear’s campaign and Defending Bluegrass Values, a committee backed by the Democratic Governors Association — each of which have spent more than $23 million.

Ads supporting Mr. Beshear have focused on two major themes: hammering Republicans for their opposition to abortion rights, and Mr. Beshear’s record on infrastructure and economic growth. The ads have steered clear of mentioning Mr. Biden, who has low approval ratings nationally and especially in heavily conservative Kentucky.

Mr. Cameron’s campaign ads have painted the popular Mr. Beshear as an ally of Mr. Biden, caving to the left on crime, L.G.B.T.Q. rights and schools. Ads supporting him, many of which are linked to national organizations, including the Republican Governors Association, have heavily featured Mr. Trump’s endorsement of Mr. Cameron (which also includes digs at Mr. Biden).

In Mississippi, Gov. Tate Reeves, a Republican who has been weakened by a sprawling welfare scandal involving well-connected G.O.P. donors, has also banked on Mr. Trump’s endorsement.

That support is featured in an ad painting Mr. Reeves’s Democratic opponent, Brandon Presley, as a puppet of “Joe Biden’s people.” (Another ad says Mr. Presley’s campaign money has come from “liberal states.”)

The two sides have spent a similar amount of money on ads— $8.5 million for Mr. Presley, $9.5 million for Mr. Reeves.

Ads for Mr. Presley — a cousin of Elvis Presley, with the voice to prove it — have focused on his upbringing and leaned into an argument that Mr. Reeves “doesn’t care about working people.”

Mr. Presley, who has said he is “pro-life,” has also campaigned on the expansion of Medicaid to the state. Healthcare is a major focus of Democratic ads in Mississippi, where hospitals are facing an acute funding crisis.

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