Abortion rights have continued to change in the U.S. a year after Roe fell. Access to reproductive care is not always as simple as voting yes or no on a ballot, in fact only one state is voting to enshrine abortion into its constitution in this election. In other cases, who is elected into office or who sits on the Supreme Court are big factors that can have an impact on what reproductive freedoms citizens are allowed – now or in the future.

As the political pendulum swings, the focal points shift to states where crucial decisions hold the potential to shape the destiny of bodily autonomy.

In the 2023 General Election, voters in Ohio, Pennsylvania,Virginia and Kentucky are making decisions that will either directly or indirectly influence their reproductive rights. Here’s why our eyes are on voters in these states.

Ohio

Ohio is the only state voting on whether abortion will be enshrined as a constitutional right in this election. Issue 1 on the ballot, if approved, would include the “The Right to Reproductive Freedom with Protections for Health and Safety” amendment to Ohio’s constitution, allowing each person the right to make decisions on their own reproductive medical treatment including abortion, contraception, fertility treatment, continuing one’s pregnancy and miscarriage. It would also extend protection to providers who help people seek reproductive care.

As Reckon reported last month, misinformation has infiltrated the election through political ads making false claims of what voting yes on Issue 1 would allow, and the usage of non-medically accurate language like partial birth abortion. The term partial birth abortion refers to a procedure that was federally banned in 2007, and would not be legal in Ohio whether Issue 1 passes or not.

“This notion of partial abortions, in my mind, is language that conservatives have used to try to push this notion of fetal personhood. I don’t necessarily equate those with science, so much as they are words to help incite people to particular a position,” Dr. Regina Davis Moss, President and CEO of In Our Own Voice told Reckon.

Ohio’s six-week abortion ban is not currently enforced due to a temporary restraining order and preliminary injunction against it. However, if voters do not pass Issue 1 then the Ohio Supreme Court has the power to uplift the injunction, reinforcing the strict ban which has no exception for rape or incest.

According to Ballotpedia, voting “yes” on Issue 1 in Ohio supports the constitutional amendment to allow people the right to make decisions about reproductive care and allows the state to restrict abortion after fetal viability except in cases that could result in death or injury to the patient.

Pennsylvania

The stakes are high in Pennsylvania as voters prepare to elect a new member to the Pennsylvania Supreme Court. Democrat Daniel McCaffery and Republican Carolyn Carluccio are facing off in what’s proving to be a costly election. In late October, the Associated Press reported that combined campaign spending surpassed $17 million.

A group of local voter engagement and reproductive rights organizations banded together to launch the “Can’t Trust Carluccio” tour, traveling through counties to shed light on Carluccio’s stance on abortion and how they feel her election could disrupt reproductive rights in the state. They accuse Carluccio of not only being pro-abortion, but trying to hide her stance. A resume on Carluccio’s website, which stated that she is a “Defender of 2nd Amendment Rights and All Life Under the Law.” was removed earlier this year, according to The Keystone. Carluccio has also been endorsed by the Pennsylvania Pro-Life Federation.

Even with the potential addition of a conservative judge, four out of the seven seats on the bench are already filled with Democratic justices, reports The Guardian on Nov. 4. While it would not disrupt the Democrat’s upper-hand in the court, it would narrow down their lead to only one vote, which has the potential to sway future court decisions.

Voting in McCaffery would strengthen the Democrat court majority, making it more challenging for anti-abortion initiatives to pass through the state’s highest court.

Virginia

Virginia is the last Southern state without harsh abortion restrictions, but Gov. Glenn Youngkin has made clear his hope to implement a 15-week ban in the state. Both the House and Senate have the potential to flip majority in this election, and if Republicans gain full control it’s predicted a stricter ban will likely follow.

Khenia Haro-Perez, Virginia State Policy Advocate at the National Latina Institute for Reproductive Justice says an attempt at passing a ballot initiative, similar to Ohio’s, that would have enshrined abortion rights into the state constitution failed this year, but with the potential for Democrat control in 2024, Haro-Perez hopes it could make it past the floor.

“If we’re in the minority in both the house and the senate, then we will not only not be able to introduce a constitutional amendment again, but we will be on the defense to all of the opposition pieces of legislation that the opposition is going to put up,” said Khenia Haro-Perez, Virginia State Policy Advocate at the National Latina Institute for Reproductive Justice.

Virginia has become a haven for folks living in neighboring states who cannot access abortion where they live, according to local providers. Instituting a stricter policy in Virginia would mean abortion seekers would have to travel further to receive care or risk not being able to access an abortion at all.

“The communities that have been historically marginalized are the ones that have already been facing the brunt of these national bans on abortion. If things go awry this election season, the people that have been most marginalized already will feel the weight of that even more,” said Haro-Perez.

All 40 state Senate seats and 100 state House seats will be on the ballot, according to PBS News Hour. Voters looking to prevent further abortion restrictions in Virginia can vote to prevent the GOP from gaining legislative majority.

Kentucky

Abortion is completely illegal in Kentucky, with a trigger law that only allows abortion in cases of potential death or disability of a patient and separate six-week ban with no exceptions for rape or incest.

Democratic Gov. Andy Beshear is seeking re-election against Republican nominee Daniel Cameron, who previously succeeded Beshear as state attorney general. Cameron has used his stance on abortion as a major platform of his campaign, with political ads stating, “Only one candidate stopped abortion in Kentucky, Daniel Cameron.”

Abortion is a key issue for Beshear as well with ads specifically addressing his opponent, “This is to you, Daniel Cameron. To tell a 12-year-old girl she must have the baby of her stepfather who raped her is unthinkable.”

Though Kentucky is a red state, initiatives against abortion have not always passed.  Last year, Kentucky voted against a ballot measure to deny abortion constitutional protection.

Beshear says he will continue to fight for abortion rights if elected, while Cameron referred to himself as the pro-life candidate in a televised debate last month.