When Annie Boyle picked up the phone, the woman at the other end of the line wanted to know: what’s going on with Ohio’s abortion referendum?
As a patient advocate at Preterm, a sprawling abortion clinic in Cleveland, Ohio, Boyle is used to confusion over Ohio’s six-week abortion ban, which took effect shortly after the US supreme court overturned Roe v Wade, but is now on hold. “I’m old, I don’t need an abortion,” the woman on the phone said, but she sounded disturbed by the ban.
“Six weeks?” the woman exclaimed, according to Boyle, who recounted the call. “What if I was raped?”
On Tuesday, Ohioans will head to the polls to vote on Issue 1, a proposal to enshrine abortion rights into the state constitution. The stakes are high: if Issue 1 fails, abortion rights supporters suspect that the Ohio supreme court will reinstate the six-week ban. It does not include exceptions for pregnancies resulting from rape or incest.
“It’s just really terrifying to think about. I don’t know anyone who’s not scared,” said Sri Thakkilapati, the clinic’s executive director. “There’s a kind of moral injury that comes with fighting so hard to provide this care, because you think it’s the right thing – and then not being able to do it and having to turn literally hundreds of people away each week.”
Staffers at Preterm are haunted by memories of the six-week ban, which was in effect for just under three months before a state court blocked it. The day Roe fell, they had just a few hours before Ohio moved to implement it. They rushed to squeeze in as many procedures as possible; at one point, a doctor performed an abortion on his knees because he couldn’t grab a stool quickly enough, one Preterm staffer recalled. The clinic’s senior staff stayed late into the night to call patients and cancel their upcoming appointments.
“Some people were completely devastated – screaming, crying on the phone,” recalled Kelsey Bowman, Preterm’s director of operations. “As empathetic human beings, you’re just like: ‘This is awful. This is the worst. I’m having to tell somebody that they can’t receive their care here and they have to go out of state.’ And then so many people were saying: ‘I can’t possibly do that.’”
A court paused the ban in September 2022. A year later, the Ohio supreme court heard arguments in the case, but the justices have not yet ruled.
Over the months that the ban was in effect, abortions fell by 60% at Preterm, Thakkilapati said. After the courts froze the ban, Preterm employees called the patients who were still early enough in their pregnancy to get abortions.
“Many of them had gone out of state, and the people who didn’t came back and had an abortion here,” Thakkilapati said. “They hadn’t changed their mind. They didn’t want to continue their pregnancy. They just were being forced to be pregnant.”
Preterm is among the first legal abortion clinics in the United States: a group of women opened the clinic in March 1974, months before US women gained the right to open credit cards in their own name. Now, Preterm normally performs abortions up to 21 weeks of pregnancy and accounts for somewhere between a fifth and a fourth of all abortions in Ohio.
On Friday, just days before the vote, Preterm appeared back to business as usual. Staffers in scrubs worked briskly, bringing ginger ale to patients who had just undergone abortions and helping patients who were preparing for the procedure stretch out on top of couches and under heating pads. Others manned the phone lines in the call center, softly answering questions about morning-after pills, ultrasounds and periods.
However, reminders of the referendum were everywhere. The street outside Preterm was littered with at least a dozen signs urging people to vote either for and against Issue 1. A handful of protesters milled amongst the Issue 1 signs and carried signs of their own. One woman stood near the clinic driveway with a sign that read, “It’s Not Too Late to Change Your Mind.” Bright yellow posters that read “STOP KILLING BABIES HERE” and “MOMMY LET ME LIVE” were propped up near the clinic.
Bellamy Morales, a Preterm patient advocate, accessorized their bright blue Taylor Swift cardigan with a shirt bearing the words “Ohioans for Reproductive Freedom”, a name of the coalition backing Issue 1. The stress of the ban – and the chance that it may cost them their job – had led Morales, whose pronouns are they/she, to check into a mental health center in summer 2022.
Now, Morales said that they are “cautiously excited” about the vote on Tuesday. Polling looks good for abortion rights supporters: in an October poll, 58% of Ohio residents said they would vote in favor of Issue 1. But Donald Trump’s surprise victory in 2016 tempered her optimism.
“I want so much for it to be OK and to pass and to be able to celebrate with everyone,” Morales said. “But I think, at least for me, 2016 has shown you don’t really know for sure – you can make all the projections and think it’s gonna pass, but you’re never 100% sure.”
Preterm staffers are preparing, both logistically and emotionally, for the possibility that the ban will snap back into effect. They are ready to provide patients with the resources they need to potentially go out of state.
“It’s very nerve-racking to have to wait,” Bowman said. “But having to make those phone calls again – it’s just a nightmare scenario.”
