Abortion in Ohio, Part 1: This Is Where Abortion Currently Stands

This is what abortion care and access look like in Ohio right now.

Jun 29, 2022 at 5:18 pm
click to enlarge Abortion-rights advocates gather in Cincinnati in May. - Photo: Mary LeBus
Photo: Mary LeBus
Abortion-rights advocates gather in Cincinnati in May.

This story is part of CityBeat's and Cleveland Scene's feature package about what the June 24 reversal of Roe v. Wade means in Ohio. Read more stories in our abortion series.

What is an abortion?

The Cleveland Clinic defines abortion using two separate methods for the procedure: medication abortion and surgical abortion. The clinic’s definitions are as follows:

Medical abortions (nine weeks of pregnancy or less): A woman will take two different medicines (usually within a 48-hour period). The medication is given by a healthcare provider and is either taken in the provider’s office or at home (or a combination of both). Your healthcare provider will give you specific instructions about how and when to take the medications.

Surgical abortions: In this type of abortion, a healthcare provider will surgically remove the embryo from the uterus. These types of abortions require mild sedation, local anesthesia (numbing an area) or general anesthesia (fully asleep). Some other terms for surgical abortions are in-clinic abortions, aspiration abortions and dilation and curettage (D&C) abortions. Some reasons women have a surgical abortion are personal preference, too far along in pregnancy or a failed medical abortion.

At six weeks gestation, an embryo is not yet a fetus and is about 3.5-6 millimeters, or roughly the size of a grain of rice. In comparison, a blood clot commonly passed during a typical menstrual period is about the size of a dime, or 17 millimeters.

What abortion services are currently legal in Ohio?
Prior to Dobbs v. Jackson Women’s Health Organization, abortion was legal in Ohio until 20 weeks gestation; as of press time, it is only legal until just six weeks gestation. Lebanon, Ohio, is the only city in the state where abortion is outlawed, but there was no provider there when the procedure was banned in almost all cases in 2021.

How many abortions happen in Ohio?
Ohio Department of Health data for 2020 shows there were 151 cases of abortion care per 1,000 cases of live births. Abortion care, overall, has trended downward since 2000, with the exception of slight increases in 2012 and 2020, according to data released annually from ODH.

The gestational time frame when a patient seeks abortion care also has steadily skewed earlier. There were 20,605 legal cases of abortion care in Ohio in 2020, according to ODH. Of those cases, 62.3% happened before nine weeks gestation, and 25.4% happened between nine and 12 weeks. That means 87.7% of cases of abortion care occurred within the first trimester.

Only about 10% of abortion care cases happened between weeks 13 and 18, and there were 441 cases involving pregnancies of 19 weeks or more.

What kind of abortion care is used in Ohio?
About 47% of abortion treatments were carried out using mifepristone, commonly known as the “abortion pill,” according to ODH. The number of patients receiving mifepristone (as opposed to using methods like curettage or dilation with evacuation) has seen a steep increase since 2015, when only 4% of patients were prescribed the pill.

Who seeks abortion care in Ohio?
2020 data from ODH shows that 59.2% of patients were ages 20-29 and 28.9% were in their thirties. Black patients accounted for 48.1% of abortion care patients, with 43.8% listed as white. A majority of patients — 81.8% — had never been married. Patients were likely to already have children, with 24.3% having one child and 38.4% having two or more children.

What kind of abortion care will be available in Ohio now that Roe v. Wade is overturned?
The 2019 “Heartbeat Bill” passed by the Ohio legislature limits a patient’s right to terminate a pregnancy after the detection of a "fetal heartbeat," sporadic electrical flutters which occur after about six weeks and before many people even know they’re pregnant (medical experts say this is not an actual heartbeat). There are few allowances for a person to get an abortion after six weeks, and there are no exceptions for rape or incest. Doctors who perform abortions can be charged with a fifth-degree felony. Previously under an injunction, that bill became state law the evening Dobbs and Roe were decided.

Ohio Republicans also are prioritizing bills like House Bill 598, which would eliminate access to abortion care almost entirely. It would only permit an abortion in narrow medical cases, offering loose language that makes medical exemptions hazy. Multiple physicians would need to determine that the procedure is “necessary to prevent the pregnant individual’s death or a serious risk of the substantial and irreversible impairment of a major bodily function.” A doctor can get around some of the hoops in the case of an emergency, but the bill doesn’t define what qualifies as an emergency.

HB 598 uses language that does not align with terminology defined by medical professionals. Cleveland Clinic’s definition of abortion refers to the removal of an embryo, whereas HB 598 refers to the organism developed from the point of fertilization as “an unborn child.”

Nonetheless, Ohio Gov. Mike DeWine has said he would sign the legislation.

Will there be repercussions for those who perform or seek abortion care in Ohio?
Abortion care won’t just be inaccessible but criminal under Ohio's new and potential laws. Those caught performing abortion care could face felony charges, hefty fines and jail time — up to $10,000 and 25 years in prison under House Bill 598. Likewise, “promoting” abortion services would also be a misdemeanor, and a physician could lose their license. For now, Ohio’s bills provide legal immunity to a patient; only those performing abortion procedures would be liable, but patients would be able to sue providers in a wrongful death cause of action. Other bills could be developed that criminalize more participants, including patients.

What do Ohio voters think of abortion access?
A Pew Research Center study finds 48% of Ohioans approve of abortion care access in all or most cases. About 61% of Americans nationwide approve of abortion care.

What’s next for Ohio?
With Roe v. Wade overturned, individual states have the power to set their own rules about not just abortion, but also bodily autonomy and privacy. The outcome will create vast swaths of land where abortion care is inaccessible, forcing patients to travel great distances for care. Ohioans would need to travel to states like Illinois, New York or Maryland, which have abortion protections in place.

Are abortions legal in Kentucky?
The decision on Dobbs has effectively and immediately banned abortion care in the state of Kentucky. The Commonwealth’s 2019 “trigger” law bans abortions except in order to prevent the death of or “the serious, permanent impairment of a life-sustaining organ” of a pregnant person. It does not provide exceptions in cases of rape or incest. Kentucky’s law also states that any person who performs an abortion or provides relevant medication can be charged with a Class D felony, which is punishable by up to five years in prison.

People in Kentucky who want an abortion can travel to Ohio while abortion care is still accessible in the Buckeye state (for now). Ohio Department of Health data from 2020 shows that 5.7% of abortions in Ohio were for people from out of state.

With Roe now reversed, CityBeat is exploring what comes next for Ohioans seeking abortion resources and reproductive care. Click below to read our in-depth stories about each topic.
Editor’s note: Some of the people and organizations quoted in this feature frame their abortion language around “women,” meaning a sex assigned at birth. But transgender men, intersex individuals, non-binary individuals and agender individuals also receive abortion care. We will continue to explore abortion issues that affect all individuals in future stories.

This feature is a collaborative effort by reporters and editors at CityBeat in Cincinnati and Cleveland Scene in Cleveland, including Sam Allard, Allison Babka, Madeline Fening, Vince Grzegorek, Gennifer Harding-Gosnell, Maggy McDonel, Ashley Moor and Maija Zummo.

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