What It’s Like to Get an Abortion in Ohio

In April 2019, Ohio lawmakers passed a bill that would have criminalized abortion as early as six weeks into pregnancy. It was blocked on July 3—a week before it would have gone into effect—but in November lawmakers introduced another attempt to criminally penalize providers and patients as well.

Under the (blocked) six-week ban, abortion providers could have faced up to a year in prison. The most recent proposed legislation would create new types of criminal offenses such as “abortion murder” and “aggravated abortion assault”; offenses which are punishable by up to life in prison and the death penalty, respectively. It also includes a provision that would require physicians to attempt to re-implant ectopic pregnancies (which can be life-threatening) into the uterus, even though no such procedure exists.

As the law stands now, abortions are banned after 20 weeks of pregnancy (from fertilization), which is based on the inaccurate claim that a fetus may feel pain at that stage. There are exceptions if the pregnancy isn’t viable, or if the pregnant person faces irreversible damage to their health, or if their life is in danger, but no exceptions if the pregnancy is the result of rape or incest.

Most Ohio counties don’t have an abortion provider. There are currently just nine clinics in the state; two of which only provide medication abortion, which is only FDA-approved for use up to 10 weeks. Clinics must adhere to medically unnecessary standards, such as having “written transfer agreements” with a hospital that’s within 30 miles of the provider; publicly funded hospitals are banned from entering into such agreements with abortion providers. These rules have affected the operation of clinics, including The Center For Choice in Toledo which had to close after providing care for more than 30 years.

Here’s an overview of other current restrictions in Ohio:

• People must receive biased in-person pre-abortion counseling which is designed by the state to influence their decision. Providers are required to inform them of the fetus's gestational age and the risks associated with an abortion and carrying to term.
• Ultrasounds are required before every abortion. The provider doesn’t have to describe what the ultrasound shows, but they do have to offer the option to view the screen, which would include imaging of the heart activity.
• People must wait at least 24 hours after the ultrasound before having the abortion; requiring at least two visits to the clinic, and three for those who opt for a medication abortion.
• The same doctor who performed the ultrasound must also perform the abortion, which means people can’t use sonograms from their primary physicians or OB/GYNs, and if the doctor intending to perform the abortion suddenly becomes unavailable, the process must start from the beginning with a new provider.
• People under 18 must have written consent from one parent or legal guardian to access an abortion, unless they obtain a judicial bypass; or consent from a judge instead. The teen must get a judicial bypass in the same county where they live, and the judge is required to ask a series of questions based on medically inaccurate information. (Minors can contact abortion provider Preterm for help learning about the steps to obtain a judicial bypass; including local courthouses.)
• Insurance for public employees and health plans purchased under the Affordable Care Act are banned from covering abortion except in cases of rape, incest, or life endangerment. But some private insurance plans may provide coverage for abortions outside those circumstances, and some state health plans may offer "abortion riders" to purchase for an additional monthly cost. Most people pay for the costs completely out of pocket, or with the help of Women Have Options—Ohio’s statewide abortion fund.

This is one person’s story.

Kayla, 25, is a working, single parent of two children. She’s also had two abortions at Preterm, one of the largest abortion providers in the state. Several years before her first abortion, Kayla was incarcerated for a crime she says she didn’t commit. She was pregnant and requested an abortion, but the jail refused, so she continued the pregnancy.

She joined Preterm’s advocacy program called Patients to Advocates—a year-long paid fellowship which, according to Preterm, focuses on developing the leadership and engagement of patients who want to share their story. Through this program, Kayla has spoken at juvenile correctional facilities, where she’s provided young people support through sex education (which is often not adequately taught in school) and shared experiences. The interview has been edited for length and clarity.

Kayla: I knew as soon as I found out I was pregnant. There may have been different circumstances with both experiences, but the underlying reasons were the same each time. Not being able to access an abortion when I was incarcerated was awful, because back then I knew that I didn’t want kids because I was in a crazy situation. So when I needed an abortion again, but this time as a parent, I knew immediately that I wasn’t ready for another [child]. I know the responsibilities that come with that. And now that my kids are older, I can’t imagine another running around here .

Between the waiting period, the availability of the clinic, and my own schedule—I wasn’t able to just go in and have the abortion. I work and I have kids, but I knew what I needed to do and I wanted to do it immediately. It took me two weeks to get the abortion the first time, and the second time it took me three weeks.

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The first one, my insurance only covered something like $59, which left me with $300. At that time I didn't have any money, and it was not easy to come up with that. I borrowed it all until I got paid, but when I got paid that put me all the way in the hole, trying to pay for bills, groceries, and gas. I was struggling to pay for the second abortion, too, and I was able to get some financial assistance [from local groups].

There’s always protestors at that clinic. Every single day, whatever day it is, they’re there. As a spiritual person, it was hard not to let it get to me. I almost told my mom, who was with me, that I didn’t want to do it. It almost changed my mind, it was that powerful. I had never been in an abortion clinic before, and I had seen my friend go through a medication abortion when we were teens. Back then, I didn’t even know you could get an abortion from a clinic—I thought it was an underground thing. So even though I now know that bleeding and cramping is normal…what I saw [from her medication abortion] completely terrified me. But I worked up the courage to go inside, and I told myself that my mom wouldn’t let me do something harmful.

I spoke with a counselor who was unbiased, but she still had to tell me things that aren’t accurate, like [that it would cause] an increased risk of infertility. It wouldn’t have stopped me from doing it, though. To me, it’s like being told the risks of any other necessary medical procedure—even childbirth. If this is what I need to do, then it’s what I need to do. But I still know it’s safe.

I [inadvertently] called two crisis pregnancy centers before I found Preterm, and I could tell right away that they sounded off. I know tons of people who’ve visited them. But overall, it was really overwhelming, so for such positivity to come from a vulnerable situation—I can’t believe it. I needed this experience to be who I am today, and I want the things I’ve been through to help someone else .

So many things I’ve experienced have shaped what I’m about—like being incarcerated, having two abortions, and raising two kids as a young, single mother. I'm Black. I come from slavery. And I come from not having the choice to make the decisions we need to make. And a lot of people are still raised this way, so I’m just trying to break the cycle of what our ancestors taught us. I’ve went as far as jeopardizing my freedom—I was one of two Black women who were arrested at a peaceful protest [of abortion restrictions]. And I will always strive to do whatever I can to make sure that our abortion experience is not only easier, but more comfortable.

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