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By Holly Honderich
in Washington
Ohio voters will decide on Tuesday whether to enshrine abortion rights in the state's constitution.
The vote is being viewed as a litmus test for whether abortion rights will continue to be a winning issue heading into the 2024 elections.
After the Supreme Court overturned the nationwide right to abortion last year, a series of votes returned victories for pro-choice supporters.
Polls show a majority of Ohioans intend to vote for the abortion amendment.
But Ohio's measure, called Issue 1, is being widely seen as the toughest fight so far for abortion rights supporters.
Abortion access has won in all six ballot measures held since the Supreme Court overturned Roe v Wade, the decision that had guaranteed abortion access throughout the US. But Ohio is the first Republican-led state to consider changing its constitution to explicitly guarantee the right.
What is Issue 1?
If passed, the amendment would establish the "right to make and carry out one's own reproductive decisions", including on abortion.
Similar to the standard set by Roe v Wade, Ohio could bar abortion after the point of viability - around 23 weeks of pregnancy - except in instances where the patient's doctor determines the procedure is needed to protect life or health.
Opponents of the measure have seized on this element of the amendment, telling voters Issue 1 would allow for "late term abortions" - a non-medical term referring to abortions later in pregnancy.
Supporters of Issue 1 have countered that any abortions later in pregnancy would require sign-off from a medical professional attesting to serious health concerns. They say the government should not play a role in private medical decisions.
What's at stake?
Abortion is currently legal in Ohio until 22 weeks of pregnancy.
But abortion rights supporters say that if Issue 1 fails, the path will be cleared for a six-week ban which is currently on hold pending review by Ohio's conservative Supreme Court.
An abortion ban in Ohio, one of the few midwest states where the procedure is still legal, would further cut off access for those in its neighbouring states - Indiana, West Virginia and Kentucky - where abortion is already outlawed.
The result in Ohio will also offer clues about voters' views on abortion more than a year after Roe was overturned.
"If the ballot initiative passes really easily it will confirm that voters are still mad," said Mary Ziegler, a law professor at the University of California, Davis, and a leading expert on the US abortion debate. "But it won't confirm abortion is a priority issue for them, that's a different question."
What do the polls say?
Polls from Ohio show the majority of voters support Issue 1.
But a recent survey from Ohio Northern University showed the particular ballot language - namely the phrase "unborn child" - may dampen support for the amendment.
Pro-choice supporters were left disappointed in September when an Ohio court ruled that the term could remain in the ballot language. The ruling meant that instead of seeing the actual amendment on the ballot, voters will see a summary approved by the state's Republican Secretary of State Frank LaRose that says Issue 1 "would always allow an unborn child to be aborted at any stage of pregnancy, regardless of viability".
Still, a vote from earlier this year in Ohio (also called Issue 1) may give pro-choice supporters some comfort.
Republicans said the move was meant to protect the state constitution from outside influence, but critics said it was an attempt to move the goal posts ahead of the coming abortion vote. The measure failed and was seen as an early indication that abortion supporters would have the wind at their back.
"The feel I get in this state is very similar to August," said Michael Curtin, a former Ohio state legislator and journalist. "The overall feel of everybody I talk to who's a long-time politics watcher - Republican, Democratic you name it - they all expect a win tonight for the yes side."
Polls will close at 19:30 local time (00:30 GMT on Wednesday).