Ohio Abortion Rights After Issue 1: What You Should Know

Abortion is legal in Ohio until fetal viability, the point at which the patient’s treating physician judges that the fetus has a significant likelihood of surviving outside the uterus. After viability, an abortion cannot be prohibited if the physician finds it necessary to protect the patient’s life or health. That protection comes from Article I, Section 22 of the Ohio Constitution, which voters approved as Issue 1 in November 2023 and which took effect December 7, 2023.

Several older restrictions are blocked by courts but have not been repealed, and the legislature keeps proposing new ones. This guide covers what is allowed, what is blocked, and what to do if you need care.

What Section 22 of the Ohio Constitution Protects

Section 22 gives every individual a right to make and carry out their own reproductive decisions, including contraception, fertility treatment, continuing a pregnancy, miscarriage care, and abortion. The vote was 57% in favor. The text is in Article I, Section 22 of the Ohio Constitution.

The state may not “directly or indirectly” burden, penalize, prohibit, interfere with, or discriminate against a person exercising that right, or anyone who helps them. The one exception is a restriction the state proves is the least restrictive means of advancing the patient’s health under widely accepted, evidence-based standards of care.

The amendment defines “State” to include any governmental entity and any political subdivision. That means city and county rules fall under it too. It also says the section is self-executing, so it applies without the legislature passing any enabling law.

Infographic showing Article I, Section 22 of the Ohio Constitution, effective December 7, 2023, approved by 57% of voters

How Far Into Pregnancy Is Abortion Legal in Ohio?

Ohio has no fixed week limit. The amendment lets the state prohibit abortion after fetal viability, and it defines viability as a case-by-case judgment by the treating physician. Viability is commonly placed somewhere around 22 to 24 weeks, but the constitution does not set a number.

Ohio’s older post-viability statute, R.C. 2919.17, is a 2011 law that is still in the Revised Code. It makes a post-viability abortion a fourth-degree felony and presumes viability at 24 weeks. It also says no abortion counts as necessary “based on any reason related to the woman’s mental health.” Neither the fixed presumption nor the mental-health exclusion appears in Section 22, which leaves the life-or-health call to the treating physician.

Stage	What is allowed	Who decides
Before viability	Abortion is protected; the state needs a least-restrictive health justification to regulate it	The patient and provider
After viability	The state may prohibit abortion	The treating physician determines viability
After viability, life or health at risk	Cannot be prohibited	The treating physician’s professional judgment

Medication abortion with mifepristone and misoprostol is the most common method. The FDA approved mifepristone in 2000, and its labeling covers use through the tenth week of pregnancy. Surgical procedures are available later in pregnancy.

What Happened to Ohio’s Six-Week Heartbeat Ban?

The six-week ban, Senate Bill 23, is permanently struck down. A Hamilton County judge ruled it unconstitutional in October 2024, and a second ruling on October 29, 2026 struck down the provisions that were built around it.

Governor Mike DeWine signed S.B. 23 in April 2019. It took effect in June 2022 after the U.S. Supreme Court overturned Roe v. Wade, and Hamilton County Judge Christian Jenkins paused it that September. The amendment took effect December 7, 2023, and Judge Jenkins then permanently struck the ban in October 2024.

The state kept arguing that the ban’s side requirements could survive on their own. In January 2026 the First District Court of Appeals sent that severability question back to the trial court. On October 29, 2026, Judge Jenkins held that the remaining provisions could not be enforced either. News reports describe them as follows:

Mandatory testing for fetal cardiac activity before an abortion
Reporting requirements to the Ohio Department of Health
A fifth-degree felony for performing an abortion without the test
Wrongful-death suits of up to $20,000 against doctors who did not get a signed acknowledgment

The Attorney General’s office said it was reviewing the decision and considering an appeal.

Hand-drawn timeline of Ohio's six-week abortion ban from its 2019 signing to the October 2026 ruling striking its remaining provisions

Which Ohio Abortion Restrictions Are Blocked and Which Apply?

Most pre-amendment restrictions are blocked by court order, but a block is not a repeal. The statutes remain in the Revised Code, and a preliminary injunction can be revisited as a case moves forward. Parental consent for minors is enforced.

Law	Status	Court action
Six-week ban (S.B. 23)	Struck down	Permanent, October 2024; related provisions October 29, 2026
24-hour wait and two in-person visits (R.C. 2317.56)	Blocked	Franklin County preliminary injunction, August 2024; the case continues
Ban on telehealth abortion (S.B. 260, 2021)	Blocked	Hamilton County preliminary injunction, September 2024
Limits on nurse practitioners, physician assistants, midwives	Blocked	Hamilton County preliminary injunction, July 2025
Burial or cremation of tissue (S.B. 27)	Blocked	Permanent injunction February 2025; First District affirmed February 2026
Parental consent for minors (R.C. 2919.121)	Enforced	No court has blocked it

The 24-hour waiting period

R.C. 2317.56 requires a physician to meet with the patient in person at least 24 hours before an abortion and give state-published materials. A physician who skips the steps can face a civil suit for damages and discipline from the State Medical Board. Judge David Young of Franklin County paused the requirement, including the in-person meeting, in August 2024 because it likely violates Section 22.

The legal fight has an open disagreement. Abortion providers say a mandatory delay is a burden Section 22 forbids. Supporters of the law, including House Speaker Matt Huffman, argue a short waiting period does not “prohibit” anything, in the same way a free speech right is not absolute. No Ohio Supreme Court opinion has resolved how the amendment’s “least restrictive means” test applies.

Can You Get Abortion Pills by Telehealth in Ohio?

Yes. Since a Hamilton County ruling in early September 2024, Ohio clinics can prescribe mifepristone by video visit and send it to a pharmacy or by mail to the patient’s home. A July 2025 injunction also lets nurse practitioners, physician assistants, and certified nurse-midwives provide medication abortion, because the state’s licensing rules could be read to leave them out.

These are preliminary injunctions, so the underlying cases continue and the state can appeal. Planned Parenthood of Greater Ohio announced a telehealth expansion in March 2026, limited to patients who live in Ohio.

Federal law matters here too. After the Fifth Circuit ordered mifepristone back to in-person dispensing nationwide on May 1, 2026, the U.S. Supreme Court stayed that order on May 14, 2026 in Louisiana v. FDA. Telehealth prescribing and mail delivery continue while the case is heard in the lower courts.

Patient on a telehealth video visit with a clinician from a kitchen table

Why House Bill 324 matters for pill access

H.B. 324 would require an in-person visit and bar mail-order delivery for any drug the Ohio Department of Health finds causes severe adverse effects in more than 5% of users. It does not name a drug, but sponsors and opponents agree it would reach mifepristone. The House passed it along party lines on November 19, 2025, and it is in the Senate Health Committee. It is not law.

Abortion for Minors: Parental Consent and Judicial Bypass

A person under 18 needs the written consent of one parent, guardian, or custodian, unless a court authorizes the abortion. R.C. 2919.121 also exempts emancipated minors, defined to include those who have married, joined the armed services, or become employed and self-supporting.

The alternative is judicial bypass. The minor files a petition in the juvenile court of her home county or any bordering county, and the court must help her prepare it. The statute sets a tight schedule:

The court holds a hearing within five days of filing.
If the minor has no lawyer, the court appoints one at least 24 hours before the hearing, plus a guardian ad litem.
The judge decides by clear and convincing evidence whether the minor is mature and informed enough to decide, or whether the abortion is in her best interests.
The court issues its order within 24 hours after the hearing.

There is no filing fee or court cost, and the records are confidential and not public records. A denial can be appealed on an expedited schedule. A provider who performs an abortion on a minor without meeting one of these conditions commits a first-degree misdemeanor, or a fourth-degree felony for a repeat offense.

A Trumbull County juvenile judge, David Engler, sued in the Ohio Supreme Court in April 2026, claiming the amendment had eliminated parental consent and his bypass jurisdiction. State officials answered that the amendment had not ended the consent requirement. In August 2026 all seven justices dismissed the case without an opinion.

Flow diagram of Ohio's judicial bypass process for minors, from filing a petition to a ruling within 24 hours of the hearing

Costs, Insurance, and Who Pays

Ohio restricts public and exchange-plan coverage for abortion, so many patients pay out of pocket. The Ohio Department of Medicaid pays only when a physician certifies a life-endangering physical condition or when the pregnancy resulted from rape or incest, under Ohio Adm.Code 5160-17-01. Ohio law also bars health plans sold on the state exchange from covering “nontherapeutic” abortions (R.C. 3901.87 and R.C. 9.04), meaning abortions where the patient’s life is not endangered and the pregnancy was not the result of reported rape or incest.

Employer and other private plans may cover abortion, so ask your insurer before the visit. Prices vary by clinic and by how far along the pregnancy is, so ask for a written quote. Nonprofit abortion funds, including the Abortion Fund of Ohio, can help with costs and travel.

How Many Abortions Happen in Ohio?

The Ohio Department of Health’s 2025 abortion report, released March 1, 2026, counted 25,135 abortions in 2025, up from 19,892 in 2024. News coverage of the report put out-of-state patients at 20.9% of the total. Ohio has 13 abortion clinics, concentrated in the state’s larger metropolitan areas, and telehealth lets patients in rural counties skip a long drive.

Pending Bills That Would Change Ohio’s Abortion Laws

None of these bills has become law. Each would need to pass the General Assembly and then survive a challenge under Section 22.

Bill	What it would do	Status
H.B. 324	In-person visit required for “high-risk” drugs, which would reach telehealth abortion pills	Passed House November 19, 2025; in Senate Health Committee
H.B. 347	Restores a 24-hour waiting period	Passed House March 25, 2026; Senate Health Committee heard testimony in June 2026
H.B. 87	Allows “conceived children” to be claimed as dependents, which opponents call a personhood measure	Third House committee hearing February 4, 2026
H.B. 370	Ohio Prenatal Equal Protection Act; defines personhood at fertilization to ban abortion	In House Judiciary Committee since September 15, 2025

Doctors told the Senate Health Committee in June 2026 that H.B. 347 would duplicate informed consent and require them to share abortion “reversal” claims that they say are medically unsound. The committee’s next meeting on it may not come until November.

Lawsuits Against the Amendment Itself

Two lawsuits tried to undo Section 22, and both were dismissed without a ruling on the merits. The Ohio Supreme Court dismissed Judge Engler’s case in August 2026. On September 22, 2026, Butler County Common Pleas Judge J. Gregory Howard dismissed a suit by two state representatives and a Lebanon city council member, ruling that they lacked standing because they had sued as private individuals.

The Ohio Supreme Court has six Republican justices and one Democrat, and it has not issued an opinion explaining the amendment’s text. Lower courts have so far applied it to block restrictions. How the state’s highest court reads it will decide how long the current injunctions hold.

Steps If You Need an Abortion in Ohio

Confirm the pregnancy and estimate how far along you are. The date of your last period and an ultrasound at a clinic both help.
Contact a clinic or a telehealth provider. Planned Parenthood of Greater Ohio and independent clinics in Cleveland, Columbus, Cincinnati, Dayton, and Toledo offer care, and some offer video visits for medication abortion.
Ask about the in-person visit rules. The 24-hour wait in R.C. 2317.56 is blocked by court order, so ask the provider what their process is.
Get the price in writing and ask about funding. Check your insurance and contact an abortion fund if cost is a barrier.
If you are under 18, choose your route. Either bring one parent or guardian, or ask your county juvenile court to start a bypass petition.

Frequently Asked Questions

Is abortion legal in Ohio?

Yes. Section 22 of Article I protects abortion until fetal viability, which the treating physician decides case by case. After viability, an abortion cannot be prohibited if the physician finds it necessary to protect your life or health.

Can I get abortion pills by mail in Ohio?

Yes. A September 2024 court order lets Ohio clinics prescribe mifepristone by video visit and mail it, and a July 2025 order extends that to nurse practitioners, physician assistants, and certified nurse-midwives. These are preliminary injunctions, and H.B. 324 would restrict telehealth prescribing if it became law.

Is there a waiting period for abortion in Ohio?

The 24-hour waiting period in R.C. 2317.56 is blocked by a Franklin County injunction issued in August 2024. The statute has not been repealed, and H.B. 347 would restore the requirement.

Do I need parental consent if I am under 18?

Yes, unless you are emancipated or a juvenile court authorizes the abortion. Judicial bypass hearings happen within five days of filing, cost nothing, and are confidential.

Will Medicaid pay for an abortion in Ohio?

Only in narrow cases: a physician-certified life-endangering physical condition, or pregnancy resulting from rape or incest. Health plans sold on the state exchange cannot cover nontherapeutic abortions.

What happened to Ohio’s six-week ban?

A Hamilton County judge permanently struck it down in October 2024 under the 2023 amendment. On October 29, 2026, the same judge also struck down its testing, reporting, and penalty provisions.