"They feel like if they can win here, they'll take this roadmap to the rest of the country," he said of abortion rights groups. "So our battle here is important, not only for the kids' lives at stake and the culture of the state, but also for the rest of the nation."

The anti-abortion movement last year suffered a string of statewide losses at the polls – including in Republican states Kansas, Montana and Kentucky – after the U.S. Supreme Court eliminated a nationwide right to abortion. Now activists on both sides have focused on conservative Ohio as a critical testing ground of their messaging, strategy and mobilization ahead of 2024's elections.

Already, abortion-related ballot initiatives for 2024 are in various stages of advancement in close to a dozen states, including crucial presidential swing states such as Arizona and Florida.

In addition to the Ohio referendum, next week's legislative elections in Virginia are also centered on abortion, after Republicans have vowed to push through a 15-week limit if they win a majority in the statehouse.

The Ohio ballot question, known as Issue 1, asks voters if abortion rights should be enshrined in the state constitution, a move that would render moot a six-week limit signed into law by Republican Governor Mike DeWine. That law is on hold pending litigation at the conservative state Supreme Court.

Ohioans United for Reproductive Rights, the coalition supporting the amendment, has raised almost $40 million since February, compared with just under $27 million for Protect Women Ohio, the coalition opposing the referendum, according to campaign filings last week.

The flow of money - mostly from out of state - has fueled a massive investment in television ads. More than $34 million had been committed as of last week, according to the tracking firm AdImpact.

But the battle is also unfolding door-by-door across Ohio, from urban centers such as Cleveland to the state's rural corners.

On a recent weekday afternoon, members of the Ohio Women's Alliance, a Black-led reproductive justice organization that focuses on people of color, visited a neighborhood in northeastern Columbus urging voters to support the initiative.

Takerr Lowery, a 45-year-old IT administrator who answered the door, said he would vote in favor of the amendment.

"I have a daughter who's 7," he said. "I can't imagine her having less rights than her mom did."

Another resident, Tracy Austin, said she still couldn't believe Ohio lawmakers had voted to take away abortion rights.

"The idea that men should be able to tell me what I can do with my body is infuriating," said the 53-year-old billing analyst.

Rhiannon Carnes, the co-founder of the alliance, said the amendment would not pass without support from Black Ohioans.

"As someone who has been doing this work for a long time, this is the first time I feel like we have a chance to fight back," she said.

Not everyone was supportive. One woman spoke through a screened window, telling a canvasser, "I'm voting no because I don't believe in murder."

The anti-abortion campaign has launched its own outreach to the Black community via churches. In October, more than 100 Black pastors signed an open letter calling on their congregants to oppose Issue 1, noting that Black women account for nearly half of all statewide abortions.

CRITICAL DIFFERENCES

Organizers of the "no" campaign say there are crucial differences between the upcoming Ohio vote and the unsuccessful measures in 2022.

DeWine, who easily defeated Democratic nominee Nan Whaley last year despite her emphasis on protecting abortion access, has been a visible spokesman.

The "no" side has also had far more time to raise money, air commercials and build a field operation than anti-abortion groups did in the few months after last year's Supreme Court ruling, said Amy Natoce, a Protect Women Ohio spokesperson.

In addition to get-out-the-vote pushes in reliably Republican areas, the anti-abortion coalition has sought to persuade independent and even Democratic voters by labeling the amendment as extreme.

The campaign has said, citing conservative lawyers, that the wording of Issue 1 could allow minors to obtain abortions without parental consent and permit abortions on demand at any time, even in the final weeks of pregnancy.

"Whether you are inherently pro-life or firmly identify as pro-choice, hearing how radical this amendment is gets people fired up," Natoce said.

Abortion rights supporters say those claims are incorrect. Several legal experts have said the amendment's language, which does not mention parental rights, would not override the need for minors to get parental consent for an abortion.

The ballot question says the state can still restrict abortion past the point of fetal viability – typically around 23 or 24 weeks – unless needed to protect the mother's health. While such abortions do occur, they are rare: less than 1% of Ohio abortions in 2022 were performed beyond 20 weeks, according to the state health department.

For their part, abortion rights activists warn that rejecting the amendment will result in a near-total ban.

The "no" side has called that argument deceptive because abortion is currently legal in Ohio up to 22 weeks, pending a decision by the state Supreme Court on the six-week limit.

The abortion rights side notched an initial victory in August, when voters rejected a Republican-backed ballot initiative that would have raised the threshold for approving constitutional amendments – including November's abortion vote – from a simple majority to 60%.

"We've seen it time and time again across the country: When you put abortion on the ballot, it wins," Carnes said. "It's a matter of reminding people that if we don't win in November, these extremist politicians will strip away our rights."