Ohio became the seventh state where voters decided to protect abortion access after the landmark ruling and was the only state to consider a statewide abortion rights question this year.

The outcome of the intense, off-year election could be a bellwether for 2024, when Democrats hope the issue will energize their voters and help President Joe Biden keep the White House. Voters in Arizona, Missouri and elsewhere are expected to vote on similar protections next year.

Ohio’s constitutional amendment, on the ballot as Issue 1, included some of the most protective language for abortion access of any statewide ballot initiative since the Supreme Court’s ruling. Opponents had argued that the amendment would threaten parental rights, allow unrestricted gender surgeries for minors and revive “partial birth” abortions, which are federally banned.

Public polling shows about two-thirds of Americans say abortion should generally be legal in the earliest stages of pregnancy, a sentiment that has been underscored in both Democratic and deeply Republican states since the justices overturned Roe in June 2022.

Before the Ohio vote, statewide initiatives in California, Kansas, Kentucky, Michigan, Montana and Vermont had either affirmed abortion access or turned back attempts to undermine the right.

Voter turnout for Ohio’s constitutional amendment, including early voting, was robust for an off-year election. Issue 1’s approval will all but certainly undo a 2019 state law passed by Republicans that bans most abortions after fetal cardiac activity is detected, with no exceptions for rape and incest. That law, currently on hold because of court challenges, is one of roughly two dozen restrictions on abortion the Ohio Legislature has passed in recent years.