Ohio voters will choose Tuesday whether to enshrine abortion rights into the midwestern state's constitution in a vote that may well be a bellwether on an issue likely to dominate next year's US presidential race.
The vote comes a year and a half after the Supreme Court struck down the national right to abortion, paving the way for some states to completely outlaw the practice, even in cases of rape or incest.
In Ohio, the reversal of the landmark Roe vs Wade decision triggered a state law that would halt all abortions after a heartbeat is detected in the womb -- usually around six weeks of gestation, before many people even know they are pregnant.
The law is currently suspended as it winds its way through legal challenges, meaning that for now it is still possible to obtain an abortion in Ohio up to about 22 weeks of pregnancy.
But the law sparked a national outcry for the short time it was allowed to remain in effect last year, when a 10-year-old rape survivor was forced to travel to neighboring Indiana for an abortion after being denied care at home.
As Tuesday's vote approached, Ohioan Matthew Hartman was on the fence.
"I'm actually doing research now," Hartman told AFP on the eve of the vote.
"I don't think some people should be forced into having a kid" after a sexual assault, the 20-year-old Ohio State University student said. "But I do believe in God's decisions. So it's something that as a Christian, I gotta figure out myself."
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The "yes" vote on Ohio's referendum, known as Issue 1, would create a constitutional amendment allowing individuals to "make and carry out one's own reproductive decisions, including but not limited to decisions on contraception, fertility treatment, continuing one's own pregnancy, miscarriage care and abortion."
It would allow abortions to be prohibited after "fetal viability" -- when a fetus is able to survive on its own outside the womb -- unless a doctor believes a pregnant patient's life or health is in danger.
Organizers on both sides of Issue 1 have mobilized millions of dollars and knocked on thousands of doors in the latest test to abortion rights in the fractured, post-Roe United States.
A previous referendum that would have made state constitutional amendments harder -- put up for vote in direct response to the looming abortion referendum -- was defeated.
Many conservative voters in the country -- if not their elected representatives -- have expressed reservations about how far restrictions on abortion have gone after the overturning of Roe.
But Issue 1's abortion protections may prove too much for Ohio, which former president Donald Trump won in both 2016 and 2020 as its voters have drifted right.
Governor Mike DeWine has warned that the ballot language would open the door to abortions at "any time during the pregnancy," with the possibility of minors obtaining abortions without their parents' knowledge.
The "Yes" camp has called that kind of framing "disinformation."
Hartman, the Ohio voter, is "leaning towards 'Yes'" -- for now.
Abortion will be on the ballot in other states as well.
Conservative Kentucky, to Ohio's south, votes for governor Tuesday, with incumbent Democrat Andy Beshear having made abortion rights a key issue in his battle against Republican Daniel Cameron.
In Virginia, which also goes to the polls that same day, Republicans are hoping a win in legislative races will allow them to tighten abortion restrictions.