Last month, Ohio governor Mike DeWine signed controversial Senate Bill 23into law. The law, which bans abortion as soon as six-weeks into a pregnancy, is an almost total ban on the procedure, as many people do not even know that they are pregnant by six weeks. While the bill does include an exception in the case a pregnant person’s life is at risk, there are no exceptionsfor rape and incest included in the legislation.

Many abortion opponents have celebrated Senate Bill 23 as “the heart-beat bill,” (the bill is officially knownas The Human Rights and Heartbeat Protection Act)and argue the bill is meant to prevent abortion once a heartbeat is detectablein an embryo. While such a label may seem innocuous at first glance, there are serious ramifications for allowing anti-choice rhetoric, such as the term “heart-beat bill,” to dominate the political conversation on reproductive rights. This is evidenced by many previous efforts by abortion opponents, and even already existing abortion restrictions in the state of Ohio, to shame or otherwise hinder those who may need abortion access.

First, state funding in Ohio for reproductive healthcare is not always prioritized for actual health-care clinics: instead, much of the funding goes to “Crisis Pregnancy Centers” (CPCs). Unfortunately, such centers are deliberately misleading to their clients, who often go in the hopes of finding legitimate reproductive healthcare services. In a 2016 academic study published by the Contraception Journal, researchers from The Ohio State University acted as persons needing reproductive healthcare in a multitude of interactions with CPC personnel. They called over 100 CPCs and visited fifty-five in person, discovering in the process that CPCs consistently misled clients about the services they offered, and even lied to patients about the realities of reproductive care. For example, CPC workers often overstated the risks of miscarriage or other negative side-effects a patient could endure after having an abortion. After in-person researchers had pregnancy tests at CPCs, furthermore, they were not usually offered contraceptive services. CPC staff instead recommended abstinence to the researchers, or incorrectly argued that contraception did not work or caused abortion.

Although CPCs largely do not provide legitimate care, and even lie or otherwise deceive their clients, they receive funding from the state of Ohio. Meanwhile, Planned Parenthood, a service that actually provides STI testing, access to contraception, and abortion services depending on location, was defunded in Ohio in March.

Just as many CPCs deliberately mislead the population on reproductive healthcare,there are many medically unnecessary abortion restrictions that have been considered or passed in the state of Ohio that largely have the same function of misleading and hindering potential abortion recipients. Much of this is done by incorrectly conflating an embryo or fetus with a living human child, and therefore shaming patients for wanting to end a person’s life. Before providing an abortion in Ohio, for example, the doctor must provide an ultrasoundof the fetus to patients who wish to receive abortion services. There is no medical necessity for such a procedure; rather, the Guttmacher Institute, a think tank for sexual and reproductive healthcare, arguesthe procedure is a “way to personify the fetus and dissuade [someone] from obtaining an abortion.” In March, a bill requiring aborted fetuses to be given a proper burial or cremationwas passed by the Ohio Senate, and has since been introducedin the House of Representatives.

While such restrictions demonstrate the desire of anti-choice advocates to personify a fetus beyond reasonable measure, legislation attempted in other states has gone so far as to criminalize the procedure. In Texas, a bill recently introduced would have made it possible to try a woman having an abortion for the crime of homicide, which in the state of Texas can even include the punishment of the death penalty.

Crisis Pregnancy Centers, along with rampant anti-choice legislation employing similar language, have helped to normalize incorrect information about reproductive healthcare, which further stigmatizes abortion. The "heartbeat" bill is just another step in this process, as it uses the emotional appeal of the beating heart to re-enforce the belief that abortion is murder, and should therefore be made illegal or harder to obtain.  Unfortunately, such anti-choice efforts are paying off in the realm of public policy: fromthe years 2010 through 2016 alone, 338 new abortion restrictions were passed by state legislatures. These 338 new restrictions are nearly 30% of all 1,142 abortion restrictions passed at the state level since the 1973 Supreme Court decision made in Roe v. Wade, the landmark case that originally made banning abortion unconstitutional.

It is important to realize, however, that anti-abortion activists are not simply using Senate Bill 23 to limit abortion to about six-weeks in Ohio. Rather, the bill is part of a national attempt to challenge and even overturn Roe V. Wade.

While the six-week abortion ban used to be something of a “fringe idea,” not even universally backed by pro-life groups (Ohio Right to Life, for example, was “neutral” on such a ban until 2018, previously preferring more incremental legislation), six-week abortion ban bills have recently been considered in several states around the country. Because such bans are largely considered unconstitutional, they have been struck down in many courts, such as in Iowaand Mississippi. Anti-choice advocates know that these bills will likely be struck down, and in fact their tactics are deliberate: they hope to use the situation to their advantageand get their case to the Supreme Court of the United States. With Brett Kavanaugh, a conservative judge, now sitting on the nation’s highest court, many anti-abortion activists now believe the Supreme Court, if presented with a bill such as the six-week abortion ban, may well consider overturning Roe V. Wade.

While it must be understood that anti-choice advocates are aiming at Roe V. Wade with the “heartbeat” bill, it is also important to note that, with or without the six-week abortion ban, access to abortion within the last decade has declined significantly in Ohio:

• In recent months, Ohio has voted to pass major abortion restrictions. A twenty-week abortion ban, for example, was signed by governor John Kasich in late 2018. Senate Bill 145 was also passed in December 2018, which prohibits the dilation and evacuation (D&E) abortion method, the most common second-trimester abortion procedure, from being utilized by medical doctors. Fortunately, part of Senate Bill 145 has since been temporarily struck down in court.
• As a result of many of Ohio’s medically unnecessary transfer-agreement requirements, in which abortion clinics are to have written agreements with hospitals in case they must transfer a patient, in addition to other superfluous restrictions, more than half of Ohio’s abortion clinics have closed since 2011. While there were 26 abortion providers total in Ohio in2011(18 of these were clinics, the rest provided medication); only 7 clinics are now open, with two additional facilities only providing abortion medication.
• The number of abortions that have taken place in the state of Ohio has declined substantially in the last fifteen years: while over 35,000 abortions took place in Ohio in 2003, only 20,893 were completed in 2017.

While many anti-abortion advocates may argue that more Ohioans are choosing to continue their pregnancies in recent years as opposed to having an abortion, this idea of "choice" ignores how extensively recent abortion restrictions have created significant hardships for those who may need abortion services. After all, obtaining an abortion is not free or cheap in Ohio: even the base cost of an abortion can be anywhere from $550 to $1,100 at Planned Parenthood of Greater Ohio, depending on the stage of the pregnancy (fortunately, insurance may help payin some cases).

In addition to the price of an abortion itself, many other factors make it difficult and costly for persons needing reproductive care to reasonably obtain access. Because there are now less than ten facilities in Ohio that provide abortion services, many patients have to drive hours (if they have a car and can afford to pay for the gas, that is) to reach a clinic, book a place to stay, and call off work for the twenty-four hour waiting periodrequired by Ohio law in between a patient’s consultation meeting with an abortion provider (which includes information designed by lawto sway them against getting an abortion) and their actual abortion appointment. While wealthy Ohioans can likely take care of these predicaments without difficulty, such costs and arrangements are prohibitive to those who may be less well-off.

Considering that the American working class has sustained substantial losses to its net-worth since the Great Recession, and about 4/5 Americans now live pay-check to pay-check, coming up with the money to justify paying for an abortion is becoming increasingly out-of-reach for much of the American population.

Ultimately, abortion is a sound and safe medical procedurethat human-rights organizations such as Amnesty International describe as basic healthcare. In fact, almost one in four womenwill undergo at some point throughout the course of their lives. The ongoing attacks on reproductive healthcare are direct attacks on the livelihoods of these women, and to all who may need reproductive care for any reason. If we are to meaningfully prevent abortion services from being taken away from those who need it, we must take the time to understand that the current situation, in Ohio and around the country, is dire.