Abortion is legal in Ohio up to fetal viability, and remains available after viability when a treating physician determines it is necessary to protect the patient’s life or health. That protection comes from the Ohio Constitution itself, not from federal law. In November 2023, Ohio voters approved Issue 1, which added Article I, Section 22 and wrote reproductive rights directly into the state’s founding document. So while the U.S. Supreme Court’s 2022 decision in Dobbs ended the federal right that Roe v. Wade had recognized since 1973, abortion rights in Ohio after Roe v. Wade now rest on a state constitutional guarantee that no legislature can repeal on its own.
What the Ohio Constitution Now Protects
Article I, Section 22 took effect on December 7, 2023. Its core guarantee is that every individual has the right to make and carry out their own reproductive decisions. Those decisions include contraception, fertility treatment, continuing a pregnancy, miscarriage care, and abortion.1Ohio Legislative Service Commission. Ohio Constitution Article I, Section 22 – The Right to Reproductive Freedom with Protections for Health and Safety
The amendment also sets a demanding test for any state restriction. Ohio cannot burden, penalize, prohibit, or discriminate against someone exercising these rights unless it can show it is using the least restrictive means to advance the individual’s health, based on widely accepted and evidence-based standards of care.1Ohio Legislative Service Commission. Ohio Constitution Article I, Section 22 – The Right to Reproductive Freedom with Protections for Health and Safety A regulation does not survive just because it sounds reasonable or has some loose connection to health. The state has to prove it picked the option that interferes least with individual rights while still accomplishing a genuine health objective.
Because the protection sits in the state constitution, lawmakers cannot weaken it by ordinary vote. Only another constitutional amendment, approved by Ohio voters, could change what Section 22 guarantees.
When Abortion Is Legal in Ohio
The amendment defines viability as the point when, in the professional judgment of the treating physician, the fetus has a significant likelihood of survival outside the uterus with reasonable measures.1Ohio Legislative Service Commission. Ohio Constitution Article I, Section 22 – The Right to Reproductive Freedom with Protections for Health and Safety That is a case-by-case medical judgment, not a fixed week on the calendar. In practice, viability generally falls somewhere around 23 to 24 weeks, though circumstances vary.
After viability, the state still cannot prohibit an abortion that the treating physician determines is necessary to protect the pregnant patient’s life or health. The word “health” here carries real weight and is not limited to immediate life-threatening emergencies.
Licensed clinics across Ohio currently provide both medication-based and surgical abortion services. Patients do not need to leave the state to access care during the pre-viability period.
Medication Abortion and Telehealth
Medication abortion in Ohio uses mifepristone followed by misoprostol. It is available through both in-person clinic visits and telehealth appointments. In 2023, the FDA permanently removed the requirement that mifepristone be dispensed in person, allowing certified clinicians and pharmacies to prescribe and ship the medication by mail. Ohio patients can currently obtain a medication abortion prescription through telehealth without visiting a clinic.
Mail-order access faces ongoing federal litigation. A Fifth Circuit ruling attempted to bar the mailing of mifepristone nationwide, and the Supreme Court has extended a hold on that decision while litigation continues in the lower courts.2Supreme Court of the United States. Moyle v. United States For now, mail-order access remains in place in Ohio, but the federal outcome could change availability regardless of what the state constitution says.
A separate question involves the Comstock Act, an 1873 federal law that prohibits mailing “obscene” materials. A 2022 Department of Justice opinion concluded that the Comstock Act does not prohibit mailing abortion medications as long as the sender does not intend them to be used unlawfully. Whether the current administration will keep that interpretation is an open question.
Rules Still on the Books, and the Ones That Have Fallen
The amendment did not automatically erase pre-existing restrictions. Courts have been reviewing each law one by one. Several of the biggest barriers are no longer being enforced.
Senate Bill 23, the so-called Heartbeat Bill, made it a fifth-degree felony for a physician to perform an abortion after cardiac activity could be detected, typically around six weeks.3Ohio Legislature. Senate Bill 234Ohio Legislative Service Commission. Ohio Revised Code Section 2919.195 – Performance of Abortion After Detection of Fetal Heartbeat, Penalty The Hamilton County Court of Common Pleas issued a permanent injunction blocking the six-week ban. On appeal, the state chose not to contest that part of the injunction, effectively conceding that the ban cannot be enforced under the amendment.
Ohio’s 24-hour waiting period and the requirement to receive state-scripted information in person have also been temporarily blocked. A Franklin County judge ruled that these requirements do not advance patient health and violate the rights guaranteed by the amendment. That case is still moving through the courts, but the waiting period is not currently being enforced.
Senate Bill 27, which required burial or cremation of fetal and embryonic tissue from procedural abortions, has been permanently enjoined. Ohio’s First District Court of Appeals upheld that injunction.
Parental Consent and Notification for Minors
Ohio still requires a minor to obtain written consent from one parent, guardian, or custodian before having an abortion. If parental consent is not possible or safe, the minor can petition a juvenile court for a judicial bypass. The court must hold a hearing within five days and appoint both a guardian ad litem and an attorney for the minor if she does not already have one. The court can authorize the abortion if it finds the minor mature enough to make the decision independently, or that the abortion is in her best interests.5Ohio Legislative Service Commission. Ohio Revised Code Section 2919.121 – Unlawful Abortion Upon Minor
A separate statute requires at least 24 hours’ notice to a parent before performing an abortion on a minor, unless one of the consent exceptions applies.6Ohio Legislative Service Commission. Ohio Revised Code Section 2919.12 – Informed Consent Both the consent and notification requirements remain on the books. The amendment’s text does not explicitly address minors, and whether these rules will survive under the new constitutional standard has not been definitively tested.
Paying for an Abortion in Ohio
Legality is not the same as affordability. The federal Hyde Amendment prohibits using federal Medicaid dollars for abortion services except in cases of rape, incest, or when the pregnancy endangers the patient’s life. Ohio follows those federal restrictions. Patients on Medicaid who do not qualify for one of those exceptions pay out of pocket or seek help from private abortion funds. Medication abortion typically costs several hundred dollars, and first-trimester surgical procedures generally fall in a similar range, though prices vary by provider.
Federal Issues Worth Knowing About
Two federal pieces sit alongside Ohio law and are worth a brief note.
The Emergency Medical Treatment and Labor Act requires every hospital that accepts Medicare to stabilize patients in a medical emergency, regardless of state restrictions on specific treatments. EMTALA is less of a flashpoint for Ohio than for ban states because Section 22 already protects abortion through viability and beyond for health reasons. In June 2025, HHS rescinded earlier guidance that had reinforced EMTALA obligations for pregnant patients, though the statute itself still applies.
In 2024, HHS finalized a HIPAA rule that would have blocked healthcare providers from disclosing reproductive health records to law enforcement investigating someone for seeking or providing a lawful abortion.7U.S. Department of Health and Human Services. HIPAA Privacy Rule Final Rule to Support Reproductive Health Care Privacy – Fact Sheet In June 2025, a federal court in Texas vacated most of that rule. The core disclosure protections are no longer in effect. Because abortion is lawful in Ohio, the risk of state-level investigation is lower here than in ban states, but anyone traveling across state lines for care, or whose records are sought by authorities elsewhere, should know the federal privacy shield they may have expected largely does not exist right now.