Ohio voters put abortion into the state constitution in 2023.
Three years later, a new report just revealed what that vote actually built.
The Urban Institute is calling doctors skipping ultrasounds before abortions real progress for women.
What One Abortion Provider Told the Urban Institute About Freeing Up Appointment Slots
The Urban Institute just published a report on Ohio's abortion amendment called "Ohio Is Expanding Abortion Access Even as Implementation Proves Uneven."
Researchers interviewed 22 policymakers, providers, and advocates, plus two focus groups of 15 women each.
That is not a survey of Ohio.
That is the abortion industry grading its own homework.
One abortion provider told researchers that eliminating Ohio's 24-hour waiting period, routine ultrasounds, and in-person counseling freed up appointment slots and let doctors perform more abortions.
Read that again: cutting time, counseling, and ultrasounds meant more abortions per day.
Doctors call that an assembly line when it happens in any other industry.
The report calls that progress.
The Telehealth Numbers Behind Ohio's Abortion Surge
Ohio's health department has the receipts.
Abortions in Ohio jumped 15 percent in 2025, from 19,892 to 25,135.
Nearly six in ten of those abortions, 59.1 percent, involved mifepristone.
The health department says the surge is driven primarily by telehealth prescriptions mailed to Ohio residents who never see a doctor in person.
Out-of-state patients are pouring in too, up from 3,100 in 2024 to 5,200 in 2025.
Ohio is not just expanding abortion access for Ohioans.
It is becoming the regional supplier.
The Danger Doctors Say Disappears When Ultrasounds Get Skipped
Skip the ultrasound and you skip the one test that catches an ectopic pregnancy before it ruptures.
Doctors elsewhere have already documented what happens when that screening disappears.
A 22-year-old woman ordered mifepristone and misoprostol online for what she believed was a normal six-week pregnancy.
Six days later she was in an emergency room twice with escalating pain before doctors found a ruptured ectopic pregnancy and rushed her into surgery.
Dr. Eran Bornstein put it plainly: a woman who self-manages an abortion "without confirming it is an intrauterine pregnancy" is more likely to suffer complications.
Ohio Right to Life already saw this coming.
The group filed a formal complaint against the telehealth provider Hey Jane in February 2025, arguing it mails abortion pills without any physician exam and without screening for the ectopic pregnancies that mifepristone cannot treat.
A court order from September 2024 had already blocked Ohio from enforcing those same mail-order restrictions, leaving that exact danger in legal limbo when the complaint was filed.
Ohio's report treats removing that screening as an improvement anyway.
Why the Report Calls Catholic Hospitals a Barrier to Abortion
The Urban Institute also flagged Catholic-affiliated hospitals as an obstacle to abortion access.
Bon Secours Mercy Health, the Cincinnati-based Catholic system that operates hospitals across Ohio, is a case in point: it backs doctors who perform medically necessary abortions in true emergencies, but it will not perform elective ones.
That distinction, between saving a mother's life and ending a healthy pregnancy on demand, is exactly what the report treats as a barrier to fix.
The report stops short of demanding Catholic hospitals be forced to comply.
But the framing raises the question Ohio will eventually have to answer out loud: does a right to abortion create an obligation for every doctor, nurse, and hospital to provide one.
"Reproductive freedom" cannot mean erasing everyone else's freedom of conscience.
The SHE WINS Act Ohio Lawmakers Passed to Undo What the Report Celebrates
Ohio Republicans are not standing still.
The state House passed the SHE WINS Act in March, 64 to 32, restoring a 24-hour waiting period and real informed consent before an abortion.
State Rep. Josh Williams said the bill ensures "abortions are held to the same clinical standards as other medical procedures."
Planned Parenthood's Nan Whaley called it a "burdensome 24-hour roadblock."
Ohio Right to Life is not only playing defense.
Executive director Carrie Snyder says the group wants pregnancy centers, foster care support, child care, and mental health help so no Ohio woman ever believes abortion is her only option.
Plenty of Ohioans who voted yes in 2023 never signed up for abortion-on-demand or taxpayer-funded abortion, and Snyder's group is betting a lot of them are ready to say so.
Three years after Ohio wrote abortion into its constitution, the state is not choosing between two settled sides.
It is still deciding, one bill and one report at a time, whether faster abortions count as care.
Sources:
- Carrie Snyder, "Abortions Explode in Ohio With Abortions on Demand Up to Birth," LifeNews.com, September 2, 2026.
- Ohio Department of Health, "Induced Abortions in Ohio 2025 Report," March 1, 2026.
- "Ohio's Annual Abortion Report Attributes Telehealth to Rise in Abortions," Ohio Capital Journal, March 6, 2026.
- "She Used Pills to Medically Abort — But Had a Dangerous Ectopic Pregnancy," HealthDay, 2026.
- "Ohio Lawmakers Remain Steadfast in Passing Pro-Life Legislation," The Daily Signal, March 27, 2026.
- "Bon Secours Mercy Health Supports Clinicians Performing Medically Necessary Abortions," Becker's Hospital Review, 2024.
- "Complaint Filed Against Online Abortion Provider for Alleged Violation of Ohio Law," CatholicVote, February 2025.
