[5] The statute became active after the Supreme Court of the United States held in Dobbs v. Jackson Women's Health Organization that the U.S. Constitution does not confer a right to abortion.

[6] One such case involved a ten-year-old girl from Columbus, Ohio, who traveled to Indiana (where abortion was legal at the time) for the procedure, generating national attention and becoming a central campaign issue.

[13] They argued that a "yes" vote would further limited government, protect bodily autonomy and religious liberty, while preventing interference with patient-physician privacy.

[9][14] In August 2023, former President Donald Trump, who appointed three of the Supreme Court justices who voted to overturn Roe v. Wade, condemned six-week abortion bans, including Ohio's, as going "too far" and a "terrible mistake".

[20] Some conservative political analysts and commentators called a continued alliance with the anti-abortion movement "untenable" and an "electoral disaster", and urged the party to adopt a more pro-choice stance on the issue.

[24] It first became active three years later in July 2022, hours after the Supreme Court of the United States issued its decision in Dobbs v. Jackson Women's Health Organization.

Her case drew national attention and commentary from public figures, due in part to its proximity to the June 24, 2022, decision of the Supreme Court of the United States in Dobbs.

[36] On February 21, 2023, Ohioans for Reproductive Freedom, the group leading support for the initiative, filed the amendment's language with the office of Ohio Attorney General, Dave Yost,[38] who certified it on March 2.

The proposed amendment was then sent to the Ohio Ballot Board,[39] which further certified it on March 13, permitting supporters to begin collecting signatures.

[40] The Ohio Republican Party tried to increase the threshold required for referendum passage to 60%, in an attempt to thwart the proposed constitutional amendment.

[43][44] The campaign for the initiative drew support from Ohio scientific and medical communities,[45][46] economists,[11] trade unions,[12] editorial boards,[12] human rights,[12] and many religious organizations.

They argued that the initiative would limit government, protect bodily autonomy and religious liberty, and prevent interference with personal medical decisions, including another situation similar to the aforementioned abortion case.

[9] According to legal historian Mary Ziegler, "The main force behind the ballot initiative was physicians who said, 'We are not willing to practice medicine under this regime, and we think voters support us.

The summary, written by Ohio Secretary of State and Republican Senate candidate Frank LaRose and approved by the Ballot Board's Republican majority, received criticism for its allegedly biased language, including opting for the phrase "unborn child" over the medically accurate term "fetus" and omitting reference to other rights the proposed amendment would protect, including contraception, miscarriage care, and fertility treatment.

[50] The Ballot Board's summary received criticism from medical groups as well as some voices opposed to legal abortion access, who have described it as deliberately deceiving voters to vote "no" under false pretexts.

[56] These misleading assertions were strategically spread through digital advertisements and offline events,[57] as well as on a blog on the official Ohio Senate website, gaining prominence in search engine results for coming from a government source.

[59] Constitutional law expert Jonathan Entin wrote:[59]If you drink too much alcohol, if you ingest certain drugs, if you drive too fast – all of those things could have shorter or longer term implications for your ability to reproduce... That doesn't mean that speed limits and drug laws and alcohol regulations are somehow going to be affected by this amendment if it's adopted.Catholic anti-abortion columnist Mary Pezzulo criticized the advertisements for discussing parental rights while ignoring the anti-abortion movement's mission to "protect the lives of unborn babies".

[125] Within a day of the close of polling, Ohio's top Republican legislative leaders suggested that action would be taken against the new abortion rights granted by Issue 1.

[126] Ohio Republican House Speaker Jason Stephens said that Issue 1 is "not the end of the conversation" because there are "multiple paths that we will explore to continue to protect innocent life."

[21] According to Jessie Hill, professor and associate dean at Case Western Reserve University School of Law, the only way the Issue 1 amendment could be challenged is if there were a change to federal law regarding abortion or if another Ohio constitutional amendment restricting abortion was passed, which would require a majority vote in an election.