(NewsNation) — Some Democratic-leaning states have been successful in enshrining abortion access, but amending swing-state Ohio’s state constitution to include similar protections could be more challenging.

Ohio voters head to the polls next Tuesday to weigh in on Issue 1, a measure that would change the state’s constitution to incorporate access to abortion and other medical care, seeking to achieve what states including California, Vermont and Michigan have accomplished after Roe v. Wade was overturned.

California’s constitution had already broadly recognized reproductive rights since 1969, but voters took it a step further after Roe v. Wade was overturned. In passing Proposition 1 in November 2022, California voters guaranteed continued access to abortion and contraception specifically.

Vermont and Michigan similarly reinforced existing abortion rights legislation last year. The passage of Proposal 5 and Proposal 3, respectively, bolstered abortion access in the states’ constitutions.

Last year, abortion rights advocates saw success in red states including Kansas, Kentucky and Montana. Those wins, however, were achieved by rejecting anti-abortion measures, not approving protections.

The latter could be harder to achieve, particularly in a swing state like Ohio.

A Republican-led effort, which also appeared on the ballot as Issue 1, sought to make it harder to change the state’s constitution, but that measure failed during an August special election.

Following the special election, both sides have been campaigning tirelessly, including an ad recorded by Gov. Mike DeWine and his wife urging Ohioans to vote against Issue 1.

As of Thursday, about 400,000 people turned out for early voting — a level of enthusiasm that’s unusual for the Buckeye State, Ohio University professor Ben Bates told NewsNation.

 “It could be that this is a highly charged issue that people really are paying attention to, or it could be because both of the sides here have invested a lot of energy and a lot of money in getting people to vote for or against Issue 1,” he said.

Ohio’s existing abortion laws are more restrictive than California’s, Vermont’s and Michigan’s, banning the practice at 22 weeks or later. State law requires patients must first attend an in-person counseling session at least 24 hours before having an abortion.

Beyond physical access to the procedure, state Medicaid coverage of abortion care is banned except in very limited circumstances, according to the Guttmacher Institute, a sexual and reproductive rights research group.

Parental consent or notice is also required for minors, and only physicians can provide abortions.

Ohio’s policies temporarily took center stage after Roe v. Wade was upended. Reports of a 10-year-old who became pregnant after a man raped her sparked a passionate debate over the ethics of abortion laws across the country. Based on Ohio’s laws at the time, the girl traveled to Indiana for the medical procedure.

The man was later sentenced to life in prison, and the doctor who performed the abortion was reprimanded by the state for speaking about it publicly.

The majority of Ohio voters, 65%, believe abortions should be mostly legal and 57% say the Supreme Court should not have overturned Roe v. Wade, according to recent polling from the Institute for Civics and Public Policy (ICAPP) at Ohio Northern University.

The way the issue is presented to voters, however, could make a difference. The ballot measure will now use the phrase “unborn child” rather than “fetal viability,” as it was originally written.

“The framing of Issue 1 will be critical to its outcome,” ICAPP Founding Director Robert Alexander said in an official statement. “Democrats show almost unanimous support for Issue 1 while Republicans are more divided.”

NewsNation reporter Stephanie Haines contributed to this report.