Over the past three years, there has been a mercurial rise in the number of anti-abortion laws passed across the country, with legislators in solidly red states including Texas, Arkansas, North Dakota, North Carolina, Louisiana, Mississippi, and Alabama all doing their part to restrict reproductive rights. The most common laws ban abortion after 20 weeks, require that abortion providers have hospital admitting privileges, limit insurance coverage of abortion, and reduce access to medical abortion. As a result, abortion access across the American South is becoming more and more limited, and "abortion restrictions" practically go hand-in-hand with "red states" in media coverage.

But attacks on reproductive rights aren't just a Southern phenomenon — some of the most radical legislation is coming out of Ohio, a Midwestern state that's been an incubator for the kind of restrictions increasingly put into play nationwide. Despite the fact that it's a relatively moderate purple state, Ohio has been rolling back reproductive rights for more than a decade, advancing some of the most aggressive regulations in the country.

Earlier this week, politicians in Ohio proposed what is just the latest in a long line of legislation that would put women's lives at risk: a bill that would ban insurance coverage for abortion, even in cases of rape, incest, or to save a pregnant woman's life, and would also ban coverage of IUDs and, potentially, many other forms of birth control. Though the Republican sponsor, Rep. John Becker, recognized that the bill might be interpreted to outlaw coverage of the Pill as well, he said that wasn't his intention. But he maintains that its provisions are valid because, in his opinion, the IUD might prevent implantation of a fertilized egg, which he believes is tantamount to an abortion.

"This is just a personal view," he said. "I'm not a medical doctor."

Actual medical doctors point out that Becker's view is far removed from biological reality — IUDs do not cause abortions, and pregnancy differs from fertilization. But if this bill becomes Ohio law, other states may follow suit.

"Many of the laws you're seeing explode all over the country started in Ohio," Renée Paradis, a senior staff attorney with the ACLU Reproductive Freedom Project, told Cosmopolitan.com. "Ohio is a hotbed innovator of abortion rights restrictions."

In 1996, the Republican-dominated legislature in Ohio passed a law requiring abortion clinics, which in Ohio are regulated as ambulatory surgical centers, to have patient transfer agreements with hospitals, even though abortion is overwhelmingly safe and complications requiring hospitalization are extremely rare. Last year, Ohio went further and passed a new law barring public hospitals from entering into transfer agreements with abortion clinics. In other words, Ohio abortion clinics have to have contracts that allow them to transfer patients to hospitals, but public hospitals are not allowed to enter into those very contracts.

The patient-transfer law was a precursor to a move that's become a go-to for restricting abortion rights in other states: the requirement that abortion providers have admitting privileges at local hospitals. Those privileges are unnecessary to get patients emergency care and are routinely denied to abortion providers; even anti-abortion advocates admit the laws serve the goal of shutting down abortion clinics. Admitting privilege laws have been implemented in Texas and are currently under legal challenge in Mississippi, Louisiana, Alabama, and Wisconsin.

In Ohio, the patient transfer laws that predated admitting privilege regulations across the South have led to the shuttering of several clinics, and more may be on the way. The last clinic in Toledo is fighting to stay open, and the only two clinics in Cincinnati are threatened with closure — which would make that city the largest metropolitan area in America without an abortion clinic. Ohio women seeking abortions have already started going to Michigan for the procedure as it has become increasingly difficult in their home state.

In 2004, Ohio passed a law that requires doctors to prescribe unnecessarily high doses of mifepristone, the "abortion pill," making it three times as expensive. It also criminalized the use of mifepristone after the seventh week of pregnancy. Planned Parenthood sued, but the Sixth Circuit Court of Appeals upheld the Ohio law. Eight years later, Arizona passed a similar law, also banning mifepristone use after the seventh week of pregnancy, and requiring that a second dose of the drug be taken at a clinic, rather than at home. That law is currently under challenge by reproductive rights organizations; on Thursday, the Ninth Circuit Court of Appeals ruled that the law cannot be enforced until the lawsuit challenging it is decided.

Republicans control both the House of Representatives and the Senate in Ohio, and since Republican Governor John Kasich took office in 2011, he has signed nine restrictions of women's health into law.

"When you have a single party that captures the state houses, they are indebted to the more conservative segments of their party," Paradis said. "I think you're seeing that the Republican Party has to pay the piper, and that's putting Ohio on the cutting edge of these laws."

Three years ago, Kasich signed into law a ban on abortions 20 weeks after fertilization that got little national attention. In 2013, Texas Democrat Wendy Davis's marathon filibuster of her state's 20-week abortion ban brought the legislation to the forefront of the political debate. Today, states including Alabama, Arkansas, North Carolina, North Dakota, Oklahoma, and Texas, among others, have 20-week abortion bans on the books.

"It was surprising that Texas got as much press as it did, because Ohio hasn't been getting coverage even as clinics are closing and access is dwindling very severely," Paradis said.

Ohio was also an early home to "heartbeat bills," which criminalize nearly all abortions by outlawing the procedure as soon as a heartbeat is detected — as early as six weeks, before many women know they're pregnant. Other states, including Wyoming, Mississippi, Arkansas, and North Dakota, have followed suit. Janet Porter, an anti-abortion activist and conservative conspiracy theorist, pushed for Ohio's heartbeat bill to be introduced in 2011; the bill stalled, came up again in 2012, and then failed to come up for a vote. It was introduced again in March, and although it seems destined to fail again, Republican legislators are trying to force a decision.

Kasich is running for reelection this November, and abortion may be a key issue in his race against Democrat Edward FitzGerald. FitzGerald has warned that Ohio could become a state of "haves and have nots" when it comes to health care, and his running mate, Sharen Neuhardt, is an abortion-rights activist who served on the Board of Trustees of Planned Parenthood of Miami Valley from 1995 to 2002.

"John Kasich and a lot of the Republicans say that Ed picked me, basically, because I have ovaries," Neuhardt said at an event in January. "Ed FitzGerald picked me because I have a brain. Women in this state have brains, we have memories, and we vote. Memo to John Kasich: You're going to be really sorry that you messed with women come November."

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Jill Filipovic senior political writer Jill Filipovic is a contributing writer for cosmopolitan.com.

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