The state of choice in Ohio is multifaceted and complex, with different issues and sets of problems contributing to individuals’, particularly women’s, reproductive control. Access is the most important feature of choice. A legal right to bodily autonomy is meaningless in practice without access to safe and legal abortion, contraception, comprehensive and medically accurate sexual education, proper neonatal care, comprehensive OBGYN services, programs to prevent and recover from domestic violence or sexual assault, a strong foster care system, and paid family leave. This report presents a comprehensive picture of existing data and statics that relate to all of these facets of reproductive health and choice. It is meant to create a resource of compiled statistics related to choice in one location, not only to create a baseline for future projects but also to encourage an understanding of the interrelatedness of these subjects when evaluating the state of choice, and to make suggestions for additional areas of research on these issues.
There are little to no Ohio-specific data or statistics on several important areas that impact reproductive choice, safety and wellbeing. There is virtually no information available on the unique reproductive health needs of transgender and non-binary individuals in our state. Data on socio-economic status or income level as it relates to issues of reproductive choice are almost totally lacking. The Ohio Abortion Report, which provides the most recent and complete data on abortion in Ohio, does not include any direct marker of income or economic status in its demographic information. Similarly, there is scant information on income correlated with infant mortality, teen pregnancy, STI prevalence, access to OBGYN services including cancer screenings, sexual assault or domestic violence. There is also no Ohio-specific research examining the economic prosperity level of a school district correlated with the type of sexual education programs implemented in that district. Ohio-specific research on how far and by what means women travel for abortion care is almost non-existent. With fewer and fewer providers left in Ohio, distance presents a substantial obstacle to obtaining an abortion. More research should be done to investigate where in Ohio that burden is greatest.
As is detailed in section nine of this report, further research into the state of reproductive choice for incarcerated women and girls in Ohio is needed. Specifically, there is inadequate information on abortion and contraception access for this group of females, and no Ohio-specific research on shackling during pregnancy. Ohio policy includes limited regulations on the use of restraints during labor and delivery, but there is no research on whether corrections officers and other employees strictly adhere to official policies. Furthermore, transgender and non-binary individuals face unique problems in prisons. Federal prison policy requires that correctional institutions give inmates the same level of hormones that they were taking before entering custody (ACLU Ohio, 2009). State and privately managed prisons do not have this mandate, thus jeopardizing the health and wellbeing of transgender inmates (ACLU Ohio, 2009). Clearly, more Ohio-specific research is warranted to better evaluate the state of reproductive choice and care access for transgender inmates.
Finally, the fact that restrictive anti-choice legislation has shuttered clinics across the state means that there is a lack of access to safe, legal abortion care in our state. Closing abortion clinics does not reduce the need for abortion, but it does leave women without access to the health care services that they need. There is a near-total lack of Ohio-specific data on the incidence of unregulated abortion, and how it impacts the health and well-being of women. The dark truth is that when clinics close and regulations become stricter, women may turn to other methods of abortion that endanger their lives, health and wellbeing. While official data on illegal abortions in Ohio is lacking, there is no shortage of stories and anecdotal evidence that this practice occurs. Further research on what is happening to Ohio women as clinics close is critical to creating a full picture of this reproductive health and rights crisis.
The findings from this extensive search for data on choice in Ohio reveal many overlapping issues that should be investigated further. This report intends to create one consolidated resource that can be used as a base line to track some of these issues in years to come, as well as providing a comprehensive look at choice and reproductive health, based upon currently available data. Policies need to address, and in some cases, such as abortion, entirely change in order to improve the state of choice from its current dire condition. We hope that this report is useful in the identification of these necessary policy changes, and starts a conversation of what needs to be done to ensure full access to health care for the women of Ohio.