Chapter 2: Ohio — From Balloons to Bears, Heartbeat Ban Causes Heartburn In Anti-Abortion Activists

(From Crow After Roe, IG Publishing, 2013)

It started with balloons on Valentine’s Day. The Ohio legislature was about to receive a major delivery, and it wasn’t a bouquet of roses, or chocolates. Instead, anti-abortion activist Janet Porter had chosen February 14, 2011 as the day to begin the push for a never before considered bill that, if passed, would virtually eliminate abortion in the Buckeye State.

The concept behind H.B. 125, commonly known as the “Heartbeat Bill” or “Heartbeat Ban” was[1] simple enough: If a woman went in to get an abortion and a fetal heartbeat could be detected, she would not be allowed to have the procedure. To launch the campaign to create one of the strictest anti-abortion bills in the United States, Porter’s group, Faith2Action, in conjunction with a variety of other pro-life action groups, sent thousands of balloons to the Ohio statehouse as a thank you for those who had sponsored the legislation, and a warning to those who stood in its way. Attached to each balloon was a small card that read “Have A Heart. Pass The Heartbeat Bill.[i]

The heart-shaped delivery was just the beginning of the puns flying across the statehouse floor. One representative who “fought his way through a sea of balloons to get to the podium” [said] “as much as I don’t like balloons, this bill really gets to the heart of the matter!” while Republican bill sponsor Lynn Wachtmann remarked, “After all, Ohio is the ‘Heart of it all,’ so it’s only fitting that we protect our fellow human beings with beating hearts.” [ii]

Watchmann was the ideal representative to spearhead the Heartbeat Ban. Referred to among colleagues as “Captain Caveman,” he was the nominal head of the “Caveman Caucus,” a group of Ohio legislators so conservative that they were mostly ignored by the rest of the party until sweeping gains in the 2010 election gave them numbers and power. Watchman was proud to live up to his “caveman” demeanor. “To me, what it meant was the way that we were willing to keep butting our heads against the wall for what we believed in,” he told the Cleveland Plain Dealer in January 2011.[iii] This stubborn tenacity was just what anti-abortion activist Janet Porter needed to get her bill onto the docket; in spite of the numerous supporters she had for the ban in the legislature, the bill wasn’t a hit with the entirety of the pro-life movement. Many, in fact, regarded it as a waste of time, effort, resources and most especially, money.

Leading anti-abortion activist James Bopp Jr. testified against the bill, arguing that it could provide the U.S. Supreme Court the opportunity to consider abortion restrictions through the lens of equal protection guarantees in the Constitution. “If this view gained even a plurality in a prevailing case, this new legal justification for the right to abortion would be a powerful weapon in the hands of pro-abortion lawyers that would jeopardize all current laws on abortion, such as laws requiring parental involvement for minors, waiting periods, specific informed consent information, and so on,” Bopp warned. “A law prohibiting abortion would force Justice Kennedy to vote to strike down the law, giving Justice Ginsberg the opportunity to rewrite the justification for the right to abortion for the Court.”[iv] The risk, it seemed, was too great for even a grand opponent of choice like Bopp.

Also notably opposed to the ban was Ohio Right to Life, who worried that the bill would either sidetrack other anti-abortion bills they believed had a greater chance at becoming enacted law, such as a twenty week “fetal pain” ban and a twenty-four week “viability” ban, or actually become law, get challenged in the courts, make it to the Supreme Court and then be used to reaffirm the right to abortion that Roe v. Wade already upheld, making it more difficult to overturn the ruling later on.“Timing is everything,” said Mike Gonidakis, executive director of Ohio Right to Life. “I don’t want to get set back 100 years because we pushed too hard to take down (Roe v. Wade).”[v] To Porter, the lack of support from Ohio Right to Life had to be the most disappointing part of pushing the legislation, as she had spent nearly a decade as the legislative director of the group.

Porter wasn’t the only one disappointed with Ohio Right to Life’s opposition to the bill. The group’s former President Linda Theis urged unity on the bill, which she called “an engraved invitation to overturn Roe.”[vi] Dr. Jack Willke, the man best known as physician behind Missouri Congressman Todd Akin’s belief that rape victims can’t get pregnant[2] [vii]and the founder of Ohio Right to Life, went as far as to resign as a board member due to the group’s failure to support the Heartbeat Ban. Willke quickly became one of the biggest advocates for the bill, putting all of his support and influence behind it.

The bill may have been one of the most heavily opposed abortion restrictions in the legislature, but the efforts to get a vote on it ranged from mildly theatrical to completely over the top. For example, in March 2011, just weeks after the Valentine’s Day balloons were sent to politicians, a pair of pregnant women came to the hearings and allowed ultrasounds to be performed on them in order to allow the fetal heartbeats within their bodies to be heard by committee members. “For the first time in a committee hearing, legislators will be able to see and hear the beating heart of a baby in the womb — just like the ones the Heartbeat Bill will protect,” explained Porter.[viii] The spectacle itself didn’t go very well, as only one of the two “witnesses” was able to provide testimony. The nine week old fetus, on the other hand, was “barely audible.”[ix] Audible heartbeat or not, the bill was passed out of committee by a vote of 12 to 11 on March 30, and was sent to the full House.

It was there that things began to stall, as Ohio Right to Life continued to apply pressure on legislative leaders to kill the bill, advising them that if they passed the ban it would do more harm than good. By May, House Speaker William Batchelder was still trying to find a compromise that would make all of the factions of Ohio’s anti-abortion movement happy. “Obviously, we don’t want to send a bill out that has caused division within the right-to-life movement, but by the same token we have to make sure that it doesn’t come to the floor in a format that isn’t as good as we can do because it will undoubtedly end up in the (U.S.) Sixth Circuit (Court of Appeals),” he explained.[x]

No real compromise was ever found, but the House pass the bill nevertheless. On June 28, 2011, the Heartbeat Ban officially cleared the first chamber of the Ohio state legislature by a 54–43 vote. Overjoyed, supporters waited eagerly for the senate to hear the bill next. However, the senate recessed without taking any action on the bill, saying they would consider it once they returned to session in the fall. Porter prepared for their return with a rally on behalf of the ban, complete with luminaries from the anti-abortion movement and even heart-shaped cookies. [xi] By November she became even more proactive, as Faith2Action joined with other supporters to create a new group specifically for the purpose of lobbying for the Heartbeat Ban. Ohio Prolife Action was formed, joining together members of Faith2Action with the angry ex-members of Ohio Right to Life. Linda Theis became the new group’s president, Jack Willke vice president.

One of the new group’s first endeavors was to broadcast a commercial asking Ohioans who wanted abortion made illegal to call their senators and demand that they support the Heartbeat Ban. The ad, which ran on Fox News, featured a school bus pulling up to two children at a bus stop. A voiceover says that passing the Heartbeat Ban will “save the equivalent of a school bus full of children every single day.” The ad then cut to the image of bus full of children, with “The Heartbeat bill will save 70 Ohio children every day,” at the bottom of the screen, followed by a plea to call politicians and ask them to vote for the bill.

In December, a three-day senate hearing was conducted to discuss the bill, with both supporters and opponents testifying. The opposition argued that the most dangerous aspect of the bill was that it would ban abortion at a point in which many women don’t even yet know they are pregnant. Because a heartbeat can be detected in some cases as early as eighteen days after conception, and most women don’t even miss their period until fourteen days post conception, the window for obtaining an abortion would be almost impossible to hit. Dr. Lisa Perriera, MD, MPH, OBGYN and member of Physicians for Reproductive Health and Choice said as much in her testimony:

This bill is effectively a ban on abortion, since the heartbeat is usually detected between the 5th and 6th week after the last menstrual period, often before a woman even realizes that she is pregnant. Banning abortion has never stopped abortion from happening; it has only made abortion unsafe or more difficult to obtain. Worldwide 48 percent of abortions are unsafe. As a physician I do not want to go back in time and see unsafe abortion in Ohio.[xii]

Perriera, who worked with low-income women in the state through her work at Preterm, an abortion clinic in Cleveland, was especially concerned about the effect that a virtual ban would have on her own patients. “It would have presented a lot of issues. It would have required women to travel to other places to have abortions if they wanted to have them,” she said. “But, the patients that I care for are of so little means already, it would have forced them to continue their pregnancy. We would have had a lot more women that are having babies that don’t want to have them. It’s not a way to bring children into the world.”[xiii]

Kellie Copeland, executive director of NARAL Pro-Choice Ohio, attended the hearings and later reported the impact that the testimony of Perriera and several other physicians had on the committee. “I think one of the other things that got in particular, the chairman of the senate house committee was the number of physicians who came and testified,” she recalls. “He asked one of the doctors who is with the Ohio state medical center what would happen if this bill passed, in terms of his colleagues, and I think the doctor really shocked him because he said that doctors who are residents in Ohio now are leaving because of the bills they already passed.”

Copeland was referring to four bills which had passed the year before, which banned, among other things, later term abortion without a health exception, and insurers from covering abortion in insurance plans.“The chairman physically sat back in his seat,” Copeland said. “He was really shocked by that. Every doctor who testified after that, the chairman asked them the same question and they said the same thing. The doctors were leaving the state in droves. It’s a bad environment already and the Heartbeat Bill would make it impossible. Ohio already has an OBGYN shortage, that’s pretty commonly known. So to have doctor after doctor testify that, ‘If you pass this, we’re leaving.’ I think it really shook them up. I don’t think that’s something they expected to hear. They should have, of course.[xiv]

Although the testimony obviously moved the senators to be cautious about the bill, it was the actions of those who supported the ban that was the final straw. Eager to calm Senate President Tom Niehaus’s worries about the bill not being clear enough, backers proposed some adjustments to the bill. Those “adjustments” ended up being twenty proposed amendments. As a result, Niehaus called off the rest of the hearings. “These eleventh hour revisions only serve to create more uncertainty about a very contentious issue,” he said. “We’ve now heard hours of testimony that indicate a sharp disagreement within the pro-life community over the direction of this bill, and I believe our members need additional time to weigh the arguments.” The bill was officially being tabled until 2012.[xv]

With no idea of when a vote would be scheduled in the senate, the Heartbeat Ban supporters began 2012 on a mission to get a vote on the bill, and were willing to use any kind of tactic to make that happen — including the use of children and stuffed animals. In January, Pro-Life Action bused fifty children to the capitol to lobby for a hearing on the Heartbeat Ban. One young boy, only eight years old, chastised the senators, saying, “I’m here to save babies with beating hearts. And I want to tell the senators to pass the Heartbeat Bill right now. And when I mean right now, I mean right now.”[xvi] The children didn’t come empty-handed, either, as each one brought along a stuffed bear to give to a senator. The bear came complete with a recorded heartbeat.

Although the event got the attention of the media, the senators were less then impressed. Nearly all of them tried to return their bears, saying they were concerned that the amount the animals cost exceeded the maximum they were allowed to receive in gifts.[xvii] The bears and children were also seen as manipulative ploys by some senators. “I’m not at all supportive of the bill, and I’m not supportive of them sending kids in my office with a teddy bear that mimics a heartbeat, either,” Democratic Senator Shirley Smith told the Huffington Post. “I thought that was a very cheap exploitation of kids. I would rather them come in my office and ask to sit down and talk about it, rather than send a kid into my office. I didn’t like it at all.” [xviii]

Kellie Copeland also heard from many legislators who were concerned about children being used as pawns in the group’s anti-abortion message. “I think a lot of our folks looked at the flowers and other things as stunts. I think that was how it was received in a lot of the Senate offices as well,” she said. “The one that got a little different reaction was when they had the children come and lobby and deliver the teddy bears. One of the Senate staffers told me that it kind of disturbed them because some of the kids were quite young. Their family walked them to the door of the Senate office but didn’t go in with them. She told me that the kids that walked into her office looked pretty scared and intimidated. So I think that was received with a little more concern, how the kids may have been exploited.[xix]

Despite the controversy, the bears — and their young messengers — were just the beginning. On February 14, 2012, one year after beginning their initial legislative push, the Heartbeat Ban proponents switched deliveries, with Porter and her cohorts sending 2000 roses to the senate — one dozen roses to senate leaders and eight dozen to each member of the committee that would need to pass the bill before it could go to the full body. “This is the largest rose delivery in Statehouse history,” Porter told reporters. “Last year we had the largest balloon delivery in Statehouse history, but helium balloons aren’t allowed in the Senate as it turns out, so we had a delivery of red roses.”[xx]

A follow-up push to force the senate to vote on the bill came in April, when Willke took out a full page ad in the Columbus Dispatch attacking senate leaders and others he accused of blocking the bill. The ad, which took the form of an open letter from Willke, demanded Ohioans put pressure on the politicians, calling it his “dying wish:”

Republican Senators who ran on a pro-life platform have been sitting on the Heartbeat Bill since it passed the Ohio House of Representatives in June of 2011. They will tell you that they have passed several pro-life bills this session; that is true, and we commend them for their regulatory bills. But make no mistake, when I founded the pro-life movement it wasn’t to regulate how abortions would be done, it was to bring the abortion killing to an END…. Tell the Ohio GOP Senate to pass the strongest Heartbeat Bill now — or we will work to replace them with people who will.[xxi][3]

Fed up with the pressure, Senate president Tom Niehaus sent an “open letter to pro-life supporters” the following month, making it clear he was no longer going to allow Faith2Action and their followers to badger the senate over not bringing the bill up for a vote:

[T]he leaders of an organization called Faith2Action have made exaggerated and inflammatory statements about the status of Substitute House Bill 125 without offering a full explanation of the debate that has emerged within the pro-life community. Their claim that we ‘lose more than a school bus full of children everyday; due to a lack of Senate action on the bill is simply false, and I will not continue to allow the organization to question the commitment of my colleagues to ending the scourge of abortion. Ohio Senate Republicans have done more in the past 16 months to advance the protection of unborn children than any previous General Assembly in our state’s history.[xxii]

Neihaus explicitly stated there would be no vote unless advocates could come up with a compromise that would allow the ban to go into effect without a court battle. That announcement should have been the death knell of the Heartbeat Ban, but it wasn’t, as Porter responded to Niehaus’s open letter with one of her own:

[M]ake no mistake: this bill was crafted with the Supreme Court in mind. Those who say the bill is ‘unconstitutional,’ fail to realize that it is Roe v. Wade that is unconstitutional and the only way to reverse it is with a challenge. If the few who stand against the Heartbeat bill want a gutted, ‘informed consent only’ bill, the best thing the Ohio Senate can do is to pass the strongest Heartbeat Bill now. If the naysayers are right and the courts say ‘no’ to legal protection, the severability clause will ensure that they still get everything they say they want: Informed Consent. Meanwhile, the ‘trigger clause’ in the bill will restore legal protection to babies with a favorable High Court ruling in the future. There simply is no downside. As a former President of Ohio Right to Life, Jane Grimm said, ‘The Heartbeat Bill is a win-win for everyone. Let the judges decide what’s Constitutional and let the Senate do what we elected them to do: Protect human life.’[xxiii]

Porter’s ceaseless campaigning wasn’t just an attempt to pass a groundbreaking abortion ban, but to build her group’s profile and raise money as well. “There’s no question that she’s been fundraising and building organizations,” said Kellie Copeland. “They’ve done quite a bit of fundraising throughout their advocacy. So definitely I think there’s that component. I also think that there’s a bit of an ego thing here for her as well. It’s been interesting watching her and President Niehaus communicate with each other through the press. It’s clearly two egos.”[xxiv]

While it might have been easy to write off Porter’s bravado as a symptom of her staunchly anti-abortion politics, the truth is that anti-abortion advocates had every reason to feel comfortable litigating controversial abortion issues like this in the state of Ohio, a jurisdiction in which they’ve often found significant success. As an example, in June 2004, Ohio passed H.B. 126, a law that banned the off-label use of mifepristone, an abortion-inducing medication. On the surface, this would seem to have little to do with the Heartbeat Ban, other than the fact that both laws restrict abortion rights and access. However, the litigation success surrounding the mifepristone ban helps explain why Ohio anti-abortion advocates have pushed so hard for the Heartbeat Ban, despite strong opposition.

H.B. 126 regulates and restricts the use of mifepristone by mandating that it can only be administered in the exact dosage that was approved by the Food and Drug Administration back in 2000. This is a specific and intentional prohibition of off-label use of the drug, a common medical practice where doctors alter the dosage of a medication based on current medical knowledge and individual patient needs. The law also imposes criminal and administrative penalties on doctors who prescribe mifepristone past forty-nine days of a woman’s last menstrual period (LMP). For women with gestational ages through 49 days LMP, H.B. 126 requires an oral dose of 600 mg of mifepristone followed by an oral administration of a lesser dose of misoprostol two days later as dictated by the FDA’s original approval in 2000. However, over the past dozen years, medical practitioners have learned that this dosage is approximately three times the amount of mifepristone needed to induce an abortion in many cases. While ingesting 600 mg of mifepristone is considered safe, there is no advantage, nor medical need, to take three times that amount. The increased dosage also adds $200 to the price of an abortion, often leaving surgical abortion as a cheaper option. Yet, this is the law in Ohio.

The state’s decision to force doctors to ignore their own experience and best practice in order to adhere to an out of date FDA protocol means not that only are legislators purposefully driving up the cost and inconvenience of a medication abortion, but they have also managed to coerce a large number of doctors to refuse to provide them all together. “I think it’s definitely true that doctors are not offering medical abortions because of the restrictions,” says Dr. Lisa Perriera. “I know personally, when it came to my institution, I intended to get medical abortion on the formulary for the hospital or at least in my private office. I couldn’t get it in the formulary.”[xxv]

The outdated protocol also requires women to make four separate clinic visits when taking mifepristone, including one for a follow-up ultrasound to confirm termination of the pregnancy. H.B. 126 mandates this as the legal course of medical treatment for women, allowing no exceptions of any kind. It is, in effect, a medical protocol frozen in time. “As an evidence-based medical practitioner it is appalling to me that I can’t provide medical abortions the way that it’s most effective and most cost effective for patients,” says Perriera. “We do offer medical abortion at Preterm, but we have to give them the FDA regimen which costs more money and doesn’t work and it makes me angry every time I have to give it to patients when I know they only need 1 pill instead of 3 and where I know that they can do it in a manner that’s more convenient for them so that they don’t have to come in for separate visits.”

Almost immediately after H.B. 126 was passed in 2004, Planned Parenthood, on behalf of three affiliates in Ohio and Preterm in Cleveland, filed suit, seeking a preliminary injunction and challenging the bill as unconstitutionally vague, unduly burdensome to abortion rights and violating a woman’s right to privacy and bodily integrity. On September 22, 2004, U.S. District Court Judge Susan Dlott sided with the Planned Parenthood plaintiffs, issuing a preliminary injunction preventing the law from going into effect. Abortion opponents appealed the decision to the U.S. Sixth Circuit Court of Appeals, which resulted in the injunction being remanded back to the District Court for further proceedings. The Planned Parenthood plaintiffs renewed their motion to have the bill blocked permanently, and in September 2006, the District Court agreed. Following this, the state of Ohio appealed to the Sixth Circuit to have the injunction overturned and challenged the District Court’s finding that the law was unconstitutional because it contained no exception for the health of the mother.

Desiring guidance on how to proceed, the Sixth Circuit certified two questions to the Ohio Supreme Court, asking if H.B. 126 required that physicians who perform abortions using mifepristone do so in compliance with the forty-nine-day gestational limit described in the FDA approval letter, and if doctors using mifepristone must do so in compliance with the treatment protocols and dosage indications described in the drug’s final printed labeling. On July 1, 2009, the Ohio Supreme Court handed anti-abortion activists a decisive victory by answering “yes” to both questions, stating that, “provisions of [H.B.126] are not ambiguous. It allows physicians to provide or prescribe mifepristone to a patient to induce an abortion only if ‘the physician provides the RU-486 (mifepristone) … in accordance with all provisions of federal law that govern the use of RU-486 (mifepristone) for inducing abortions.’” Based on this decision, the U.S. Sixth Circuit Court of Appeals remanded the case back to the District Court, vacating the 2006 permanent injunction but leaving the 2004 preliminary injunction in effect. In May 2011, the District Court again sided with the plaintiffs, ruling that the law was unconstitutional. That order was appealed to the Sixth Circuit, and in October a divided court upheld the law[xxvi] and in doing so created yet another dangerous restriction on abortion access based on faulty medical evidence and spurious political motives.

No matter what was going to happen at the Sixth Circuit anti-choice forces have essentially won this battle. Had the Sixth Circuit found the mifepristone ban unconstitutional, anti-abortion advocates would simply appeal to an Ohio Supreme Court eager to speak loudly on the issue of abortion rights. All the while, the Ohio Supreme Court ruling essentially froze medical treatment of women in time by mandating the prescription of mifepristone according to scientific evidence that is over a decade old. As a result, most medical providers have stopped using mifepristone all together because of the possible criminal liability attached, making medication abortions in the state of Ohio effectively unavailable.

It is thus no surprise that Faith2Action would aggressively pursue a wide-ranging and controversial abortion restriction like the Heartbeat Ban, as they now have years of judicial signals that the high courts of the state are on their side. They no longer need to worry about precise legislative language since they can get the desired result they want without it. If the bill is vague and tied up in litigation, it will spook providers from offering the challenged service, and if it is not, the case law is increasingly shifting rightward away from women’s liberty interests and toward the state’s interest in protecting potential life.

Since the battle of the open letters, Porter’s tactics have changed. Gone are the cookies, balloons, roses, children and stuffed animals. Now, she and her fellow Heartbeat Ban proponents are digging in their heels even harder, targeting lawmakers with newspaper ads, phone calls, emails and mailings. “This is a warning shot across the bow,” Porter said in a press conference, holding up a copy of a newspaper ad. “You see this? Do you like this? Well it’s only going to get more hard hitting. It’s going to get more frequent. And as I said before, we’re just getting started.”[xxvii]

The legislative session ended on June 15, 2012 without the Heartbeat Ban ever coming up for a vote. Porter may have just been getting started, but Neihaus appeared done. At the time, Kellie Copeland predicted that as an outright abortion ban, it was unlikely the bill will ever make it to the floor while Neihaus is controlling the chamber. “Janet has tangled with the wrong guy when it comes to senate president. He is definitely unmovable with regards Heartbeat Ban the way it stands,” said Copeland.

Copeland did suggest that the bill might morph into a different restriction, such as an informed consent bill or a mandatory ultrasound bill. “There’s a chance they could move something during lame duck in November or December before the finally adjourn for the session or into next year.”

However, by the time the lame duck session began in November, abortion opponents were ready to go all in to fight a woman’s right to choose. Mike Gonidakis, the executive director of Ohio Right to Life who had advocated for caution on the Heartbeat Ban had been appointed to the state board of health, and although the voters across Ohio voted to reelect both Democratic President Barack Obama and Democratic Senator Sherrod Brown, the state legislature remained firmly in the hands of Republicans and those who opposed abortion.

The lame duck session opened with the a House panel vote to revamp state funding payments to family planning agencies in order to reduce or all together eliminate funds to Planned Parenthood clinics, and rumors swirled that a compromise had been reached in the Heartbeat Ban.[xxviii] But a term-limited out Niehaus made blocking both bills from a full senate vote his last act, telling his caucus he would not put either issue up for a vote and asking them to respect his decision.[xxix]

Republican Keith Faber would be taking over leadership of the senate for the 2013 session, and had already stated that if the ban ever did make it to the floor for a vote, he would be in favor of it.[xxx] Faber did note the continuing concerns of some who oppose the bill as too much, too quickly, including statements from Niehaus and Bopp, leaving it unclear exactly what form the Heartbeat Ban would take in 2013. Many believed it was likely to follow the exact strategy that Porter had advocated earlier, with a series of severable amendments that could be removed if the courts rejected them, leaving one final informed consent bill in effect if all other

Copeland expects that eventually they will find a way to work together and pass the bill, as well as reach their true goal — eliminating a woman’s right to control her reproductive health. “I think the thing that sometimes gets lost in all this is that they don’t disagree about the goal, which is outlawing all abortions. It’s just how to best do it. That’s still a unifying thing.”

Read all of Crow After Roe here and learn the other ways that abortion opponents are prepared to end Roe and make abortion illegal again.

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[i] Faith2Action, “NATION’S LARGEST VALENTINE’S DAY DELIVERY TO OHIO STATEHOUSE, Thousands of Red-Heart Shaped Balloons to Support Heartbeat Bill!” news release, February 14, 2011.

[ii] Faith2Action, “NATION’S LARGEST VALENTINE’S DAY DELIVERY TO OHIO STATEHOUSE

[iii] “Conservative Republicans relish their new power in the Ohio House,” Cleveland Plain Dealer, January 11, 2011, http://www.cleveland.com/open/index.ssf/2011/01/conservative_cavemen_relish_th.html

[iv] Interested Party Testimony on Substitute HB 125 James Bopp Jr.* Ohio Senate Health, Human Services, and Aging Committee December 13, 2011 http://www.ohiosenate.gov/senate2012/Assets/Media/Content/9314.pdf

[v] Alex Stuckey, “’Heartbeat Bill’ divides Ohio anti-abortion leaders,” Columbus Dispatch, September 27, 2011, http://www.dispatch.com/content/stories/local/2011/09/27/heartbeat-bill-divides-ohio-anti-abortion-leaders.html

[vi] Julie Carr Smyth, “Abortion foes push vote on Ohio ‘heartbeat bill,’” Associated Press, March 29, 2011, http://abclocal.go.com/kfsn/story?section=news/state&id=8041312,

[vii] Pam Belluck, “Health Experts Dismiss Assertions on Rape,” The NewYork Times, August 20, 2012, http://www.nytimes.com/2012/08/21/us/politics/rape-assertions-are-dismissed-by-health-experts.html

[viii] Peter J. Smith, “Unborn babies to ‘testify’ in heading on Ohio Heartbeat Bill,” LifesiteNews, March 1, 2011, http://www.lifesitenews.com/news/unborn-babies-to-testify-in-hearing-on-ohio-heartbeat-bill/

[ix] Aaron Marshall, “Ultrasound images of two fetuses shown to lawmakers during the ‘heartbeat bill’ hearing,” The Cleveland Plain Dealer, March 2, 2011, http://www.cleveland.com/open/index.ssf/2011/03/ultrasound_images_of_two_fetus.html

[x] William Hershey, “Commentary: GOP Speaker must walk a tightrope on ‘Heartbeat’ bill,” Middletown Journal, May 15, 2011, http://www.springfieldnewssun.com/news/news/state-regional/commentary-gop-speaker-must-walk-a-tightrope-on--1/nMrWr/

[xi] Janet Porter, “I can see the end of abortion from here,” WorldNetDaily, September 12, 2011, http://www.wnd.com/2011/09/344369/

[xii] Dr. Lisa Perriera, “Doctor to Ohio Senate: I Do Not Want To Tell My Patients I Cannot Help Them,” RhRealityCheck.com, December 12, 2011, http://www.rhrealitycheck.org/article/2011/12/14/doctor-to-ohio-senate-i-do-not-want-to-tell-my-patientes-that-i-cannot-help-them

[xiii] Interview with Dr. Lisa Perriera, July 23, 2012

[xiv] Interview with Kellie Copeland, June 12, 2012

[xv] Ann Sanner, “Ohio abortions: Leader suspends hearings on Ohio ‘Heartbeat’ bill,” Associated Press, December 14, 2011, http://www.politico.com/news/stories/1211/70448.html

[xvi] Marc Kovac, “Kids want Heartbeat abortion bill passed,” Dix Capital Bureau, January 11, 2012, http://www.the-daily-record.com/local%20news/2012/01/11/kids-want-heartbeat-abortion-bill-passed

[xvii] Jim Seigel, “Most senators return anti-abortion bears,” The Columbus Dispatch, January 16, 2012, http://www.dispatch.com/content/stories/local/2012/01/15/most-senators-return-anti-abortion-teddy-bears.html

[xviii] Laura Bassett, “Anti-abortion group sends children with teddy bears to lobby lawmakers,” The Huffington Post, January 12, 2012, http://www.huffingtonpost.com/2012/01/12/ohio-heartbeat-bill-anti-abortion-group-teddy-bears_n_1202580.html

[xix] Copeland interview, June 2012

[xx] Blade’s Columbus Bureau, “’Heartbeat Bill’ backers send roses to Ohio lawmakers,” The Toledo Blade, February 17, 2012 http://www.toledoblade.com/State/2012/02/17/Bill-s-backers-send-roses-to-Statehouse.html

[xxi] Newsbrief, “Abortion foes ready new Ohio attack,” Associated Press, April 17, 2012, http://www.herald-dispatch.com/news/briefs/x1817470275/AP-NewsBreak-Abortion-foes-ready-new-Ohio-attack

[xxii] “An Open Letter From Ohio Senate President Tom Niehaus” May 2, 2012, http://www.ohiosenate.gov/senate2012/Assets/Media/Content/9313.pdf

[xxiii] Faith2Action, “Janet Porter Responds to Heartbeat Opponents Quoted in Ohio Senate President’s Letter,” news release, May 3, 2012 http://www.f2a.org/index.php?option=com_content&view=article&id=2579:janet-porter-responds-to-heartbeat-opponents-quoted-in-ohio-senate-presidents-letter&catid=52:life&Itemid=29

[xxiv] Copeland interview, June 2012

[xxv] Interview with Dr. Lisa Perriera, July 23, 2012

[xxvi] Planned Parenthood Southwest Ohio Region v. DeWine, Decided October 2, 2012. The panel decision was has appealed to the full Sixth Circuit for consideration and reversal, and in December 2012 the full Sixth Circuit refused reconsideration. Thus, the October 2012 decision stands.

[xxvii] Ted Hart, “Heartbeat Bill Supporters Changing Tactics,” Ohio Votes.com, June 5, 2012, http://www2.ohio-votes.com/news/2012/jun/05/3/heartbeat-bill-supporters-changing-tactics-ar-1061100/

[xxviii] Robin Marty, “Ohio Legislature Seeks to Punish Women with Unconstitutional Bills During Lame Duck Session,” RH RealityCheck, November 13, 2012, http://www.rhrealitycheck.org/article/2012/11/10/ohio-legislature-to-punish-women-with-unconstitutional-bills-during-lame-du

[xxix] Jim Siegel, “Heartbeat bill dead, Planned Parenthood funding alive,” Columbus Dispatch, November 27, 2012 http://www.dispatch.com/content/stories/local/2012/11/27/controversial-sente-bills-fade-away.html

[xxx] A Message from President Pro-Tempore Keith Faber On House Bill 125 (“The Heartbeat Bill”) and Abortion,” KeithFaber.org, retrieved November 23, 2012 http://keithfaber.org/hb125/