Republican officials are undermining citizen-led ballot initiatives that seek to protect the procedure. Ohio is the latest state to get protections on the November ballot.

In Ohio, a GOP-controlled agency rewrote language for a ballot measure that would guarantee access to abortion in the state constitution, swapping in new wording that opponents said was designed to confuse voters. In Missouri, a Republican official launched legal challenges that have stalled a citizen-led effort to pass a law guaranteeing reproductive health care. And in Michigan, a Republican lawmaker went one step further, introducing a bill that would undo a popular new access law.

In the year since Roe v. Wade was overturned, Gallup polling shows that a majority of Americans believe abortion should be legal, with two-thirds of those polled saying it should be permitted in the first trimester.

To protect access to reproductive care, coalitions across the country are organizing ballot initiatives — a democratic tool that enables proposed amendments to become state law with enough petition signatures.

But abortion-rights advocates say their opponents are increasingly matching their efforts with an assortment of legal and political challenges that have stalled or even blocked their ability to introduce initiatives.