WASHINGTON (AP) — A proposal to enshrine abortion rights in Ohio’s Constitution was approved in a statewide election Tuesday, with a significant number of Republicans joining with Democrats to ensure the measure’s passage.

The Associated Press has called the race, with votes cast in favor of proposal winning with about 56% of the vote, compared with about 44% for votes cast in opposition — a lead of approximately 232,000 votes as of the latest tally.

Known as “Issue 1,” the proposal would amend the state Constitution to establish the right to “make and carry out one’s own reproductive decisions” on matters including abortion, contraception and fertility treatment. It would also allow for abortions to be banned once it has been established that the fetus can survive outside of the womb, unless a physician determines that continuing with the pregnancy would endanger the patient’s “life or health.”

Tuesday’s vote followed a similar path as an August ballot measure election that would have raised the threshold to amend the state Constitution from a simple majority to 60% of the statewide vote. The August measure, which failed 57% to 43%, did not mention abortion or reproductive rights specifically but quickly became a proxy fight over reproductive rights as it would have made it more difficult for Tuesday’s measure to pass.

In this election, the more than 836,000 advance votes cast by mail or in-person before Election Day broke heavily in favor of the amendment, with Yes votes receiving roughly 63%, compared with 37% for No votes. This is not surprising, considering Ohio Democrats campaigned heavily in favor of Issue 1, and pre-Election Day voting tends to skew heavily Democratic.

The Yes side also appeared to have a slight lead among votes cast on Election Day, which is notable because Election Day votes have tended to favor Republicans ever since Donald Trump discouraged advance voting in his failed 2020 reelection bid. The No side initially led in the Election Day vote on Tuesday evening in the early stages of vote-counting, but that advantage steadily eroded.

When the AP called the race, the No side was still ahead among Election Day voters but not by enough to offset the advantage the Yes side had amassed in the pre-Election Day advance votes.

The scope of the victory for the Yes side suggests that a significant number of Republicans voted in favor of Issue 1. While the No side appears to have won all 44 of the counties Trump won in 2020 with more than 70% of the vote, the Yes side won 9 of the 10 counties that Trump won with less than 60% of the vote. Yes was also leading in a third of the counties that Trump carried, with between 60% and 70% of the vote. The No side trailed Trump’s performance in every county in the state except for Putnam, as of the latest tally. Yes votes had an overwhelming lead in areas President Joe Biden won in 2020, as expected.

The pro-abortion rights forces appear to have scored a broader victory geographically than they did in the August ballot measure vote. Yes was leading in 21 of the 22 counties that the pro-abortion rights position won in August and also prevailed in a handful of additional counties that previously sided with the abortion rights foes.

Yes had comfortable leads in the counties making up the metropolitan areas of Cincinnati, Cleveland, Columbus and Youngstown, mirroring the August vote. No was ahead in Dayton and appears to have picked up Toledo, which voted with abortion rights supporters in August.

Ohio is the latest state to put the question of abortion rights directly to voters. It’s also the latest state where voters decided either in favor of protecting access to abortion or against placing further restrictions on the procedure. In 2022, voters in California, Michigan and Vermont approved state constitutional amendments enshrining abortion rights, while voters in Kansas and Kentucky rejected measures to amend their state constitutions to restrict the procedure. Montana voters also rejected a proposal that year backed by opponents of abortion rights.