The first major election of the post-Roe era yielded new protections for abortion rights, as voters in three states approved measures to add constitutional protections guaranteeing access to the procedure…California, Michigan and Vermont backed ballot measures that effectively make it impossible for state lawmakers to enact bans.

Latinas are the largest group of women of color affected by current and future state abortion bans and restrictions: More than 4 in 10 Latinas of reproductive age live in the nearly two dozen states where officials are working to make abortion inaccessible. A new analysis from the National Partnership for Women & Families and the National Latina Institute for Reproductive Justice, first shared with NBC News, found that close to 6.5 million Latinas (42% of all Latinas ages 15-49) live in 26 states that have banned or are likely to ban abortions after the Supreme Court struck down Roe v. Wade this summer.

A few blocks from the Ohio State University campus in Columbus, America’s battle over abortion is playing out under one roof. On one side of a squat single-story office building, a Planned Parenthood clinic offers reproductive health care and refers patients for abortions. Next door is a branch of Pregnancy Decision Health Center, a crisis pregnancy center that offers counseling and support for pregnant women – but also works to dissuade them from terminating their pregnancies and has been accused of promoting misinformation about abortion.

The fate of abortion rights and abortion access will be determined this November at the state and local level during midterm elections. Since the Supreme Court overturned Roe v. Wade in June of this year, most abortions have been banned in 14 states and are actively threatened in seven. Now, voters will directly influence the future of abortion in five states, while local gubernatorial and judicial races across the country will similarly shape the makeup of each state’s abortion access—either acting as stopgaps between the state and abortion bans or paving the way for expanding an already staggering abortion desert.

Abortion rights advocates are exploring ballot measures to enshrine access to the procedure into state constitutions in 2024, including in a handful of Republican-led states with restrictions on the books. The effort represents an emerging strategy for the abortion rights movement and a growing belief that public opinion is on their side. After the Supreme Court overturned the constitutional right to an abortion, advocates know appealing directly to voters is one of the only ways to counteract bans in conservative states and reshape access in a post-Roe America. While in the early stages, discussions around whether to pursue an abortion rights ballot measure are occurring in states including Ohio, Florida, Arizona, Oklahoma, Colorado and Missouri, according to interviews with over a dozen advocates, liberal groups and others, some of whom spoke on the condition of anonymity to detail private conversations.

Earlier this year, five people altered the landscape of reproductive rights in more than a dozen states across the country when the Supreme Court overturned Roe v. Wade. In November, millions of voters will weigh in, casting votes in dozens of races and ballot measures that will determine how restrictive their state can be. Ballot initiatives in three states could determine abortion access for millions of women and what kind of reproductive health care is available to them. Abortion has also become a key issue in races for governor and state attorneys general, who have direct control over their states’ abortion laws and how they are enforced. Democratic candidates for governor want to gain or retain veto power over Republican-controlled state legislatures that want to curb abortion rights.