“I’m voting ‘yes’ on Amendment 4, and I’m telling everyone I know to vote ‘yes.’” “I’m voting ‘yes,’ but it will never pass; this is the Bible Belt.” “I’m voting ‘no’ to prevent more babies from being murdered.” These were a few of the responses I heard when phone banking in early October in support of Florida’s Amendment 4 to enshrine abortion rights in the state constitution.

Amendment 4 is a high-stakes ballot initiative with ramifications for the entire South. Until Republican lawmakers passed the six-week abortion ban that went into effect on May 1 of this year, Florida was a destination for many abortion seekers from other states in the South that had already passed six-week restrictions or total bans.

Out-of-state residents fueled an increase in abortions in Florida, even despite the fifteen-week ban that went into effect in July 2022 soon after Roe v. Wade was overturned. Nearly eight thousand people traveled to the state last year for abortion care, according to data from the state Agency for Health Care Administration — a 15 percent increase from the year before. There was an even larger spike in 2022, when out-of-state patient totals were up 38 percent from the previous year. Florida’s role as an important regional provider of reproductive health care makes the outcome of this ballot referendum extremely consequential for women in the South.