When a draft opinion leaked in early May showing the Supreme Court planned to overturn Roe v. Wade, Cincinnati Mayor Aftab Pureval turned to his staff. Pureval wanted to figure out what he could do to shore up abortion protections in his city, in a state that was set to restrict abortion access. Ohio now bans abortion after six weeks of pregnancy.

“We immediately started thinking, ‘What can we do in the instance that Roe v. Wade went down?’” he told The 19th. “That’s frankly when, during that research, we discovered the 2001 ordinance.”

That ordinance, passed by a different city council, restricted city employees from having their work health insurance cover an elective abortion. On Monday, Pureval announced the council planned to repeal the restriction and pass new rules that would allow city health insurance to include abortion-related services. It did so unanimously Wednesday.

Hamilton County, where Cincinnati is located, is just one of a handful of Ohio counties where a majority of voters backed President Joe Biden in 2020, even as the state overall went for Republican Donald Trump by eight points.

“We are a blue city in a red state. And that dynamic … is playing out right now in real time, where local leaders are trying to understand how to effectuate these laws, if at all, and also how to protect their constituents,” Pureval said.

A similar dynamic exists in several Republican-led states that are also home to large populated urban areas. Polling shows liberals are more likely to live in cities, while conservatives lean toward rural areas and small towns. The result has been Democratic officials at the helm of some of the biggest local government bodies in red states. Now, Democrats like Pureval are trying to work through bans and restrictions in the state to offer additional protections for residents who seek abortions — no matter how limited that might be. 

Leaders in several cities — including in Atlanta; Austin, Texas; Cincinnati; and Phoenix and Tucson, Arizona — are talking openly about their options. Several are trying to lessen the impact of criminalizing people who seek or perform abortions. Some are considering how to limit the use of city funds for related criminal investigations. Others, like Pureval, are offering more protections for city employees.

“They’re doing the right thing because they are pro-choice champions,” said Heidi Sieck, co-founder and CEO of #VOTEPROCHOICE, an organization that works to elect people in local and state offices that support abortion and mobilize voters on the issue. “They realize that they have to step up and do this.”

Several leaders acknowledge there are limitations to what they can do, especially if state and district attorneys are determined to seek prosecutions related to an abortion.

In Austin, the Democrat-led city council plans to vote on a resolution this month that would provide guidance to city law enforcement that aims to lower the priority of abortion-related investigations. It would also recommend that city funds not be used for such investigations. Abortions up to six weeks of pregnancy are currently allowed in Texas but will likely be completely banned in the near future.

Chito Vela, an Austin council member who co-introduced the resolution, said the Texas legislature might preempt the city council, stopping it and other cities from creating city-specific rules on abortion. It’s a tactic state lawmakers have turned to before, subverting city policies on police budgeting and use of plastic bags.

“We have to be very careful about trying to kind of craft our local ordinances in such a way that they minimize conflict with the legislature, and at the very least make it harder for the legislature to try to stop us from implementing local will with regard to these issues,” he said.

Vela added that local officials need to step up even if the legal road ahead is messy.

“Don’t underestimate something like morale,” he said. “The people of Austin do not want to just sit there and see it happen. They want to do everything that they can to push back for abortion rights.”

​​In Phoenix, Mayor Kate Gallego said the city council plans to vote on a resolution stating that they are not allocating resources toward investigating or prosecuting cases involving abortion providers. The state is in the midst of sorting out legal questions about which of its abortion restrictions is in place. Gallego explained that its police department can be asked to investigate both misdemeanor and felony cases.

“We are going to prioritize resources to focus on violent crime and not preventing women from getting health care,” she said.

In Cincinnati, Pureval has committed to offer travel reimbursement for any of the 6,000 city workers who need health care services not locally available. He has also directed his administration to examine how to decriminalize abortion in the city and “to prioritize law enforcement resources to protect the health and safety of women and medical care providers.”

Pureval has asked his administration to provide a report within 30 days that explores the city’s options on decriminalization efforts. But they may be limited. City prosecutors have jurisdiction over misdemeanors, but abortion, according to state law, is a felony. The prosecutor with jurisdiction over felonies in the county Cincinnati is in has indicated he plans to pursue cases involving abortion.

Democratic leaders agree that state and county prosecutors will be pivotal in figuring out what comes next. At least 90 district attorneys and other prosecutors from more than 30 states and territories and the District of Columbia have signed onto a letter committing not to investigate those who seek, assist in or provide abortions.

“The degree to which we can decriminalize the issue in Cincinnati really hinges upon our ability to deprioritize the issue of abortion using our police resources,” Pureval said.

Sieck added that it’s important for local officials to take action now because there is such confusion about what policies will be in place on the local and state level following the Supreme Court ruling. She called the dynamic “utter total legal chaos.”

“You’ve got all this complexity. Every single situation now is a patchwork of unknown,” she said. 

In recent days, national Democrats have called on the public to vote for candidates who support abortion access — a form of action that may be complicated in states with gerrymandered state legislative and congressional maps that may make it harder for Democrats to flips seats. But Pureval said it will be up to people to vote for policymakers who support abortion access if they want the rules to change in the state. He added that he’s reached out to the mayor of Chicago in an effort to address and support a potential influx of Cincinnati residents seeking services in the area.

“This is not a solve for this issue. This is our attempt to fight back as creatively and firmly as possible,” he said. “But unless there is federal legislation or unless your state legislature protects a woman’s right to choose, it is an uphill battle, no doubt about it.”

Gallego in Phoenix encouraged people to vote in the August primary and November general election. The state is electing a new governor, U.S. senator, state legislators and local prosecutors.

“All of those matter for the outcome related to women’s health care,” she said. 

Vela said his staff has been in communication with officials within other Texas cities and outside of the state, including in Atlanta about enacting similar policies. The council approved a resolution last week, before the Supreme Court ruling, urging local police to make abortion investigations the “lowest possible priority.”

“There is strength in numbers, and the more cities and counties that speak up, the stronger our voice will be,” he said.