A week after Kelly Kuhns learned in a heartbreaking phone call that her son would be born with Down syndrome, abortion was mentioned.
"I loved him already," said Kuhns, 36, of Plain City.
On April 26, 2015, her son Oliver was born.
"Honestly, I love his extra chromosome; it makes him even better," Kuhns said.
Two bills in the state legislature would attempt to ensure that others follow suit. Senate Bill 164 and House Bill 214 would prohibit a person from performing or attempting to perform or induce an abortion on a woman whose unborn child has or may have Down syndrome.
Violators would face a fourth-degree felony. If convicted the state medical board would take away a physician's license to practice medicine in Ohio. They are the latest in a series of bills before a legislature that has steadily chipped away at abortion rights in recent years.
"I believe they're really compatible bills," said Rep. Derek Merrin, R-Monclova Township, sponsor of the House version. "We're all reaching for the same goal."
A genetic disorder, Down syndrome is caused when abnormal cell division results in an extra full or partial copy of chromosome 21. People with Down syndrome have an increased risk for some medical conditions including congenital heart defects, respiratory and hearing problems, Alzheimer's disease, childhood leukemia and thyroid conditions. Down syndrome is the most common chromosomal condition in the United States and about one in every 700 babies in the United States is born with it, according to the Centers for Disease Control and Prevention.
"It's very concerning to think that some lives would be judged as less valuable than others," said Sen. Frank LaRose, R-Hudson, sponsor of the Senate version.
A review published in 2012 showed termination rates following a prenatal diagnosis of Down syndrome ranged from 67 to 85 percent depending on maternal age, race and ethnicity and gestational age.
To Kuhns, the legislation is personal. Raising Oliver, she said, is hardly any different than raising her other two children, Ethan, 10, and Charlotte, 9.
"We do have a couple extra appointments, but other than that, it's not really different," Kuhns said.
But Dr. Erika Boothman said the law would drive a wedge between the patient-physician relationship.
"Even though this bill doesn't criminalize women who get abortions, I think that anytime you hear about a law prohibiting abortion care, women get scared that they will end up being in trouble with the law if they choose to have an abortion," Boothman, a physician resident specializing in obstetrics and gynecology, said.
Building a patient's trust can be tough, Boothman said, especially when patients have a lower medical literacy.
"The last thing that I want is a woman not feeling like she can come to me with questions," Boothman said. "If you can't ask questions of your OB/GYN, who can you ask questions to?"
Such legislation would divide patients and physicians, said Kellie Copeland, executive director of NARAL Pro-Choice Ohio.
"They shouldn't feel like Big Brother is watching them," she said.
Ohio would not be the first state to place restrictions on selective abortions.
Seven -- Arizona, Kansas, North Carolina, North Dakota, Oklahoma, Pennsylvania and South Dakota -- ban abortions when it comes to sex selection. Arizona enacted legislation prohibiting a woman from receiving an abortion because of race. In 2013, North Dakota became the first state to prohibit abortions in cases of genetic abnormality.
Ohio Right to Life President Mike Gonidakis wonders what other prenatal diagnoses may lead to an abortion.
"If we don't draw a line and say enough is enough, how far does that continue to go?" Gonidakis asked. "It's scary to think about."
The American Congress of Obstetricians and Gynecologists recommends that every pregnant woman be screened for chromosomal abnormalities, Boothman said. Doctors use "soft markers" to gauge the probability that the fetus has Down syndrome, Boothman said.
"That can be tough to explain to patients because we're not saying yes or no," she said. "We're saying here's the probability."
If there is a high probability, doctors can offer two different types of diagnostic testing, amniocentesis and chorionic villus sampling, Boothman said. Amniocentesis samples amniotic fluid to look for birth defects, genetic diseases and chromosomal abnormalities. Chorionic villus sampling looks for chromosome abnormalities.
"There's nowhere in the culture of prenatal testing or genetic counseling or obstetricians that would try to coerce or force a woman to terminate a pregnancy," Boothman said. "This is all about providing a patient with information and letting her make the choice with what she wants to do with that information."
Boothman fears this would make it difficult to practice obstetrics in Ohio.
"I think that it would make us think twice about offering prenatal testing to a patient," she said.
Megan Henry is a reporter for the Columbus Dispatch.