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We are just four days out from Election Day and abortion rights are on the ballot again. (Really, when are abortion rights not on the ballot? I honestly can’t remember.) This time around, three states have ballot measures related to abortion access: Alabama, Oregon, and West Virginia.

In West Virginia, a ballot measure aims to amend the state constitution so that it no longer “secures or protects a right to abortion or requires the funding of abortion.” The initiative is broadly written but would at a minimum prohibit the use of state Medicaid funds from going towards abortion, except in cases of rape, incest, fetal anomalies, or life endangerment. (This is already the case in most states because of the Hyde Amendment, but some states, like West Virginia, do currently allow Medicaid to cover abortion services.)

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Abortion rights groups say they are doing their part to help stop the measure from passing, and that the issue is much bigger than just Medicaid: “If it was about Medicaid, that’s all this amendment would say,” Julie Warden with WV Free, a state abortion-rights group, told the Washington Post. “But they added language to allow them to make further restrictions in the future. Legislatures aren’t silly; they put language in these things that they want in these things.”

Similarly, Oregon’s ballot measure would ban the use of state money from funding abortion except in cases of rape, incest, ectopic pregnancy, or life endangerment. As Rewire News points out, this would affect people on Medicaid as well as government employees who receive health insurance through their employer.

Oregon Governor Kate Brown—who helped pass the state’s Reproductive Health Equity Act last year, which guarantee access to abortion across the state—called the initiative a “back-door ban on abortion.” Brown is also up for re-election next week; Brown’s advantage over her opponent, Representative Knute Buehler, is fairly narrow and has slimmed as election day approaches.

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Alabama will vote on a so-called “right to life” initiative that would amend the state constitution to establish “fetal personhood,” which gives a fetus legal rights. This could prohibit abortion should the Supreme Court, with the help of Brett Kavanaugh, decide to chuck Roe v. Wade out the window. It could also have downstream effects on reproductive healthcare, such as criminalizing birth control and in-vitro fertilization. Similar ballot initiatives have failed elsewhere in the country, but the threat posed each time is real. Beyond posing a threat to abortion rights and basic birth control, fetal rights have been invoked across the country to criminalize pregnant people, like those with substance abuse problems who continue their pregnancies to term. In even more draconian cases, people who deliver stillborn babies may be criminalized for their health care choices, like a woman who, in 2004, gave birth to twins though one was stillborn. She was later charged with murder for refusing to undergo a C-section. (She later accepted a plea deal and avoided jail time.)

If you live in Alabama, Oregon, or West Virginia, please get out there and vote.