As voters streamed into Bell Avenue Elementary School in the Delaware County borough of Yeadon, poll watcher Gabriella Coleman stood by ready to help maintain order. But the 32-year-old lawyer said when she cast her own vote Tuesday, she was focused on reproductive rights above all other issues — including the economy, crime, or threats to democracy.

Coleman said she’d had her first baby 14 months ago. But she and her husband are hesitant to plan their second until they know abortion rights are secure.

”If, God forbid, something were to happen with my pregnancy and I needed to terminate, I want to make sure that that’s something that I’m able to do in the state of Pennsylvania,” Coleman said.

Coleman is among many voters who cited abortion as the deciding issue in Pennsylvania’s first election since the U.S. Supreme Court in Dobbs v. Jackson, held in June that “the Constitution does not confer a right to abortion” — overturning the long-standing protection under Roe v. Wade.

They were keenly aware that the outcome of the elections in Pennsylvania could have sweeping implications for abortion access. That’s true both at the state level, where the governor’s race represented a choice between criminalizing abortion and safeguarding it, and nationally, given that control of the U.S. Senate and the fate of a bill to codify the right to abortion could hang in the balance.

In the Senate race, Democratic Lt. Gov. John Fetterman has promised to support legislation protecting abortion at the federal level, while Mehmet Oz, the Republican doctor and TV personality, said “women, doctors [and] local political leaders” should handle such decisions.

For governor, it was a choice between Democratic Attorney General Josh Shapiro’s defense of abortion rights and Republican State Sen. Doug Mastriano’s plan to ban abortion after six weeks and to institute criminal penalties for providers.

» READ MORE: What the Fetterman-Oz debate means for abortion in Pennsylvania

In Mastriano’s state Senate district, some voters at St. Paul United Methodist Church in Chambersburg, Franklin County, said they found the candidate’s strong antiabortion stance compelling.

“I don’t want them reversing what we just accomplished [in the Dobbs decision],” said Shirley Koontz, 84.

Abortion is currently unrestricted in Pennsylvania up to the 24th week of pregnancy; after that, it’s still permitted if the mother’s life or health is in jeopardy. Clinics in the commonwealth have seen an influx of patients from neighboring states since Roe was overturned.

Gov. Tom Wolf has twice vetoed laws that would have further restricted abortion access, including a 2019 bill to ban abortions due to genetic abnormalities, and a 2020 bill that would have barred telemedicine providers from prescribing abortion drugs.

In response, the Republican-dominated state legislature has advanced a proposed ballot measure asking voters to affirm that there’s no right to abortion, or taxpayer funding for it, in the Pennsylvania constitution. That would have to pass out of the General Assembly a second time before it could be put to a vote.

Planned Parenthood president Alexis McGill Johnson, who spent Election Day in Delaware County campaigning for Democratic candidates, said the national group views “Pennsylvania as being such a critical state on so many different levels for protecting access.”

She said voters she spoke with were motivated by that in the months after Dobbs. “This is the first time [since then] that Pennsylvanians have to actually express their outrage, their frustration, their betrayal,” she said.

Across Philadelphia, that outrage was voiced by voters of all ages, races, genders, and political leanings.

» READ MORE: Pennsylvania's next governor will determine the future of abortion access

Voting at the East Passyunk Civic Center in South Philadelphia, Karen Wapinski, 42, said she felt “a heightened sense of panic” this election year because of “Republicans, the Roe decision, and the perpetual lie cycle.”

Outside the Global Leadership Academy Southwest, Tina Acholla, 33, said she was casting a vote for control over her body.

“People have been wanting to give women who get abortions the death penalty for a long time. But they weren’t saying it because it was blasphemous,” she said. “And now they’re like ‘Oh wow. I can get away with that.’ ”

But those who opposed abortion said they were just as motivated.

Carmen Perez, a 51-year-old “pro-life Republican,” said she often feels at odds with her left-leaning North Philadelphia neighbors. She said Oz’s opposition to federal abortion protections won her vote.

”I understand there’s situations like rape and incest, and it’s hard,” she said after voting inside Cramp Elementary School. “I know people who have been raped and they have their baby up for adoption because two wrongs doesn’t make a right.”

The discourse over abortion has been so heated that some voters came to believe — falsely — that such a question was already on the ballot this election cycle, poll workers said.

At the polling site at the North Philadelphia Municipal Building, judge of elections Antoinette Holder estimated almost half of voters asked about such a question.

» READ MORE: Thousands of out-of-state patients are coming to Pennsylvania for abortions

Measures codifying or explicitly denying the right to an abortion were on the ballot in five states on Tuesday. Even without such a ballot question, Pennsylvania voters said there was plenty on the line.

One was Diana Santiago, 65, a retired nurse who had been a fan of Oz’s, back when he was Oprah Winfrey’s go-to doctor.

But when she voted at Fox Chase Elementary Tuesday morning, Santiago voted emphatically against him and Mastriano — citing their views on abortion as one reason.

Her daughter just had a difficult pregnancy, Santiago said, with significant health complications.

Going forward, what if her daughter wasn’t able to make choices around her own health? ”It’s so scary.”

Staff writers Layla A. Jones, Kristen A. Graham, Aubrey Whelan, Rodrigo Torrejón, Wendy Ruderman, William Bender, Lynette Hazelton and Erin McCarthy contributed to this article.