The same tactic could not be deployed by abortion advocates, since they had no means of inflating turnout in the gubernatorial race. Opponents of the amendment said that this was a "fundamentally unfair voting scheme" that gave more consideration to a "yes" vote than a "no" vote.
The legal challenge argued that "no" voters did not have the choice to abstain from voting for governor to make their vote possibly "count" more.
A federal court in Nashville ordered a recount in April of 2016, but in January of 2018, the Sixth Circuit Court of Appeals agreed with the state's interpretation of how the ballots should be tallied. The eight "no" voters then appealed to the Supreme Court, which declined to hear the case.
The amendment was conceived following a 2000 Tennessee Supreme Court decision which struck down various abortion restrictions, including a 48-hour waiting period for women seeking abortions, and a requirement that they receive in-person counseling by a doctor who had to give them specific information about the procedure as determined by the state.
That decision held the state restrictions to be unconstitutional under Tennessee law, and found for a "right to privacy" and greater protections for abortion than was recognized at the federal level. Amendment 1 effectively prevents such a finding from standing.
A new 48 hour waiting period law was passed by state legislators in 2015, but is currently being challenged in federal court.
Following the passage of tighter restrictions on abortion in neighboring states, Tennessee saw a increase in the number of abortions being performed for women from elsewhere.
Statistics from 2014 found that a quarter of abortions in the state were for non-Tennessee residents. At the time of the Amendment 1 vote, "yes" campaigners encouraged voters to stop Tennessee from becoming an "abortion destination."