The family of Amy Acton, the Democratic candidate for governor of Ohio, is criticizing her Republican opponent Vivek Ramaswamy for using Acton’s estranged mother in a recently released campaign ad.

In the ad, which has circulated among conservatives on social media, her mother, Donna Arthur, said: “She says she grew up living in a tent. None of that is true. She’s lied her entire life.”

The attack came amid a fierce contest between Acton and her Republican opponent, Ramaswamy, to lead the right-leaning state, which polls have indicated is either’s to lose.

In a Tuesday statement, Acton’s brother, Philip Stearns, said his sister is estranged from her mother, who had married a man that sexually abused Acton when she was 12 years old. He added that Arthur remained in the marriage even after her husband was arrested and her children were taken away from her.

“It’s not surprising that Vivek Ramaswamy has stooped to such a despicable low as to attempt to turn the sexual abuse Amy endured at twelve years old from our birth mother’s husband into a political talking point,” he said in a statement released by Acton’s campaign.

“After he was arrested and Amy and I were removed from their custody, our birth mother stayed married to Amy’s rapist until he died. This desperate, disgusting attack reveals exactly who Vivek Ramaswamy is at his core – a pathetic excuse for a man who is willing to hurt anyone as long as it gets him what he wants.”

Acton directed Ohio’s public health department between 2019 and 2020, overseeing the state’s initial response to the Covid-19 pandemic. In an interview with the Youngstown Vindicator, she said her stepfather had a history of molestation and was arrested for his actions towards her, and also described living in a tent outside the north-east Ohio city.

Ramaswamy’s campaign sought to cast doubt on her recollection of her childhood, with spokesperson Connie Luck saying:

“We don’t know what happened between Amy and her mother, who first spoke out about Amy in 2020, but we know that Amy Acton is a serial fabulist who has some serious problems with the truth that the public needs to be aware of before deciding who to entrust as governor.”

“Everyone who knows her best – her former boss, her former state colleagues, her fellow physicians, and now her own mother – are clearly warning Ohioans not to vote for her. Ohioans deserve to know that,” Luck added.

In a 2020 interview with Operation Rescue, an anti-abortion group, Arthur did describe being present at grand jury proceedings related to Acton’s allegations of abuse.

Democrats condemned the ad, with the Cincinnati-area congressman Greg Landsman calling it “one of the most despicable things I’ve ever seen in politics”.

The Democratic Governors Association said: “With this disgusting attack, and the relentless smear campaign leading up to it, Vivek Ramaswamy has shown that there is no depth he will not sink to if it serves his own ambitions.”

The campaign between Acton and Ramaswamy is regarded as one of the uglier contestsin the 3 November midterm elections.

Acton has refused to debate Ramaswamy, who she has called a “chronic liar” and has also criticized him for airing an ad which features a woman married to a registered sex offender, as the Bulwark first reported.

Last month, an armed man lunged at Acton during a campaign stop during a county fair, leaving several attenders injured, before he was arrested. Acton was not hurt in the incident.