Ilyse Hogue of NARAL worried as she tracked the numbers. It was the spring of 2019, the Democratic presidential primary campaign was already underway, and twenty-three candidates were vying to combat Donald Trump in the coming general election. Abortion-rights advocates desperately needed a champion for their cause. The situation seemed to grow more dire by the week, as state after state passed abortion bans. In May, Alabama surpassed Mississippi for approving the most restrictive abortion law in the country, a near total ban, including in cases of rape and incest, with limited exceptions for the health of the mother.
Most of the Democratic primary candidates responded with force. Senator Elizabeth Warren warned of “back-alley butchers” and “desperate women.” Senator Kamala Harris solicited donations for abortion funds. Senator Kirsten Gillibrand called for Americans to “fight like hell” against the new bans.
But the front-runner was more like the kind of Democrat Hogue had tried to purge the party of the year before than his rivals were. Like Trump, who Marjorie Dannenfelser once worried wouldn’t support the antiabortion cause, Joe Biden wasn’t known as a stalwart champion of Hogue’s movement. He released one comment about Alabama’s new near-total ban, using language about “choice” that abortion-rights supporters had long ago disavowed. “Roe v. Wade is settled law and should not be overturned,” Biden wrote on social media. “This choice should remain between a woman and her doctor.”
That kind of restraint didn’t cut it for Hogue. She didn’t know about ADF’s specific plans. But she saw an ecosystem of antiabortion activists pushing toward the Supreme Court. “All of these state legislators are acknowledging that these bills are designed to actually gut Roe and criminalize abortion—and they’re doing that now because they don’t know if they’ll have the White House in 2020, and they need to move fast,” she said in an interview with The Riveter, the online publication of a women’s professional network.
Democrats needed a more aggressive approach, and it couldn’t wait. The next president had to be the fiercest defender of abortion rights. And for Hogue and other abortion rights activists, that wasn’t Biden. He refused to meet with their movement. He wouldn’t talk about the issue publicly. And he continued to support the Hyde Amendment, which barred the use of Medicaid funding for most abortions, despite the party rejecting the policy in its 2016 platform. Hogue knew his record—and she didn’t like it. Biden, she and others in her movement believed, represented a generation of Democrats who were squishy on abortion rights and whose era had passed.
Unlike Trump, Biden held strong beliefs about abortion. He was raised in the Catholic church in the post–World War II era. As a child, Biden learned that life began at conception and abortion was murder. But as a Democratic politician, he championed the liberal pluralism that he saw as central to American values. Torn between allegiance to his faith and his politics, Biden would spend nearly a half century struggling to square his two belief systems.
He entered the Senate at age thirty in 1973, just weeks before Roe was decided, as he sought comfort in his faith following the deaths of his wife and infant daughter in a car crash in Delaware. In an interview with the celebrity biographer Kitty Kelley the next year, when Americans were divided over issues of drugs and young people who had avoided the draft, he made his opposition to the procedure clear. “When it comes to issues like abortion, amnesty, and acid, I’m about as liberal as your grandmother,” he said. “I don’t like the Supreme Court decision on abortion. I think it went too far. I don’t think that a woman has the sole right to say what should happen to her body.”
In his early years in the Senate, Biden was an antiabortion Democrat who backed a constitutional amendment allowing states to overturn Roe. Over the four decades that followed, his position evolved. Biden still backed policies limiting abortion access, like the so-called partial-birth abortion ban championed by the Bush administration and the Hyde Amendment. He believed taxpayer funds should not pay for abortion procedures. But in later interviews, he defended Roe as correctly decided.
By the time he ran for president in 2007, against Obama and Clinton, Biden had come to a decision: Roe was the best means in a “heterogeneous society” to find some “general accommodation on what is a religiously charged and a publicly charged debate,” he said on Meet the Press that year. He drew a firm line between his policy choices and his faith, taking the opposite view from conservative Catholics like Leonard Leo and Marjorie Dannenfelser. “I’m prepared to accept that at the moment of conception there’s human life and being, but I’m not prepared to say that to other God-fearing, non-God-fearing people that have a different view,” he told the Catholic magazine America in 2015.
Biden’s position was clear: personally antiabortion; politically pro–abortion rights. It was a view that made him like so many Americans with their own, idiosyncratic views on the topic. For decades, public opinion surveys struggled to capture those complexities, making polling about the specifics of abortion policies notoriously unreliable. So much depended on how the questions were phrased. Were the words pro-life and pro-choice used? Politicized terms like partial-birth abortion or clinical ones? Different surveys would deliver results that seemed contradictory, such as a majority of voters saying they wanted abortion to be legal in “all or most cases,” but large shares also backing various restrictions, like fifteen-week bans or parental notification.
But a few policies had clear and broad support. A majority of Americans backed some form of federal abortion rights. A majority of Americans supported Roe. A majority believed abortion should be legal in cases of rape or incest, or if the mother’s health was at risk. Americans became more uncomfortable with abortion as pregnancy progressed, though they disagreed on precisely when the limit should be set. And many Americans believed taxpayer dollars shouldn’t pay for abortions.
And so, in 2020, as the other Democrats running for their party’s nomination offered uncompromising defenses of the procedure, Biden rarely spoke about the issue publicly. When he did, it was always in euphemisms, never uttering the word abortion. Privately, he worried that the uncompromising pro–abortion rights rhetoric of his rivals could alienate the moderates his party would need to win a general election against Trump. And despite a pressure campaign from abortion-rights activists, he refused to budge on his support for the Hyde Amendment.
To the activists, Biden’s candidacy felt like moving backward to a time when abortion was kept in the shadows. As they saw it, Hyde was an issue of reproductive rights but also racial justice and health care. The policy meant that more than 7.9 million low-income Americans—overwhelmingly women of color—were denied coverage for an abortion, making them more likely to end up carrying a pregnancy to term if they couldn’t find the money to pay for the procedure. As Republican states ratcheted up their efforts to pass restrictive abortion laws, Biden’s position signified to some liberal voters that he was out of date and out of touch with the stakes of this new fight, campaign aides warned. Just as Trump’s Make America Great Again movement pushed the Republican Party further to the right, the response to Trump’s administration had emboldened the liberal flank of the Democratic Party. Positions once considered radical, like expanding the Supreme Court, abolishing Immigration and Customs Enforcement, and eliminating the Hyde Amendment, had become mainstream, championed by top candidates in the party’s primary.
Most of his primary opponents had adopted the party’s position in their platform. Several now highlighted their opposition to the policy to cast Biden as out of touch. “No woman’s access to reproductive health care should be based on how much money she has. We must repeal the Hyde Amendment,” Senator Kamala Harris of California wrote on social media.
Celebrity allies, powerful Black female Democrats, and abortion-rights activists pushed Biden to change his position on Hyde. “You can’t tell me that this vice president who has been a champion for women would want to continue a discriminatory policy that is so detrimental to poor women, to women of color, to low-income women,” Representative Barbara Lee, a Democrat from California and progressive champion, told The New York Times of Biden’s position. Under pressure, Biden came to realize that the times had changed from when he first supported Hyde all those decades ago. It wasn’t just the Democrats who had shifted: Republicans had become more uniform in their opposition to abortion since the early 1990s, when Biden was being lobbied as a swing vote on the issue in the Senate. They’d embraced state abortion bans, which, Biden thought, had forced a discussion about racial and economic equity. That, too, was a core tenet of Catholic social teaching, which stressed helping the poor and vulnerable.
In early June, Biden headed to Atlanta to address a DNC fundraising dinner. The Georgia legislature had passed a six-week abortion ban just weeks earlier. Reading the additional pages aides inserted into his speech for the event, he made peace with changing his thirty-year-old position. “I signed up to do this to win,” he said. “That has to be part of the equation.” When he took the stage, his stance was clear. “If I believe health care is a right, as I do, I can no longer support an amendment that makes that right dependent on someone’s ZIP code,” he said.
Still, even after his announcement, Biden wrestled with how the rapid escalation of abortion bans and the radicalization of the antiabortion movement during the Trump administration had made his support for Hyde, a policy he long viewed as a compromise position between his faith and his politics, rapidly untenable. “What hit me was we’re in a situation where when the assault was going on in Georgia, what’s going on in Alabama, Missouri, it’s just outrageous,” Biden said, campaigning in Iowa. “How do you say, ‘Well, guess what, it’s gone, it’s gone’? So that’s the reason why I made that decision.”
Yet, while Hogue and her allies won over Biden in the primary, they did not maintain their grip as the race moved toward the general election. As Warren, Harris, and others embraced policies like requiring private insurers to cover abortion and making abortion pills available over the counter, Biden stayed mum. His campaign didn’t release an abortion policy plan and declined to respond to a New York Times survey on the candidates’ views. There was little evidence from 2012 or 2016 that the issue energized large swaths of Democratic voters, his aides argued, so why force Biden to highlight an issue that he struggled to discuss publicly?
The Democratic Party followed his lead. At its national convention in August 2020, the word abortion was never uttered. On the rare occasion the issue was raised, it was through the language of racial justice, with more oblique references, like when Harris, the vice-presidential nominee, spoke about inequities in “reproductive and maternal health care.”
The silence frustrated Hogue. Biden was their nominee. He would be challenging the most antiabortion president in history. And he didn’t seem to want to talk about abortion at all. In strategy memos and presentations to politicians and aides, she urged Democrats to talk more about the issue. Yet, even the abortion-rights movement could not agree on what to say. With the general election looming, each of the three major national abortion-rights political organizations took a slightly different approach to the issue. Under Alexis McGill Johnson’s leadership, Planned Parenthood cast the race as a battle for reproductive health care, embracing another new slogan—“Bans Off Our Bodies”—as the number of restrictions ballooned in Republican states. EMILYs List ran only one notable general election ad about abortion, attacking incumbent Senator Susan Collins for backing Brett Kavanaugh as she ran for reelection in Maine. And at NARAL, after investing in a yearslong research project to figure out the best messaging for the movement, Hogue was trying to rally Democrats around the idea of framing abortion as a personal freedom—a classic American value. In presentations detailing their new approach, which was based on intensive polling and focus groups, NARAL strategists advised Democrats to play offense by describing the full scale of state restrictions and promising to create a country where “people respect other people’s personal decisions around parenthood and pregnancy.” Much of their research showed that “freedom to decide” was a more powerful argument for Americans than Planned Parenthood’s messages about health care and women’s rights.
To local abortion-rights activists in states that had passed restrictive abortion laws, the whole discussion about messaging felt entirely out of touch. As Democrats debated whether to talk about abortion and movement activists fought over how to discuss it, abortion providers were struggling with the most basic function of all: providing it.
While Planned Parenthood remained the biggest abortion provider in the country in 2019, it wasn’t performing the majority of abortions in America. About 60 percent of abortions happened in small, unaffiliated independent clinics, which performed most of the controversial procedures later in pregnancy.
The flood of state restrictions had forced more than a third of those clinics to close their doors. In 2012, when Obama was president, there were 510 independent abortion clinics, according to the Abortion Care Network, the national association of independent clinics. By 2019, their numbers were down to 344.
Those clinics had little lobbying power and none of the fundraising prowess or brand recognition of Planned Parenthood. “We don’t have the infrastructure,” said Tammi Kromenaker, the straight-shooting feminist activist who ran Red River Women’s Clinic, the only remaining abortion clinic in North Dakota. “You need an advocacy person? That’s me. You need a legal person? That’s me. Someone to plunge the toilet? That’s me.”
Many of these providers felt dismissed and powerless. Some of them blamed Planned Parenthood for dominating the debate, sucking up financial resources to bolster its own operation while ignoring the clinics struggling to provide services in the most hostile areas. “When people are up in arms and angry and upset about the bans, their instinct is to give to Planned Parenthood,” said Kwajelyn Jackson, the executive director of the Feminist Women’s Health Center in Atlanta, an independent clinic. “People want to do what’s easy. Planned Parenthood is easy to think about.”
Alabama provided a striking example of the disconnect. In the weeks after its near-total ban was passed, celebrities and liberal donors poured money into Planned Parenthood. Musicians, from Lizzo to Carole King to John Legend, promoted the group’s #BansOffMyBody campaign. Ariana Grande donated the proceeds from her concert sales, and the founder of Tumblr pledged $1 million.
But Planned Parenthood didn’t actually perform abortions in the state. Its two Alabama clinics hadn’t offered abortion services since March 2017, according to data from the state department of health, though they advertised the service. Meanwhile, Gloria Gray, the head of the independent West Alabama Women’s Center in Tuscaloosa, was having trouble paying her bills. Her clinic performed more than 3,300 abortions in 2018, more than half of all the procedures in Alabama. Yet she couldn’t afford a $20,000 fence to keep the protesters off the property. While Planned Parenthood collected millions, her crowdfunding effort produced about $4,000. “We saw an outpouring of love and support throughout the whole country, to which we’re very grateful,” said Gray. “But we as independent providers have not necessarily seen a lot of benefit from that.”
Even within Planned Parenthood, disparities persisted between the national office, which raised hundreds of millions to be spent on lobbying and campaigns, and its independent affiliates, which paid dues to the national office to operate their clinics under the organization’s brand. Some of their health centers in conservative states struggled financially, constantly racing to keep up with laws requiring they meet standards that made it expensive and burdensome to operate.
There had been no movement-wide strategy to prepare for the multipronged legal assault from the antiabortion forces. “They are pulling us in fifty million different directions. You can’t just go to the US Congress. It is this legislature, that one. This one meets this month. This one meets every other year. It’s Whac-A-Mole,” said Kromenaker, in North Dakota. “I don’t think anybody ever thought it would get to where it is right now.”
Kromenaker grew up Catholic and opposed abortion. She broadcast her views, even pasting a GOD IS PRO-LIFE bumper sticker in her dorm room at Minnesota State University. Then a friend had an unwanted pregnancy, and her views changed. It was “an immediate flip of the switch,” she said. After graduation, Kromenaker got a job as a part-time patient advocate at the clinic in North Dakota. Eventually, she became the owner of the small brick building in Fargo. The clinic didn’t see a ton of patients. Maybe twenty or twenty-five on Wednesdays, when staffers performed abortions. But many of those patients traveled hours to reach the state’s only abortion provider. After more than two decades, the lavender walls of the intake rooms, the rituals of patients and procedures, even the hate mail had become the rhythm of Kromenaker’s daily life.
Kromenaker echoed a version of Leana Wen’s philosophy. Planned Parenthood’s focus on progressive politics had not helped her in North Dakota—or preserved the political career of Heidi Heitkamp, their former senator—and in the fall of 2019, it felt like very little could. The attacks were coming too fast and too frequently. “I don’t think anyone ever foresaw that we would need a movement strategy,” she said at the time. “We’ve had Roe.” If abortion-rights activists could do it all again, Kromenaker thought, they wouldn’t have stopped at the Supreme Court back in 1973. They would have worked to enshrine abortion rights state by state, town by town, to protect Roe from conservative state legislators.
But, of course, that wasn’t what happened. And now there was no broader plan—or even a unified national message—to fight back in this crucial moment. If Roe fell, a trigger law would ban abortion in her state within thirty days. Similar laws were on the books in a dozen other states. They would essentially make the procedure illegal across broad swaths of the South and Midwest.
To Kromenaker, it was clear that the fate of Roe now rested on the frail shoulders of Ruth Bader Ginsburg, the now-elderly Supreme Court justice whose picture was displayed on a banner in Kromenaker’s office. Roe itself felt like it was dangling, too, she thought.
“I can only be hopeful that we don’t get to the place where it is all taken away for us to realize what is going on,” she said. “It feels like it is hanging by a Ginsburg thread.”