Lila Rose has had a very good year.

In October, she starred in a just-released mini-documentary from The Atlantic about the anti-abortion organization she founded in her parents’ San Jose living room at age 15. Then she got married and went on a honeymoon, posting to Instagram from the beach with her new, extremely clean-cut husband in matching blue and white outfits. And in the same month, the U.S. Supreme Court confirmed a justice who will likely do more to end abortion than anyone in recent history.

Reproductive justice advocates are preparing for the biggest rollback of abortion rights in decades, and the mood among pro-choice women and sexual assault survivors is low. “It scares me for my daughters and their friends,” says Laura Jimenez, executive director of California Latinas for Reproductive Justice. But Rose told The Atlantic she was “excited to be alive” during this time, when abortion could become illegal everywhere.

Rose, now 30, became a high-profile anti-abortion activist after she pretended to be a 13-year-old and infiltrated Planned Parenthood in 2008, making hoaxy videos that she hoped would get the organization defunded. Even with heavy Breitbart promotion that led to a Congressional investigation, the videos didn’t affect Planned Parenthood’s national funding. “The videos were heavily edited and fraudulently obtained, and ultimately there was no finding of wrongdoing,” says Lupe Rodriguez, spokeswoman for Planned Parenthood Mar Monte and board member at ACCESS: Women’s Health Justice. But they put Live Action, the nonprofit she founded as a homeschooled 15-year-old in her parents’ San Jose living room, on the map.

It’s a right-wing version of the Silicon Valley startup narrative, except Rose is marketing herself; these days, she leads a team of about 20 employees in an Arlington, Virginia, office, the millennial figurehead for the same anti-abortion tactics that groups like Operation Rescue have been using for decades. Rose calls pro-choice feminism “antiquated,” but nothing about Live Action’s opposition to abortion, birth control, and in-vitro fertilization (IVF) is modern; one in four American women of reproductive age will have an abortion, 98 percent of sexually active women have used birth control at some point, and IVF is old news in Silicon Valley, a hotbed of tech fertility companies that are based around its possibilities.

Neither is Silicon Valley known for its anti-abortion activism, though it’s home to plenty of Catholics. Rose converted to Catholicism in 2009, before the church’s pedophilia scandals broke open. These days, adult conversion is not popular: for every convert, about six Catholics leave the church, and only 16 percent of millennials say they’re Catholic. But Catholics are overrepresented on the Supreme Court—Kavanaugh was the fifth Catholic on a court of nine—and the religious belief that abortion is murder could define what the rest of us can do what our bodies for generations.

A Supreme Court poised to roll back protections on body autonomy feels especially extreme at a time when #MeToo has reshaped consequences for sexual harassment and in a county that recalled a judge that voters deemed too lenient on a rapist. Stanford professor Michele Dauber, who led the Judge Aaron Persky recall and founded the Enough is Enough political action committee, thinks we’re in a new moment. In the Obama era, she says, there was broad consensus “that women should be captains of their own fate, and they should be able to decide when and under what conditions they have sex and and when and under what conditions they have babies.”

But Kavanaugh’s confirmation indicates that things have changed. “That consensus is starting to break apart under the pressure of Trumpism,” Dauber says.

The moment might be new, but Rose’s work feels old-school. Her organization uses the same grisly photos of fetuses that protesters have always used outside abortion clinics, now with the addition of memes, like the one on her social media pages that compares photos of slavery and the Holocaust to abortion (Rose is neither black nor Jewish, and Facebook blocked the photo, calling it “hate speech”). Her Twitter background is a direct echo of the Women’s March logo: same colors, same silhouette-style image, except the woman in the image has a pregnant belly with a fetus. Her tweets skip weekends, as if she’s employed someone to do her social media and they take Saturdays and Sundays off.

That’s hard to know, since the “who we are” page on LiveAction’s website lists no other staff members, as if Rose is the only person in the organization. Even her Instagram feed, featuring screenshots from her Fox interviews and carefully posed selfies, is oddly impersonal. (Among the 174 accounts she follows: Chris Pratt, Sean Hannity, some friars, a lot of bridal designers and someone whose handle is “catholicwifecatholiclife.” She does not follow Rep. Steve King, the openly white supremacist Iowa congressman who spoke at a recent Live Action press conference and said he’s a “big fan” of her work.)

Abortion destroys dreams.

It destroys opportunities.

It destroys happiness.

It says "this situation is hopeless."

It says "you don't have what it takes."

It offers a child's death as the path to survival. It's all a total, rotten lie. And America's women are beginning to see it. — Lila Rose (@LilaGraceRose) November 27, 2018

Perhaps the hope is for Rose’s polished image, piped into Fox News viewers’ homes, to legitimize the sometimes violent tactics of the anti-abortion movement. When three people were murdered at a Colorado Springs Planned Parenthood in 2015, pro-choice groups linked the attack to Rose’s latest round of videos. Rose’s friends at Operation Rescue—she promotes the same anti-abortion films as they do and shares their videos—were known for their “Wanted” posters of abortion doctors, several of those doctors were eventually murdered.

But Rose is a leader for winning times, and abortion foes are winning. She doesn’t need to be scrappy and terrifying like the evangelical extremists camped out in front of midwestern abortion clinics in the early ‘90s. She also, apparently, doesn’t need to speak with any media she deems less than fawning. Rose skipped out on a long-planned interview with San Jose Inside/Metro; her communications director cited surprise late travel before press time. She can simply appear on TV and smile on her tightly-curated Instagram feed, secure in the knowledge that reproductive rights are fading in America.

That fade could be gradual, but it does seem likely. Usually, when states pass anti-abortion laws that seem unconstitutional, higher courts shut them down. But with Kavanaugh on the Supreme Court and the Trump administration stacking lower courts with young anti-abortion judges, we might see fewer of those laws get overturned in the early stages. “Many of these laws and policies have also been explicitly about teeing up the court cases that would make it to a changed Supreme Court and give the court the opportunity to yes, overturn Roe, but more realistically, gut the protections that it affords,” said Megan Donovan, senior policy manager at the Guttmacher Institute, a sexual reproductive rights think tank.

States are already vastly unequal in what they provide: Kentucky and Missouri each have only one clinic that does abortions, which means there are only a few doctors, it’s further to travel if you need to end a pregnancy, protests are all focused on the single clinics, and legislation can get passed specifically to make those individual clinics harder to run.

For anyone needing reproductive health care in red states, that’s a problem, especially if Texas is the model, with its far-right-controlled legislature and governorship. Five years ago, Texas state senator Wendy Davis tried to filibuster an anti-abortion law for 13 hours in pink running shoes, with a roaring packed capitol building behind her. She staved off the law for a night, but Gov. Rick Perry convened a special session to ram it through, and 19 abortion clinics closed immediately afterwards. That means there’s nowhere to get an abortion in the 552 miles between San Antonio and El Paso. Laws requiring extreme inspections and arcane building codes mean that states like Kentucky and Missouri have only abortion clinic each.

Cynics say the right might not want to overturn Roe v. Wade itself, since its existence drives right-wing voter turnout for anyone who promises to get rid of it. Instead, the idea is to close abortion clinics one by one, until they’re concentrated in blue states and it’s almost impossible to get an abortion in most of the country. “It’s more likely that the court would stop short of overturning Roe but alter the legal framework and make more and more restrictions on abortion constitutional, to the point that the protections of Roe would be rendered essentially meaningless,” says Donovan.

But California is not immune to this strategy, either. Rose cheered on social media this month after Gov. Jerry Brown inexplicably vetoed a bill that would have allowed abortion pills on University of California campuses, calling it “unnecessary,” even though Berkeley students couldn’t get their campus to provide the medication and the law passed in the Assembly and Senate by a wide margin. At a time when young people were reminding each other to stock up on emergency contraception in case it disappears, Brown handed anti-abortion activists a victory on his way out of office. “It was not in line with other bold moves that California has been making in shoring up people’s rights, especially in light of what’s been happening with the Trump administration,” says Jimenez.

The Supreme Court ruled against California in June when it said “pregnancy crisis centers” that masquerade as abortion clinics and convince unsuspecting patients to carry their pregnancies to term are allowed to maintain their facade. The clinics don’t provide help with rent after the baby is born or free child care so you can keep your job or stay in school, and California’s high cost of living makes an unintended pregnancy even more difficult to manage.

Those political decisions mean reproductive rights advocates in California can’t focus all their attention on supporting other states. It means they have to put at least some energy into protecting what rights Californians already have. Those rights are pretty solid; California is considered a model for pro-choice legislation, especially because our state constitution explicitly protects the right to abortion. As long as Roe v. Wade remains law, Californians will have access to abortion, even as other states squeeze out their clinics. The state also allows advanced-practice clinicians to provide abortions in the first trimester. “That allows for more providers and more access to a broader range of providers that can perform abortion,” says Donovan.

That makes California a good place to train the resistance, in addition to providing abortions for out-of-state travelers. “We already see women from other states coming to California for care,” Rodriguez says. “If things are further restricted in other parts of the country, we’ll see more of that.”

But access is still an issue here. Medi-Cal covers abortion, which is the best possible insurance scenario to allow everyone who needs an abortion to get one. But the high cost of living in California means that for many people, the list of financial hurdles for getting an abortion is long. “Just because something is legal in the state does not make it accessible,” Jimenez says. “Do I have paid sick leave? Even if I do have paid sick leave, do I have child care? Do I have transportation to get where I need to go? Do I have a place to stay if I have to go someplace overnight?” Rodriguez’s Bay Area-based ACCESS: Women’s Health Justice raises funds to cover those costs as part of the National Network of Abortion Funds, which counts over 70 member organizations providing financial support for abortions across the country.

And threats to exclude Planned Parenthood from receiving funding through Medicaid, the ostensible goal of Rose’s attack videos, would directly affect access to abortion in California. “Eight-seven percent of the patients we see are dependent on some form of federal funding for the services we provide, and if we weren’t able to see them anymore, because we wouldn’t be reimbursed for their care, they wouldn’t have anywhere to go,” says Rodriguez. According to Rodriguez, “about 95 percent” of the health care Planned Parenthood provides is preventive and primary care—birth control prescriptions, STI testing and treatment, prenatal care in the Central Valley, hormone therapy for transgender patients in some locations, and even pediatrics and behavioral health care - and that would disappear if federal funding were cut.

Live Action avoids many underlying questions behind the policies they support, including that life starts at fertilization and contraception is as bad as abortion. The idea seems to be that if you’re not having procreative sex in a heterosexual marriage, you shouldn't have sex at all. But that’s contrary to what 95 percent of Americans do.

For Rodriguez, Rose’s positions don’t match the public health reality of a sexually active public, nor do they align with what most people believe. “Young people, and all people really, are not abstaining from sexual activity,” she says. “A lot of this is about who should be having sex with whom and when,” Jimenez adds. “What we’re saying when we condemn young people for having an abortion is saying you shouldn’t have been having sex in the first place because you’re young.”

“Would Jesus agree?” one of Rose’s followers asked when a guy on Twitter wanted Rose to butt out of people’s sex lives. “Who cares?” he answered. That’s the big question, the vast gap between those who’ve just stacked the Supreme Court and everyone else. The debate rages, but the shift away from legalized body autonomy is already underway, and the impact will be generational.

“This is violence that’s being done to our communities, and it’s going to have a long term effect that we are going to have to reconcile,” Jimenez says. “We’re going to have to call on our leaders to be responsible for that.”