Margaret Sanger opened the country’s first birth-control clinic, in Brooklyn, in 1916, an action that led to her being arrested and sentenced to thirty days in jail. Photograph from Chicago History Museum / Getty

The Planned Parenthood health center in Brooklyn occupies ten thousand square feet on the sixth floor of an office building across the street from a courthouse. After you get off the elevator, you have to go through a metal detector. A guard behind bulletproof glass inspects your bags. The day I was there, in June, the waiting room was full; the line at the registration desk was ten deep. A bowl on the counter was filled with condoms, giveaways. A sign on the wall explained Plan B, the morning-after pill. In the waiting room, a couple of dozen women sat in rows of blue plastic chairs, texting. A few wandered over to a display of glossy brochures and picked up “Am I Ready to Have Sex?” or “Birth Control and GYN Care: For FREE. For REAL.”

Aside from its proximity to the site of the United States’ first birth-control clinic—opened in Brooklyn in 1916—the place is a typical Planned Parenthood clinic. Last year, seventeen thousand patients received medical care here. Two-thirds were insured by Medicaid, or paid reduced rates, or received free treatment. They were tested for S.T.I.s and U.T.I.s; they were prescribed birth-control pills and antibiotics; they were fitted for diaphragms and I.U.D.s and cervical caps; they learned how to check their breasts for lumps. They had pregnancy tests and Pap smears and abortions.

Nearly every woman there looked to be in her twenties, and everyone was wearing flip-flops and jeans and T-shirts or halter tops; outside, it was sultry. Ponytailed college students carried bike helmets and backpacks; women wearing head scarves clutched handbags. One woman had brought her boyfriend. Another had brought her son. He was playing with a Nintendo DS. Thumbs herky-jerky, he would sometimes elbow his mother by accident, and she would smile and stroke his cheek.

Nellie Santiago-Rivera has been the director of the Brooklyn health center for the past eleven years. The corkboard behind her desk is covered with family photographs. When she was a teen-ager growing up in the Bronx, a friend brought her to the Planned Parenthood clinic at 149th Street to get contraception. “Birth control is not something we talked about in my family,” she told me. Her parents were born in Puerto Rico. “We believed, ‘You light the candle, and you pray.’ ” A report published in 1965, when Santiago-Rivera was a girl, found that ninety-four per cent of women who died in New York City from illegal abortions were either black or Puerto Rican.

The Brooklyn health center is one of four clinics run by Planned Parenthood of New York City, an affiliate of the national organization. There’s one in Manhattan, one in the Bronx, and one in Staten Island. There are eighty-two Planned Parenthood affiliates nationwide, operating nearly eight hundred clinics. Planned Parenthood says that one in five women in the United States has been treated at a Planned Parenthood clinic. Critics of Planned Parenthood, who are engaged in a sustained attack on the organization, say that most of those women are going to those clinics to have abortions, paid for, in violation of the Hyde Amendment, with taxpayer money.

“This started the day after the mid-terms,” Cecile Richards said when we met in July. Richards, the daughter of the former Texas governor Ann Richards, has been the president of Planned Parenthood since 2006. She’s long-boned and fair-haired and glamorous, and she is in the eye of a perfect political storm. “What happened at the elections had nothing to do with abortion or birth control or Planned Parenthood,” she said. “It had to do with the economy.” But the election reshaped both Congress and state legislatures, and her theory is that “when those guys can’t figure out what to do about jobs, and they can’t, their first target is women.”

The campaign against Planned Parenthood has been unrelenting. Michele Bachmann, in one speech, accused the organization of “committing crimes and enabling young minor girls and covering up issues I don’t even want to talk about it because it’s so disgusting” and, in another, described clinics in swank suburban malls where wealthy women who are “picking up Starbucks” can be found “stopping off for an abortion.” Was it shabby and underhanded or upmarket and unabashed? “We would wake up and, every day, it would be about something else,” Richards said. “Some days it was about abortion. Some days it was about race. Some days it was about me. Some days it was about kids.”

The fury over Planned Parenthood is two political passions—opposition to abortion and opposition to government programs for the poor—acting as one. So far, it has nearly led to the shutdown of the federal government, required Republican Presidential nominees to swear their fealty to the pro-life lobby, tied up legislatures and courts in more than half a dozen states, launched a congressional investigation, and helped cripple the Democratic Party. What’s next?

Planned Parenthood’s latest round of difficulties dates back about a year. Just as the new Republican-majority House was being seated, a group called Live Action, whose mission is “to expose abuses in the abortion industry and advocate for human rights for the pre-born,” sent a man posing as a pimp and a woman posing as a prostitute to Planned Parenthood clinics across the country, equipped with a hidden camera. Live Action was started in 2003 by a homeschooled fifteen-year-old California girl named Lila Rose; she has worked with James O’Keefe, who has engineered stings on ACORN and NPR. Charmaine Yoest, who heads Americans United for Life, has called Rose “the Upton Sinclair of this generation.”

Santiago-Rivera believes that the pimp and the prostitute came to her clinic and left, frustrated by the questions they faced at the registration desk. Planned Parenthood reported the man to the F.B.I. At the beginning of February, Live Action posted on the Internet very troubling videos taken at seven clinics, including one in New Jersey, where a clinic manager suggests lying to avoid detection. (The manager was subsequently fired.) In footage shot at the clinic in the Bronx, where Santiago-Rivera went to get birth control when she was a teen-ager, the couple asks about making appointments for girls who don’t speak English and who might need abortions. Live Action’s transcript reads like this:

PP: We see people as young as 13 years old. Prostitute: How old? PP: We see people as young as 13 and— Pimp: As young as 13. PP: Everything is totally confidential.

Days later, Mike Pence, a Republican representative from Indiana, introduced to Congress a measure to eliminate all federal funding for Planned Parenthood. “I thought that was an error on Pence’s part,” Richards says. “I thought they’d go for abortion restrictions, one by one, bit by bit. To have gone foursquare against Planned Parenthood—well, to do that is to go after health care for women.”