Last week, Robin Utz went to Washington.

Utz, an American woman from the Midwestern state of Missouri, arrived there during the confirmation hearings for President Donald Trump's choice for the nation's highest court, which Trump has indicated he would like to ban abortion in the United States. She went, invited by elected officials, to tell the story of her abortion in November.

"The mission is to tell our story," Utz says, referring to herself and other American women who've chosen to have abortions.

In Washington, Utz's story featured prominently in California Senator Dianne Feinstein's statements of opposition to Trump's nominee for US Supreme Court judge, Neil Gorsuch. It was used as an example of how anti-abortion legislation, Feinstein argued, often appears to be at odds with the medical profession.

Fighting the bigger battle

Utz is at the helm of a growing push among American women - in her state and beyond - to tell their own stories about abortion and to ensure access to the procedure for future generations. It is difficult to do that, she says. There's a lot of stigma surrounding the procedure in the US and particularly where she lives; Missouri is an example of the many states across the country engaged in a mounting bid to restrict access to abortion with a series of bills - some of which are meant to bar certain aspects of the procedure, others to convince and embolden people against it.

When Utz tells her story, she races through the details she finds more difficult to discuss. This is not because of the abortion itself, she is careful to note, but because of what many campaigners for access to legal, safe abortion say is misinformation about the emotional toll of the procedure. Utz's story is difficult for her because she wanted her pregnancy. An ultrasound revealed foetal anomalies - a rare kidney disease - that her child would not have been able to survive.

"We'd have had to immediately put her on life support," she says. Utz had hoped to act as quickly as possible. "This is just inhumane to our daughter," she recalled thinking. "We have to do this now before she's developed a nervous system."

Utz had the full support of her husband and parents - and even her husband's friend, a nun, despite the Catholic Church's steadfast stance against the procedure. But she had to wait for 72 hours, because of a controversial law enacted in 2014 requiring that delay. New legislation also mandated that in that time, she received what doctors have called medically inaccurate information on abortion designed to shame or frighten her out of the procedure.

Particularly given her circumstances, "these things were at a minimum tone deaf and at worst just callous," she says, adding that she would feel no differently if the pregnancy was unwanted.

There is always a reason

Among the women she has spoken to about their experiences, "even those who've had birth control fail, had a good reason," she says. Contrary to claims by abortion opponents, she adds, she has never known a woman to use abortion - particularly given the comparative cost relative to prophylactics - as birth control; it's never an easy or inexpensive choice, she reflects.

"I don't feel ashamed of any of it. Abortion doesn't have to be a shameful thing," she says, adding that she would like to engage her opponents in a rational and respectful conversation about it. She admits that a sober, empathetic discussion among opponents on abortion is a tall order in Missouri and elsewhere in the US, where the topic rouses sensibilities on both sides.

Abortion is, for campaigners for access to the procedure, a lightning rod on a number of problems in the US: The rapid erosion of women's rights, the ever-flailing bid for equitable healthcare, the fight to maintain the separation of church and state guaranteed in the US constitution. For abortion's opponents, who believe - often premised on religious principle - that life starts at conception, the procedure amounts to killing.

This year, there is an unusually high number of bills before the Missouri state legislature that would restrict access to abortion there. Among the 40 different potential laws blocking access to the procedure, activists for access say one calls for an exhibit at a museum in the state's capital that would have for its theme comparisons between abortion, the Holocaust and the US's history of slavery.

"It is the highest number of bills we've seen introduced in the past four years," says M'Evie Mead, director of organising at Planned Parenthood affiliates in Missouri. Planned Parenthood is a nationwide organisation that offers a host of reproductive healthcare services. The organisation has been attacked by conservatives - most recently in the Trump administration - because among those services is abortion and counselling services related to the procedure.

Mead explains that over the past few years, 25 to 35 new bills that would restrict abortion have been proposed, and that in a typical year, only one or two actually become law.

But Mead has noticed an "effort to have your name on [an] anti-choice bill" among conservative state politicians seeking re-election for the state's legislature next year.

Missouri State Representative Tom Hurst, another Republican, introduced a bill that would make it illegal to transport a minor across state lines without parental consent. Hurst argues that the bill would both prevent minors from obtaining abortions without parental consent and also guard against sex trafficking of minors.

Another bill sponsored by Hurst is one "allowing the burial of a baby that has been aborted. [It] gives the parent the choice of burying their baby so that Planned Parenthood cannot sell the body parts," he said, alluding to claims by abortion opponents - repeatedly disproven in investigations - that Planned Parenthood sells body parts.

"We honor life and wish to protect it," he said.

On Trump, Hurst said, "I am hopeful he will respect our concerns and help with our effort."

"I hope our government has better respect for human life than the previous [Obama] administration," he added.

Hurst was the only anti-abortion legislator or activist to respond to an interview request from Al Jazeera.

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'Atrocious and salacious'

Mike Moon, the Missouri state representative behind the bill calling for the museum exhibit, did not respond to Al Jazeera's questions about what inspired the comparison. Mead characterises Moon's comparison as "atrocious and salacious".

Many of Moon's fellow Republican Party members - in government and out of it - have ignored interview requests since Trump's inauguration in January.

Some say the legislators are encouraged by a Trump White House that has pledged to come to their support.

Trump has promised to overturn Roe v Wade, the landmark Supreme Court decision that in 1973 guaranteed access to abortions for American women. Gorsuch has promised to respect the precedent set by the ruling in that case, but Senator Feinstein has cautioned that his responses to her questions at his confirmation hearing have evaded any specific indication of what he would do if a case came before the court in which a ruling might drastically restrict the availability of the procedure.

Abortion access campaigners, including the National Abortion Rights Action League, say that before Roe v Wade, thousands of women died each year in botched illegal abortions. An accurate number is impossible to obtain due to the secrecy enshrouding these deaths.

A return to that era of American history is possible under this administration, some warn. Trump is unpredictable, says Colleen McNicholas, a doctor at Washington University School of Medicine - one of a few performing abortions for Midwestern women.

"I think what we all should be thinking is there is no way to predict what he will do," McNicholas says. "He has traditionally not been conservative on social issues, although like is true of most politicians, it seems like giving up principals in the quest for political advancement and power is common place."

Mead also acknowledges that Trump was not always in favour of banning abortion, but that does not seem to concern some opponents of the medical procedure.

Trump famously said on the campaign trail that women should be punished for having abortions.

McNicholas says that Trump's firebrand rhetoric has put many people across the country in danger.

"The rhetoric demonising these entities is really dangerous and has led to an uptick of violence targeting abortion providers and clinics. Our elected officials have a responsibility to choose their words carefully, and at a minimum to make sure the statements they put out are accurate," she says.

"But that is sort of the crux of it - isn't it? We live in a world - in the US - of alternative facts - where science and evidence only matter when it supports your argument. One of the most fascinating perspectives from my standpoint is that if you support reproductive choice and freedom you support someone's decision not only to have an abortion but to not have one as well."

McNicholas travels long distances regionally to provide abortions to women living in states where now - following a series of state legislature restrictions that demand that clinics meet what she and other abortion access campaigners say are impossible standards for their facilities - there is often only one abortion clinic within hundreds of miles. She estimates that women in Missouri travel, on average, more than 100 miles to get the procedure.

Overwhelming costs

Utz says she is "privileged" to have been able to get an abortion. She lives in Missouri's largest city, St Louis, and has health insurance and the support of her family. Many women, she says, cannot afford, without ample financial support, to take time off work, find child care, travel 100 miles and then find a hotel where they wait 72 hours for a procedure that can cost anywhere between hundreds and thousands of dollars, with insurance.

Like Utz, Sally, a pseudonym as she spoke under the condition of anonymity for safety reasons, lives in Missouri. "I drive by Planned Parenthood every day on the way to work and there are people protesting and there are people that don't want to let women have choice within two miles from my home," she says.



"People have bombed abortion clinics. There have been people shot and killed. The people who have been protesting there aren't always mentally level."

Sally had an abortion in her late 30s. As a single, working-class woman, "it's expensive, you have to take time off work, so you're missing work," she says. In total, including her time off work, it cost her more than $2,000.

"I don't think anyone should have to worry about their decision - whether it be because they made a mistake or their child would be born with an illness and just a 10 percent chance of survival," she explains.

Like Utz, Rachel Goldberg is a Missourian who wanted her pregnancy, but foetal abnormalities led her to make the difficult decision to terminate rather than see her would-be child suffer and almost inevitably die.

Because of Missouri's abortion restriction, Goldberg had to leave the state. "My husband and I travelled to Colorado, we took out a loan to cover the cost of the procedure," she says. These practical considerations compounded what she describes as an overwhelming emotional burden.

"Women die from lack of access to adequate reproductive rights, and Trump's agenda shows a disdain for their lives," Goldberg says.

Because of the circumstances of her abortion, Goldberg was unable to receive an autopsy that would explain why the foetus had not properly developed - leaving her uncertain of whether she should again try to conceive.

"The best medical advice I received was to try again, but it seems scarier to me to make those decisions now, because of the agendas of both my state and national representatives," she says. "Will I be denied healthcare that could save my life? Will I have a right to make choices about my body?"

It cost Kadie Tannehill about $5,000 to get an abortion, with insurance. "I would say abortion is not affordable for all women where I am from, no," she says. For her, there were religious considerations that made the decision difficult, compounded by practical ones. Even as a religious woman, "I think abortion will always be a hot-button issue as long as we allow government to be driven by religion," Tannehill reflects.

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A woman's march

Utz is in contact with other Missouri women, forming strategies about potential activism.

It's difficult to get involved, she says. "I have struggled at times to focus my energy and desire to make a difference; there isn't a playbook for becoming an advocate for abortion."

Despite "warmth, gratitude and enthusiasm" from others at the frontline of this battle, "I'm finding there isn't always a lot of actionable items I'm able to do," she says.

"It'd be great to have a process where, if someone wants to advocate, there is a process to notify and enrol them with all necessary parties," she adds. "I am trying to build a framework around this, but I can't even figure out if I'm reinventing the wheel [and] who to collaborate with yet."

Sally, Goldberg and Tannehill also say that they are actively seeking ways to guarantee women's access to the procedure as elected officials at the federal and state level carry on with plans to eradicate the procedure. But Sally says that speaking to the press was, in itself, a feat for her, where she lives.

While these women find their way in grassroots activism, others continue to note the importance of that work. Under a Trump presidency, many of these women believe that the fight for access to safe, legal abortions is becoming ever more emblematic of many other fights.

"It is my belief that reproductive choice and justice means so much more than just being able to have an abortion," McNicholas, the Washington University doctor, says.

"It means supporting women who desire sterilisation before having any children, it means supporting women who want to have 10 children, it means improving our public education system so that children of all [socioeconomic backgrounds] have an equal playing field, it means supporting equal pay initiatives, and it means supporting paid maternity/paternity policies. Abortion, no matter how much they try to spin it, does not exist in a vacuum. It is just a small piece of the larger picture of equity."

Kadie Tannehill's husband, Justin, observes that there are reasons across party lines to support access, if not the actual procedure. "I would like to point out one of the platform issues of the Missouri Republican Party, 'We believe government governs best when it governs least,'" he says. "And how they contradict themselves with that very statement."

For Kadie Tannehill, like Utz, abortion is emblematic of a pantheon of US civil liberties concerns - causes of the left in a country where all branches of government are now dominated by the right.

"I can also go a step further and say that it is a political indicator and that I believe in funding sex education, universal healthcare, medical marijuana, marriage and gender equality," she says. "I think a lot of politicians like to weigh in on abortion because they will receive support either way on the topic, but when it comes down to it, no one should be able to tell someone what to do for or to themselves. It's my body, my life, my child."