I arrive at Kentucky’s last abortion clinic around 8 AM on a Saturday in October. There are a handful of protestors gathered out front, bearing signs that liken abortion to murder and toting Bibles. Like all the employees there, I have to enter through a gated fence in the back, away from the chants of the demonstrators. But the patients unfortunately have to enter through the front, pushing past the anti-abortion activists, and into the waiting area.

Through the glass window in the waiting room, I can see the throng of protesters outside and hear them yelling, “Please don’t do it!” The women awaiting their appointments avert their eyes from the shouting and keep their heads down, trying their best to ignore the scene outside.

The clinic, EMW Women’s Surgical Center, in Louisville, has become a flashpoint in the debate around abortion access in the US and a symbol of quiet resistance against an insidious anti-choice agenda. In recent months, EMW Women’s Surgical Center has been under sustained attack from hundreds of anti-abortion protesters and from conservative legislators, who hope to make Kentucky the first state without a single abortion provider. But the women and men who work here remain determined to keep its doors open and provide their patients with quality care.

One of those at forefront of this fight is Anne Ahola, who has been working as the clinic director for the past 17 years. A tall and imposing woman who has a thick Swedish accent, even though she moved to the US 40 years ago, Ahola has devoted her life to reproductive rights ever since she first came to Louisville to study social work. With patients, she’s personable and nurturing, though she can come off as a bit stern—sort of like a wise, older friend. (She tells me, for instance, that she’s counseled several women to “stop feeding the men that just use you for your bed.”)

As the surgical center director, it is Ahola’s duty to ensure each patient properly follows several steps—including vitals, blood work, medical history, and an ultrasound, the last of which is specifically mandated by the state—before getting her procedure. I watch as she leads a group of about 15 women from the waiting area into a separate room containing a TV and comfortable chairs. She welcomes them warmly and then starts an informational video, about the procedure and its side effects and risks. Once this is over, she takes each patient, one by one, to her office and holds a counseling a session, where each is asked if she has questions and if she is certain about her decision.

“In the Bible, God breathed into Adam’s nostrils the breath of life, and that’s when man became a living being. It doesn’t say anything about a heartbeat.”

Ahola later tells me that she conscientiously allows the session to move in whatever direction the patient wants to take it, studying each woman’s demeanor to make sure she wasn’t coerced into the procedure. If the patient seems to be struggling emotionally—if she feels distraught by the religious protesters outside, for instance, or if she “hears the heartbeat and becomes upset” during the state-mandated ultrasound—Ahola will pause and make sure she’s sure this is the right choice for her.

According to Ahola, many of these conversations will turn towards religion; a lot of patients come from religious families, she explains, and many come to their appointments alone, not wanting their loved ones to know. Ahola herself identifies as a devout Christian, which helps. “My God is a loving and forgiving God. I don’t know what God those people outside are talking about,” she proclaims, referring to the protesters outside. “In the Bible, God breathed into Adam’s nostrils the breath of life, and that’s when man became a living being. It doesn’t say anything about a heartbeat.”

Ahola says she’s invited religious demonstrators into the clinic on several occasions in the past to show firsthand how the facility operates, to get a sense of the protestors’ viewpoint, and to prove to them that, in her words, “God is in here, too.” She once noticed a man in his mid-twenties outside, she continues, and it struck her as odd that “he would just linger there after most of the protesters have gone for the day.” So she invited him into the clinic one day and finally heard his story: The man had come from a deeply religious family that found lust sinful, and in college he had sex with a woman, leaving him with feelings of extreme remorse.

“It was almost like he was coming to the protests to rid himself of that guilt,” Ahola says sympathetically. (She saw him a few times again out front after their interaction, but he hasn’t been back in recent months.)

Very few other protesters or anti-abortion groups are so willing to hear Ahola’s perspective. In July, most notably, the notorious anti-abortion group Operation Save America was in Louisville for a week-long national event with up to 700 protestors from across the nation participating. The organization staged demonstrations in front of the EMW Women’s Surgical Center, bearing graphic anti-abortion banners and posters, resulting in the arrest of 11 demonstrators. Operation Save America also targeted Ahola personally, she says, mailing thousands of fliers to her neighbors with her picture, address, and the word “murderer” across the top—though she remains steadfast in her views that helping women access the full breadth of reproductive care is a moral duty.