After nearly four decades working in, running, and owning abortion clinics, both her champions and her opponents call her the “abortion queen.” That Diane Derzis, the owner of the state’s last abortion clinic, embraces that moniker is one of the myriad reasons Mississippi’s prolife absolutists want to put her out of business.

Today they may have their chance. The Jackson Women’s Health Organization has been in court to stop the implementation of a law that would effectively close its doors. The law was temporarily blocked by District Judge Daniel Jordan, a George W. Bush appointee, before it could take effect July 1. And today that same judge will hold a hearing on whether the law should go forward.

While the suit to save her clinic started in June, Derzis has been fighting this kind of opposition since she first went to work at a clinic in 1973, the year Roe v. Wade was decided. The 1992 Planned Parenthood v. Casey decision opened the floodgates for states to regulate abortion, leading to the kinds of small-bore but potent restrictions that could lead to her Mississippi clinic’s closing. In 1998 an anti-abortion activist name Eric Rudolph nail-bombed and killed a security guard at the first clinic she owned, New Woman All Woman in Birmingham, Ala., which she had run for a decade. She owns the clinic, which was recently forced out of business by anti-choice efforts Derzis calls “an absolute witch hunt.”) She owns a small Smith & Wesson (“I’ve got a cute little holster for it”) and a couple of Tasers, just in case.

Friends and colleagues describe the 58-year-old as “well put-together,” funny, savvy, and tough. She loves yard sales, thrillers take her mind off tough days, and in the ’80s she returned to school for a law degree after years of operating clinics.

Derzis said reproductive choice work found her for two reasons—her own abortion in 1974 at the age of 19, and the fundamentalist backlash to the passage of Roe, with the subsequent political candidates running to overturn the law, and the swirling propaganda of “fetuses and embryos on TV.”

In 1974 she married, but was still in college at Alabama University of Montavello when she decided to terminate her pregnancy at 12 weeks. There were no clinics in the state then, but she says she and her husband found a Birmingham doctor who performed the procedure for $125. Derzis remembers a crowded waiting room—old, young, working class, men in bib overalls and women in panty hose—all there for the same thing. “You went in and you pulled your dress up. The doctor said to me, ‘You didn’t have any problem spreading your legs before, so spread them now,’” Derzis said. “I was grateful that I was able to have a safe abortion, but it was not a great experience.” Catching site of a female prolife political candidate on television, alongside pictures of fetuses telegraphing that women were “just vessels,” “pissed [her] off” and cemented her calling to make things better.

When a clinic did open in Birmingham, Derzis “bugged them to death until they did hire me as a counselor at $5 an hour” while she was still in college. She helped open Alabama’s first clinic, the Summit Medical Center in Birmingham, which no longer exists but its building was home to her clinic New Woman All Women until it closed in May.

Derzis recalls early distaste for her profession coupled with her mother’s pride in a trip to a farmers’ market with her mother in Virginia’s Shenandoah Valley, where she grew up. “Ask my daughter what she does for a living,” Derzis’s mother said to the lady bagging their tomatoes. “I’m a stripper,” Derzis joked and the woman smiled. “She is not, she runs an abortion clinic,” Derzis remembers her mother saying, to the tomato lady. The woman wasn’t smiling anymore. “That woman was fine with me being a stripper, not running an abortion clinic,” Derzis says, punctuating this, like many of her stories, with a deep smoker’s laugh.

Derzis bought the Jackson clinic from friend and colleague Susan Hill in 2010, after Hill died of breast cancer, and practically the first thing she did was redecorate—she painted the walls bright purples and yellows, and added red leather furniture to create a “happy, warm feeling”—a stark contrast with her own abortion experience three decades before.

Derzis has a knack for design (her home with its Jacuzzi tub and skyline view was featured in a Birmingham paper recently). The ambience of the clinic, she says, goes a long way. “Most [Mississippi patients] know nothing about abortion. After they see the dead-baby pictures and hear all that stuff, I think they feel, ‘oh wow, this is OK.’ You see the relief on patients’ faces when they walk in.” The Jackson Women’s Health Organization sees about 200 women each month. Derzis says they treated 44 in one night the Friday before the law that still may close the office was supposed to take effect.

Ann Rose, who runs an online directory listing of abortion providers from her home in Atlanta, remembers helping Hill find a building for a clinic in 1995. “People wouldn’t rent or sell to us. It was almost like we were black in [the South] in the ’60s,” she says. After a yearlong search, Rose and Hill found an art deco–style building in a rough part of town, among vacant buildings, intermittent gang activity, and across the street from a “seedy” bar called the Recovery Room. They chose the location mostly because it was next to the office of the state’s first black OB/GYN and physician, Helen Barnes, who “probably delivered more babies in Jackson than anybody, and also did abortions, including the first abortion in Mississippi after 1973,” said Rose. Now the area, called Fondren, has gentrified and is filled with shops, restaurants, and progressive-minded residents.

A week before the Jackson clinic would open, a gunman opened fire at a Brookline, Mass., abortion clinic, killing two receptionists. The next week, as the Jackson clinic opened its doors, anti-choice protesters were there. Early on Derzis encouraged a dialogue, inviting them into the clinic, offering them space and a table to hand out life-affirming information because “this is what choice means.” As debates with patients became more noxious, this invite became untenable. Derzis doesn’t open her doors anymore, because she feels the opposition is more acrimonious than ever before.

When her Birmingham clinic was nail-bombed, a guard killed, and a nurse injured in 1998, she was back within days to reopen it. Rose remembers sitting with Derzis in the clinic at night in 30-degree weather, wearing their coats because the windows and door had been blown out. The police had handed over the clinic, but it was still a crime scene. Rose describes the pink iridescent web of string that crisscrossed the building, connecting all the places where the hundreds of nails had hit. “Diane was upset, but she was more determined to get the clinic back open, not to let them deter services,” she said.

Derzis herself has faced plenty of attacks over the years, but she still describes herself as a spiritual person. Though she no longer attends the Birmingham Episcopal church because she realized being in the building and worship itself “don’t necessarily coincide,” she sometimes likes to read Bible verses to her adversaries who canvas clinic perimeters, often holding ghastly images or berating those on their way inside.

“They don’t own the Bible. God is on my shoulder as much as theirs,” she says. A favorite verse she describes with a laugh is Jesus’ warning “Beware the street corner preachers.” “He’s talking about you,” she says as if to protesters, then adds, “I only do that if I’m feeling a little frisky that day.”

Still, she admits she doesn’t see enough women helping defend to abortion rights. According to the best data available, one in three women will have an abortion during her lifetime, and some 50 million legal abortions have been performed from the 1973 passage of Roe v. Wade—which legalized the procedure—until 2008. “That’s been the biggest disappointment in my life that I have not figured out how to identify those women.” Her patients over the years have been grateful, but she wants them to be loud, too. “People will come up and whisper ‘thank you.’ But it’s a whisper.”