The Senate confirmed Sarah Pitlyk to the federal judiciary on Wednesday by a 49–44 vote. Every Democrat presented voted in opposition; every Republican present except Sen. Susan Collins voted in her favor. Pitlyk’s nomination drew controversy for her extreme opposition to reproductive rights: She opposes not just abortion but also surrogacy and even fertility treatments. She currently serves as special counsel to the Thomas More Society, a conservative anti-choice law firm. The American Bar Association unanimously rated her “Not Qualified”; she has never tried a case, though she will now serve as a trial judge. Nonetheless, Senate Republicans gifted her a lifetime appointment to the U.S. District Court for the Eastern District of Missouri.

Pitlyk, 42, has spent much of her career attacking the rights of couples who seek to have children using assisted reproductive technology, or ART, like gestational surrogacy and in vitro fertilization. She co-authored an amicus brief opposing California’s ART protections, asserting (without evidence) that “the practice of surrogacy has grave effects on society, such as diminished respect for motherhood and the unique mother-child bond.” Pitlyk has also declared (again without evidence) that surrogacy “is harmful to mothers and children, so it’s a practice society should not be enforcing.” And she has proclaimed that frozen embryos should be recognized as human beings under the law, writing that these “children” are “killed” when embryos are destroyed. Pitlyk’s position—that states should treat embryos as humans—would likely outlaw not only abortion but also IVF and surrogacy.

Naturally, Pitlyk is a foe of abortion in all forms, for all reasons. She specializes in vilifying abortion providers and their patients, telling a federal appeals court that the “modern abortion industry continues to target ethnic minorities.” She also wrote that states should bar women from terminating a pregnancy because of fetal abnormalities, accusing these women of engaging in “increasingly widespread eugenic practices that devalue and disadvantage the most vulnerable members of society.” (While this claim is objectively false, it has been promoted by Justice Clarence Thomas, who echoed Pitlyk’s disparaging rhetoric.)

Pitlyk will now serve as a federal judge in Missouri, whose lone remaining abortion clinic is under constant legal threat. State regulators have sought to shut down the clinic by citing vague, unproven health concerns. Missouri’s abortion providers may soon ask the federal judiciary to protect their patients’ access to abortion—and wind up in Pitlyk’s courtroom.

Outside of her contributions to these anti-ART, anti-abortion briefs, Pitlyk has minimal legal experience. As the ABA explained when awarding her a “Not Qualified” rating:

Ms. Pitlyk has never tried a case as lead or co-counsel, whether civil or criminal. She has never examined a witness. Though Ms. Pitlyk has argued one case in a court of appeals, she has not taken a deposition. She has not argued any motion in a state or federal trial court. She has never picked a jury. She has never participated at any stage of a criminal matter.

Why, then, did Donald Trump nominated Pitlyk to a lifetime appointment on the federal bench? She is a member of the Federalist Society who served as a clerk to Brett Kavanaugh when he served on a federal circuit court and defended him during the battle over his confirmation to the Supreme Court. Pitlyk amped up her defense after Christine Blasey Ford accused Kavanaugh of sexual assault. She inveighed against Democrats for “trying to tarnish the character of a man we and so many other people admire and respect” and said Ford’s allegation was “hard to take … seriously… in light of the transparently politically-motivated manner in which it has come to light.”

Likely as a reward for her loyalty to Kavanaugh and the Federalist Society, Pitlyk has been elevated to a federal district court in Missouri. There, she will join her fellow Trump appointees in dismantling the constitutional right to reproductive autonomy, laying the groundwork for the Supreme Court to overturn Roe v. Wade. The Senate may not be passing any legislation these days. But by rapidly ramming through radical nominees like Pitlyk, Republicans are ensuring that the GOP platform will be implemented from the bench for decades to come.