Norma McCorvey, who under the pseudonym “Jane Roe” served as the plaintiff in the landmark Supreme Court decision that legalized abortion, died Saturday at 69 in Katy, Texas, of a heart ailment.

The Supreme Court’s 1973 decision in Roe v. Wade would transform the debate over reproductive rights in the U.S., bringing the ability to safely terminate pregnancy to millions of women while inspiring virulent opposition from anti-abortion critics. The decision ushered in a new era of reproductive options for women but intensified a debate over contraception fueled by health considerations, ethics, religion and politics — and the plaintiff at its center would eventually oppose abortion herself.

Justice Harry A. Blackmun wrote the 7-to-2 ruling, which determined that a constitutional right to privacy included the right to terminate a pregnancy. Blackmun also established the trimester framework as a system to determine the state’s ability to regulate abortion at each phase of pregnancy.

Norma Lea Nelson, whose middle name has been spelled several different ways, was born in Simmesport, Louisiana, on Sept. 22, 1947, into generations of hardship.

Her grandmother was a sex worker, her mother was an abusive alcoholic and McCorvey stole money from the gas station where she worked to run away from home at the age of 10, according to The New York Times.

In her early teenage years, she went to reform school and said that she was sexually assaulted by a nun and her mother’s relative at a young age. At 15, she met steelworker Woody McCorvey and soon married him, but he was abusive. She left him in order to raise their unborn child alone in her mother’s home.

After their daughter Melissa was born in 1965, McCorvey said she was tricked into signing over custody to her mother, according to “I Am Roe,” an autobiography she published in 1994.

Years of drugs and alcohol use followed, and she became pregnant again during an affair with a co-worker at 19. She gave the baby up for adoption.

She became pregnant a third time in 1969, days before her 22nd birthday. Joshua Prager wrote for Vanity Fair that McCorvey, now living in Texas, told her doctor that she did not want to bring this pregnancy to term. At the time, abortion was illegal in Texas, except in cases where the mother’s life was in danger. The procedure was legal in six states — Alaska, California, Hawaii, New York, Oregon and Washington — but she could not afford the trip.

Her doctor referred her to an adoption lawyer, his childhood friend Linda Coffee, who was looking for a plaintiff to challenge the abortion statute in Texas. When McCorvey was six months pregnant, Coffee filed the suit against Dallas County district attorney Henry Wade on March 3, 1970.

McCorvey gave birth before a three-judge panel on June 17 struck down the the Texas abortion statutes. The baby was adopted and its identity has been kept private, according to Vanity Fair. Regardless, it would take several more years for the case to go through the appeals process.

A decade after the case, she began volunteering at a women’s clinic and spoke to media around the anniversary of the decision in support of abortion rights.

In 1995, a Christian group devoted to making abortion illegal moved in next door to the clinic where she was working. McCorvey would visit and ask for them to “pray for her, and that summer, she “accepted Jesus as her savior” and began speaking out against abortion, according to Vanity Fair. In 1998, she converted to Roman Catholicism and continued to be a vocal opponent of abortion.

The 1973 decision in Roe v. Wade came less than a decade after a 1965 Supreme Court ruling that overturned a state law that criminalized the use of contraceptives, and one year after the court ruled that unmarried women could receive birth control pills.

The legalization of abortion was one of the most significant landmarks for women’s health in American history. But after decades of debate, access to the procedure still varies widely throughout the U.S., with some state laws outlawing abortion after a certain point of pregnancy and others that place strict requirements on abortion providers that critics say do not contribute to the health or safety of patients.