Shortly after the anti-abortion group Democrats for Life of America was founded in the late 1990s, its website listed more than 40 members of Congress it had identified as pro-life. Back then, it wasn’t hard to find Democrats in public office who opposed abortion legislation, or at least spoke comfortably about their own anti-abortion convictions. As late as 2009, anti-choice Democrats had enough sway in Congress to hold up the Affordable Care Act until they were allowed to vote on a ban on taxpayer-funded abortions.

Times have changed. This year, Democrats for Life found only seven candidates to endorse in both chambers of Congress combined. And the ranks of pro-life Democrats in Congress dwindled yet again on Tuesday night, when Sen. Joe Donnelly lost decisively to Republican businessman Mike Braun in Indiana. “Donnelly’s loss is a significant hit, there’s no doubt about it,” said Michael Wear, a Democrats for Life board member. “Pro-lifers, particularly those who are uncomfortable with Trump, need to really consider that one of the reasons there aren’t many pro-life Democrats in major elected office is because they fail to truly mobilize to support those that exist.”

The rest of the coalition looks shaky. In West Virginia, Democrats for Life endorsee Sen. Joe Manchin eked out a victory over his Republican challenger after becoming the only Democratic senator to vote to confirm Supreme Court Justice Brett Kavanaugh. Manchin will now be one of only two pro-life Democrats in the Senate; the other is Sen. Bob Casey of Pennsylvania, who also had a competitive race but ended up winning by a comfortable margin on Tuesday. As of last year, Donnelly, Manchin, and Casey were the only three Democratic senators with lifetime scores under 100 percent from the Planned Parenthood Action Fund.

In the House of Representatives, Rep. Dan Lipinski easily won re-election Tuesday in Illinois’s solidly blue 3rd District—but only after facing a fierce challenge in the primary from Marie Newman, a progressive opponent who made his anti-abortion votes a centerpiece of her campaign. Several members of the House Democratic Caucus endorsed Newman in the primary, while the Susan B. Anthony List backed Lipinski. Now, the only other Democrats for Life endorsee in the House is 74-year-old Rep. Collin Peterson of Minnesota. Rep. Henry Cuellar, a conservative Democrat in South Texas who often votes with Lipinski and Peterson, also won re-election easily on Tuesday.

The list of pro-life Democrats is now notable for more than just its brevity. All of the remaining members of Congress on the list are men.

Donnelly’s loss is a good illustration of the increasingly impossible bind for pro-life Democrats hoping to retain their seats. Although more than 20 percent of Democratic voters say abortion should be illegal under all circumstances, the Democratic Party has become an increasingly inhospitable place for pro-life candidates, as reproductive choice becomes an increasingly significant part of its agenda. Meanwhile, conservative pro-life groups rejected Donnelly because of his votes against defunding Planned Parenthood. The Susan B. Anthony List, an advocacy group that supports pro-life candidates, organized a field team in Indiana to defeat him. On Tuesday, the major anti-abortion news outlet Life News ran a scathing story with the headline “Abortion President Barack Obama Campaigns for Fake ‘Pro-Life’ Democrat Joe Donnelly.”

The list of pro-life Democrats is now notable for more than just its brevity: All of the remaining members of Congress on the list are men. Democrats for Life found only one woman to endorse this year, Dawn Barlow, a Tennessee doctor and military spouse who was trounced in Tennessee’s 6th District by a “pro-gun, pro-life, pro-President Trump” conservative. The fact that the coalition now consists of a handful of white men doesn’t exactly make it look like the future of the Democratic Party.

Michael Wear, the Democrats for Life board member, said that Tuesday’s results should prompt questions among both pro-lifers and Democrats. Wear led faith-based outreach for Obama, and he wants to see Democrats make serious appeals to religious and anti-abortion voters. “What is it about the Democratic brand, what is it about the stories we allow Republicans to tell about us, that makes the label ‘Democrat’ such a burden in places like Indiana, Tennessee, Florida, North Dakota, and Missouri?” he asked. “Should we just be accepting defeat in these places? I think it’s unhealthy to lose incumbent seats and respond with the idea that voters in that state were just so driven by fear, or identity politics, that there is nothing Democrats could have done.”