He once called himself "pro-choice." But a year into his presidency, Donald Trump is stepping to the forefront of his administration's efforts to roll back abortion rights.
And though his record is mixed and a midterm election looms, abortion opponents say they have not felt so optimistic in at least a decade.
"I don't think anybody thinks that the White House is a perfectly regimented and orderly family ... but that doesn't change their commitment to the issue," said Marjorie Dannenfelser, president of the Susan B. Anthony List, which is expanding its door-knocking operation across states with Senate incumbents who have voted for abortion rights.
With a Republican-controlled Congress at his back on this issue, Trump is cementing his turnaround on abortion with a video address Friday to the annual March for Life. That's a symbolic change from last year, when Vice President Mike Pence — in practical terms, the leader of the anti-abortion movement in the United States — addressed the group in Trump's absence.
"In one short year, President Donald Trump has made a difference for life," Pence told march leaders Thursday night.
Trump has given anti-abortion activists a few key victories.
Chief among them: the confirmation of conservative Justice Neil Gorsuch to the Supreme Court. Trump also has revived and expanded a ban on sending U.S. aid to groups overseas that provide abortion counseling. And he signed legislation allowing states to withhold federal family planning dollars from clinics that provide abortion services. The administration has made its priorities clear in other ways, too — including appointments to key government posts and a new mission statement for the Department of Health and Human Services. The agency announced it is dedicated to supporting Americans at "every stage of life, beginning at conception."
On Thursday, the administration announced the creation of a new office to protect the religious rights of medical providers, including those who oppose abortion. Supporters of abortion rights say it adds up to a president doing administratively what he's often failed to accomplish through Congress.
"Time and again, we have seen this administration radically redefine religious freedom to impose one set of ultraconservative beliefs on all Americans," said Sarah Hutchinson Ratcliffe, vice president of Catholics for Choice.
Trump has failed to deliver on promises to strip Planned Parenthood of federal funding or permanently ban taxpayer dollars from being used for abortions. The effort to defund Planned Parenthood, for example, failed with the Republican effort to repeal President Barack Obama's health care law.
Behind the mixed record is Trump's complicated personal history on abortion. White House counselor Kellyanne Conway says his transformation from supporting to opposing abortion rights dates back to at least 2011. And while she says he has shown his commitment to the anti-abortion movement "early and often," he has at times seemed uncomfortable with the issue.
Dannenfelser recalls her struggle in 2016 after the SBA List told GOP primary voters in Iowa and elsewhere that Trump could not be trusted on the issue. But Trump's pro-choice Democratic opponent, Hillary Clinton, made the choice easy, Dannenfelser recalled. One wobble came in October, when the "Access Hollywood" recording was released with Trump's voice boasting of assaulting women. He denied having done so; and a conversation with an aide to Pence helped Dannenfelser stay aboard.
A year into Trump's term, abortion opponents see the stall of anti-abortion legislation as a product of the slim Republican majority in the Senate. So, they're focusing on the midterm elections. Conway says abortion is a key part of discussions with prospective GOP candidates. And groups like the SBA List are boosting their ground games in an effort to turn out people who want to roll back abortions, including Hispanics, but don't tend to vote in non-presidential election years.
The group's band of door-knockers, who make about $10 an hour, are among about 220 canvassers on the ground targeting Democratic Senate incumbents in Ohio, Indiana, Florida, Missouri and North Dakota. A spokeswoman said the group is aiming to quadruple the number of paid canvassers in 2018 and expand its operations into Senate races in West Virginia, Wisconsin and likely Minnesota.
In Madeira, Ohio, on a recent chilly Sunday, Alison Pavlicek led a band of six women down Miami Hills Drive, to homes suggested by an app that tracks voter information. They knocked and asked people who answered if they were aware of Sen. Sherrod Brown's voting history. Pavlicek said she sometimes looks for statues of the Virgin Mary in front of homes — signals in stone of residents "friendly" to the anti-abortion cause.
"People are really receptive now," she said.
Polling shows Americans have complicated feelings on the divisive issue of abortion nearly 45 years after the Supreme Court legalized it in the Roe v. Wade decision. A recent poll by the Associated Press-NORC Center for Public Affairs Research found that just over a third of Americans think abortion should be illegal in most or all cases. That includes a majority of Republicans and about 20 percent of Democrats and 4 in 10 Hispanics.
More than 6 in 10 say abortion should usually be legal, though that includes just a quarter of Americans who think it should be legal under all circumstances.
Overall, 62 percent of Americans say they disapprove of how Trump is handling the abortion issue.
But the anti-abortion movement is facing challenges. Groups that favor abortion rights, such as Emily's List, dwarf their anti-abortion counterparts when it comes to raising campaign cash or spending on lobbying, according to OpenSecrets.org.
And traditionally, the president's party loses seats in the midterm elections, especially when his approval rating is below 50 percent, according to Gallup. Trump's overall rating has never risen that high.
Madeira, Ohio, resident Ginger Ittenbach isn't so sure the Trump administration is to be trusted, and that makes her a key "persuadable" voter in the eyes of anti-abortion activists. She says she is "very much pro-life" — but voted for Clinton.
"There were enough other red flags with Donald Trump just in how he treated women," Ittenbach, 52, said after talking with the canvassers.