DES MOINES, Iowa — Ruth Richardson waited near the Iowa capitol's grand staircase, just outside the limelight. At the podium nearby, abortion-rights supporters railed against the state's conservative swing on abortion following the overturning of Roe v. Wade, calling Republican bills "nonsense," "pseudoscientific" and "speaking for the extreme." Richardson glanced at her speech and its somewhat different message.

Not that Richardson disagreed with what speakers were saying. As the new president and CEO of Planned Parenthood North Central States, which oversees the organization in blue-leaning Minnesota and four red-leaning neighbor states, Richardson is one of the region's pre-eminent supporters of reproductive rights.

But as the abortion debate continues to rage, the former Minnesota legislator sees a post-Roe opportunity to reframe Planned Parenthood's mission: Instead of dated binary arguments, she believes the debate in modern America must focus on health equity.

"I don't think people understand the intersections between access to abortion and a full range of health services," she said. "It's trying to have a more comprehensive conversation and connect the dots in ways people don't spend enough time thinking about."

She points to Iowa ranking last in per-capita OB-GYN specialists; reports have shown states with the restrictive abortion laws are losing OB-GYNs. She speaks about Black women being three to four times more likely to die from pregnancy-related causes nationally, and six times more likely in Iowa. She worries about health care deserts in rural areas.

Richardson talks about the freedom to have an abortion as well as the freedom to have a child and raise that child.

Abortion opponents scoff at this equity focus as disingenuous, given the racist beliefs of Planned Parenthood's founder — something the organization acknowledges and denounces — and its clinics disproportionately being located in minority neighborhoods.

"This is not about social justice and not about equity," said Cathy Blaeser, co-executive director of Minnesota Citizens Concerned for Life. "They offer a dead baby to women who have real support needs. They take her hard-earned money and leave her in the same social need as when she walked into their facility."

At the Iowa abortion-rights rally, Richardson was experiencing whiplash. The night before, she was celebrating. At First Avenue, the famed Minneapolis music club, she walked the runway with her 2-year-old granddaughter, Trinity, in a fashion show fundraiser. Now she was in a different world, where Iowa's high court was weighing a six-week abortion ban. The next week, she'd head to Nebraska for state Supreme Court arguments on abortion.

In Iowa, the 47-year-old stepped into the limelight and began to speak.

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