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In addition to being nimbler at Web-based activism, young feminists have another advantage when appealing to millennial voters, who will make up some 40% of the electorate by 2020: relatability. "We need more leaders in this movement who are of reproductive age," says author Page, 42. Sandra Fluke, the law student Republicans barred from testifying before a congressional committee last year, was a valuable asset to the pro-choice cause in part because of her relative youth. She spoke publicly about the personal reproductive rights and birth control choices of her peers. Keenan, who has become aware that her own age might impede her effectiveness, announced last May that she would step down in 2013. She said she hoped a younger person could replace her. "They're chomping at the bit to have their opportunity," she says.
Young abortion-rights activists have a strategy to modernize the cause, which includes expanding it. They often don't even mention the term pro-choice, which they say is limiting and outdated. Instead these young leaders have embraced a cause known as reproductive justice--a broader, more diffuse agenda that addresses abortion access but also contraception, child care, gay rights, health insurance and economic opportunity. "It's a more holistic frame," says Matson. "And you see younger people connecting with that."
The term reproductive justice was coined in the 1990s by black feminists who wanted to broaden the appeal of reproductive rights and speak to the needs of African-American women, whose abortion rate is 3½ times that of white women. "The pro-choice movement would focus on 'Let's open more clinics.' The anti-choice movement would say, 'Let's stop women from going into them,'" says Ross, 59, of Sister Song. "Those of us in the reproductive-justice movement would say, 'Let's ask why there is such a high rate of unintended pregnancies in our community. What are the factors driving that?'"
Addressing issues like economic disparity marks a major shift from the pro-choice messages of the 1970s that made choice the optimal virtue and an end in itself. But the shift, says Ross, is the natural maturation of the pro-choice movement and worth the extra effort. The abortion rate in impoverished black communities has remained disproportionately high despite efforts by Planned Parenthood and others to provide access to family-planning services. "What this proves," says Ross, "is that if people are not convinced that they have realistic economic and educational opportunities, you could put a clinic in a girl's bedroom and she would still think early motherhood is a better choice."
Eye contact can be hard to come by at Red River. Many patients walk the halls with their heads down and their arms crossed. In journals scattered throughout the clinic in which women are invited to express their feelings, patients write about nonsupportive husbands and boyfriends and ask God for forgiveness. They write about how they can't afford to support another child and how they are so glad Red River exists. Amid the low hum of ringing phones, the sound of a staffer reading a state-mandated script to women wafts through the clinic's upper floor: "North Dakota law defines abortion as terminating the life of a whole, separate, unique living human being."