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ASHINGTON — Cecile Richards, the president of Planned Parenthood, is used to political hardball. But this past year, the controversies have been coming practically nonstop, and from all directions.

The women’s health organization has been a target of congressional investigations into fetal tissue research and its use of taxpayer funds. Republicans in Congress are trying to cut off its federal funding. And 24 states have attempted to block funding for the group or restrict access to its health centers.

The Republican presidential nominee, Donald Trump, has promised to defund Planned Parenthood if elected president. His running mate, Mike Pence, led the charge to cut off federal funds in Congress and has slashed support for the organization as Indiana governor.

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So when Richards took the stage at the Democratic convention in Philadelphia last month to make the case for Hillary Clinton, she delivered as fiery a speech as any partisan Clinton surrogate.

“When Donald Trump and Mike Pence said they’ll defund Planned Parenthood, they’re talking about cutting women … off from lifesaving care,” Richards told the cheering delegates. “Make no mistake: Women’s health and rights are on the line and on the ballot in this election.”

Richards has been dealing with some level of political conflict over Planned Parenthood for the 10 years she’s been president, and she has her talking points down: We’re still doing our jobs, and the clinics are staying open.

But Richards is now more deeply immersed in presidential politics than perhaps ever before. The Clinton campaign is planning to send her to campaign in battleground states this fall, hoping she can appeal to key voting groups, especially young voters, minority groups, and low-income women who depend on Planned Parenthood for their health services.

The 59-year-old Richards sees Clinton’s candidacy, especially against Trump, as a chance to encourage a “generational shift” on women’s health — one that could help build broader support for Planned Parenthood in the future, and maybe even discourage some of the attacks.

“We’re now finding that men are voting on these issues,” not just women, Richards told STAT. “I think what we’re seeing is a generation of men who want their daughters to have all of the opportunity that they can, and that includes access to reproductive care and rights.”

Cecile Richards & Hillary Clinton
Hillary Clinton at an event in Washington with Cecile Richards, president of Planned Parenthood Action Fund. Alex Wong/Getty Images

Helping Clinton

Richards’s ties to the Clintons date back to the days when her mother, Ann Richards, was the last Democratic governor of Texas. She campaigned for Bill Clinton during his 1992 race for the presidency, and maintained a friendship with the Clintons after that. Hillary Clinton spoke at Ann Richards’s memorial service after her death in 2006.

Now, Cecile Richards has other family ties to the Clintons, too. Her daughter, Lily Adams, was the Iowa communications director for the Clinton campaign and is now the director of regional press.

There was a time when Planned Parenthood wouldn’t have gotten involved in a presidential campaign or sided with the Democratic Party so vocally. But those days ended years ago, when the religious right mobilized against the organization, forcing it to create a political arm to fight back — the Planned Parenthood Action Fund, the group Richards represented when she spoke at the convention.

Republicans believe Richards has had too much influence over the Democrats’ policies on abortion rights, especially through her friendship with Clinton. And they see her as too much of an advocate to acknowledge any problems at Planned Parenthood, which they believe has been putting too much emphasis on abortion rights and not enough on other women’s health services.

“I think it would be difficult to say she takes a balanced approach to what she does,” said Republican Representative Marsha Blackburn of Tennessee, the chairwoman of a House committee that has been investigating fetal tissue research. “She takes a ‘Planned Parenthood is all good things’ approach … She doesn’t come across as someone who said, ‘Maybe there are some things we need to work on.’”

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Richards’s allies, however, said she does acknowledge problems, noting her quick response last year to secretly recorded videos that purported to show the organization selling fetal tissue for profit, a charge the group strongly denies.

Even though the group insists the infamous videos were selectively edited, Richards apologized for the “tone and statements” of a staff member who appeared in one of them, discussing the group’s procedures for donating fetal tissue for medical research while eating and drinking wine.

“I think she rose to the occasion,” said Texas Representative Donna Howard, an Austin Democrat who has known Richards since the days when Richards helped her in a school board election. “That, to me, speaks volumes about her as a person.”

These days, the group is juggling challenges in Congress and in the states. A bill that would provide emergency funding to respond to the Zika epidemic got held up in part because it did not provide any money to clinics with Planned Parenthood ties; group officials believe Florida’s response to the virus is being undermined by its efforts to steer money away from Planned Parenthood clinics.

Richards said she gets through her toughest days — including a five-hour session testifying before Congress last fall — by reminding herself of the Planned Parenthood patients she represents.

“Being able to bring a little bit of their voices into that hearing room was very important to me. Many of them will never have the chance to talk before Congress,” she said. But she said she also learned valuable lessons from her mother, including the importance of keeping a sense of humor and “realizing that it’s not all about you.”

ANN & CECILE RICHARDS
In this 1988 photo, Ann Richards, then Texas state treasurer, takes her 16-month-old granddaughter Lily from daughter Cecile at the Democratic National Convention. David Longstreath/AP

A lifetime in politics

Richards is a seasoned campaign operative, a former aide to House Democratic leader Nancy Pelosi, the founder of an antireligious right advocacy group in Texas, and Planned Parenthood’s president since 2006 — a term that has included years of defunding efforts and the scandal over the videos.

It all started with her mother’s two campaigns for governor — the one where Ann Richards defeated a gaffe-prone Republican in 1990 and became the liberal Democratic governor of a conservative state, and the reelection race that she lost to George W. Bush in 1994. Those were formative experiences that helped Cecile develop a thick skin against tough political attacks, according to Mary Beth Rogers, the campaign manager in both races.

“Both campaigns were hectic and full of terrible charges against her. Cecile witnessed all of that,” said Rogers. She described Cecile as a “well-grounded person” who has learned to shrug off political attacks — which, in her mother’s case, included insinuations of past drug use.

The 1990 campaign gave Cecile an important chance to prove her skills as a tough political operative. In the Democratic primary, Ann Richards competed against Jim Mattox, a bulldog of an opponent who was well-funded and had important political connections. Cecile helped the campaign head off an endorsement of Mattox by the state AFL-CIO, a tough task that some in the campaign had considered impossible, according to Glenn Smith, a Democratic consultant who also managed the 1990 race.

“I think one of the secrets to her success is that she doesn’t internalize these things, right? She just sees them as a challenge she’s going to meet,” said Smith. And while some people in politics get worn down by constant attacks, he said, “she gets energy from it. It makes her stronger, and that’s a really important characteristic to have.”

Cecile has her own political presence, and it’s different from her mother’s. She’s a polished speaker, but she doesn’t crack jokes the way her mother did. (“I wish I was as funny as she was,” she acknowledged.) But she can be just as withering with her opponents.

That’s the side she showed when she testified at a September congressional hearing on how Planned Parenthood uses its government funding.

Representative Jason Chaffetz, the chairman of the House Oversight and Government Reform Committee, tried to make the same argument that Blackburn made — that Planned Parenthood had been putting less emphasis on cancer screenings and other health services than it had in the past. He confronted her with a slide that he said showed the organization was performing more abortions and fewer breast exams. Richards fired back that she had never seen the slide before, and “it absolutely does not reflect what’s happening at Planned Parenthood.”

Then, a few seconds later: “My lawyer is informing me that the source of this is actually Americans United for Life, which is an anti-abortion group. So, I would check your source.”

It is true that breast exams and other tests have declined at Planned Parenthood centers — from 830,000 in 2009 to 487,000 in 2013, according to figures from the group’s annual reports. But the number of abortions has remained about the same: 332,000 in 2009, 328,000 in 2013.

Planned Parenthood officials attribute the decline in breast exams partly to changing women’s health recommendations — they’re affected by how often women come in for pap tests, which don’t have to be done as often now — and partly to the fact that some health centers have been forced to close due to the attacks on Planned Parenthood funding.

Richards has no problem engaging in political battles. After her mother’s defeat in 1994, she founded the Texas Freedom Network, a group that fought the religious right’s influence over the state education board. She also served as deputy chief of staff for Pelosi, helping to set up her leadership office and working on outreach to women and labor groups.

“It’s probably in her DNA. She doesn’t shy away from a fight,” said former Pelosi aide Brendan Daly, who worked with Richards at the time.

Cecile Richards
Cecile Richards, president of Planned Parenthood Action Fund, at a rally in Dallas in 2013. Tony Gutierrez/AP

The politics of Planned Parenthood

Richards’s active support of Clinton is the latest stage of a long political evolution for Planned Parenthood. In the 1980s, the group was advised to create a political arm so it could get involved in elections. It was a way to “punish our enemies and reward our friends,” said Faye Wattleton, Planned Parenthood’s president during that time.

That led to the creation of the Planned Parenthood Action Fund — which has been followed by other affiliates, including Planned Parenthood Votes, the group’s super PAC. At the time, though, some board members were reluctant to get involved in politics, fearing that donors would cut their support, Wattleton said. This was also a time when it wasn’t unusual for Republicans who supported abortion rights to serve on the board.

By the time Gloria Feldt — Richards’s predecessor — became Planned Parenthood president in 1996, violence against abortion clinics was on the rise, and the group needed as many allies as it could get. “It became clear that grassroots politics were so essential to the movement to make sure women had the right to reproductive self-determination,” Feldt said. “What does that mean? It means you have to get involved, and when you get involved, you take sides.”

Planned Parenthood Action Fund has endorsed other Democrats in presidential elections, including John Kerry in 2004 and Barack Obama in 2008 and 2012, in each case doing so in the general election.

This year, the group endorsed Clinton in the Democratic primaries, before the nomination was settled.

That decision didn’t go down well with Bernie Sanders, who later suggested that the group was “part of the establishment.”

Richards said the group was especially enthusiastic about Clinton because “she has frankly put women’s health and rights at the forefront for her entire career … This really was an opportunity to support a candidate who has not only been a solid vote and a solid supporter, but has really been a champion of these issues.”

And although there aren’t a lot of Republicans left on Capitol Hill who support abortion rights, Planned Parenthood still has GOP supporters outside of Congress.

Jim Greenwood, a former Republican congressman who’s now the president and chief executive officer of the Biotechnology Innovation Organization, said he watched Richards’ Democratic convention speech with a group of Planned Parenthood officials in Philadelphia. Greenwood, who used to serve on the group’s board, said he had no problem with Richards taking such a high-profile role in support of Clinton, given that the GOP has made it so difficult for Republicans who support abortion rights to stay in office.

“Planned Parenthood didn’t move away from the Republican Party. The Republican Party moved away from pro-choice positions,” Greenwood said. If the Republicans had nominated a presidential candidate who supported abortion rights, he said, Richards probably would have stayed out of it.

“Donald Trump has staked out an antichoice position, and this is politics,” Greenwood said.

And for Richards, there’s no escaping the historic nature of Clinton becoming the first woman to win the nomination of a major party — a moment she said her mother would have appreciated.

“She taught me at an early age that if you’re going to really fight for things you believe in — for progressive change, for expanding civil rights and women’s rights — it’s never going to be easy, and if it was easy, someone else would be doing it.”

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