Joe Biden and Kamala Harris celebrated what would have been the 51st anniversary of Roe v. Wade in late January — their first campaign event of 2024. The “Restore Roe” rally in northern Virginia made it clear that the Biden/Harris ticket will center abortion rights in the reelection campaign. The theater was filled with the president’s supporters and leadership from national reproductive rights organizations who have endorsed him, including Planned Parenthood, the National Organization for Women and Reproductive Freedom for All.

Only a few minutes into Biden’s speech, several protesters interrupted, calling for a cease-fire in Israel’s U.S.-backed military operation in Gaza, which has killed more than 28,000 Palestinians and set off a maternal and reproductive health crisis.

The president was interrupted over a dozen times as security struggled to wrangle protesters who were screaming “Genocide Joe!” and demanding a cease-fire. Hundreds of Biden supporters tried to drown out the protesters by clapping and chanting, “Four more years!”

“Israel kills two mothers every hour in Gaza! Cease-fire now! End the genocide!” one protester yelled at Biden, who was standing on stage in front of a massive “Restore Roe” banner and flanked by supporters holding “Defend choice” signs.

A video of the event shows Alexis McGill Johnson, the president of the Planned Parenthood Federation of America, clad in her trademark hot-pink pantsuit, standing up and chanting “Four more years!” as security dragged the shouting protester out.

It was a real-time illustration of the growing rift in the reproductive rights movement during an election year that will determine the future of reproductive health in the U.S.

‘No One Is Making The Connection’

Biden has seemingly embraced abortion rights, a pivotal issue for Democrats, and earned an extremely early endorsement from national reproductive rights groups. Despite the president making abortion rights a pillar of his campaign, Biden is generally reluctant to talk about abortion, saying things like “I’m not big on abortion” and, more recently, “I don’t want abortion on demand.” When it comes to abortion care, many who work for reproductive justice believe that the president is a lukewarm advocate at best.

Now workers are deeply concerned that Biden’s administration is contributing to a maternal and reproductive health crisis in Gaza through its aid to Israel.

Gaza is home to about 55,000 women who are currently pregnant, according to a recent report. There’s been a 300% increase in pregnancy loss due to the lack of neonatal and maternal health care since the conflict began five months ago. Most women are giving birth in crowded tents or on the streets because there’s no ambulance or car to take them to a hospital. There have been several reports of women undergoing C-sections without anesthesia or properly sanitized medical tools, leading to wound infections.

Basic prenatal care, such as treating anemia, is nonexistent, causing more women to die during childbirth and more babies born prematurely, many of whom die without access to hospital incubators. Food shortages are leaving pregnant women, new mothers and newborns malnourished. And a lack of menstrual hygiene products has caused an increase in infections in women and girls.

“No one is making the connection that there’s a huge repro genocide happening in Gaza that we are funding, and the big repro organizations that are endorsing him are pretending like it’s not happening,” one leader who has met with the Biden administration on abortion issues told HuffPost. Most of the workers who spoke with HuffPost asked to remain anonymous for fear of retaliation from their employers or others in the reproductive rights field.

HuffPost spoke with over a dozen people who work for reproductive justice causes ― including current Planned Parenthood employees, legal experts, nurse midwives, abortion fund workers and clinic staffers from across the country ― who say that Biden’s unwavering support for Israel has fractured the movement. The rift has left those who support Palestinians to feel ostracized by the larger reproductive rights groups and questioning whether they can vote for Biden in November. They also fear retaliation.

All of the workers said that they cannot ignore how their reproductive justice work in the U.S. ties into the reproductive health crisis happening in Gaza, especially when the U.S. is actively involved in the conflict.

Many of the workers stressed that although abortion access is critically important, it’s part of the larger reproductive justice framework that includes the right to choose when and how to have a child and the right to raise that child in a safe environment.

“Denying a woman dignified health care in birth is such a huge part of reproductive justice. How can you not see that this is the same thing?” Allie Felker, a stillbirth prevention advocate whose first child was stillborn, told HuffPost. “There’s so much more to reproductive justice than just having access to abortions.”

The workers tell HuffPost they cannot in good conscience vote for Biden in the 2024 election given his ardent support for Israel. Nearly every worker, including those at Planned Parenthood, said they wished big reproductive rights organizations, which have the ability to endorse and help fund presidential candidates, had used their political power to demand a Democratic candidate that was a stronger advocate for abortion rights.

“There’s so much you can do in 10 months to make Biden a better candidate, and instead of doing that, you’re yelling at people like me who have been doing the hard work for a long time,” one abortion fund worker from the South told HuffPost. “You’re telling me I should forget about all these bad things he’s done because it could be worse, instead of asking the person who could change things to change them.”

Biden’s halfhearted support for abortion access had already soured many of the workers on his administration. Many said they can no longer support a candidate who barely says the word “abortion” and is working to restore a status quo that never gave marginalized people abortion access to begin with. Some said that Biden’s policy stance on immigration also contributed to their decision to not vote for him in November. Everyone said that Gaza was the last straw.

They understand what’s at stake: A second Trump presidency would likely be worse for abortion access in the U.S. But they’re tired of campaigning for Democrats who rarely listen to frontline service workers and then renege on their abortion rights promises once in office.

The Biden campaign declined to comment on the record.

“The Biden administration is using abortion access to win his presidential campaign, which is a huge problem when there is a reproductive justice crisis in Palestine that he is contributing to,” said one Planned Parenthood employee.

“There’s a huge divide in our movement now that a lot of the union workers are talking about. We’re feeling used; we’re feeling abandoned,” the worker added. “It’s definitely a betrayal to see these CEOs saying ‘Four more years’ when Biden hasn’t even done anything to help our movement.”

Two people in the reproductive rights space who are close to some of the national groups told HuffPost that organizations don’t penalize employees for speaking out about their viewpoints. Leaders at these groups are also put in a tough position, they said, because they’re asked to put their personal opinions aside in order to lead in an environment that can be hostile.

Voters need to pay more attention to Vice President Kamala Harris, they said, who they believe has been a critical part of the administration’s push to protect abortion care. “Vice President Harris’ words and actions have made her, in particular, the reproductive rights champion that we need for the time that we’re in,” one of the people who works closely with some of the national organizations told HuffPost.

“We’re going to continue to work with [the administration], but we also push them,” they said. “Just because people don’t hear it or see it doesn’t mean we aren’t using the relationship that we have to push them harder.”

Tensions Rise Across The Movement

Many of the U.S. workers became emotional when discussing what they described as genocide in the Gaza Strip. They told HuffPost they can’t ignore the racist history of the reproductive rights movement.

“The truth is it plays right into our movement’s history of participating in reproductive coercion, injustice and genocide,” the reproductive rights leader who has met with the Biden administration told HuffPost, referring to the sterilization of Puerto Rican women who sought contraception and the experimentation on Black women’s bodies to create modern gynecological care. “What I see is our movement’s history repeating itself, and that is so dangerous.”

“We’re not going to talk about the entire generations of Palestinians who are dead so, what, this man can stay in office?”

ARC Southeast, an abortion fund in the South, is one of the few reproductive rights organizations in the U.S. that has put out a powerful, in-depth statement of support for the Palestinian people.

Much of the statement acknowledges the parallels between the barriers their callers, the majority of whom are Black, experience when trying to get health care in the South and the obstacles to maternal and reproductive health care Palestinians are facing. Nearly 70 other grassroots reproductive justice organizations across the country signed on in support of the statement, which was published in October.

Repro Jobs, a hub for workers in the industry, also published a statement signed by about 700 workers that calls for a cease-fire and acknowledges the industrywide concern over the “rising suppression of speech” of workers who protest the “genocide of Palestinians.”

In contrast, Planned Parenthood put out a statement in December that directly condemned Hamas for killing Israelis but chose to use a passive voice when describing Palestinian deaths. Many employees were deeply frustrated with the statement because, they said, it did little to acknowledge the violence in Gaza and did not call for a cease-fire.

More than 430 current and former employees, as well as donors, criticized Planned Parenthood in a letter responding to the organization’s statement. The letter was written by PPFA union workers who claimed that their employer’s December statement contributed to the spread of “rampant disinformation.”

“For PPFA to ignore the Israeli government’s war crimes against the Palestinian people stands antithetical to their purported mission to fight for the dignity, safety, and rights of all people,” the letter says. The letter is endorsed by a range of departments that the signatories work in, including Planned Parenthood’s litigation and law sector, Planned Parenthood Global and Planned Parenthood state groups from all over the country.

Planned Parenthood declined to comment on the record.

Some workers who spoke with HuffPost acknowledged that this is simply the role of larger organizations during a critical election year; organizations like Planned Parenthood have to tread carefully on controversial issues in order to ensure donations continue, some said. Others felt differently.

“All of the Planned Parenthood workers, I think we know that Planned Parenthood is a white liberal feminist organization that’s of the Hillary Clinton types or imperial feminists,” one Planned Parenthood worker said. “Through our unions we’re trying to change that… but it’s not easy.”

Reproductive Justice Isn’t Only About Abortion Care

Since October, the Biden administration has supported Israel on the world stage, bypassing Congress multiple times to approve sending weapons to Israel.

Despite months of international criticism and growing concern from lawmakers at home, Biden has aided Israel like no other president before him. He only recently began pushing for a “sustained pause” in fighting and calling Israel’s military response in Gaza “over the top.” The president promised to adjust U.S. policy to curb violence in the region, though current and former officials told HuffPost’s Akbar Shahid Ahmed that they’re skeptical the administration will actually reduce U.S. military or diplomatic support for Israel.

Dr. Deborah Harrington, a high-risk obstetrician, saw women die from pregnancy complications in December when she worked in Al-Aqsa Hospital in central Gaza for two weeks as part of a humanitarian aid trip.

Harrington told HuffPost that most of the maternal and newborn health care providers were moved to Al-Helal Al-Emirati Maternity Hospital in Rafah, one of the last designated “safe zones,” sheltering nearly 1.4 million displaced Gazans.

Al-Emirati hospital was designed to accommodate 30 to 40 daily appointments for pregnant patients but now sees 300 to 400 pregnant women, postpartum mothers and newborns each day. Most of the newborns admitted to Al-Emirati are dying of infections because of the horrible conditions, said Dr. Ahmed Al Shaer, a pediatric specialist at the hospital.

“Today I am scheduled for a cesarean section, then I’ll return to the same suffering in the tent,” a pregnant woman at Al-Emirati told the United Nations. “I will be facing difficulties after birth from physical pain to an ice-cold tent.”

“The baby has no clothes,” she added before starting to cry.

Israel began airstrikes in Rafah this week. One Gazan described the first night as full of “horror, strikes, death and destruction.” Harrington fears for her colleagues who are continuing their work at Al-Emirati hospital, adding that there will likely be no place left to safely give birth if Rafah becomes an active military zone.

Felker, the stillbirth prevention advocate, was part of a group of reproductive justice workers who disrupted a Harris campaign event that was part of the vice president’s “Fight for Reproductive Freedoms” tour late last month in San Jose, California.

Before Felker stood from her seat to demand a cease-fire, she said there were several women sitting on either side of her who were cheering any time Harris talked about reproductive freedom. When Felker stood up and yelled: “Cease-fire now! I have lost a child, I know how these women [in Gaza] feel,” the same women pulled on her purse to get her to sit down. One woman stood in front of her and said, “I will not let you speak.”

“When we first attained these [reproductive] rights, it was from women doing exactly what I’m doing: standing up for justice, protesting, shouting in the streets, raising our voices,” she said.

“Now it’s like these same women who would champion that justice here are standing against me for championing that justice where our administration is actively repressing it.”