Biden has, at times, disappointed progressive activists with less-than-full-throated support for abortion. Yet he quickly embraced Cox’s story as proof of the dangers of allowing lawmakers and courts to interfere in personal health care decisions, saying in December that it illustrated the “legal and medical chaos” that “is a direct result of Roe v. Wade being overturned.”

Here’s what to know about Cox and the abortion debate ahead of Thursday’s address.

Who is Kate Cox?

Cox drew national attention in December when, at 20 weeks pregnant, she sued Texas seeking an emergency abortion. A district court granted her request but the decision was quickly overturned by the state Supreme Court.

Cox left the state and had an abortion in New Mexico, where the procedure is legal.

“No woman should be forced to go to court or flee her home state just to receive the health care she needs,” Biden said at the time.

Why couldn’t Cox get an abortion in Texas?

Cox and her husband, who already had two children, learned their fetus had trisomy 18, a genetic disorder. Nearly 40 percent of fetuses diagnosed with the condition don’t survive labor, and 60 to 75 percent of those that are born survive their first week, according to the Cleveland Clinic.

Continuing the pregnancy would have put Cox, who had two prior cesarean sections, at “high risk for severe complications threatening her life and future fertility,” including uterine rupture and hysterectomy, according to her lawsuit, which sought an exemption from Texas’ near-total abortion ban.

State law allows the procedure if a pregnant person is facing a “life-threatening physical condition” or a “serious risk of substantial impairment of a major bodily function.”

While the district court ruled in Cox’s favor, Republican State Attorney General Ken Paxton warned doctors and hospitals that they could still face prosecution if they performed the abortion.

How has Cox’s story changed the abortion debate?

Cox, one of several guests invited by Democrats to attend Thursday’s speech who have personal stories related to the fight over abortion, contraception and fertility care, has become a lightning rod — complicating assumptions about who gets abortions in America and why, and focusing the debate on the broader unintended consequences of state bans.

Abortion-rights activists have seized on Cox’s story to argue that exemptions touted as a compassionate compromise by GOP leaders, including Trump, fail to help in practice.

Each of the dozen-plus states with partial or near-total abortion bans has an exemption if a pregnant person’s life is in danger — and some, including Texas, have broader language allowing people to terminate pregnancies that pose serious threats to their health. But Cox and many others who have tried to qualify for such exemptions have found doctors unwilling to perform abortions as the medical community struggles to interpret vague and unscientifically worded state laws. Given this, experts say Cox’s experience undermines the core argument of the Dobbs decision.

“Dobbs is premised on the distinction between elective and therapeutic abortions, that … you can ban one while protecting the other,” said Greer Donley, a law professor at the University of Pittsburgh. “We’re learning in real time that that’s not possible.”

The case has also highlighted the power of state supreme courts heading into an election where voters will have an opportunity to remake them. In Texas, for instance, progressives said they were motivated by Cox’s case to form a political action committee to defeat three of the Republican judges who ruled she could not have an abortion.

What are abortion-rights supporters saying?

Those in the abortion-rights movement see Thursday’s State of the Union address as a key opportunity for Biden to shine a light on the real-world impacts of the Dobbs decision. They believe that bringing Cox to the address — and mentioning her during it — will make the issue more salient for voters who aren’t necessarily experiencing the impacts first hand, or don’t understand the consequences of the court’s decision for emergency care during pregnancy.

“Kate Cox being there is a big deal,” said Mini Timmaraju, president and CEO of Reproductive Freedom for All. “You don’t want to just talk about policy and codification of a federal right — that’s going to go over the heads of some folks. You want to talk about something real that happened to someone who they can empathize with: a mom, who already had kids, who was in a crisis.”

How are conservatives responding?

Anti-abortion groups have not attacked Cox directly for seeking an abortion, but they have mounted arguments that people in her situation should carry their pregnancies to term and have compared abortions based on such diagnoses to eugenics.

“We have empathy and we want to stand with families who’ve received an adverse prenatal diagnosis, but that’s not the end of the story,” Kristan Hawkins, the president of Students for Life of America, told reporters on a Tuesday call. Hawkins and her fellow activists’ message is that fetal diagnoses can prove incorrect and that even if the child ultimately dies — whether in utero or shortly after birth — it’s better for grieving parents to have had a brief time together than none at all. “You don’t end the suffering by ending the sufferer,” she said.

Conservatives, aware of the power of putting a sympathetic face on a fraught topic, have their own stories to share — highlighting parents who received the same diagnosis as Cox but chose to continue their pregnancies. And some anti-abortion members of Congress are bringing guests to the State of the Union who they hope will help push back on calls for broader exemptions to state abortion bans.

Rep. Bob Good (R-Va.), for example, told reporters on the call that his guest is an anti-abortion activist who was conceived through rape.

“When you talk to individuals who move from a pro-choice position to a pro-life position, it’s so often because of an encounter they had, whether it’s a personal experience or someone they knew or what they saw on an ultrasound or someone that they’ve met,” he said. “It’s stories that tend to change minds.”