Proponents of abortion rights were dumbfounded by President Joe Biden’s vague and sometimes incoherent messages on abortion access during Thursday night’s debate, especially when he declined to rebuke former president Donald Trump’s false claims that Democrats are in favor of killing babies.

“The debate was a disaster,” said Dr. Warren Hern, director of the Boulder Abortion Clinic in Colorado. “It’s going to be hard to recover from this.”

The debate should have been a layup for people in favor of abortion rights. Trump, the presumptive Republican nominee, touted the fact that he nominated three anti-abortion justices to the Supreme Court while in office from 2017 to 2021. As a result, the constitutional right to an abortion was overturned in 2022, leaving states in charge of whether to allow women to terminate a pregnancy and at what stage.

But Biden did little to challenge his opponent on the issue during Thursday’s showdown. He said the decision to overturn Roe v. Wade was a “terrible thing,” but then changed the subject to a nursing student who was murdered earlier this year on the University of Georgia campus — an incident that had nothing to do with abortion.

Julie Burkhart, co-owner of Hope Clinic, which provides abortions in Granite City, Illinois, said that Biden’s weak showing on the topic sparked a sense of “discouragement, alarm and concern” among her colleagues. She said she fears a second Trump presidency could lead to a national ban on abortion.

“This presidential election, I feel, is the most pivotal election that I will ever witness in my lifetime,” Burkhart said.

Abortion opponents said the same. They are hopeful that a second Trump presidency would lead to “reasonable measures” to make sure that “tax dollars are not being used to pay for abortion,” said Carol Tobias, president of the National Right to Life Committee.

The polarizing views come as the nation continues to grapple with the topic of abortion care. This past week marked the second anniversary of the Supreme Court’s decision to overturn Roe. According to a recent survey from KFF, a health care research and policy group, 1 in 10 women say the right to an abortion is the most important issue determining their vote.

“Abortion rights advocates need to make sure that the public understands what’s at stake for women’s health care and women’s rights,” Hern said. “It’s a desperate situation.”

Supporters of abortion rights say they will stick to their messaging ahead of the election. They’re attempting to steer voters away from Biden’s poor performance by focusing on his administration’s overall goals and decisions about who should be in charge of influential health care agencies.

“What kind of direction are those heads of agencies going to take? Are they going to defend attacks on abortion access, or are they going to promulgate rules that make it more challenging, if not impossible, for people to access care?” said Michelle Velasquez, chief strategy officer at Planned Parenthood Advocates of Wisconsin.

“The presidency is more than just one person,” Velasquez said.

Leila Abolfazli, director of national abortion strategy at the National Women’s Law Center Action Fund, said the group will continue explaining the impact of ongoing decisions, such as the Supreme Court’s sidestep of a decision about whether Idaho’s abortion ban conflicts with a federal law that sets standards for emergency room patients, including women whose pregnancies are life-threatening.

“The struggle I have is explaining to people what these ephemeral concepts and law actually mean on a day-to-day basis,” said Abolfazli. “Pregnancy-related care is under attack, like across the board. That’s what people need to realize.”

Beyond the presidential election, four states have amendments on the November ballot that would aim to preserve abortion rights: Colorado, Florida, Maryland and South Dakota.

“We’re all holding our breath until November,” said Candace Dye, owner of A Woman’s World Medical Center in Fort Pierce, Florida, a clinic that provides abortions. “I’m hoping and praying that that amendment gets passed.”