WASHINGTON (AP) — President Joe Biden had plenty of opportunity during the presidential debate to lay out a clear vision regarding abortion rights in the face of growing restrictions and worsening medical care for women since the fall of Roe v. Wade, something his campaign sees as a major motivator for voters.

That’s not what happened.

Biden’s jumbled and even nonsensical responses Thursday night to questions about abortion rights — coupled with Trump’s outlandish but unchecked claims about Democrats’ views — were panned by some abortion rights advocates who suggested the performance was a failure.

“Look, no one who cares about abortion access felt good about Biden’s comments or his performance last night,” said Kellie Copeland, the director of Abortion Forward, an advocacy group in Ohio. “We need better — we need a lot better.”

Put more bluntly: “He failed us last night,” said Sarah Garza Resnick of Personal PAC, an Illinois group that supports candidates who back abortion rights.

Reproductive rights have already proven to be a winning issue for Democrats. On ballot initiatives, voters consistently choose to safeguard abortion rights. About two-thirds of U.S. adults and nearly 9 in 10 Democrats say abortion should be legal in all or most cases, according to AP-NORC data from last June. It’s a topic that should be an easy win for Biden.

The president recovered a bit on Friday, telling supporters at a North Carolina rally: “Folks, for all his lies, we learned some important truths about Donald Trump last night. We learned he’s still proud to be the person that killed Roe v. Wade.”

But the night before, Biden seemed unable to explain the landmark Supreme Court ruling that legalized abortion.

When asked by the moderators if he supports some restrictions on abortion, Biden said he “supports Roe v. Wade, which had three trimesters. The first time is between a woman and a doctor. Second time is between a doctor and an extreme situation. A third time is between the doctor, I mean, between the women and the state.”

Abortion rights advocates lamented a missed chance to clearly lay out the stakes.

“Biden had a wonderful opportunity to really show the difference between him and Trump in who stands for abortion access and who doesn’t,” said Nourbese Flint, president of the national abortion justice group All Above All Action Fund. “And I think he really missed the mark.”

The overturning of federal protections has meant the issue is now mostly in the hands of state legislatures, where the laws vary wildly. At least 25 million women now live in states with abortion restrictions.

And since Roe’s demise, reproductive health in the U.S. has become increasingly more fraught. Women who never intended to end their pregnancies have nearly died because they could not get emergency treatment. Miscarriage care has been delayed. Routine reproductive medical care is drying up in states with strict bans. Fertility treatments were temporarily paused in Alabama.

The Supreme Court weighed in on the issue again Thursday, ruling for now that women in Idaho should be able to get abortions in medical emergencies; the state’s strict abortion ban does not generally allow for it, and the Biden administration sued. Trump even said he was for exceptions to bans — but Biden failed to seize on it.

Trump again bragged about how he appointed three of the Supreme Court justices who voted to overturn Roe with their decision in Dobbs v. Jackson Women’s Health Organization.

And he made false claims that Democratic-led states were passing legislation “where you can execute that baby after birth.” Infanticide is criminalized in every state, and no state has passed a law that allows killing a baby after birth.

Abortion rights advocates say language like this and “late-term abortions” are a not-so-subtle attempt to stigmatize abortions later in pregnancy. But even those are exceedingly rare. In 2020, less than 1% of abortions in the United States were performed at or after 21 weeks, according to the Centers for Disease Control and Prevention. And those types of abortions are usually the result of serious complications.

“Donald Trump has shown us exactly who he is and what he is capable of. There should be no doubt in anyone’s mind that, if given the chance, he will sign a national abortion ban into law,” said Mini Timmaraju, head of Reproductive Freedom for All. But even as abortion rights groups criticized Biden’s performance, they closed ranks around the president, praising his record on abortion rights and highlighting concerns over what Trump might do if he won the election.

“The choice between the two presidential tickets is crystal clear: Donald Trump represents an existential threat to women in America,” according to a joint statement Friday from multiple groups.

Biden is hardly a “shout your abortion” type and has long been seen as an imperfect messenger: He’s an 81-year-old Catholic man who still avoids using the word. But his evolution over the years mirrors that of the Democratic Party at large. And the way he talks about it — as a matter of health care and personal freedom is something that resonates with voters.

Vice President Kamala Harris has been the chief administration spokesperson for the issue. But Biden’s campaign has also deployed a growing group of women who speak to voters about how a lack of abortion access has affected them. These are women who never intended to end their pregnancies but who have been swept up in the medical confusion brought on by the fall of Roe. Biden’s campaign released an ad featuring one of them on Thursday.

Still, during the debate, Biden missed key chances to fact-check Trump and clear up falsehoods.

“It was incumbent on him to call out the lies,” said Jennifer Driver, senior director of reproductive rights at the nonprofit State Innovation Exchange. “He just could not accurately and effectively push back on the lies that were being presented. And when he doesn’t do it in real-time, people watching don’t know what’s incorrect.”

About 4 in 10 approve of how Biden handles abortion policy — making it one of his better issues — even as many disagree with his approach, according to a new AP-NORC poll. Seven in 10 Democrats say they approve, compared to about 3 in 10 Independents and roughly 2 in 10 Republicans.

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Christine Fernando reported from Chicago. Associated Press Writer Linley Sanders contributed to this report.