Jill Biden on Friday used the story of how one of her teenage friends ended a pregnancy at a time when abortion was illegal, including being declared mentally unfit, to illustrate what she says is at stake for women in November’s elections.

“How could we go back to that time?” the first lady asked in a political speech to a women’s conference sponsored by the House Democrats’ campaign arm. She was talking about pre-1972, when the Supreme Court legalized abortion nationwide with its Roe v. Wade ruling.

Women no longer have a constitutional right to abortion after a conservative majority on the Supreme Court in June overturned its ruling in Roe, allowing individual states to decide whether abortion should be legal.

Democrats running for office at the state and federal levels hope opposition to the decision will give their candidates an advantage when voters go to the polls on Nov. 8.

Biden said she was 17 when one of her friends got pregnant in the late 1960s. They lived in Pennsylvania and abortion was illegal.

“To end the pregnancy, she told me that her only recourse was to undergo a psychiatric evaluation that would declare her mentally unfit before the doctor would perform the procedure,” said Biden, now 71. She did not identify her friend.

“I went to see her in the hospital and then cried the whole drive home,” she told several hundred people at the Democratic Congressional Campaign Committee’s Women’s Lunch and Issues Conference at San Francisco’s Fairmont Hotel.

Biden said her friend couldn’t go home after she got out of the hospital, so she asked her mother to let her friend stay with them. Her mom agreed, she said, and “she never told a soul, including, as far as I know, my dad.”

She said she and her mom “never spoke about it again.”

“Secrecy. Shame. Silence. Danger. Even death. That’s what defined that time for so many women,” the first lady said, going on to say she was “shocked” by the decision to overturn Roe v. Wade.

“It was devastating. How could we go back to that time?” she asked.

The first lady addressed the Democratic campaign committee’s luncheon, where she was introduced by House Speaker Nancy Pelosi, D-Calif. Earlier, Biden toured the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco, to mark Breast Cancer Awareness Month and highlight advances in breast cancer research and support programs as part of the Biden administration’s “cancer moonshot” initiative.”

Biden also highlighted the court’s abortion ruling in a speech last Friday at a Democratic National Committee women’s luncheon in Washington. The decision has freed states to decide whether abortion should be legal or illegal, resulting in a patchwork of laws nationwide, with the procedure outlawed in some Republican-led states and legal where Democrats are in control.

In San Francisco on Friday, as she did in Washington last week, Biden criticized “extremist Republicans” for passing state laws that “prevent women from getting the health care they need,” and accused them of also going after marriage equality and voting rights, echoing comments from President Joe Biden and other top Democrats.

She said they are underestimating women — and erring by doing so.

“We’re all here because someone — our mothers, our nanas, our teachers and mentors — taught us to fight for what we believe in, told us that we didn’t have to accept the world as it is, that we could make it better,” the first lady said.

She said women have fought too hard for too long and know “there is just too much at stake.”

“Women will not let this country go backwards,” the first lady said. “We will not let some radical Republican agenda be the legacy we leave to our daughters and granddaughters.”