Planned Parenthood pulled this off, pollsters and strategists say, with a two-pronged strategy. First, it turned Mitt Romney's words against him. Then the group used algorithms to identify a group of 1 million female voters, largely in swing states, who were particularly receptive to the group's message.
Planned Parenthood got an inkling that reproductive health could be a much bigger issue than abortion back in February, when a heated fight broke out over the health-care law's requirement that all employers include contraceptive coverage in their insurance.
"This would be an election where we could seize the opportunity," says Anna Greenberg of Greenberg Quinlan Rosner, who worked for the group.
Greenberg began tracking how much women's issues came up at various points in the campaign. She kept seeing spikes in interest happening over and over again.
Planned Parenthood started with focus groups in the spring, trying to figure out how much voters knew about Romney's positions on women's health issues. The answer seemed to be: not a lot.
"Women did not know about Romney's position on women's health," says Molly O'Rourke of Democratic polling firm Hart Research, who worked on those groups. "To the extent they made a guess, there were a lot of wrong assumptions. They knew him as a businessman and not particularly strong on these issues."
After that, O'Rourke and her team began testing out what messages worked best to define Romney. They would put up online ads that had personal messages or ones that leveraged Planned Parenthood as an authority on women's health.
What worked best, it turns out, were using Romney's words themselves. The debates from the Republican primary gave them a number of options to choose from, including, "I'll cut off funding for Planned Parenthood. We're going to get rid of that," and remarks that he would be "delighted" to sign legislation that would overturn Roe v. Wade.
Figuring out the best message was only half the puzzle; Planned Parenthood had to figure out who would be most receptive to their ideas. For that, they turned to micro-targeting, identifying 1 million female voters who were likely to support legal abortion and the health law's contraceptive mandate.
The group spent about $15 million this year, more than tripling the $4 million it spent in 2008. It wanted to make sure those dollars were targeting the voters who would be open to their message.
"Those were the women that we were going to relentlessly target over and over and over again between June and November," says Planned Parenthood Executive Vice President Dawn Laguens.
If you were among the women in that group who lived in Virginia, you received five pieces of direct mail and dozens of phone calls. You would get visits from canvassers, who might hand you a folded-up brochure, styled to look like a pocketbook, that told you Mitt Romney could cost you $407,000 over your lifetime by not supporting no co-pay birth control or equal pay legislation.
You also saw lots of advertising: Campaigns and outside groups spent $39 million on abortion-related ads this cycle, a huge jump over previous cycles.
"There was a huge increase in the number of spots in these issues 2012 versus 2008," says Ken Goldstein, president of Kantar Media, a media tracking firm. "Overall, the Democrats aired over six times as many spots on abortion as Republicans."
Democrats weren't only airing more ads than Republicans, Goldstein notes; they were also airing them at different times. While Republican advertising on abortion aired largely during the primaries, Democrats focused on the general election. Goldstein describes that as the "ultimate tell on how the issue changed during the election."
Planned Parenthood focused mostly on swing states, such as Virginia, Ohio and New Hampshire. But they also put some resources into solid red states, including Montana, where they targeted 41,000 female voters they thought they could turn out for Sen. John Tester's reelection.
The group was a bit wary about that race: They had a "Keep Calm and Trust Nate Silver" poster in their office, even as the polling guru was predicting a Tester loss. But they stuck with the campaign, mostly focusing on why Tester's opponent, Rep. Denny Rehberg, was a bad choice for women.
Tester ultimately won that race by a 3.9 margin, with a 6-point gender gap in his favor. He told The Washington Post's Rachel Weiner in a statement that “Planned Parenthood understood the importance of Montana’s race because women’s rights were at stake, and they knew winning was going to take hard work and connecting directly with Montanans."
Post-election polling suggests that Planned Parenthood's messages did break through. By the end the campaign season, more voters knew that Romney did not support no co-pay contraceptives than those who were aware that he opposed legal abortion. That comes from a post-election survey conducted by Hart Research and Chesapeake Bay Consulting, a Republican polling firm.
"In a way, our theory was there were a few people who said I'm done with that guy [Obama]," she says. "There were a whole bunch more who were on the fence. Our job was to keep the elevator door open long enough for Barack Obama, and the improved economy, in order to make our final elevator pitch."