When she was younger, Sarah Prager thought she'd climb mountains for a living. Now 48 and living in Wedgwood, she started mountaineering in college and worked as an instructor after she graduated.

"I love many things about mountaineering," she told me. "It brings me much closer to all the elements of basic survival—cooking over a camp stove, gathering and treating all our water, setting up the tarp or tent each night for shelter. And the fact that I have to carry everything on my back also really helps me pare down to what is truly essential."

Prager planned to keep leading people up mountains, but then, while working at a mountaineering company in Seattle, she started volunteering at Planned Parenthood once a week. The job was basic—administrative stuff, mostly—but it was there that Prager's life changed, because it was while observing doctors and patients at Planned Parenthood that she decided to give up professional mountaineering and become an abortion provider.

"Seeing women come in feeling stigmatized and then leave feeling well cared for and supported, that just felt like really important work," she said. "I realized that if I felt so strongly that women should have this access, I should actually be providing abortions myself."

Prager, who had a degree in Italian, quit the mountaineering company and went back to school to get her prerequisites in science at Harvard. From there, she went to medical school in Dallas, did a residency in Vermont, a fellowship in San Francisco, and then joined the University of Washington School of Medicine, where she's been both teaching and practicing medicine for the last 13 years. She also works in clinics around King County, including one in Renton that often has a lone protester standing outside with a sign.

"One was just a big sign that said 'abortionist' with an arrow pointing to the door, so I would tell my students, just look for the abortionist sign and that's where you turn."

Still, Prager is in one of the easier states to be doing this work, especially now, when some states seem to be in a contest over who can ban abortion first. One day, Georgia passes a law restricting abortions after six weeks of pregnancy, and the next, Alabama passes one that's even stricter. In Washington, however, there's no waiting period or mandatory counseling, the procedure can be performed at a clinic instead of a hospital, and public funding is available in cases where it's medically necessary. It's the gold standard of abortion access.

But while abortion opponents are far outnumbered by those who support it, that doesn't mean plenty of people here don't still object. A 2014 Pew survey on abortion found that 36 percent of Washington respondents thought abortion should be illegal in most cases, a view shared by a number of Prager's own patients.

"The majority of patients think that their situation warrants an abortion," she said. "Sometimes that's because of a fetal anomaly, sometimes it's because they want to finish school, sometimes it's because their partner left them or they got pregnant from somebody who is not their partner. Any number of reasons can feel very valid. I've had countless patients come in and say, 'I don't believe in abortion, but I really can't have this pregnancy.'"

When that happens, Prager treats the patient like anyone else. "I don't feel like it is my job to make anyone feel stigmatized," she says. "If I can be a compassionate, skilled doctor for that person, maybe that will shift the needle. I don't know if I knew this in the beginning, but there is a way in which I can be an activist just by doing this work."