She could have opted to go into education.
But Jill Meadows decided after her freshman year in college to be a doctor - like her father, her brother, uncles and cousins.
That decision, and a collection of others, led to a professional life defined by controversy, potential danger and, at the same time, a deep passion for her work.
Dr. Jill Meadows chose to specialize in obstetrics and gynecology and family planning. Women's reproductive rights became her focus.
In July, the 41-year-old doctor became the medical director of Planned Parenthood of the Heartland, a merger of the women's health care providers in Nebraska and Iowa. With that, she donned a more public face in the abortion battle in the two states - bordering states that approach the issue from much different vantage points.
Nebraska is conservative. Iowa allows gay marriage, has no death penalty and Democrats control both the governor's office and the statehouse.
Meadows presides over Planned Parenthood's medical services in both states, with legal, operational and clinical duties, from a perspective grown from her Iowa roots.
She is a quiet feminist activist who has stepped in where mainstream medicine and many doctors have locked arms and marched out because of fear, aversion, ambivalence or their own convictions.
For her part, Meadows has chosen to defend women's reproductive choices. She jumped into the middle of a high-profile, partial-birth abortion lawsuit and added her name to a lawsuit filed to stop a new Nebraska law she believed was aimed at limiting access to abortion.
She contributed a 14-page plaintiff statement for the Planned Parenthood suit against Nebraska's LB594, that requires more evaluation of risk factors before an abortion can be performed and allows civil lawsuits against doctors who don't comply. A federal judge has stopped major parts of the law from being enacted and the state has said it won't appeal.
"I've been public about my being an abortion provider for many years now," she said.
Meadows is operating in a time when a higher percentage of Americans identify themselves as pro-life rather than pro-choice.
Last year for the first time since polling on the issue began in 1995, a majority of Americans - 51 percent - said they were pro-life. This year a Gallup poll continued to find a higher percentage of pro-life responses over pro-choice.
Meadows has seen support for her decisions, she said. But she's also painfully aware of the potential for hate mail, violence and worse.
"There have been a couple of days when I wondered whether it would be my last day on Earth but, you know, confronting your own mortality actually provides tremendous spiritual growth, so it actually worked in the positive for me."
Meadows didn't head to medical school thinking she would become an abortion provider. But the contrasts she observed there shaped her decisions.
When she entered the University of Iowa College of Medicine in 1991, Operation Rescue and other extreme anti-abortion groups were launching aggressive protests at abortion clinics and targeting the doctors who worked there. Operation Rescue founder Randall Terry zeroed in on doctors as part of the organization's strategy, promising to "shame them, humiliate them, disgrace them and expose them."
Extremists who identified with the anti-abortion movement went further.
In 1993, Dr. David Gunn of Pensacola, Fla., was the first of four doctors murdered by one of those zealots.
And Meadows was among 33,000 medical students that year who received a multi-page anti-abortion publication called "Bottom Feeders," filled with vulgar cartoons and ethnic jokes rewritten to target abortion providers:
Q. What would you do if you found yourself in a room with Hitler, Mussolini and an abortionist, and you had a gun with only two bullets?
A: Shoot the abortionist twice.
Meadows responded by founding Medical Students for Choice at her school.
In contrast to the violence were the physicians she watched in the university's obstetrics and gynecology department who provided abortions. She saw them as some of the most intelligent and compassionate faculty members.
Family planning became Meadows' passion. She began her practice in 1999, providing a full range of services including labor and delivery, high-risk pregnancies and gynecology surgeries. She said providing abortions in a caring, nonjudgmental way to women who wanted them satisfied her professionally.
"I have a very strong sense of who I am and what I believe," she said. "I made a decision to move in a faith-based manner instead of a fear-based manner. I feel it's more important to live out my spiritual principles than for the purpose of self-preservation."
Once, a gunman was reported at a clinic where she worked. "Going to your car after something like that has been reported is interesting," she said.
She also was there when aggressive protesters tried to obstruct access to a clinic where she worked in Iowa City. And she had safety concerns when she testified in 2004 in a Nebraska federal courtroom during the partial-birth abortion lawsuit.
But she feels strongly: "If I'm not going to do it, who is?"
The doctor views the world as a Christian feminist.
Women have abortions for "very good and moral reasons," she says. And her calling is to support them.
Last year in Nebraska, the Department of Health and Human Services recorded 2,551 abortions. Iowa recorded 5,829.
Studies show the No. 1 reason women give for terminating a pregnancy is their sense of responsibility toward others, Meadows said. That includes lack of adequate financial support, existing responsibilities, lack of a supporting partner or estrangement from family.
Growing up, she learned that relatives in both her grandmother's and her mother's generation had abortions.
"I could see that they made that decision to provide better lives for their current and their future children and families," she said. "And they were all wonderful mothers and providers down the road."
Meadows combines her faith in women's decision-making with her religious beliefs. She regularly attends church.
"I do believe in heaven, that this life is temporary, and the most important thing is to follow our calling," she said. "I feel like most of the positive changes over history have been due to people making sacrifices."
She has reflected, prayed, studied the scriptures and has come away with different interpretations than the religious right.
She has come to believe that life begins, not at conception, but when it becomes meaningful, when ensoulment is possible, when viability and taking breath is possible. The miracle of life occurs at birth, she says.
"But I believe it's personal for everybody. Our religious beliefs differ, and we need to respect each other's religious beliefs," she said.
The Iowa native describes her childhood as privileged.
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Her father, a general practitioner, owned a plane and for a time would fly her to another Iowa city for music lessons.
"I've always loved music. I played classical guitar starting in the second grade," she says.
At age 11, she heard a harpist at her church and turned her attention to that instrument. She still plays.
"I'm down to Christmas carols, an occasional wedding, a charity event," she says. "But someday I hope to get back to it."
She is married with a son, 7, and a daughter, 5, who was adopted from India. Her husband, who is returning to school to get a master's degree in nursing, is "very supportive" of his wife's philosophies and activities, she says.
For the rest of her family, it's a somewhat different story.
"I'm not close to my parents for a variety of reasons, but they did raise their children to be independent," she says.
Her mother was a Methodist who joined a charismatic church when Meadows was in junior high.
"That's partially where my love of church and spiritual subjects comes from. ... And then my own spiritual beliefs evolved to be very different from hers."
Her dad is passively pro-choice, she said, and more politically conservative than she is.
Her brother, also a doctor, lives in Florida and differs from her politically but is "very supportive" of her personally, she said.
"He just understands the importance of being true to yourself and living by your spiritual principles."
Her relationship with her sister is a mirror image.
"Our political views match up more, but she just doesn't support me personally," Meadows explained.
Colleagues of Meadows know her as passionate, dedicated, intelligent and outspoken - someone who feels strongly that any law limiting abortion rights limits women's rights.
Penny Dickey, chief operating officer for Planned Parenthood of the Heartland who hired Meadows, sees her as compassionate, caring and highly skilled.
"I think Dr. Meadows is an absolute gem," Dickey said.
Diana Jones met Meadows when both were working at a women's health clinic in Iowa that provides abortions.
In working with patients, Jones said, Meadows reflects the seriousness she feels about the abortion procedure, that it's not to be taken lightly. But she makes her patients feel as comfortable as possible.
"Jill's dedication is the one thing that struck me," she said.
Dr. Veronika Kolder, a colleague, said Meadows' "unwavering and courageous attitude toward women's health care comes from caring deeply."
Meadows became an assistant professor at age 30 and associate professor in her mid-30s. She continues, even with her current role at Planned Parenthood, as an adjunct professor. She takes her teaching role at the university very seriously, Kolder said. She knows both the literature and the medical evidence.
"She's not going to give you an unfounded opinion," Kolder said.
Meadows is outspoken in her view of people in the anti-abortion crusade. They say they are pious, she said, but use tactics of guilt and shame against women and spread medical misinformation and fear.
"So I look at that and say, ‘What are they really trying to accomplish? Is it a loving intent, or one of control?'" she said. "And obviously I've decided it's one of control and punishment, self-righteousness and judgment."
Julie Schmit-Albin, director of Nebraska Right to Life, doesn't know Meadows. But she takes exception to the doctor's views.
Guilt, shame and fear? She doesn't see that in the pro-life movement, she said. She sees two victims of abortion - the mother and the baby.
"There are so many walking wounded in our country, from millions of abortions," Schmit-Albin says. "We embrace them. We never, ever point a finger of guilt."
Abortion providers, she said, don't want to address the fact that what they do is hurtful to women and that there are consequences for years - emotional, medical and psychological, she said.
Abortion is pitting the baby against the mother, the most unnatural thing in the world, she said.
"We're here to help women."
Abortion is a common experience in America, with about one in three women, representing a broad cross section, having had one by age 45, according to the Guttmacher Institute.
Medical sociologist Lori Freedman of the University of California-San Francisco interviewed 40 doctors for her recently released book, "Willing and Unable: Doctors' Constraints in Abortion Care." Many of them wanted to help women in hard circumstances who are making thoughtful, difficult choices about whether to continue a pregnancy, she said.
But because of the controversy and contentious nature of abortion, many of those doctors found it difficult to integrate the procedure into their practices. If they did, they were making a large commitment with their lives and their profession, she said, and came under tremendous pressure from supervisors, peers and hospitals.
Sociology professor Julia McQuillan, of the University of Nebraska-Lincoln, said doctors like Jill Meadows know how important it is to take a stand for people who are vulnerable, who are facing horrible choices in a culture that frequently does not offer a living wage, that does not rise to the obligation to care for children no matter how they come into this world.
These doctors take into consideration their medical ethics, medical oath, responsibilities, and how they define the issue of abortion, she said.
People who have a longer memory of the abortion issue recall that before the decriminalization of abortion with Roe v. Wade, many women aborted their own babies or sought illegal abortions from untrained practitioners. Many women were harmed, some died as a result, McQuillan said.
Meadows is caring for women in difficult situations everyday, she said.
"She's seeing things we don't see."
Reach JoAnne Young at 402-473-7228 or firstname.lastname@example.org.