WASHINGTON (AP) — A 22-year-old woman who became an abortion rights advocate after being raped as a child by her stepfather is telling her story in a new campaign ad for Democratic presidential candidate Kamala Harris.

Hadley Duvall says in voiceover that she’s never had a full night’s sleep in her life — her stepfather began abusing her when she was five and impregnated her when she was 12. As she speaks, images of Duvall as a child flash across the screen. The ad’s soundtrack is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I remember thinking, ‘I have to get out of my skin. I can’t be myself right now. This can’t be it,'” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant. But I had options.”

The ad is part of an ongoing effort by the Harris campaign to highlight the growing consequences of Roe’s overturning, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering from increasingly dangerous medical care, and the first reported case of a woman dying from delayed reproductive care came to light this week. Harris places the blame squarely on Republican candidate Donald Trump, who appointed three of the same conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall also blames Trump.

“Because Donald Trump overturned Roe v. Wade, girls and women across this country have lost the right to choose, even rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the Sept. 10 presidential debate, Trump repeatedly took credit for nominating the three Supreme Court justices and leaned heavily on his sweeping response to questions about abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I will not sign a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly refused to say whether he would veto such a ban if re-elected — a question that lingers as the Republican nominee has shifted his position on the crucial election issue.

Duvall, of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for her home state’s gubernatorial race, endorsing Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she suffered a miscarriage.

Beshear was re-elected and Democrats say Duvall’s ad was a strong motivator, especially for rural male voters who had previously voted for Trump.

Duvall is also traveling the country campaigning for Harris, along with other women who have been sharing their personal stories since Roe was overturned. Last week, she joined Pennsylvania Gov. Josh Shapiro.