Abortion and reproductive rights took center stage at the 2024 State of the Union, as President Joe Biden sought to overcome concerns about his re-election chances by emphasizing an issue that has energized voters again and again since the overturning of Roe v Wade.

“My predecessor took office determined to see Roe v Wade overturned and he brags about it,” said Biden, referring to former president Donald Trump, his presumptive rival for the presidency. “Look at the chaos that has resulted.”

Biden has in large part pinned his hopes for re-election on the passions stirred by threats to abortion rights and, in particular, on his vice-president, Kamala Harris, who has embarked on a nationwide tour to trumpet the threat to reproductive freedom posed by another Trump presidency. The demise of Roe, which was overturned with the help of three justices appointed by Trump, has led more than a dozen states to enact near-total abortion bans. Many do not have exceptions for rape or incest, and doctors across the country have said that exceptions for cases of medical emergencies are unworkable in practice, prompting a stream of high-profile cases of women needing to flee their home states for life-saving medical care.

Related: Kate Cox case reveals toll of US abortion bans on women in medical emergencies

A number of guests attending this year’s State of the Union address have ties to post-Roe disputes over reproductive rights that are now roiling the US. The first lady, Jill Biden, invited Kate Cox, a Texas woman who had to leave her the state for an emergency abortion, as well as LaTorya Beasley, an Alabama woman whose in vitro fertilization treatment was halted after the state supreme court ruled that frozen embryos are “extrauterine children”. Abortion foes who believe life begins at fertilization have long worked to enshrine protections for embryos and fetuses into law – even though such rights can conflict with the rights of people carrying them.

Outrage over the overturning of Roe is credited with preventing a widely expected “red wave” of Republican victories in the 2022 midterms. Abortion rights have also repeatedly won when the issue is put directly to voters in ballot referendums, including in traditionally red states such as Kansas, Ohio and Kentucky.

But during the segment of his address about abortion, Biden did not actually utter the word, instead referring to “reproductive freedom”. Biden, a devout Catholic who has previously said he is “not big” on abortion, has been criticized by reproductive rights advocates for shying away from using the word.

“Many of you in this chamber and my predecessor are promising to pass a national ban on reproductive freedom,” Biden said. “My God, what freedoms will you take away next?”

Biden singled out Beasley in his speech, urging members of Congress: “Guarantee the right to IVF. Guarantee it nationwide.”

Last week, Republican Tennessee senator Cindy Hyde-Smith blocked the passage of a bill by Illinois senator Tammy Duckworth, a Democrat, to establish federal protections for IVF. On Thursday night, no Republicans appeared to stand in support of Biden’s plea for IVF, despite the fact that an overwhelming majority of Americans support access to the treatment.

In his speech, Biden also quoted the supreme court majority opinion that overturned Roe. In the opinion, supreme court justice Samuel Alito ruled that, in demolishing Roe, the nation’s highest court was returning the issue of abortion to state legislatures and female voters.

“Women are not without electoral or political power,” Alito wrote. And, on Thursday night, Biden agreed.

“With all due respect, justices, women are not without electoral or political power,” Biden said. “You’re about to realize just how much.”