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In the week since a gunman killed 10 people in a grocery store in Buffalo, N.Y., countless articles and television spots have unpacked the racist conspiracy he shared in a hate-filled manifesto before his shooting spree.

The conspiracythe so-called great replacement theoryis the idea that Democratic lawmakers and other elites are working to force white people into a minority in the United States, usually by increasing immigration. Fox News pundit Tucker Carlson has hammered on the idea more than 400 times while railing against immigration on his show, according to a New York Times investigation, and elected Republicans, including Rep. Elise Stefanik of New York and Rep. Matt Gaetz of Florida have bluntly echoed the language in comments and campaign materials criticizing Democrats immigration policy.

But the conspiracy theory also animates another cornerstone of the modern Republican agenda: opposition to abortion.

The anti-abortion movement was born in the 19th century of white fears of a declining white birth rate, says Jennifer Holland, assistant professor of history at the University of Oklahoma. The idea was that by allowing white women to receive abortions, lawmakers were leaving white populations vulnerable to demographic replacement by non-white or immigrant groups with higher birth rates. In the 1870s and 80s, the fear was primarily focused on Jewish and Catholic immigrants, especially those from Italy or Ireland, who had higher birthrates than white Protestants at the time; now, white power organizations that embrace replacement theory focus on Black and Latino communities, which have higher birth rates than whites.

While the Buffalo gunman did not explicitly mention the word abortion in his manifesto, he references birth rates more than 40 times, according to a TIME analysis, and repeatedly expresses his belief that white birth rates must change.

This week, Matt Schlapp, the head of the Conservative Political Action Conference, explicitly linked replacement theory, immigration and anti-abortion, telling reporters in Hungary that overturning Roe v. Wade, the 1973 Supreme Court decision enshrining a right to abortion, would be a good first step in fixing the U.S.s immigration problem. If youre worried about this quote-unquote replacement, why dont we start there? he said. Start with allowing our own people to live.

The modern mainstream anti-abortion movement denounces racist groups and ideologies. In January, after white supremacists marched alongside protesters at March for Life event, then showed up at the March for Life rally in Washington, DC, the anti-abortion movements biggest annual gathering, organizers decried any association with them. We condemn any organization that seeks to exclude a person or group of people based on the color of their skin or any other characteristic, Jeanne Mancini, president of the March for Life, said in a statement to TIME after the January rally. Neither Mancini nor National Right to Life, another prominent national anti-abortion group, responded to TIMEs requests for comments for this article.

But if mainstream anti-abortion activists flatly reject rightwing extremists, the relationship is complicated by the fact that rightwing extremists see the anti-abortion movement as a useful political allyand a potential pool of new recruits. In December, Thomas Rousseau the leader of the white nationalist group Patriot Front reminded his members of approaching opportunities to recruit and proselytize. Our two March For Life events are coming up, he wrote to his followers, according to leaked chats published by media nonprofit Unicorn Riot. The aim is to be more understated, friendly, in smaller groups, and get as many flyers out as possible.

Rightwing extremists attach themselves like a leech to traditional Republican constituencies, Mike Madrid, a veteran Republican strategist who has been critical of the party in the age of Trump, told TIME earlier this year. In doing so, he says, they legitimize and normalize their extremist positions.

Read More: The Coming Battle Over the Anti-abortion Movements Future

Some mainstream anti-abortion activists worry that racist and nationalist groups appear to be increasingly vocal at their events. When you breed this nationalism together with a movement thats largely religious, you start to see these types of things crop up, says Destiny Herndon-De La Rosa, the founder of the anti-abortion group New Wave Feminists, which calls itself a pro-life feminist organization. But never to the degree this year. I was horrified that an actual white supremacy group was there at the March for Life rally in D.C.

In 2018, Herndon-De La Rosas organization pushed out its vice president, Kristen Hatten, after she began sharing white supremacist ideas, including reportedly sharing a Tweet that mocked the idea of Muslims becoming a British majority on social media, according to HuffPost. Hatten later told HuffPost: Ive said I identify with the alt-right to a large extent, and I doThat said, there are elements within the alt-right with whom I dont see eye to eye. I am not a national socialist nor am I a Nazi. I am not a eugenicist. In fact I remain pro-life.

Belief in rightwing conspiracies is ascendent in an increasingly conservative Republican Party, says Kurt Braddock, assistant professor of communications at American University and a faculty fellow at the schools Polarization and Extremism Research Innovation Lab. What weve seen from the Right in recent years is that what was originally on the fringe in 2015, from 2016, forward, the fringe has moved more and more into the mainstream, he says.

Nearly one in three American adults now hold a belief that is in line with the replacement theory. According to an Associated Press and the NORC Center for Public Affairs Research poll published May 9, a third of Americans believe a group of people is trying to replace native-born Americans with immigrants for electoral gains. Another 29% shared the concern that a rise in immigration is leading to native-born Americans losing influence in culture and politics.

Prior to the Civil War, abortion was legal with minimum restrictions in the U.S. But when the war ended, white Protestant Americans fears shifted. After slavery was outlawed, the womens suffrage movement began, and immigration increased, the idea that a white Protestant America would soon be diluted or replaced by immigrant groups gained steam. In 1858, group of physicians with the American Medical Association, led by Horatio Storer, began lobbying lawmakers to begin restricting and banning abortions on the grounds that a low birth rate among whites would allow immigrants, particularly Catholics from Ireland and other parts of Europe, to overtake white Protestants demographically.

While replacement theory wasnt given a name until 2012, these 19th century activists embraced the notion and language explicitly. If a majority of all the youths and children under fifteen years of age in a place is made up from those of a foreign parentage, and is relatively increasing in number every year, how long will it be before such a power will be felt in the management, if not in the control, of the municipal government of those cities and towns? said one of those physicians, according to researchers at Northwestern University and University of California, Berkeley.

Storers movement was successful. By the year 1900, abortion was illegal in all U.S. states, marking a profound shift in four decades. (Ironically, Storer would in the later years of his life convert to Catholicism, according to James Madison Universitys undergraduate research journal).

It really is a radical break from American laws before then, Holland, at the University of Oklahoma, says. Prior to this group of physicians involvement in the procedure, abortion was widely legal and was inherited by English common law. The question is, why would state legislatures be open to [abortion restrictions]? Holland adds. It very much has to do with race.

Read more: How the Great Replacement Theory Has Fueled Racist Violence

Even on its own terms, the logic of anti-abortion racism is deeply convoluted. People of color receive disproportionately more abortions than white Americans. But Seyward Darby, author of Sisters in Hate: American Women on the Front Lines of White Nationalism, says logic is not the point. You have to step away from theory, and you have to realize the kind of wider world worldview, she tells TIME. What they ultimately want is a series of policies, including making white women have more babies, by force if necessary, and then finding ways if not to reduce the number of children who are not white in the country, then to marginalize them to such an extent that they have no power.

Some far right anti-abortion extremists oppose both immigration and abortions for white women only, and throughout history, similar racist thought has undergirded forced-sterilization campaigns of women of color. For white supremacists, they are not seeking to end abortion because of any kind of morality related to the fetus itself, says Alex DiBranco, executive director of the Institute for Research on Male Supremacism, an organization of experts and scholars who study misogynist movements and ideology. Theyre very much seeing this as a strategic and tactical way to force white women to give birth.

With replacement theory and other racist ideologies no longer relegated to 19th century lobbying efforts or the fringes of the internet, experts on political extremism say that Americans must now grapple with the implications of these beliefs on mainstream politics. Its difficult to get into the minds of the people that engage in this violence and say that theyre pro life, says Braddock, at American University. Generally speaking a lot of these individuals, what theyll say is that they had to engage in violence to precipitate something that would inherently make the world better around them.

With reporting by Vera Bergengruen

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Write to Jasmine Aguilera at jasmine.aguilera@time.com and Abigail Abrams at abigail.abrams@time.com.

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Where the Buffalo Gunman and the Anti-Abortion Fringe Meet | Time - TIME