One of the most exciting state house races in Pennsylvania this year is a primary race between two Democrats in Pittsburgh.

The race between Reps. Harry Readshaw and Erin Molchany for House District 36 illustrates a split in the Democratic Party that tends to happen the farther west you go in Pennsylvania. Though of the same party, the candidates couldn’t be more distinct: Readshaw, 72, is a boy’s club conservative who has cast 31 votes against women’s health since 2002, according to advocates, while Molchany, 36, is a former Planned Parenthood employee who has spoken out about the importance of working women’s access to abortion services.

Advocates see the race leading up to the May 20 primary election as a referendum on women’s health—an issue so polarized in Pennsylvania that last year concerned lawmakers formed the Women’s Health Caucus, a group dedicated to combating legislative attacks on women’s health and introducing pro-active health initiatives.

The race is a result of redistricting plan approved last year. The new boundaries combined parts of Readshaw’s and Molchany’s districts into one new area. The newly combined House District 36 includes Pittsburgh’s South Side, the South Hills neighborhoods ranging from Mount Washington to Carrick, Mount Oliver, and some neighborhoods in Brentwood and Baldwin Borough.

The redistricting plan favors Readshaw. As the Pittsburgh City Paper describes it:

That’s mostly Readshaw’s turf: More than 7 out of 10 voters in the new 36^th were already Readshaw’s constituents, prompting Molchany to say, half-jokingly, “I feel like I’m a victim of cartography.”

Even Molchany’s home address was redistricted into Readshaw’s turf. The situation’s created an epic race: In addition to being seen as a referendum on women’s health, the race is also being framed as a fight for the soul of “a new Pittsburgh,” to borrow the campaign-winning slogan of Pittsburgh’s new mayor, Bill Peduto, who endorsed Molchany.

Molchany’s supporters hope that unlike the old Pittsburgh, the new Pittsburgh includes some female voices. Molchany is currently the only woman in Allegheny County’s house delegation. Overall, the state is hardly better: With less than 18 percent female representation in the general assembly, Pennsylvania is one of the worst states in the country when it comes female representation, and it shows in the state’s policy.

“I feel a certain responsibility as a woman legislator,” Molchany has said. “It changes the conversation when you have diversity in any body.”

To further set the stage, Republican Gov. Tom Corbett has been called the most endangered governor in the country, due in large part to a persistent gender gap, meaning less women support Corbett than men. In January, a Quinnipiac poll found that Pennsylvania women were giving Corbett a “big thumbs down,” which would likely hurt his chances at re-election this fall. From the poll: “There is a large gender gap in today’s results, as women disapprove 45-31 percent while men approve 41-37 percent.”

Another recent poll indicates that the 2014 elections are in the hands of “unmarried women, people of color and young people between the ages of 18 and 29.” Together, these groups are referred to as the RAE, as in “rising American electorate.” Single women are particularly significant this year.

“While we always see a reduction in voter turnout during mid-terms, the differences between 2010 and 2006 were dramatic in terms of who dropped off and the subsequent election results,” Celinda Lake, president of Lake Research Partners, is quoted as saying on the state politics blog PoliticsPA. “The candidates that addressed the issues of the RAE and unmarried women succeeded at higher rates than those that did not. In Pennsylvania, the effect of unmarried women turnout could determine the strength of the delegation in [the] state legislative body as well as control within the U.S. House and U.S. Senate.”

Allegheny County has, by far, the highest number of unregistered unmarried women in Pennsylvania. According to the U.S. Census and PA Voter File, 45,517 unregistered single female voters live in Allegheny County. (Second in line is Philadelphia County, with 26,505 potential single female voters.)

If all the single ladies do decide to vote this election, they have much more than identity politics to help them choose who to cast their vote for in House District 36. The candidates’ split on women’s health issues is so stark that Aleigha Cavalier, Western Pennsylvania project director for Planned Parenthood Pennsylvania Advocates and PAC—which officially endorsed Molchany—says she views this race as a referendum on women’s health.

“These are Democratic primary voters in an off-year election,” Cavalier told Rewire. “So there’s absolutely the opportunity to use women’s health as a referendum.”

Recent national attacks on women’s health compound the tension. As the state where the Casey decision was made—the ruling that opened the doors to the tidal wave of state-level restrictions on abortion all over the rest of the country—Pennsylvania has always been a battleground for women’s health policy. In the last four years, the Pennsylvania legislature has spent a significant amount of energy diminishing women’s reproductive rights.

Under Corbett, Pennsylvania lawmakers passed new abortion clinic regulations that shut down four abortion clinics that had been in good standing. They passed a law making it impossible for women to purchase private insurance abortion coverage through the state health insurance exchange, even when the mother’s health is at stake. They also introduced legislation requiring doctors who perform abortions to get admitting privileges at a nearby hospital, just as Texas did with HB 2, which has shut down roughly a third of the state’s abortion clinics. (It is expected that Pennsylvania lawmakers will sit on the admitting privileges legislation until after the primary election.)

Readshaw sponsored or voted affirmative on all of these initiatives. In fact, according to Planned Parenthood Pennsylvania Advocates, Readshaw has cast 31 votes against women’s health since 2002, making him one of a handful of Pennsylvania Democrats with voting records virtually indistinguishable from state Republicans.

He even co-sponsored Pennsylvania’s forced ultrasound bill, which was the most severe in the country. It would have required that doctors move ultrasound screens close to the face of a patient, and then document whether or not the patient “accepted” or “refused” to look at the screen as the transvaginal wand was pushed into her body. It also required that the patient pay separate fees to the doctor performing the ultrasound, with a refund available only if she did not obtain an abortion.

When a female constituent wrote Readshaw an email against the bill, he responded by sending her a handwritten letter that remarked on her voting record and her position in her household; the letter included the line “I do not choose to debate ‘intellect’ vs. morals, as I believe morals should overwhelmingly be the favorite.”

The overwhelming favorite, as it turned out, was neither intellect or morality: It was political survival. After similar legislation invited a huge backlash in Virginia, Readshaw (along with 12 Democrats and 19 Republicans) dropped support of the bill just ahead of the 2012 election, and it never passed.

Molchany’s record on women’s health care is short but clear. The first time she stood up on the floor to address the assembly was to advocate against the bill prohibiting private insurers from covering abortion in plans sold through the state exchange.

“I was hoping to talk about legislation that impacts the life of everyone in the Commonwealth,” she said. “Unfortunately, this house is focused on government restrictions on women’s health care. … I rise today because House Bill 818 is a bad bill. It is a dangerous bill, and it carries severe unintended consequences by creating barriers to legal and safe health-care options for women. So why are we doing this?”

What Readshaw has going for him is a history of personally assisting constituents and name recognition. His campaign recently commissioned a poll showing Readshaw in the significant lead, and noting 77 percent of Democrats in the district are familiar with him.

Planned Parenthood Pennsylvania Advocates’ Aleigha Cavalier says being familiar with Readshaw’s name and being aware of his voting record are two different things. “When you really talk to people on the South Side and … explain to them that [Readshaw] cast 31 votes against reproductive health care, that doesn’t align with the values of the district,” she said.

Planned Parenthood points to a recent poll indicating that most Pennsylvanians are pro-choice. But the general attacks on women’s health and access to health-care services and insurance have been much larger than abortion. The fact that these attacks don’t align with Pennsylvania voters is already evident by Corbett’s re-election struggle and the strategic political maneuvering around bills that endanger women’s health care—such as shelving the forced ultrasound bill before the 2012 election and keeping quiet on admitting privilege legislation until after this primary.