First off, NEVER engage, no matter how enraging, false and upsetting the content may be. This ad had 3k+ likes and 1k+ comments. Doesn’t matter how many of those are angry reaction emojis, they all contribute to social (i.e. free) reach, pushing the ad into more newsfeeds and allowing it to reach more people.
The anti-choice campaign is already awash with secretive money, and they are under no obligation to report where it is from. So the last thing they need is their messaging spread further for free.
So what can you do to make it more expensive for them? It’s really simple – either hide or report the ad. Not only does this matter for people’s own mental health ‘cos they never have to see this shit again, it also drives the price up for the people running the ad. Basically FB try to limit low-quality ads, and among the key measurements is how much an ad is being hidden/reported. This makes it more expensive for that account to run this ad. If it gets really bad, the system will stop delivering the ad entirely.
tl;dr, anti-choice orgs run these shocking ads to get people to comment/react, even negatively, to spread them further. Just hide or report them to strike a small blow to their budgets, and then move on with more positive things ✌️
(P.S. also lobby your TD for stronger regulations of online political advertising, because what they can get away with is ludicrous.)