Nancy Pelosi has won broad recognition as an effective Speaker of the House of Representatives. But she is also the target of opposition Republicans trying to win back control of the House in this November's congressional elections.
Nancy Pelosi made history on January 4, 2007 when she was sworn in as the first female speaker of the U.S. House of Representatives in its 218-year history.
The mother of five invited the children and grandchildren of House members, including her own eight grandchildren, to join her.
Nancy Pelosi talked about her background at a street-name-changing ceremony in her honor in Baltimore, Maryland.
"I was born and raised in Baltimore, where my father was mayor, and we were raised in a family that was devoutly Catholic, deeply patriotic, extremely proud of our Italian-American heritage, extremely proud of that, and in our case, staunchly Democratic," she said.
As a child, the young Nancy learned hard-nosed political skills from her politician father.
Democratic pollster and Pelosi advisor, Celinda Lake:
"Politics was certainly not something that was new to her," said Lake. "I don't know if she ever aspired to be arguably the most powerful woman in the United States today, and one of the most successful. Because she has really organized that Democratic Party and gotten them to do things in the House that no one else could do and that people said was impossible in this day and age in politics."
One of the things Pelosi got done as Speaker, that Democrats had been trying to do for more than 70 years, is to pass sweeping health care reform. Lake says Pelosi was clearly the driving force in the effort.
"And when other people wanted to cave in, when people wanted to say, including a very powerful man in our party said, 'let's just do children's health care and let's come back at it another day,' she said no, this country needs health care reform, we are going to take on the insurance industry, we are going to get it done," noted Lake.
Republican political strategist Terry Nelson agrees that Pelosi was the key to passing health care reform, but points out that she is a polarizing figure for many conservatives.
"Her unfavorable rating is usually in the high 40s to low 50s, which, for a speaker of the House is really, really extraordinary," said Nelson. "I mean Speakers of the House tend to be, they are obviously important figures, but they tend not to be extraordinarily well-know across the country. With Nancy Pelosi, a lot of people know who she is and they have strong feelings about her."
Nelson says Pelosi is so unpopular among conservatives because she represents one of the most left-leaning, heavily Democratic districts of the country, San Francisco, California. And he says she is not known for reaching out to Republicans.
"That has never been the case," he added. "When I worked on the Hill it wasn't the case and I don't think it has developed since then. So I think that those two things kind of together, her own perspectives on the world, her lack of relationships on the other side have made for a divisive kind of leadership, that has come out of the House. And it has stood in contrast to the way Barack Obama campaigned in 2008."
Some analysts say that Speaker Pelosi and President Barack Obama complement each other, with her tough, behind-the-scenes way of getting things done, and his gift for inspiring many with his public speeches. The two still have a lot more they want to accomplish, including financial reform, immigration reform, and climate change legislation.
To do this, Pelosi has to try to hold on to the Democrats' current majority in the House of Representatives when the entire House is up for re-election this November.
If the Republicans do win back the majority, she will no longer be Speaker. But her place in history will be secure as the first female speaker, and the one who helped pushed health care legislation through Congress.