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Mariannette Miller-Meeks, an Iowa Republican who ran for Congress four times, is expected to be sworn in Sunday -- even as a challenge to her razor-thin, six-vote victory looms. 

Her journey to the House of Representatives has been longer and tougher than probably anyone else's in the 2021 freshman class, so her swearing-in -- albeit provisional -- is especially meaningful.

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"It has been a tumultuous, arduous journey to get here," Miller-Meeks said in a recent interview with Fox News.

"It is very humbling," she said. "And you realize that when you tell people that you're going to fight for them, that they know it comes from a place in your heart that is deep, that's personal, and ... you have that resolve."

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Miller-Meeks and Rep.-elect Ashley Hinson will become the first two GOP women to represent Iowa in the House, following in the footsteps of Sen. Joni Ernst, who became the first female senator from Iowa. 

Rep.-elect Mariannette Miller-Meeks, R-Iowa, will be sworn in Sunday, Jan. 3 after winning Iowa's Second Congressional District by six votes and flipping the seat from blue to red. Her Democratic opponent Rita Hart, however, says she won if all the votes had been counted. Hart is contesting the results in the House of Representatives, which will have the final say.

Rep.-elect Mariannette Miller-Meeks, R-Iowa, will be sworn in Sunday, Jan. 3 after winning Iowa's Second Congressional District by six votes and flipping the seat from blue to red. Her Democratic opponent Rita Hart, however, says she won if all the votes had been counted. Hart is contesting the results in the House of Representatives, which will have the final say. (Provided by Mariannette Miller-Meeks campaign)

Miller-Meeks, 65, is a physician and Army veteran who is moving up from a seat in the state senate. She ran as a pro-life and pro-Second Amendment Republican who would be a government watchdog on spending and fight for common-sense solutions to lower health care costs.

She supports increasing health savings accounts, tort reform, allowing the purchase of insurance over state lines, price transparency and altering what is considered an essential benefit on insurance coverage.

She first ran for Congress in 2008 to fight against socialized medicine. She lost by 18 points to incumbent Democratic Rep. Dave Loebsack. Undeterred, she ran against Loebsack again in 2010 and 2014 -- improving her vote share each time but still falling short. 

She decided to not give up, hoping to set a good example for her two children.

"For me, part of this was role-modeling for my children how to respond to loss, how to respond to grief, to failure, and how you pick yourself back up and conduct yourself,"  Miller-Meeks said. "And then I felt I have something to give."

When Loebsack announced his retirement, Miller-Meeks got in the ring a fourth time --  this time with a solid chance to claim a rare open seat for Republicans. She had more political experience this time around after winning a state senate seat in 2018. 

UNITED STATES - AUGUST 13: Former Iowa State Senator Rita Hart speaks with a reporter at her home in Wheatland, Iowa on Tuesday August 13, 2019. (Photo by Caroline Brehman/CQ Roll Call)

UNITED STATES - AUGUST 13: Former Iowa State Senator Rita Hart speaks with a reporter at her home in Wheatland, Iowa on Tuesday August 13, 2019. (Photo by Caroline Brehman/CQ Roll Call) (Getty Images)

She faced Democrat Rita Hart, a former teacher and fellow state senator, in the closely watched toss-up race. On election night, Miller-Meeks held a 282-vote lead. As more absentee and provisional ballots were counted, Miller-Meeks' lead shrunk to 47 votes.

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A recount of the southeast Iowa district then found that Miller-Meeks had won by merely six votes. Iowa officially certified Miller-Meeks the winner with the narrowest margin of a congressional victory since a four-vote win in 1984.

Instead of challenging the results in court, Hart is contesting the election with the House in a formal petition. Her campaign has identified 22 voters in the 2nd District who voted legally, but whose ballots were not included in the final tally. Hart is asking the House to launch a review of the election and count these legal voters -- which would make her the winner.

Some of the 22 voters were shocked to learn their ballots were not included in the final count for minor issues with their outer envelopes. They held a virtual press conference this week demanding that their ballots count. 

"Iowans deserve to know that they will be represented by the candidate who received the most votes in this race," Hart said in a statement. "A review of the uncounted ballots in this election proves that I am that candidate." 

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Even though House Speaker Nancy Pelosi, D-Calif., said she'll seat Miller-Meeks in the new Congress on Sunday, her office said the swearing-in is provisional and could change depending on the outcome of the pending election challenge. It would take a vote of the full House to seat Hart instead. 

Rep. elect Mariannette Miller-Meeks, R-Iowa, campaigns in Iowa. (Photo provided by the Mariannette Miller-Meeks campaign.)

Rep. elect Mariannette Miller-Meeks, R-Iowa, campaigns in Iowa. (Photo provided by the Mariannette Miller-Meeks campaign.)

Miller-Meeks has faced setbacks before.

She was born the fourth of eight children in a family that relocated a lot because of her father's service in the Air Force.

Miller-Meeks was the serious child who picked up reading at the age of 3 and enjoyed math and science. Because both her parents worked, the responsibilities of cooking, cleaning and doing laundry fell on the children. 

Her life took a scary turn at 15. Her family was living in Ohio, where her father was stationed at Wright-Patterson Air Force Base in Dayton. One day, her brother was cooking bacon and the grease caught on fire. Miller-Meeks tried to put out the fire but the grease splattered everywhere and the kitchen went up in flames -- burning her and her brother. 

She said she was hospitalized for 5 to 6 weeks recovering from painful burns on her arms and legs.

"Being a little petite, it was a lot of my surface mass," said Miller-Meeks, who is just under 5 feet tall.

Rep.-elect Mariannette Miller-Meeks, R-Iowa, campaigns for Iowa's 2nd Congressional District. (Photo provided by the Mariannette Miller-Meeks campaign.)

Rep.-elect Mariannette Miller-Meeks, R-Iowa, campaigns for Iowa's 2nd Congressional District. (Photo provided by the Mariannette Miller-Meeks campaign.)

Her physical therapist showed such kindness and support that Miller-Meeks had an epiphany: She wanted to help people, too. She decided to become a doctor.

Her parents, however, tried to temper her enthusiasm by being realistic, which Miller-Meeks took as being dismissive. So when her father was reassigned to Lackland Air Force Base in San Antonio, Texas, Miller-Meeks left home at 16 and set out to prove herself.

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She got a studio apartment, starting working as a waitress and then enrolled in junior college in San Antonio even though she never officially graduated high school, she said.  At 18, she enlisted in the Army and retired from the Army Reserves 24 years later as a lieutenant colonel. 

Along the way, she completed nursing school and medical school, met her husband, Curt Meeks, and had two children. She relocated to Iowa for her residency in ophthalmology and started a private practice in Ottumwa, where she helped patients suffering from eye problems like cataracts, glaucoma and macular degeneration to restore their vision. 

Miller-Meeks served as director of Iowa's Department of Public Health under former Iowa Gov. Terry Branstad from 2011 to January 2014. 

Despite her success, she never wanted to forget her hard-fought upbringing.

"It's why my name is hyphenated," Miller-Meeks said. "I was the first in my family ever to go to college. The first to get a master's degree, the only one ever to go to medical school -- and it was important for me to be able to acknowledge my roots."

Miller-Meeks leaned into her health care leadership and her doctor bio during the coronavirus pandemic, talking about the need for making health care affordable and lowering prescription drug prices. Despite her medical background, she does opposes lockdowns to control the spread of the virus and said schools and businesses instead should find ways to reopen safely. The shutdown consequences of suicide, depression and poverty are too great, she said. 

"I think the biggest thing to tell people about the pandemic is that it's life versus life," Miller-Meeks said. "There is this false narrative that it's life versus the economy, but it is life versus life." 

After her narrow victory, Miller-Meeks talked of the tenacity it took to keep going despite losing congressional races in 2008, 2010 and 2014.

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"I had a background of resiliency and grit and tenacity in just my life story, which was, I think, very appealing to people," she said. "People had a sense that I really would go to Washington, D.C. and to Congress to fight for them."

Miller-Meeks added: "If nothing else, I hope my story inspires people to be willing to take a risk and to trust in their own talents and to not let failure define who they are and what they become."