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Abortion Clinics Face Increased Harassment Post-Roe

Those who work in abortion care have long understood the impact overturning Roe would have on their work. Still, the scene outside the Supreme Court the day Dobbs was announced put it into stark relief. “They were really emboldened,” Melissa Fowler, chief program officer for the National Abortion Federation (NAF), said of anti-abortion activists gathered outside the Supreme Court Building. They were yelling “racially charged things” and calling people rallying to support abortion access “whores.” Protests broke out at clinics around the country, some attended by protesters who had traveled to D.C., and, after the ruling, stopped to target clinics along the way as they bused home.[1] At Jackson Women’s Health Organization, the Mississippi clinic at the center of the Supreme Court case, protesters erected ladders to yell at patients inside and attempted to block the building’s entrance.

Since abortion was legalized nationwide in 1973, providers and clinic workers have faced an immense campaign of intimidation and violence. That includes, since NAF began gathering statistics in 1977, 11 murders, 42 bombings, 200 acts of arson, 531 assaults and nearly 500 clinic invasions.[2] The focus on providers is possible, in part, because abortion care in the United States is offered primarily in clinics that are physically separated from other medical services. OB-GYNs created abortion clinics because they were looking to expand access to reproductive care after Roe, but they also became a necessity as fewer medical school programs – intimidated by anti-abortion forces – taught doctors how to perform abortions. As a result, few hospitals offered the procedure. Eighty percent of the country’s abortion facilities were hospitals the year Roe was decided, according to The New York Times. But by 2017, 95% of abortions were performed at clinics.

Since the Supreme Court overturned Roe, anti-abortion activists have redoubled their efforts to intimidate clinic workers and people seeking abortions. NAF statistics show that incidents of arson, invasions, death threats, burglaries and stalking all increased between 2021 and 2022. But the increases in violence and harassment against clinics, providers and patients in states protective of abortion were most dramatic, in some cases spiking exponentially. Stalking, for example, increased 229% overall from the previous year, but by 913% in states that maintain access to abortion care. Clinic obstructions increased by 538% in protective states compared to a 14% overall decrease.

Promotion block to next essay: The Community Cost of Abortion Restrictions

The anti-abortion movement has faced major impediments since their victory overturning Roe. Most notably, voters in seven states across the country have used ballot measures to protect abortion, and the issue will likely be put to a vote in many more states in 2024. Nevertheless, the anti-abortion movement remains galvanized, emboldened both by Dobbs and an increasingly authoritarian – and mainstream – right-wing movement that seeks to strip women, the LGBTQ+ community, and others of their rights and bodily autonomy. As a result, clinics, providers, their patients and abortion advocates face increased threats of harm from a movement that has a record of extraordinary violence.

Increased Anti-Abortion Activity in Protective States

Without abortion clinics to protest in states that have outlawed the procedure, anti-abortion activists have flocked to those where it is protected. The movement has long coordinated protests, encouraging people to target specific clinics and arranging busing to get them there. Protesters often travel long distances to harass clinic workers and patients. A federal indictment related to a 2021 clinic blockade, for example, noted that five of the seven people facing conspiracy charges for obstructing access to a Tennessee clinic came from out of state.

After Dobbs, Fowler said, “people are picking up and moving to other places to really be able to target providers every day.” Providers in protective states who had few protesters before the decision have noted an uptick in their numbers, she said.[3] Across the country, according to the Armed Conflict Location & Event Data (ACLED) Project, abortion-related protests rose dramatically in 2021 and 2022 and, between 2020 and 2021, armed abortion-related demonstrations also increased. “Armed abortion-related demonstrations have turned violent or destructive 40% of the time, while unarmed abortion-related events have turned violent 0.2% of the time,” ACLED reports.

Many anti-abortion demonstrations are coordinated by large, nationwide organizations like Students for Life of America, the nation’s largest anti-abortion student group, and 40 Days for Life, which is best known for organizing mass anti-abortion events annually during Lent. The latter organization trains activists to host prayer vigils at their local clinics, both in the United States and more than 60 other countries around the world.

A person behind a religious banner talks with two people wearing vests that say "Clinic Escorts."
Anti-abortion protester Coleman Boyd argues with volunteer clinic escorts outside the Jackson Women’s Health Organization in Jackson, Mississippi, on May 20, 2021. (Credit: Reuters/Evelyn Hockstein)

Smaller organizations around the country have adopted similar models, outsourcing protests to local activists. One such group is Love Life, a North Carolina-based organization that coordinates with churches to hold “prayer walks” to local abortion clinics on Saturdays. As a result, protests at clinics targeted by the group have grown dramatically, sometimes attracting hundreds of people.[4] While they are headquartered in North Carolina – which adopted a 12-week abortion ban after a long legal and legislative fight – Love Life is active in many states that protect abortion, including California, Washington and New York.

“They have really figured out the formula for intensifying harassment at clinics and bringing danger to activists who support abortion rights,” Kelsea McLain, who organizes a group of clinic escorts in North Carolina, where she lives, in addition to working at Alabama’s abortion advocacy group Yellowhammer Fund, told the SPLC. “Every bit of extremism and violence we’ve encountered over the last three years has been tied directly to Love Life.”

According to McLain, protesters film the license plates of people entering and exiting the clinic and have made intimidating comments to patients. “I see you drove in from Alabama, where abortion is illegal. You should be concerned about that,” she recalled a protester saying to a person entering the clinic, according to a separate interview with Prism.[5]

McLain has consistently faced harassment from anti-abortion protesters, both outside clinics and at her own home. In one incident, an anti-abortion activist told her during a clinic protest, “I’ve killed in defense of the innocent before, and I absolutely will do it again.” Her personal information, including her address, has been posted on a Facebook profile created seemingly specifically to harass abortion activists. People have driven by her house taking pictures, and anti-abortion activists have followed her as she left a clinic. She has, at times, pulled away from public-facing activism “just out of fear, basically.”[6]

Like McLain, abortion activists and providers face regular intimidation and threats, including online doxing and death threats. While abortion providers in the past were targeted by “wanted” posters that anti-abortion activists posted around their neighborhoods or mailed death threats, today the internet makes harassment even easier. When a doctor or abortion worker is featured in a news article, for example, Fowler said it is not unusual for them to receive “hundreds of emails and death threats and horrible things.”[7]

While states that ban abortion now see far fewer anti-abortion protests, advocates in those states – and especially those of color – remain targets for the anti-abortion movement. After Yellowhammer’s executive director, Jenice Fountain, appeared on MSNBC to discuss Alabama’s restrictive legal landscape after Dobbs, for example, a person attempted to kidnap one of her children. “They literally tried to pick up my youngest from school,” she told Tina Vásquez of Prism. “People have driven by my home and taken pictures of me. I did a risk assessment with a security team, and they said my current risk level is high,” in part because she was on the radar of a large white nationalist hate group.

Attempting to Limit Clinics’ Activities

Outside of harassment and intimidation, anti-abortion forces have found other ways to try to stop the work of clinics, in many cases before they even open. In Illinois, for example, an anti-abortion group called the Rockford Family Initiative spent months protesting a new clinic and attempted to challenge its zoning permit. Though the Rockford Family Planning Center – which serves many patients from Wisconsin, whose border is less than 20 miles away and where abortion was almost entirely unavailable for 15 months following the Dobbs ruling – was able to open in December 2022, multiple other clinics in the state have faced far more aggressive attacks.

In May 2023, 73-year-old Philip Buyno rammed his car into a building in Danville, Illinois, that was being renovated to become an abortion clinic. Buyno, who had been active in the anti-abortion movement since the 1980s and arrested multiple times in the past for trespassing at a Peoria, Illinois, clinic, told investigators that he planned to burn down the building. “If I could sneak in with a gas can and a match, I would go in there again,” he told them. He was sentenced to five years in prison in February for his attempted arson of the building in Danville.

In January 2023, another man set fire to a Peoria, Illinois, abortion clinic with a Molotov cocktail. Tyler W. Massengill received a sentence of 10 years in federal prison for the attack, which forced the clinic to close for more than a year.[8]

The Peoria clinic is one of at least five that have been attacked by arsonists since the Dobbs decision was leaked at the beginning of 2022. Clinics in California, Wyoming, Michigan and Nevada – all of which, except for Wyoming, have continued to protect or expanded abortion access – have been attacked. In August 2023, a Southern California Planned Parenthood clinic, which served as an essential source of reproductive care for citizens of Arizona, where abortion care is banned after 15 weeks, burned down. The cause of the fire remains unknown.

Two people stand along wall with a sign pointing to one person reading "Fake Escort."
Anti-abortion activists and abortion-rights advocates converge during a rally Oct. 1, 2022, at a Planned Parenthood location in New York. (Credit: Brian Branch Price/ZUMA Press Wire/Alamy)

In addition to banning abortions in more than a dozen states, new abortion restrictions have had a chilling effect on the activities of abortion funds and advocacy organizations in restrictive states. Before Dobbs, Alabama’s Yellowhammer Fund provided funding for people seeking abortions, covering abortion services as well as additional costs like childcare and lodging, to ensure that even those facing financial obstacles could secure medical care. But once the Supreme Court handed down its decision overturning Roe, it triggered a law banning abortion in Alabama. Then, in August 2022, Alabama Attorney General Steve Marshall joined a local radio show and told listeners he intended to criminally prosecute abortion funds. “For example, if someone was promoting themselves out as a funder of abortion out of state,” he said, “then that is potentially criminally actionable for us.” He specifically mentioned “groups out of Tuscaloosa,” where Yellowhammer is located. Yellowhammer feared it would face conspiracy charges for funding abortion seekers, or even simply sharing information about how people could get abortion care in states where it is legal. It completely ceased offering funding or abortion referrals.

In order to allow Yellowhammer to resume its work without fear it will be criminalized, The Lawyering Project and the SPLC have filed a lawsuit to block the attorney general from prosecuting individuals and organizations helping pregnant Alabamians seek legal out-of-state abortion care.[9] Their complaint alleges that Alabama does not have the power to restrict legal activity in other states, and that Marshall’s threats are “chilling Yellowhammer Fund’s constitutionally protected speech.” As it waits for a decision, Yellowhammer Fund is focused on training new organizers, distributing reproductive care items like contraception and menstrual products and providing material and other forms of support for low-income families across Alabama.

Abolitionists and ‘Rescuers’

A segment of the anti-abortion movement who call themselves “abolitionists” have been especially emboldened by the country’s increasing restrictions on reproductive health care. Abolitionists, whose chosen moniker seeks to compare themselves to those who fought to abolish slavery before the Civil War, are among the most extreme anti-abortion activists. They believe that the procedure should be outlawed in all cases and that women should be criminally punished for having an abortion. The group Abolitionists Rising argues that under abolitionist laws, “Some men and women would get charged with first-degree murder. Some would get charged with third-degree murder or manslaughter. Some would not be charged at all. ... It all depends on the facts of the case.” Under such laws, however, nothing would change the fact that people who get abortions could potentially receive the death penalty.

Abolitionists are aligned with some of the most militant anti-abortion activists in the United States, including men like Rusty Thomas and Matthew Trewhella, who have both endorsed the use of violence against abortion providers. They are also among the savviest when it comes to using social media to organize protests and promote their views. Abolitionist groups like End Abortion Now and Abolitionists Rising have large YouTube and TikTok audiences. Apologia Studios, the YouTube channel for End Abortion Now, has nearly 550,000 subscribers. There, End Abortion Now leader Jeff Durbin livestreams protests and sermons, where he critiques what he calls “the Woke church,” abortion, LGBTQ+ people and the Black Lives Matter movement. Abolitionists Rising tends to favor more confrontational content, filling its TikTok feed with videos of members (who are nearly always men) arguing with abortion supporters (who are very often young women) during its frequent sidewalk protests. Its videos not only spread its beliefs to a broader audience but provide a blueprint for people to engage in their own clinic protests.

Activists also use social media to livestream and post rescues at abortion clinics. “Rescues” – or, more accurately, “clinic invasions” – have a long history within the anti-abortion movement and were commonly used by militant groups like Operation Rescue in the 1980s and 1990s. Rescuers enter clinics, often under false pretenses, with the intention of disrupting operations and harassing people in the clinic, sometimes barricading themselves in exam rooms or chaining themselves to equipment. Progressive Anti-Abortion Uprising (PAAU) is responsible for many of these recent invasions, in which they try to interact with patients to dissuade them from having abortions – actions they paint as an effort to put their “bodies between the oppressor and oppressed.” The group made headlines in 2022 when police found five fetuses in the freezer of Lauren Handy, PAAU’s director of activism. It remains unclear where Handy acquired the fetuses, though she claims she received them from a medical waste truck driver. Other members have reportedly alleged the fetuses were obtained to prove an abortion clinic was conducting illegal, late-stage procedures.

Promotion block to Anti-Abortion Extremism page.

PAAU’s content is made to be consumed by a Gen Z audience: The group’s primary medium is TikTok and features messages like “hot girls hate abortion.” In addition to its opposition to abortion, it also claims to be anti-capitalist and invested in elevating LGBTQ+ voices and those of people of color (on its website, you can purchase a “gay fetus sticker” that depicts a fetus in the scheme of an intersex progressive Pride flag). PAAU is, in notable ways, starkly different from most militant anti-abortion groups: In addition to its appropriation of the language of social justice movements, the group appears to be composed overwhelmingly of women.

TikTok videos show PAAU members demonstrating on sidewalks, wheatpasting flyers, singing folk songs they’ve penned about abortion and performing “rescues.” In one video, members march through a largely empty Walgreens calling on customers to boycott the company for selling pills used in medication abortions. Their content is designed to encourage others to use on-the-ground actions to stop abortion: “Personally, I believe we can shut down abortion facilities without the Supreme Court through sustained and mass mobilization, protests and people power,” Handy said before the Supreme Court’s Dobbs decision leaked.

Most abortion proponents do not see PAAU’s tactics as particularly effective, but they do worry that their presence on social media could encourage more people to engage in aggressive tactics. “The people that are watching those think they’re successful. They think they’re great. There’s a potential to do harm in that, by inciting the wrong person or recruiting that wrong type of people, that actually do believe in these types of things,” Calla Hales, a director of abortion clinics in North Carolina, told VICE in 2023. Aggressive tactics also fuel engagement. After the Dobbs victory, “how do you sustain the [anti-abortion] movement? You do it by escalating,” Shireen Rose Shakouri, the executive vice president and chief of staff of Reproaction, told the SPLC.

By September 2023, eight people had been convicted of felony conspiracy against rights and a FACE (Freedom of Access to Clinic Entrances) Act offense in connection to a PAAU-led invasion and blockade of a Washington, D.C., clinic in October 2020. Another pleaded guilty to the same charges. The group has since appeared to ramp up its efforts to revoke the act that criminalizes blocking abortion clinic entrances. Six days after PAAU activists posted a photo of themselves on Facebook with the caption “on Capitol Hill lobbying in an effort to repeal the FACE Act!!!!” U.S. Rep. Chip Roy (R-Texas) announced that he and Sen. Mike Lee (R-Utah) were introducing legislation to do just that, claiming the FACE Act had been “weaponized” against anti-abortion activists.

The FACE Act, signed into law in 1994, makes it a federal crime to use violence, the threat of violence or physical obstruction to prevent people from obtaining or providing reproductive health care. If repealed, clinics would lose one of their most effective tools for protecting patients and providers from intimidation, harassment and violence. Attacks from conservatives like Roy come as the Biden administration has increasingly relied on the FACE Act, using it to bring 20 criminal prosecutions. All but one have been brought against defendants accused of disrupting abortion clinics.

Clinic Security

What measures do clinics, doctors and activists take to protect themselves and their patients? Most clinics have extensive safety plans, as well as controlled entrances and bulletproof glass. They also rely on organizations like NAF to coordinate between clinics and, in some cases, work with federal law enforcement. Some clinics, Fowler pointed out, have good relationships with the local sheriff or law enforcement. “And then of course,” she added, “there’s some places where they’ve just given up and stopped calling because the police aren’t going to do anything if they come. Or you know, they’ll be there for a second, and then the protesters will go right back to trespassing when they leave.”

Fowler said clinics often deal with “anti-choice law enforcement” who fail to enforce existing laws and offer little help when facing harassment or threats. In 2021, staff at a Raleigh, North Carolina, clinic called for an investigation into how the police handled an incident in which an anti-abortion protester shot himself in the leg outside of the clinic. Police allowed other protesters to remain outside, saying that they “had no information suggesting that anyone else present was connected to criminal activity or that any particular individual was armed and threatened safety,” in a statement obtained by Newsweek. They also did not share information about their investigations, including whether the man had been looking to target clinic workers, or his name, which the clinic needed to request a restraining order. The clinic only found out about that information from a reporter. Police have even joined anti-abortion demonstrations, including one case in which a Louisville, Kenutcky, police officer, in uniform and carrying his gun, marched outside of a clinic with an anti-abortion sign.[10] Fowler added that providers are hesitant to call law enforcement because they often serve many Black patients who are already disproportionately criminalized, and they do not want to subject them to further interactions with the police.

In large part, clinics, staff and abortion activists rely on one another for safety. Organizations like Planned Parenthood and local activists like McLean organize clinic escorts to protect and shield patients from protesters as they enter clinics. Ultimately, it is the advocates, volunteers, clinic workers and providers who show up to clinics under increased threats who protect patients and one another.

Illustration at top by Cristiana Couceiro.

[1] Melissa Fowler, chief program officer for the National Abortion Federation, in discussion with the author, May 19, 2023.

[2] “2022 Violence Disruption Statistics,” National Abortion Federation, 2022.

[3] “We started working with a lot of our members in those states because some of them didn’t have a lot of protesters before or a lot of this activity, because they are in more protective, more friendly states where the communities just don’t want that. But so, we started hearing, you know, from those folks that they are seeing more people.”

[4] Matt Talhelm, “Raleigh considering ‘buffer zones’ to maintain safety at abortion clinics after recent displays draw concerns,” WRAL News, Raleigh, November 16, 2022.

[5] Tina Vásquez, “We need people to know abortion is still legal in North Carolina,” Prism, June 27, 2023.

[6] Kelsea McLain, employee of the Yellowhammer Fund, in discussion with the author, May 1, 2023.

[7] Melissa Fowler, chief program officer for the National Abortion Federation, in discussion with the author, May 19, 2023.

[8] “A man who set fire at an Illinois Planned Parenthood clinic sentenced to 10 years in prison,” Associated Press, August 15, 2023.

[9] Yellowhammer Fund v. Attorney General of Alabama Steve Marshall, 2:23-cv-00450 (2023),

[10] Emma Austin, “LMPD investigating report of officer seen at Louisville abortion clinic protest,” Louisville Courier Journal, February 20, 2021.