The killings of two civilians and a police officer last month by a gunman proclaiming “no more baby parts” intensified the national focus on Planned Parenthood since it occurred at one of its clinics.
But this attack in Colorado Springs, Colo., and others involving Planned Parenthood also raise the stakes for the country’s lower-profile network of independent abortion clinics, which provide a greater number of abortions.
One clinic director, who requested anonymity for safety reasons, said staffers keep a close watch on protestors. “New faces are always worrisome,” the director said in a phone interview, “because they may not be satisfied with pushing pamphlets in patients’ faces and screaming epithets at the staff as the regulars have done for years. The longer the expanded protests continue, the greater, the risks of copycat crimes like the arsons at the four Planned Parenthood clinics this summer.”
What Are Independent Abortion Clinics?
These clinics are not affiliated with Planned Parenthood or any other organization. Some are nonprofit clinics, women’s health centers, physician’s offices and a few hospitals.
Some clinics provide a variety of services, such as gynecological screenings and bone-density exams. Others provide only abortions.
Nikki Madsen is executive director of the Abortion Care Network, a nonprofit organization in Washington, D.C., founded in 2008 that includes 71 nonprofit clinics, women’s health centers, physician’s offices and hospitals in 30 states.
“Independent clinics provide 2-out-of-3 abortions in the U.S. so we are prime targets for individuals that want to bully, shame and marginalize people seeking and providing abortions,” Madsen said in a phone interview. “Since July, when the controversy over Planned Parenthood supplying fetal tissue made national headlines, our members have experienced an increase in harassment. Our clinics serve low-income women, especially in rural areas. Unlike Planned Parenthood clinics they don’t have the extensive infrastructure of technology, lawyers, public relations specialists and other experts who can be summoned into action when a threat occurs.”
While these clinics have fewer resources, the intimidation pressure on them is often greater.
“Instead of one or two protests showing up once a week, 250 people have gathered daily outside some clinics’ doors,” said Madsen. “Protestors have taken down the license plates of receptionists and counselors as well as physicians and nurses and even family members of employees in a few cases. But so far, we have been spared violent confrontations.”
There are now about 340 independent clinics, down from 600 a decade ago, Madsen said.
About 1.2 million women, ages 15 to 44, are expected to have an abortion in 2015, about 2 percent of women of reproductive age.
Anti-abortion groups also target the websites of independent clinics because they provide a vital resource for patients who must travel far distances to obtain abortions. But in most cases, Madsen said, “the clinics had anticipated the attacks and had taken steps to secure their sites. The few that were taken down quickly restored services so that patients didn’t have to make multiple trips and incur extra expense to obtain care.”
Some 87 percent of U.S. counties do not have an abortion provider, notes the New York-based Guttmacher Institute, a leading provider of research on reproductive health.
DuVergne Gaines is director of the National Clinic Access Project, a project in Beverly Hills, Calif., of the Feminist Majority Foundation. Gaines was not surprised by the spike in protests that followed the release of highly edited tapes by the Center for Medical Progress, an anti-abortion group based in Irvine, Calif., that wants to eliminate all federal funding for Planned Parenthood.
“We have seen an increase in protests since 2010 because some groups and individuals have interpreted recent Supreme Court decisions and the passage of restrictive state laws as a green light to make it impossible for women to access abortion, even though the procedure has been legal since 1973,” Gaines said in a phone interview.
In 2014, the U.S. Supreme Court struck down a Massachusetts law that banned protestors within 35 feet, ruling that the law violated the First Amendment rights of anti-abortion activists. Sixteen states enacted 27 anti-choice laws last year.
Gaines said her group’s 2014 survey of 242 abortion providers across the nation–independent as well as Planned Parenthood–found that one-fourth of the clinics experienced anti-abortion activity every day. Another 42 percent of clinics reported weekly incidents. Thirteen percent experienced vandalism, break-ins and home picketing, up from 11.2 percent in 2010.
“But what was most alarming was the steep increase in the targeted intimidation of doctors and staff, which rose from 26 percent of clinics in 2010 to 51 percent last year,” Gaines said. “Wild West ‘wanted’ style posters, pamphlets which featured the photos and home addresses of the doctors and placement of information about the doctors on the Internet are extremely worrisome, because in the 1990s, four physicians who were featured on the wanted posters were killed.”
‘A Calling, Not a Job’
Most staffs of independent clinics have responded by digging in their heels, continuing to provide services under daunting circumstances.
“Protestors don’t realize that the greatest asset of independent clinics is the determination of the staff to provide care to women during what–for many women–is the low point of their lives,” said Kim Chiz, executive director of the Allentown Women’s Center in Bethlehem, Penn. “Many of our staff members have worked in the field for decades because it is a calling, not a job.”
The first and only independent abortion clinic in Northeast Pennsylvania, the center has been providing the procedures for women in 20 counties of Pennsylvania and nearby New Jersey for more than 35 years.
“Safety is something we think about every day, not just when an event like the congressional investigation of the Planned Parenthood tapes is dominating TV screens,” said Chiz in a phone interview. “In 1981, protestors broke into another abortion clinic in nearby Philadelphia, so we trained staff in self-defense techniques, which made them feel empowered.”
When the clinic moved to Bethlehem in 2012, Chiz said they chose a location with a large parking lot immediately adjacent that provides immediate access and limits patients’ exposure to protestors.
Like the Allentown Women’s Center, other clinics have instituted preventive measures. Some have installed warning devices to decrease the risk of bomb and arson attacks while others have established special rooms where staff and patients may gather if the clinics are attacks. In addition to safety devices in their homes and cars, many staff members alter their routes to work and stopped using social media since the Planned Parenthood protests began.
Support by law enforcement is also a key deterrent. The 2014 survey by The Feminist Majority Foundation found that clinics that rate their experience with local police as poor or fair were more likely to experience anti-abortion activity than those who rated it as good or excellent.
In September, the FBI sent an intelligence alert to local law enforcement agencies across the nation, warning them to be aware of increased threats and violence against abortion clinics.
“This warning helped a lot,” noted a clinic director who asked to remain anonymous for safety reasons. “It is amazing how even the most menacing protests quiet down when the squad cars drive by.
“One of the positive aspects of the protests generated by the Planned Parenthood tapes is that it has energized pro-choice supporters,” said the Abortion Care Network’s Madsen. “In addition to rallying political support for keeping abortion legal, many pro-choice supporters have volunteered to serve as clinic escorts for patients.”
Feminist groups such as the New York City chapter of the National Organization for Women, or NOW, are sponsoring training programs for clinic escorts in the New York area.
The Clinic Vest Project, a Chicago-based nonprofit, provides free colorful vests and training materials to clinics that are unable to afford such supplies.
Although the protests have been disconcerting for patients and staff, Madsen believes that they will not stop women from seeking care at the independent clinics.
A 2012 study by researchers at the University of California San Francisco Medical Center published in the journal Contraception found that about half of the 1,000 women at 30 different clinics reported feeling slightly upset after encountering an anti-choice activist. However, women who were stopped by a protestor were no more likely to feel guilty, sad, angry or regretful a week after the procedure than those who had not been exposed to any confrontation.
The only women who suffered negative feelings were those who had struggled to reach a decision before they came to clinics. As a result, the researchers concluded that protestors have little impact on women’s decisions to end their pregnancies.