The best offense is more clinic defense

On December 1, The U.S. Supreme Court began hearing oral arguments in Dobbs v. Jackson Women’s Health Organization, a case that seeks to overturn Roe v. Wade. The case is set to determine the so-called constitutionality of a 15-week Mississippi abortion ban. Most observers suspect that SCOTUS will rule in favor of the ban, ending abortion rights in the U.S. as currently conceived, which are already alarmingly limited. If the Supreme Court effectively overturns Roe, existing abortion bans in 26 states could go into effect.

This looming crisis has been forecasted by those fighting hardest for safe and legal abortion for decades. Unfortunately, liberal organizations that position themselves as being “on the front lines” of abortion access have disempowered some of those most willing to fight for abortion rights. In this piece, I will argue that the corporate dismissal of abortion clinic defenders has contributed to the precarity—and in some cases, absence—of abortion rights. I will make the case that abortion providers and advocates need to end their complicity with law enforcement and other oppressive institutions and, instead, engage in campaigns of active resistance and civil disobedience to defend abortion access. Rather than leaving the sphere of public protest to forced-birth zealots, we must mobilize to claim abortion as a fundamental human right and a positive moral good.

The battle outside abortion clinics

Since the legalization of Roe, as a result of the cowardice, capture, and racism of the American medical establishment, abortion has been marginalized in medicine, forcing the majority of abortion care to be provided in freestanding abortion clinics. And for the entirety of their existence, abortion clinics have been on the receiving end of right-wing extremist terror. In 1977, only four years after Roe v. Wade, an abortion clinic in Long Island, NY was attacked by anti-choice arsonists. After that event, clinics began seeing more regular attacks, with bombings and arsons occurring almost quarterly over the next six years (29 total). In the mid-eighties, the Right began formalizing, escalating, and becoming more efficient and effective in their violent organizing.

The National Abortion Federation (NAF) has been tracking violence against abortion providers since 1977. Their most recent report (released in 2020 with data up to 2019) indicates that, in total, there had been “11 murders, 26 attempted murders, 42 bombings, 189 arsons, and thousands of incidents of criminal activities directed at abortion providers.” Since I began drafting this article, there has been a clinic-destroying arson in Knoxville, TN–the second time this clinic has been attacked in less than a year–and a clinic blockade in Fort Myers, Florida. Even more concerning than the total numbers are the recent upticks in reports of violence, with clinic invasions more than doubling and death threats increasing almost 60 percent between 2018 and 2019.

Often overlooked when we consider violent clinic terror is the day-to-day presence of anti-abortion extremists in the streets or on the sidewalks in front of clinics. Forced-birth advocates all over the country routinely show up to abortion clinics to intimidate patients through performative prayer, the sharing of religious handouts littered with disinformation, offensive signage, and so-called “sidewalk counseling” in which they attempt to coerce patients to continue their pregnancies. In some cases, these efforts lead to the blocking of clinic entrances or the invasion of clinics. It was only in 2012 that NAF started tracking incidents of obstruction of health care facilities, which has increased year after year. (In 2018: 3,038. In 2019: 3,387.) Picketing also increased in 2019, with more than 100,000 incidents reported.

Anti-abortion extremists’ ongoing attacks and routine presence at the site of health care delivery have contributed to the success of the anti-abortion movement. First, the oft-unchallenged voices in front of clinics have normalized extremist positions and increased abortion shame. Over time, these activists have claimed the moral high ground in their obstruction of health care. Their rhetoric, persistent and unchallenged, has defined the grounds on which the battle over abortion has been waged.

In response to the anti-choice charge that abortion should be considered shameful and immoral, many liberal feminists who support abortion have slinked away from offering a passionate defense of abortion. Instead, they typically elevate “good” abortion narratives in their advocacy (rigorous but failed birth control efforts, pregnancies that are the result of rape or incest, late pregnancy discovery of fetal anomalies), use euphemisms to refer to abortion care, or ignore abortion care altogether in their rhetorical defense of abortion providers. (See, for example, this wildly popular tote, which does not even mention that one of the essential services Planned Parenthood provides is abortions). Joe Biden, throughout his entire first year in office, has yet to utter the word abortion despite calls to do so by reproductive justice activists. Even on the 49th, and likely the last, anniversary of Roe, the administration used euphemisms like “privacy” “choice” and “reproductive health” to refer to abortion rather than taking an unapologetic, let alone urgent, defense of abortion care.

Many people to the left of center have now accepted the narrative put forth constantly from the front of clinics: abortion is evil or distasteful and should be avoided. We were, famously, to keep abortion “safe, legal, and rare.” The rare part was entirely driven by a loud minority of anti-abortion extremists, and centrist feminists adopted it, accepting that there was, perhaps, something morally questionable about abortion. With the narrative of abortion’s objectionable nature in place, Democrats then made the argument about political expediency, claiming that progressives would never find a broad class coalition unless they dropped abortion rights as a “litmus test” for determining support. And just like that, coalitions formed based on the denial of fundamental human rights.

The “mainstream” plan to counter clinic harassment and violence

Another effect of the regular, unopposed presence of anti-choice zealots showing up in the streets week after week is the opportunities it has provided for anti-abortion organizing and coalition building. Clinic protests offer gathering space and purpose for like-minded people and people-powered, decentralized anti-abortion action. These foot soldiers have been putting anti-abortion ideology into practice week after week, month after month for decades. They recruit, build, reflect, and learn how to be more effective in their action.

By contrast, the so-called “pro-choice” establishment encourages supporters to respond to these attacks on abortion rights primarily through institutionalized channels: donating (to Democrats, to abortion-providing corporations, to legal organizations who will eventually “save” abortion in the courts) and voting (for Democrats, who have by and large fallen short of their promise to protect abortion rights). If there are concerns about “safety,” given the escalation of violent attacks at clinics, establishment institutions encourage supporters to rely on the police for protection and order.

Through these institutional channels, the Democrats won their main mechanism of clinic “protection”: legislation (enforced, in theory, by police) to protect clinics and clinic entrances. In 1994, the federal government passed a piece of legislation called the Freedom of Access to Clinic Entrances (FACE) Act, which prohibited intentional property damage and the use of “force or threat of force or … physical obstruction” to “injure, intimidate, or interfere with” someone entering an abortion clinic. In some places, the FACE Act has been more or less replicated on the state level. Other states have enacted “buffer zones” around clinics to prevent protesters from coming within a certain distance of the clinic property or entrance. The latter of these protections has been challenged in courts. In 2014, the Supreme Court unanimously struck down a Massachusetts law that established a 35-foot buffer zone around clinic entrances. Buffer zones were then challenged in other states, with mixed results.

In some cases, establishment liberals have ignored the need to protect clinics. Take Mississippi: less than a decade after Roe v. Wade, there were thirteen clinics that provided abortions in Mississippi. But, as a result of right-wing terrorist violence, the number of these clinics shrunk to eight in 1992 and eventually to one by 2006. Mississippi-based reproductive justice activists have argued that abortion rights advocates in other parts of the country have ignored the crisis there, characterizing the state as “backwards” or disposable. They argued that what was happening in Mississippi, and in the South more generally, could happen anywhere and that what happened in Mississippi could impact the entire country. They were right, of course: Jackson Women’s Health Organization, the one remaining abortion clinic in the state (known as the “Pink House”), is the clinic involved in the Supreme Court case upon which Roe currently depends.

It is important to recognize that those warning about the realities of inaccessible abortion and about the narrowness and shortfalls of the purely institutional focus on winning abortion rights were generally Black and Brown women, and those that were controlling the narrative and the strategy (from their seats at the tops of large nonprofits or within legislative bodies or in influential academic centers) were generally–and continue to be–white upper-class people. This pattern underscores why abortion access is an issue of racial and economic justice.

Clearly, the liberal establishment’s approach to protecting abortion patients, abortion providers, and abortion rights against an activated Right–a Right that is fueled by activism in the streets–is failing. As captured by the NAF data cited above, violence, harassment, and obstruction of clinics have persisted or surged over time. Anti-abortion extremists win gerrymandered and voter-suppressed majorities at the state level and then introduce and pass abortion-restricting legislation. The Right has fueled a battle over federal funding for abortion rights that has led both Republicans and anti-choice Democrats to repeatedly pass the Hyde Amendment year after year since 1977, prompting anti-choice Democrats to hold up passage of the Affordable Care Act until Obama agreed to exclude federal funding for abortion. Anti-abortion extremists have influenced the rule-making process at the FDA, limiting access to medication abortion through onerous regulations. The Right pushes for and wins the strategic appointments of radical Federalist Society judges. At the same time, Christian fundamentalists have codified the right of private organizations to deny healthcare on religious principles, and Catholic Diocese has taken over hospital systems, defining the care that can and cannot be provided there.

These anti-choice efforts have made abortion (and other reproductive healthcare) practically inaccessible for many or most people in the U.S. And right-wing efforts have reached beyond U.S. borders as well, such as the Mexico City Policy, often referred to as the “global gag rule,” which bans federal funding of foreign non-governmental organizations that counsel or refer for abortion. It has been instated and reinstated during every Republican administration since 1985.

But perhaps the strongest evidence of the success of right-wing tactics, and the concomitant failure of the liberal establishment’s approach, is that despite overwhelming public support for legal abortion, there is no mass movement organized to take to the streets to protect abortion rights in the face of the potential fall of Roe.

Clinic defense

As long as there have been clinic protesters, there have been people willing to challenge them. Over the years, clinic defense has taken a variety of forms, from clinic-employed or volunteer patient escorts to counter-protesters who engage rhetorically with anti-choice zealots to clinic defenders who put their bodies between terrorists and patients. In many cases, clinic administrators and/or clinic owners discourage clinic defenders from showing up. They claim that the presence of clinic defenders creates chaos in front of clinics and causes patients confusion and distress. Some have argued that clinic defense more intensely activates anti-abortion protesters and brings larger and larger crowds to the clinic. Instead, many clinics opt for hiring private–oftentimes armed–security guards, or they call the police on protesters, relying on racist, misogynist, violent institutions to “protect” patients.

Clinic defense is a grassroots, often militant tactic of interrupting radical anti-abortion extremists from harassing abortion clinics, staff, and patients. Perhaps the first example of a nationwide clinic defense campaign was in 1992, when pro-abortion activists opposed Operation Rescue’s plan for a multi-clinic, multi-week campaign to blockade and occupy clinics and to harass abortion providers, staff, and patients in Buffalo, NY. (The year before, a similar campaign in Kansas had forced clinics to close for days.) Pro-abortion activists came from around the country to oppose Operation Rescue, shutting down the protest and keeping the clinics open. Again, national pro-choice groups initially refused to endorse the nationwide action, but later admitted to reporters that the strategy of clinic defense works. Since then, and despite this acknowledgment of its value, clinic defense and clinic defenders have been marginalized, scolded, and shamed by large, mainstream abortion providers.

But, as clinic protests have grown in number and aggression, clinic defense has reappeared in pockets across the U.S. from Seattle to Chicago to New York. In New York City, where I provide abortion care, NYC for Abortion Rights (NYC4AR) has been working to counter the protesters from a local church who harasses patients once monthly at a busy clinic in Manhattan. The defenders wield signs with supportive messages, sing songs of liberation, and chant pro-abortion messages while slowing the harassers’ procession from the church to the clinic. Typically, NYC4AR defenders are wildly outnumbered: there are sometimes hundreds of forced-birthers compared to dozens of clinic defenders. NYC4AR’s continued presence in the street has offered an opportunity not only to protect patients and staff, but also to learn about the systems which uphold and perpetuate clinic and street harassment.

A successful defense campaign

NYC4AR’s campaign to protect NYC abortion clinics from protestors escalated last May, when clinic invader Fidelis Moscinski, announced he would lead harassers in four of the five boroughs in what they called a “Witness for Life” event. Over the course of the next few months, NYC4AR counter-protested in Brooklyn, forcing the procession to slow and delaying their arrival to the clinic (sometimes by hours), using tactics learned from years of defending the Manhattan-based clinic. In August, after the Archdiocese of NYC launched a PR campaign of National Review op-eds and lobbied the NYPD publicly to come down hard on the (wildly outnumbered and nonviolent) counter-protesters, the cops showed up in full militarized gear and arrested two members of NYC4AR, charging them with disorderly conduct, resisting arrest, and obstruction of pedestrian traffic. The next month, NYCFAR announced that they would continue to show up to defend clinics. In response, the church announced:

Due to the 20th Anniversary of 9/11, the police who normally accompany us during our prayerful Witness for Life in Brooklyn on the second Saturdays of the month will be unable to join us, and so the Brooklyn Witness has been suspended this Saturday and will resume again on October 9.

The counter-protesters showed up on the day of the canceled protest, flyered the neighborhood with information about how the church harasses patients, and collected signatures for a petition to have the church stop hosting the “Witness for Life” events. Less than two months later, the church and Fidelis Moscinski announced they would no longer dedicate efforts to harassing patients at the Brooklyn-based clinic. An NYC4AR email announcement explains, “we were told that the church got tired of all the attention.”

This short example of clinic defense resulting in a victory clearly highlights the police’s alignment with the Church in working to control reproductive lives and reproductive labor. Policing in the U.S. is tied inextricably to white supremacy, and more specifically works to promote white supremacist heteropatriarchy.

Consequently, the state cannot be relied upon to protect reproductive autonomy. On the contrary, the state has proven concretely harmful, particularly for those at various intersections of oppression. Jane Doe, an unaccompanied minor jailed at a so-called “immigrant detention facility” in Texas, was prevented from accessing legal abortion care for weeks as lawyers and judges considered if she should be able to access care at all. And the state’s complicity in denying reproductive rights is not exclusive to abortion, as demonstrated by the cases of those in ICE custody who were forcibly sterilized. When the state is insufficiently able to control bodies, it relies on legalizing anti-abortion vigilantism as it has in SB8, forcing thousands of Texans to flee their state for care elsewhere and impacting abortion access in surrounding states in a ripple effect.

When clinic administrators and spokespeople tell clinic defenders to stay home and that the police will provide safety, they fail to acknowledge that police pose a threat to the well being of their Black, Brown, immigrant, queer, and/or poor patients and staff. It is far more likely that police will be activated against a patient of color or a disabled person who becomes agitated in a waiting room or against a clinic defender than to interrupt street harassment or clinic attacks. And, when they are called, it is more likely that the police will use the tools of the state against a patient than against an anti-choice harasser.

Creating our own safety

Clinic defense offers a strategic alternative to the failing liberal approach to protecting abortion, and indeed, to protecting reproductive autonomy at large. With the explicit goal of guarding clinics against the Right and taking back the space in front of abortion-providing health centers, clinic defense also allows an opportunity to reclaim the moral high ground and to reject, in word and deed, the stigma and shame assigned to abortion. Perhaps most importantly at this particular moment, the infrastructure required to build clinic defense networks could be the basis upon which our movement might activate currently disengaged abortion supporters, providing opportunities for the kind of community-building and praxis-based political education required to mobilize masses.

On any given day, upon my arrival to work, I am likely to see a handful of individuals handing out packets to patients and staff as they enter the clinic. I often wonder what it might look like if those handouts weren’t filled with hateful misinformation or messages intended to invoke shame and doubt. I wonder, what if those standing outside the clinic weren’t harassers at all, or if the forced-birthers were too outnumbered to stand in front of our door? Or what if we routinely showed up en masse outside so-called “crisis pregnancy centers”–the fake clinics masquerading as abortion clinics–to tell the truth about the lies peddled inside and to direct patients to appropriate care providers? I wonder what it would be like if our movement was so overwhelmingly powerful that we not only reestablished abortion as a legal right, but also contributed to the reintegration of abortion into mainstream medical, even primary, care.

But while right-wing terrorism still plagues our clinics, while our legal rights continue to erode, and while institutions actively threaten reproductive autonomy, we must not rely on the state or its tools of enforcement for our own safety. The police have and will always support vigilantism (legal and informal) aimed at repressing the rights of people exercising reproductive autonomy. Pro-abortion and Prison Industrial Complex abolitionist movements must work in support of one another to–among other goals–uplift the safe provision of abortion care without relying on the police.

Featured image credit: Charles E. Miller. Modified by Tempest.