This is the second entry in a series tracking what it’s like to open an all-trimester abortion clinic in the U.S. as abortion rights are being curtailed.
Morgan Nuzzo thinks a lot about how someone might kill her. She talked about it calmly, almost offhandedly, as she and I walked through the abortion clinic she’s opening in September with her business partner, Dr. Diane Horvath. “That’s where the steel security door will go,” Nuzzo said, pointing to an open doorway. We walked through exam rooms and offices. We talked about bulletproof glass and panic buttons. We passed a couple of ordinary-looking windows and she sighed. “I don’t know what we’re going to do about those,” she said. “We can’t put bars over them or people will feel like they’re in jail. But someone might try to come through them.”
These are the things abortion providers like Nuzzo think about, especially now. People who perform abortions are routinely harassed and threatened, as are clinic workers, patients and the friends and family members who take them to their appointments. According to the National Abortion Federation, an advocacy group for abortion providers, 11 people connected to abortion clinics have been murdered in the U.S. since 1973, when abortion became legal nationwide. In addition, 26 attempted murders have been reported through 2021.1
Seven of these killings took place in the 1990s, when some anti-abortion activists decided that violence against providers was the only way to stop abortion from happening. But anti-abortion extremism is still extensive and sometimes severe. Bomb threats, death threats, hate mail, vandalism, arson, stalking and assault and battery — abortion clinics and the people who work there are targets for them all. As recently as 2015, a man fatally shot three people and wounded nine others at a Colorado Planned Parenthood, saying later that he was “upset with them performing abortions and the selling of baby parts.” Things could shift in unpredictable ways now that abortion is no longer legal everywhere.
Nuzzo and Horvath could be particularly vulnerable to harassment and attacks since their clinic will offer abortions into the third trimester of pregnancy. But abortion providers everywhere are facing new risks. Anti-abortion protesters, emboldened by the recent Supreme Court decision overturning the constitutional right to abortion, could travel to more abortion-friendly states like Maryland, where Nuzzo, a certified nurse-midwife, and Horvath are opening their clinic. For them, every day could bring a new, unknown threat.
Nuzzo and Horvath’s clinic is in a sprawling complex of offices down the street from one of the University of Maryland campuses. Their space is on the ground floor of a building set on a small hill, which means there are only a few windows facing an interior courtyard. The lack of windows “makes the interior feel a little basement-y, but overall, it’s a big plus,” Nuzzo told me. Unlike clinics in standalone buildings or on city streets, protesters won’t be able to block the entrance without a significant intrusion onto private property. Nuzzo noted with pleasure that the entry to the parking lot is across the street from a frat house. “We might ask them to keep an eye out, let us know if anything looks weird,” she said.
Outside abortion clinics, it’s common to see clusters — or sometimes crowds — of anti-abortion activists gathering as close to the clinic as they can legally stand. Under a federal law passed in 1994, the year after an anti-abortion extremist shot and killed an abortion doctor outside his Florida clinic, penalties for blockading clinics or inflicting violence on the people who work inside can be severe. The law helped reduce some of the violence by making the potential punishments more intense, according to Mary Ziegler, a legal historian and professor at the University of California, Davis School of Law, but prosecutions are still rare — and anti-abortion protesters continue to take the risk.
Earlier this year, federal prosecutors filed criminal charges against nine people who are accused of forcefully entering a Washington, D.C., abortion clinic and blocking entrances with ropes, chains, furniture and their bodies in October 2020. In March, another group of anti-abortion activists allegedly pushed their way into an abortion clinic in San Francisco, chanting, “We know who you are, we know what you do,” and attempted to break into operating rooms. In May, a clinic under construction in Wyoming caught on fire in a suspected arson attack. A few weeks after the Supreme Court’s decision, six anti-abortion protesters were arrested at a clinic in Grand Rapids, Michigan, for blocking the employee door and the entry to the parking lot. And an Indiana OB-GYN who provided a medication abortion to a 10-year-old rape victim from Ohio in June has been aggressively criticized on right-wing media and by Indiana’s Republican attorney general, who called for an investigation of the doctor.
Third-trimester abortion providers are particularly at risk, according to Carole Joffe, a sociologist at the University of California, San Francisco, who has studied threats to abortion providers. In 2009, a third-trimester abortion doctor named George Tiller was murdered at church by an anti-abortion extremist after decades of being targeted with threats and violence, including a separate shooting and the firebombing of his clinic. “He was shot in both arms before the eventual killing,” Joffe said. Tiller had been extensively vilified by conservatives and anti-abortion advocates for years. “Bill O’Reilly referred to him numerous times on Fox News as ‘Tiller the Killer,’” she said. This year, the anniversary of his death happened just about a month before the constitutional right to abortion was overturned. On that day, Horvath texted me, “It’s a reminder that there are not an insignificant number [of] people who want us dead, and who would celebrate our deaths.”
And confrontations seem likely to increase in the coming months. In fact, they may already be on the upswing for everyone involved in the abortion debate. Crisis pregnancy centers, which try to persuade women not to have abortions, have also been vandalized and threatened recently. And even though the legal landscape is friendlier to anti-abortion advocates than it has been in almost 50 years, some are still frustrated that legal abortion will continue in many states. On its Facebook page, an anti-abortion group called Red Rose Rescue linked to an article about the Grand Rapids arrests, saying that the “rescue movement seems to be coming back to life, especially after the recent Dobbs decision overturned Roe.” Red Rose Rescue is part of a specific brand of intervention: Activists enter clinic waiting rooms in a group and hand out materials about alternatives to abortion to women waiting for their appointments (and in the case of Red Rose Rescue, roses), often refusing to leave until they’re arrested.
Anti-abortion protesters see these acts as a desperate attempt to help women understand the gravity of the decision they’re making, and to give them an opportunity to change their minds. But to the people who work at clinics — and to the patients themselves, who usually don’t have any doubts about the procedure by the time they get to their appointments — the blockades and incursions are disruptive and frightening. Part of the problem, Ziegler said, is that it’s never clear when a confrontation will become violent. Some of the people who ultimately murdered abortion providers started as protesters standing peacefully outside clinics. “You just don’t know who is dangerous, or will become dangerous,” she said.
The police are, in theory, a resource that abortion providers can tap. But Roxanne Sutocky, the director of community engagement at The Women’s Centers, a group of abortion clinics along the East Coast, said that calling the police can be complicated. For one thing, patients who have had negative experiences with the police may not find their presence especially calming. And Sutocky said that the response can vary a lot depending on the culture of the local police department: “We don’t always get the response [from the police] that’s appropriate to the level of harassment or violence we’re facing.”
And some of the threats happen away from the clinic. It’s not hard, for instance, to figure out where an abortion provider lives, particularly if they own their home. “We’ve had staff followed home from facilities,” said Sutocky. Once, she said, she got a piece of hate mail addressed to her at the clinic, with her home address in the return address spot on the envelope. “The message was pretty clear, and it really did scare me,” she said. “It’s hard not to be afraid for your family.” It’s not uncommon for anti-abortion activists to find abortion providers’ homes and plaster their neighborhood with threatening flyers. And things can escalate far beyond threats. In 1998, Dr. Barnett Slepian, an abortion provider in upstate New York, returned from synagogue on a Friday evening and was heating split-pea soup in the microwave when he was shot through the kitchen window by an anti-abortion extremist. He died within two hours.
After they decided to open their clinic, one of the first things Nuzzo and Horvath did was to hire Brightlines, an anti-doxing service for people whose security is at risk, to scrub the internet of as much of their personal information as possible. Shauna Dillavou, the company’s founder and CEO, told me that it’s not just easy for anti-abortion activists to find home addresses. “You can also find out where a doctor’s kid goes to school, where their partner works,” she said. That information can be weaponized too: Dillavou said that one of her clients was falsely reported to Child Protective Services for abusing or neglecting their children. Simply knowing that an abortion provider has children is a risk that has led to kidnapping threats. “Or a partner can be threatened at their job,” Dillavou said. “Like, ‘Did you know your wife is a “baby killer”?’”
Nuzzo, for her part, seems largely resigned to a life of constant unease. As we stood in the waiting room of the clinic, inspecting the new ice machine that had just arrived, a man knocked on the door. Nuzzo immediately straightened, her whole body on guard. “Hello, sir,” she said loudly through the door, tension radiating through her voice. “How can I help you?”
He turned out to be a sales representative for a medical device company. Nuzzo sent him on his way and turned back to me. “Every strange man knocking at the door is just a new adventure,” she said. I asked her if she’d feel safer once the clinic was open and full of people, with all the new security measures in place. “Honestly?” she said. “I don’t think I’ll ever feel safe again.”