THE
T WAS JUNE 24, 2022, and Karen Musick was working at Little Rock Family Planning Services, the last abortion clinic in Arkansas. She was guiding patients into the clinic when she heard a protester scream out the news. That's how she found out the Supreme Court had issued a ruling on Dobbs v. Jackson; the court determined that the Constitution doesn't protect the right to an abortion.
“We all knew it was coming,” Musick says now, two years later. She's sitting in the clinic's old office, surrounded by boxes piled high. “I don't know how you stop [the tears]. The whole day was tears.”
The clinic was forced to shut down that day. Arkansas is one of several states that had near-total abortion bans triggered by the landmark ruling — meaning no abortions were allowed in the state except to save the life of the mother in a “medical emergency.” For patients inside, doctors wrote down information for clinics in other states that were still open.
Outside, one family with seven children danced in the street and sang praises to God while employees and clinic escorts on shift helped despondent patients to their cars. The doors shut for the last time. The protesters went home. But in the parking lot, a large group in rainbow-striped vests gathered.
“The escorts started showing up,” says Musick, tears still fresh in her eyes.
Soon, Little Rock Family Planning Services would no longer be a clinic — but the clinic defenders were still there and determined to continue their fight for abortion access. And they're not alone. A term first used by activist groups during clinic bombings after Roe v. Wade, clinic defenders physically block protesters from sight, try to drown them out, and in some cases, actively confront masses of anti-abortion activists.
“[Clinic-focused attacks] began [with] this idea of 'If we can't end abortion in the courts, we can punish people at the place where they have abortions,'” says Lauren Rankin, a former clinic escort and author of Bodies on the Line. Pro-choice activists, spearheaded by Black female leaders and queer-rights groups, quickly moved to defense, staging distractions in front of clinics, targeting demonstrators, and even taking punches meant for providers.
In 2020, the advent of social media apps brought a fresh wave of support for clinical defense. Disillusioned by the idea of only using voting to fight for abortion access, many groups, once considered simple counterprotest forces, coordinated directly with clinics. Now, as a post-Dobbs world continues to see state legislation strip away abortion access and clinic doors close nationwide, clinic defenders face a brand-new challenge: anti-abortion activists emboldened by sweeping state bans. According to the National Abortion Federation, violence against clinics and abortion providers has continued to rise following the Roe reversal. In 2022, there were four arsons, 20 clinic invasions, and a 20 percent increase in death threats against abortion providers. Before Dobbs, the last reported anthrax scare involving abortion clinics was in 2011; in 2022, there were four. Strict state abortion laws means increased attacks have concentrated on a dwindling number of clinics. But the select groups of abortion activists left aren't letting the pressure get to them. And you know what they say about the best defense.
That day in June, Musick left the clinic and joined the escorts, which included her daughter. Musick, 68, is a co-founder of the Arkansas Abortion Support Network, a nonprofit that began as a volunteer group for clinical defense in 2013 and expanded into Arkansas' first abortion fund in 2016. The group provided defense services until 2022, when Dobbs closed its clinic doors.
“That day I didn't take off my vest until probably one in the morning,” she says. “We had a rally at the Capitol. A lot of people who were there, we went out to dinner, drank, cursed, swore, and decided 'We're not stopping.'”
YOU NEVER KNOW what you might see outside the Orlando Women's Center in Florida. The one-story brick building blends in with its neighbors, except for the ever-rotating cast of characters who crowd the sidewalks around its entrance.
“Playing the latest Lil Wayne while you're about to go murder a baby?” a protester yells, while a woman blocks him with a pink umbrella. Around him, others wave purple “Do Not Murder” signs. When Florida resident Tanya was scrolling on TikTok one day, it was a scene just like this one that persuaded her to become a clinical defender.
“I shut off immediately [the app] and said, 'OK, I'm going down there,'” she says.
The abortion advocates of the Orlando center refer to themselves as SWAN (Stand With Abortion Now). Even with mass reporting and constant attempts to ban its accounts, SWAN remains a staple on the app. Some days its work means putting bodies between people rushing to appointments. Other days, it means Tanya and other film viral TikTok dances on the lawn, place cameras near protesters, or sometimes just frolic around in a unicorn costume nicknamed “Unibort” — a sort of unofficial mascot of the group.
But while the group engages with protesters with a bit of silliness to poke holes in their messaging, the SWANs have noted the post-Dobbs world has only increased antagonism.
“What we're now seeing is less than 'We care about both the woman and the child.' It is now 'These women are harlots who are willingly committing murder, and they also need to go to prison,'” Tanya says. “There's a rise in this abolitionist kind of sect that is now very much focused on ensuring that anyone who is intent on obtaining an abortion is viewed as homicidal and is incarcerated. Any kind of state law that says they own you after six weeks is devastating to the general community. It's only steadied our resolve — we're going to keep standing strong and fighting it.”
For the past two years, Florida was a refuge for patients in the region who could still access care up to 15 weeks there, but on May 1, a new ban went into effect dramatically reducing access across the South. Today, Florida clinics like the Orlando Women's Center can only offer services up to six weeks of gestation — before many women even know they're pregnant. Any patient seeking an abortion beyond that point will now be referred to providers in other states.
With more patients needing to travel post-Dobbs, the tension at the remaining clinics has been heightened. “Once people started coming to us from other states, it only angered them further,” says Shannon Bauerle, the executive director for the Charlotte for Choice advocacy group, about anti-abortion protesters in North Carolina. Like many volunteers, Bauerle's work di lei began after a scary encounter during her own abortion di lei. “I remember having a blanket over my head because I was so scared,” Bauerle says. “They were banging on my partner's car when we were driving in, and it was absolutely terrifying.” She says violent threats have only grown with each restriction.
Clinic defenders often straddle a thin legal line while trying to protect patients. Most states allow protesting on public property, which can pack sidewalks outside of clinics. At North Carolina's A Preferred Women's Health Center, the divide is both ideological and physical, as protesters are split down the middle by a public road ever since an anti-abortion group purchased a plot of land next door. On one such day, a woman yelling about “instruments of death” heading for fetuses is only drowned out by the shouts of another protester almost prostrate on the sidewalk, wailing prayers and cries of “Oh, Lord! Oh, Jesus!”
Harassment and doxing come with the territory, too. But they say posting online has become a major component of their work these days. Defenders film antagonists and use social media to connect with clinics across state lines and identify repeat offenders, especially those who get violent or cause disruptions.
In Duluth, Minnesota, the We Health Clinic started using TikTok after the Dobbs ruling to give people a glimpse into the clinic-escort world. What they found was that even as a non-engagement clinic — one with a policy not to acknowledge or antagonize protesters — simply filming protesters changed their behavior. “Our anti-abortion protesters outside film our patients coming into our clinic, and so we wanted to give them a little taste of their own medicine,” says Paulina Briggs, executive director of We Health. Once the recordings started drawing shocked eyes on TikTok, “we saw that they really reined in some of their more problematic tactics because they knew that they were being watched by a lot of people,” Briggs adds.
Not all clinical-defense programs have been able to adapt. The Jackson Women's Health Organization — the abortion clinic at the heart of the landmark Supreme Court decision — was for years the home of the Pink House Defenders, a volunteer program dedicated to helping the Mississippi clinic. Kim Gibson and Derenda Hancock — co-founders of We Engage, the group's nonprofit face — coordinated daily shifts at the height of the clinic's activity in 2021, placing volunteer defenders as physical barriers in front of protesters. And once Jackson Women's became the center of the Supreme Court case, their jobs became even more important, as media attention made the driveway and sidewalks surrounding “the Pink House” a minefield for incoming patients. “If the clinic was open, we were there,” Gibson says.
But days later Dobbs, the clinic closed its doors for good. Now, what was once the last abortion clinic in Mississippi is an upscale furniture consignment store. Struck by the defeat, the Pink House Defenders quietly disbanded. “We had lost on many levels, and it was well-known by antis and such, so it was quite demoralizing,” Gibson says. “We're quote-unquote back to living normal lives.”
For Musick and the Arkansas Abortion Support Network, the fear was that the closure of their Little Rock clinic would prevent volunteers from continuing their work. But, in fact, it's jump-started renewed interest in supporting it. “We had so many people wanting to help initially after Dobbs that we didn't have jobs for them,” Musick says. “We couldn't figure out what to have them do.”
Their clinical defense has turned to a health-based offense. The group founded the YOU Center, a pregnancy resource center that operates in the same building as the old clinic. While it can't provide abortions, it offers free services, including contraceptives, pregnancy tests, and STI testing.
There's no blueprint for what the fight for abortion rights will look like next. As more clinics across the country close their doors, clinical defense groups will remain in flux. But “the passion has never dissipated,” Musick says. “You would be hard-pressed to find any state that knew exactly what they were going to see.
“I'm so proud of what we've done so far. All of us wish we could do more.”
