Report: Abortion providers confront a new wave of extremism

In November 2023, while an abortion provider in the South was on vacation, someone broke into their home, shattered the windows, and scribbled “Baby Killer” on a whiteboard. The case is still open.

That same year, a man crashed his car into a new abortion clinic in Danville, Illinois, trying to start a fire. A few months after that, someone left a one-star Google review for a Florida clinic that read, “I have a bomb waiting to go off.” The clinic was evacuated and the FBI was called to investigate.

These incidents, highlighted in a recent report from the National Abortion Federation, are among hundreds of threats and attacks experienced by abortion providers across the US in the nearly three years since Roe v. Wade was overturned. The end of Roe “emboldened anti-abortion extremists,” NAF reports, leading to “an immediate spike in major incidents,” including arsons, burglaries, and death threats.

Violence has remained high, NAF says, even as dozens of clinics have shut down in states where abortion has been banned or greatly restricted. In 2023 and 2024, NAF members reported 621 trespassing incidents, 296 death threats, 169 acts of vandalism, and almost 130,000 protests targeting their facilities—but the actual numbers are likely much higher. “Providers and clinic staff are experiencing intense burnout and fatigue as a consequence of today’s abortion landscape and may not have the resources, staff, or capacity to track incidents,” the report says. “Sadly, many clinic staff also normalize the unacceptable harassment, threats, and violence they endure, which likely contributes to underreporting.”

Meanwhile, NAF’s members have been bracing for new attacks after President Donald Trump pardoned nearly two dozen anti-abortion activists convicted of targeting providers in recent years. I spoke by phone with Melissa Fowler, NAF’s chief program officer, about the report and the kinds of harassment and threats that abortion providers and patients can expect to encounter for the foreseeable future. Our interview has been lightly condensed and edited for clarity.

The most common incidents in the NAF report were vandalism, trespassing, death threats, and harassment. Do any particular anti-abortion strategies stand out in terms of their approach to targeting abortion providers?

For the last couple of years, there has been a strategy just to try and make it as difficult as possible for patients to access care. That can take the form of obstructing people’s access to entrances, invading clinics, and trying to delay access to care, as well as acts of vandalism and arson designed to actually destroy the physical locations of clinics.

The Trump administration has made clear it plans to dramatically scale back enforcement of the Freedom of Access to Clinic Entrances Act, known as the FACE Act, which was passed in 1994. When you look ahead, what impacts could this have on the kinds of violence and disruption that abortion providers experience?

The FACE Act has been an important tool that has led to a decrease in some of the more significant acts of violence that we saw in the ’90s. When you think about the significance of FACE, you have to think about the landscape that necessitated its drafting. After Roe v. Wade was handed down in 1973, we saw an increase in anti-abortion attacks that escalated to large-scale obstructions and blockades. The FACE Act was passed in response to that increasing violence and harassment, and it did lead to an immediate decrease in some of those types of activities. It’s never been enough, but it has been an important tool when enforced.

And in the last few years, we have seen some enforcement and some individuals actually being charged with FACE violations and convicted. Unfortunately, the Trump administration pardoned many of those individuals early this year, which sends a very frightening message to our providers across the country. What we’ve seen this year has been unprecedented, with the Department of Justice saying that they’re only going to enforce the FACE Act in grave circumstances. It shouldn’t take someone being murdered for a law to be enforced.

In the ’80s and ’90s, we saw extreme violence against providers that resulted in the murders of several doctors. How does what we saw back then compare to what we’re seeing today?

We are seeing people in the anti-abortion movement calling for a return to those days, calling for people to go back to the large-scale blockades and obstructive events that took place in the early ’90s. Some of the people who were pardoned have already stated that they plan to go back and invade clinics and practice acts of obstruction. So I think we could see a return to that, especially if people know that the FACE Act is not going to be enforced.

One thing that struck me about the NAF report was that attacks and threats can happen anywhere—in red states or blue states. Are there any differences in what providers face depending on their location, or is it pretty much the same across the board?

It really varies. What we’ve seen since the Dobbs decision has been a shift, where some of the states that historically have been more protective of abortion are seeing more incidents of harassment and targeting of providers. This is because when clinics closed in some states, the people who targeted those clinics are now traveling—or have even moved to new communities—to target the clinics that remain open.

We’ve been working with a number of our members since Dobbs who are in areas that are usually more protective and friendlier for providers, and they’re now experiencing an increase in some of these activities, like protests and obstruction. It really can happen anywhere because anti-abortion individuals are focused on wherever there are clinics. Some of it is still happening in the states where abortion is banned, where some of those clinics that are open for other services continue to be targeted as well. Some of them are seeing pregnant patients who are getting an ultrasound and then coming up with a plan on how they’re going to travel and access [abortion] care. So they’re trying to target those patients.

Based on this report, what kinds of harassment and other problems are likely to face abortion providers in the near future?

Since the inauguration, some providers talk about seeing a shift in their protesters—they’re more aggressive and more of them are present. They seem to be emboldened by the pardons and the actions from this administration. I think providers are bracing for that—for increased targeting and a lot more hostility. I think providers are also preparing for more clinic invasions, as some of the people who are pardoned return to those activities.

Providers are trying to think about community support and working with local law enforcement because we know there’s not going to be a lot of support federally. Even now, when the landscape has changed so dramatically and we’ve had so many clinics close in really hostile places, there still remains this constant campaign of harassment and violence targeting providers in places where abortion remains legal. It shouldn’t be the way that things are. This shouldn’t be part of the job when you choose to be an abortion provider. States that have wanted to be actively protective of the legal right to abortion need to make sure providers are safe and can run sustainable practices in those states.