No “Safe Haven” in New Nebraska Law

Amanda Marcotte

"Safe haven" laws don't do much to reduce the rates of infanticide, but they do give anti-choicers cover for their argument that forcing women to give birth against their will is no big deal.

"Safe haven" laws became
national news recently when the state of Nebraska closed a loophole
that allowed desperate parents to abandon minor children in the state,
regardless of the parents’ residence status or the children’s age. 
On Saturday, the final loophole minor–a
14-year-old boy from California
–was
abandoned and left a ward of the state.  Now babies must be under
30 days old for the parents to qualify, and after that, parents and
children are on their own.  The only good news to come out of this
squalid affair is that it exposed the flaws of feel-good, do-nothing
legislation such as "safe haven" laws.   

"Safe haven" laws were
created after a national panic in the 90s over "dumpster babies"–infants
that are born and left to die of exposure by desperate mothers. 
There’s no reason to think that the rate of infanticide-by-abandonment
was rising at the time, and there’s no reason to think that most infant
abandonment fits the romantic stereotype of the pregnant teenager who
successfully hides her pregnancy only to abandon the infant once its
born. But who needs statistical trends when you have attention-grabbing
headlines?  There were a couple of high profile cases of white
teenagers who did kill their infants this way, and that was enough to
set off a panic.  The most famous of these cases is the case of Melissa Drexler, who left during the prom, gave birth
in the bathroom, threw the newborn in the trash and went back to dancing. 
The infant died, and Drexler went to prison.   

Obviously, cases like these
are a tragedy, but the response of enacting "safe haven" laws just
added insult to injury.  The whole fiasco had the fingerprints, at least the cultural
influence
of the anti-choice movement all over it. (Anti-choice groups certainly like to inject themselves
and take credit for the laws.
)  he images of white teenagers abandoning perfectly healthy white babies–babies
that could be salvaged for worthy adopting couples!–fit neatly into
the pre-existing stereotype of who gets abortions promoted by the anti-choice
movement.  It all seems designed to put people in the mindset of
thinking that the entire problem will go away if you can just make it
somehow easier for young, white women to get their babies into the hands
of eager adopting couples.  But it’s never that easy. 

In Drexler’s case, I find
it hard to believe she would have risked being seen leaving the prom
with the infant to leave it at the local fire department, even if that
was an option. A
2003 review of the laws found

that while they did result in an increase in overall infant abandonment,
they didn’t put a dent in the number of infants killed by exposure. 
Women who leave infants to die are so marginal that a quick fix, feel-good
solution is unlikely to reach them.  By enacting ineffective laws
meant to address the problem of infanticide, we may have made the problem
worse.  Patting ourselves
on the back is no substitute for real action. 

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"Safe haven" laws don’t
do much to reduce the rates of infanticide, but they do give anti-choicers
even more cover for their argument that forcing women to give birth
against their will is no big deal.  If you can give birth and walk
out of the hospital without even signing your name to paperwork, then
no harm, no foul, right?  (Except of course the nine months of
your life you gave over, your altered body, the risk to life and limb,
the searing pain, and the soul-destroying misery many women experience
when separated from their newborns.)  These laws are an extension
of the myth that if we just made adoption easier somehow, then the need
for abortion would largely vanish.   

The empty, feel-good myth about
how we just need to make giving a child up for adoption easier is popular
across the political spectrum.  Liberals say it to assure everyone
that we’re trying to reduce the abortion rate with carrots instead
of sticks.  Conservatives say it to assure audiences that a ban
on abortion won’t be that bad for women, who presumably can just give
birth and walk away, leaving their babies to worthier couples who aren’t
wayward sluts.  Few people have the guts to point out that the
belief that adoption will reduce the abortion rate is largely a myth.  Now that it’s legal in basically
all states to drop off an infant without explanation and terminate your
parental responsibilities with no effort, we can firmly state that the
rhetoric about adoption is hollow and empty.  

The Nebraska debacle demonstrates
the horror of putting symbolic gestures and empty rhetoric above real
action that could actually help people.  Not to put too fine a
point on it, but the rewrite of the law sends a clear message: Don’t
use laws meant to offer symbolic help as if they could really help you. 
As an added bonus, they helped clarify how old you have to be before
"pro-lifers" lose interest in your life–30 days old.  It’s
almost as if "safe haven" laws have failed if they manage to do
any real good in the world.   

It’s as if their entire purpose
was to make it harder for pro-choicers to plea hardship when arguing
for a woman’s right to terminate. 

It’s tempting to rant a little
about how better sex education and contraception might be a better way
to reduce the infanticide rate, but honestly, I don’t think that would
help.  In the few outlier cases that make the news–the white
teenagers who successfully hide pregnancies and then kill the infants–it
might help some.  The real story of most women in this situation
is far bleaker. Desperate
poverty is a common denominator.

Many women fall through the cracks in our society and fall prey to drug
abuse, prostitution, and other ills.  Instead of applying a feel-good,
do-nothing solution, why don’t we look into closing up the cracks
that people fall through that leave them in such desperation?

Analysis Abortion

‘Pro-Life’ Pence Transfers Money Intended for Vulnerable Households to Anti-Choice Crisis Pregnancy Centers

Jenn Stanley

Donald Trump's running mate has said that "life is winning in Indiana"—and the biggest winner is probably a chain of crisis pregnancy centers that landed a $3.5 million contract in funds originally intended for poor Hoosiers.

Much has been made of Republican Gov. Mike Pence’s record on LGBTQ issues. In 2000, when he was running for U.S. representative, Pence wrote that “Congress should oppose any effort to recognize homosexual’s [sic] as a ‘discreet and insular minority’ [sic] entitled to the protection of anti-discrimination laws similar to those extended to women and ethnic minorities.” He also said that funds meant to help people living with HIV or AIDS should no longer be given to organizations that provide HIV prevention services because they “celebrate and encourage” homosexual activity. Instead, he proposed redirecting those funds to anti-LGBTQ “conversion therapy” programs, which have been widely discredited by the medical community as being ineffective and dangerous.

Under Pence, ideology has replaced evidence in many areas of public life. In fact, Republican presidential nominee Donald Trump has just hired a running mate who, in the past year, has reallocated millions of dollars in public funds intended to provide food and health care for needy families to anti-choice crisis pregnancy centers.

Gov. Pence, who declined multiple requests for an interview with Rewire, has been outspoken about his anti-choice agenda. Currently, Indiana law requires people seeking abortions to receive in-person “counseling” and written information from a physician or other health-care provider 18 hours before the abortion begins. And thanks, in part, to other restrictive laws making it more difficult for clinics to operate, there are currently six abortion providers in Indiana, and none in the northern part of the state. Only four of Indiana’s 92 counties have an abortion provider. All this means that many people in need of abortion care are forced to take significant time off work, arrange child care, and possibly pay for a place to stay overnight in order to obtain it.

This environment is why a contract quietly signed by Pence last fall with the crisis pregnancy center umbrella organization Real Alternatives is so potentially dangerous for Indiana residents seeking abortion: State-subsidized crisis pregnancy centers not only don’t provide abortion but seek to persuade people out of seeking abortion, thus limiting their options.

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“Indiana is committed to the health, safety, and wellbeing [sic] of Hoosier families, women, and children,” reads the first line of the contract between the Indiana State Department of Health and Real Alternatives. The contract, which began on October 1, 2015, allocates $3.5 million over the course of a year for Real Alternatives to use to fund crisis pregnancy centers throughout the state.

Where Funding Comes From

The money for the Real Alternatives contract comes from Indiana’s Temporary Assistance for Needy Families (TANF) block grant, a federally funded, state-run program meant to support the most vulnerable households with children. The program was created by the 1996 Personal Responsibility and Work Opportunity Reconciliation Act signed by former President Bill Clinton. It changed welfare from a federal program that gave money directly to needy families to one that gave money, and a lot of flexibility with how to use it, to the states.

This TANF block grant is supposed to provide low-income families a monthly cash stipend that can be used for rent, child care, and food. But states have wide discretion over these funds: In general, they must use the money to serve families with children, but they can also fund programs meant, for example, to promote marriage. They can also make changes to the requirements for fund eligibility.

As of 2012, to be eligible for cash assistance in Indiana, a household’s maximum monthly earnings could not exceed $377, the fourth-lowest level of qualification of all 50 states, according to a report by the Congressional Research Service. Indiana’s program also has some of the lowest maximum payouts to recipients in the country.

Part of this is due to a 2011 work requirement that stripped eligibility from many families. Under the new work requirement, a parent or caretaker receiving assistance needs to be “engaged in work once the State determines the parent or caretaker is ready to engage in work,” or after 24 months of receiving benefits. The maximum time allowed federally for a family to receive assistance is 60 months.

“There was a TANF policy change effective November 2011 that required an up-front job search to be completed at the point of application before we would proceed in authorizing TANF benefits,” Jim Gavin, a spokesman for the state’s Family and Social Services Administration (FSSA), told Rewire. “Most [applicants] did not complete the required job search and thus applications were denied.”

Unspent money from the block grant can be carried over to following years. Indiana receives an annual block grant of $206,799,109, but the state hasn’t been using all of it thanks to those low payouts and strict eligibility requirements. The budget for the Real Alternatives contract comes from these carry-over funds.

According to the U.S. Department of Health and Human Services, TANF is explicitly meant to clothe and feed children, or to create programs that help prevent “non-marital childbearing,” and Indiana’s contract with Real Alternatives does neither. The contract stipulates that Real Alternatives and its subcontractors must “actively promote childbirth instead of abortion.” The funds, the contract says, cannot be used for organizations that will refer clients to abortion providers or promote contraceptives as a way to avoid unplanned pregnancies and sexually transmitted infections.

Parties involved in the contract defended it to Rewire by saying they provide material goods to expecting and new parents, but Rewire obtained documents that showed a much different reality.

Real Alternatives is an anti-choice organization run by Kevin Bagatta, a Pennsylvania lawyer who has no known professional experience with medical or mental health services. It helps open, finance, and refer clients to crisis pregnancy centers. The program started in Pennsylvania, where it received a $30 million, five-year grant to support a network of 40 subcontracting crisis pregnancy centers. Auditor General Eugene DePasquale called for an audit of the organization between June 2012 and June 2015 after hearing reports of mismanaged funds, and found $485,000 in inappropriate billing. According to the audit, Real Alternatives would not permit DHS to review how the organization used those funds. However, the Pittsburgh Post-Gazette reported in April that at least some of the money appears to have been designated for programs outside the state.

Real Alternatives also received an $800,000 contract in Michigan, which inspired Gov. Pence to fund a $1 million yearlong pilot program in northern Indiana in the fall of 2014.

“The widespread success [of the pilot program] and large demand for these services led to the statewide expansion of the program,” reads the current $3.5 million contract. It is unclear what measures the state used to define “success.”

 

“Every Other Baby … Starts With Women’s Care Center”

Real Alternatives has 18 subcontracting centers in Indiana; 15 of them are owned by Women’s Care Center, a chain of crisis pregnancy centers. According to its website, Women’s Care Center serves 25,000 women annually in 23 centers throughout Florida, Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin.

Women’s Care Centers in Indiana received 18 percent of their operating budget from state’s Real Alternatives program during the pilot year, October 1, 2014 through September 30, 2015, which were mostly reimbursements for counseling and classes throughout pregnancy, rather than goods and services for new parents.

In fact, instead of the dispensation of diapers and food, “the primary purpose of the [Real Alternatives] program is to provide core services consisting of information, sharing education, and counseling that promotes childbirth and assists pregnant women in their decision regarding adoption or parenting,” the most recent contract reads.

The program’s reimbursement system prioritizes these anti-choice classes and counseling sessions: The more they bill for, the more likely they are to get more funding and thus open more clinics.

“This performance driven [sic] reimbursement system rewards vendor service providers who take their program reimbursement and reinvest in their services by opening more centers and hiring more counselors to serve more women in need,” reads the contract.

Classes, which are billed as chastity classes, parenting classes, pregnancy classes, and childbirth classes, are reimbursed at $21.80 per client. Meanwhile, as per the most recent contract, counseling sessions, which are separate from the classes, are reimbursed by the state at minimum rates of $1.09 per minute.

Jenny Hunsberger, vice president of Women’s Care Center, told Rewire that half of all pregnant women in Elkhart, LaPorte, Marshall, and St. Joseph Counties, and one in four pregnant women in Allen County, are clients of their centers. To receive any material goods, such as diapers, food, and clothing, she said, all clients must receive this counseling, at no cost to them. Such counseling is billed by the minute for reimbursement.

“When every other baby born [in those counties] starts with Women’s Care Center, that’s a lot of minutes,” Hunsberger told Rewire.

Rewire was unable to verify exactly what is said in those counseling sessions, except that they are meant to encourage clients to carry their pregnancies to term and to help them decide between adoption or child rearing, according to Hunsberger. As mandated by the contract, both counseling and classes must “provide abstinence education as the best and only method of avoiding unplanned pregnancies and sexually transmitted infections.”

In the first quarter of the new contract alone, Women’s Care Center billed Real Alternatives and, in turn, the state, $239,290.97; about $150,000 of that was for counseling, according to documents obtained by Rewire. In contrast, goods like food, diapers, and other essentials for new parents made up only about 18.5 percent of Women’s Care Center’s first-quarter reimbursements.

Despite the fact that the state is paying for counseling at Women’s Care Center, Rewire was unable to find any licensing for counselors affiliated with the centers. Hunsberger told Rewire that counseling assistants and counselors complete a minimum training of 200 hours overseen by a master’s level counselor, but the counselors and assistants do not all have social work or psychology degrees. Hunsberger wrote in an email to Rewire that “a typical Women’s Care Center is staffed with one or more highly skilled counselors, MSW or equivalent.”

Rewire followed up for more information regarding what “typical” or “equivalent” meant, but Hunsberger declined to answer. A search for licenses for the known counselors at Women’s Care Center’s Indiana locations turned up nothing. The Indiana State Department of Health told Rewire that it does not monitor or regulate the staff at Real Alternatives’ subcontractors, and both Women’s Care Center and Real Alternatives were uncooperative when asked for more information regarding their counseling staff and training.

Bethany Christian Services and Heartline Pregnancy Center, Real Alternatives’ other Indiana subcontractors, billed the program $380.41 and $404.39 respectively in the first quarter. They billed only for counseling sessions, and not goods or classes.

In a 2011 interview with Philadelphia City Paper, Kevin Bagatta said that Real Alternatives counselors were not required to have a degree.

“We don’t provide medical services. We provide human services,” Bagatta told the City Paper.

There are pregnancy centers in Indiana that provide a full range of referrals for reproductive health care, including for STI testing and abortion. However, they are not eligible for reimbursement under the Real Alternatives contract because they do not maintain an anti-choice mission.

Parker Dockray is the executive director of Backline, an all-options pregnancy resource center. She told Rewire that Backline serves hundreds of Indiana residents each month, and is overwhelmed by demand for diapers and other goods, but it is ineligible for the funding because it will refer women to abortion providers if they choose not to carry a pregnancy to term.

“At a time when so many Hoosier families are struggling to make ends meet, it is irresponsible for the state to divert funds intended to support low-income women and children and give it to organizations that provide biased pregnancy counseling,” Dockray told Rewire. “We wish that Indiana would use this funding to truly support families by providing job training, child care, and other safety net services, rather than using it to promote an anti-abortion agenda.”

“Life Is Winning in Indiana”

Time and again, Bagatta and Hunsberger stressed to Rewire that their organizations do not employ deceitful tactics to get women in the door and to convince them not to have abortions. However, multiple studies have proven that crisis pregnancy centers often lie to women from the moment they search online for an abortion provider through the end of their appointments inside the center.

These studies have also shown that publicly funded crisis pregnancy centers dispense medically inaccurate information to clients. In addition to spreading lies like abortion causing infertility or breast cancer, they are known to give false hopes of miscarriages to people who are pregnant and don’t want to be. A 2015 report by NARAL Pro-Choice America found this practice to be ubiquitous in centers throughout the United States, and Rewire found that Women’s Care Center is no exception. The organization’s website says that as many as 40 percent of pregnancies end in natural miscarriage. While early pregnancy loss is common, it occurs in about 10 percent of known pregnancies, according to the American Congress of Obstetricians and Gynecologists.

Crisis pregnancy centers also tend to crop up next to abortion clinics with flashy, deceitful signs that lead many to mistakenly walk into the wrong building. Once inside, clients are encouraged not to have an abortion.

A Google search for “abortion” and “Indianapolis” turns up an ad for the Women’s Care Center as the first result. It reads: “Abortion – Indianapolis – Free Ultrasound before Abortion. Located on 86th and Georgetown. We’re Here to Help – Call Us Today: Abortion, Ultrasound, Locations, Pregnancy.”

Hunsberger denies any deceit on the part of Women’s Care Center.

“Clients who walk in the wrong door are informed that we are not the abortion clinic and that we do not provide abortions,” Hunsberger told Rewire. “Often a woman will choose to stay or return because we provide services that she feels will help her make the best decision for her, including free medical-grade pregnancy tests and ultrasounds which help determine viability and gestational age.”

Planned Parenthood of Indiana and Kentucky told Rewire that since Women’s Care Center opened on 86th and Georgetown in Indianapolis, many patients looking for its Georgetown Health Center have walked through the “wrong door.”

“We have had patients miss appointments because they went into their building and were kept there so long they missed their scheduled time,” Judi Morrison, vice president of marketing and education, told Rewire.

Sarah Bardol, director of Women’s Care Center’s Indianapolis clinic, told the Criterion Online Edition, a publication of the Archdiocese of Indianapolis, that the first day the center was open, a woman and her boyfriend did walk into the “wrong door” hoping to have an abortion.

“The staff of the new Women’s Care Center in Indianapolis, located just yards from the largest abortion provider in the state, hopes for many such ‘wrong-door’ incidents as they seek to help women choose life for their unborn babies,” reported the Criterion Online Edition.

If they submit to counseling, Hoosiers who walk into the “wrong door” and “choose life” can receive up to about $40 in goods over the course their pregnancy and the first year of that child’s life. Perhaps several years ago they may have been eligible for Temporary Assistance for Needy Families, but now with the work requirement, they may not qualify.

In a February 2016 interview with National Right to Life, one of the nation’s most prominent anti-choice groups, Gov. Pence said, “Life is winning in Indiana.” Though Pence was referring to the Real Alternatives contract, and the wave of anti-choice legislation sweeping through the state, it’s not clear what “life is winning” actually means. The state’s opioid epidemic claimed 1,172 lives in 2014, a statistically significant increase from the previous year, according to the Centers for Disease Control and Prevention. HIV infections have spread dramatically throughout the state, in part because of Pence’s unwillingness to support medically sound prevention practices. Indiana’s infant mortality rate is above the national average, and infant mortality among Black babies is even higher. And Pence has reduced access to prevention services such as those offered by Planned Parenthood through budget cuts and unnecessary regulations—while increasing spending on anti-choice crisis pregnancy centers.

Gov. Pence’s track record shows that these policies are no mistake. The medical and financial needs of his most vulnerable constituents have taken a backseat to religious ideology throughout his time in office. He has literally reallocated money for poor Hoosiers to fund anti-choice organizations. In his tenure as both a congressman and a governor, he’s proven that whether on a national or state level, he’s willing to put “pro-life” over quality-of-life for his constituents.

Investigations Violence

As Threats Spike, Advocates Urge Feds to Strengthen Law Protecting Abortion Clinic Access

Sofia Resnick

Just two days after NARAL Pro-Choice America submitted a letter asking the U.S. Department of Justice to investigate anti-choice activities as domestic terrorism, an extremist opened fire on a Planned Parenthood clinic in Colorado, murdering three people and injuring nine others.

On a frigid January afternoon this year, a day before the 43rd anniversary of Roe v. Wade, about a dozen fresh-out-of-college feminist campus organizers marched the halls of Congress after divvying up a list of representatives to visit.

Smartly dressed under bulky winter coats, organizers Kelli Musick and Chelsea Yarborough, who work for the national nonprofit the Feminist Majority Foundation (FMF), dropped by the office of Rep. Marsha Blackburn (R-TN).

Blackburn chairs the House of Representatives’ Energy and Commerce Committee’s Select Investigative Panel, created last October principally to investigate Planned Parenthood. The panel formed after the anti-choice front group the Center for Medical Progress (CMP) released a series of heavily edited videos in which it claimed—though never proved—that Planned Parenthood was illegally selling fetal tissue.

As part of their mission that day, Musick and Yarborough left written materials with a staffer asking Blackburn to either redirect her panel’s focus to violent attacks on abortion clinics, or to dissolve it. Specifically, the FMF wanted the congressional panel to investigate the leaders behind CMP, whose rhetoric has fueled a recent spate of threats and attacks against abortion providers, the foundation’s president, Eleanor Smeal, told Rewire in an interview. Though the investigative scope of the panel is actually quite broad, it does not specifically include abortion clinic violence as an area to probe.

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But in the four months since Musick and Yarborough submitted their request to Blackburn’s staff, the panel has forged ahead with its investigation, not just into Planned Parenthood’s fetal tissue donation practices, but into abortion practices generally. This week, House Democrats requested that Speaker Paul Ryan (R-WI) disband this panel, arguing that it amounts to little more than a biased, expensive witch hunt on fetal tissue researchers and abortion providers.

Really, though, the FMF’s mostly symbolic ask is part of a recent, ongoing push by abortion rights groups to demand that the federal government start taking violence and threats aimed at abortion providers more seriously. National organizations last year began identifying a spike in violent acts, such as arson, vandalism, and death threats, directed at reproductive health clinics and staffers.

NARAL Pro-Choice America started a campaign last November asking the U.S. Department of Justice (DOJ) to investigate these types of activities as domestic terrorism. Just two days after NARAL submitted its letter to the federal agency, an anti-choice extremist opened fire on a Planned Parenthood clinic in Colorado murdering three people and injuring nine others.

This rise in threats and attacks—further documented in a report published last month by the National Abortion Federation (NAF)—has also prompted abortion rights groups to demand that the government strengthen and fully enforce the Freedom of Access to Clinic Entrances (FACE) Act, a 22-year-old federal law intended to ensure access to abortion clinics and to protect the lives of abortion providers and patients.

“The time for us being quiet is over,” Smeal said at a news conference held in January. “We are determined that we are going to bring the anti-abortion violence issue to the forefront of decision making.”

A Call for More FACE Investigations

The FACE Act, which allows for criminal and civil remedies, makes it a federal crime to use force or the threat of force to prevent people from accessing or providing reproductive health care. For example, the law bans the destruction of clinic property and the practice of blocking someone’s entrance into a clinic.

Before President Bill Clinton signed the FACE Act in 1994, some abortion foes would travel the country and barricade themselves in front of clinic doors. Such blockades came to be known as “operation rescue,” pioneered by the national group of the same name whose current president, Troy Newman, was involved in the aforementioned video campaign targeting Planned Parenthood.

“It’s called ‘interposition,'” Rev. Rusty Lee Thomas told Rewire in a phone interview. He said that this blockading practice is based on a biblical and historical concept, where “someone stands in the gap between the sort of tyrant and its victim.” Thomas said in this case, the doctors providing abortions were the tyrants and the aborted fetuses the victims.

Thomas now runs a group called Operation Save America. Back in the 1990s, he joined anti-choice activists in these ventures. But Thomas said he gave up this particular brand of protest after the DOJ sued him and others under the FACE Act in 1998, after he had attempted to block the entrances of reproductive health clinics in multiple cities in Ohio. Though the federal government ultimately dropped the charges, the threat of prison time and hundreds of dollars in fines ended his blockading days, Thomas said.

“Like anything else, when the price tag goes up, people really do have to weigh that,” he said. “By that time, the government was successful at scaring people and shutting it down. The tactic of ‘operation rescue’ was put to an end.”

Many abortion rights supporters agree with Thomas that the FACE Act curbed clinic blockades. They say this federal policy and similar state laws helped decrease violent attacks, such as clinic bombings and murders of clinic workers and doctors. Smeal said that, according to the FMF’s frequent clinic surveys, the year the FACE Act went into effect, more than 50 percent of abortion clinics reported experiencing violence; today that number has dropped to 20 percent.

Since 1994, the DOJ has filed a total of 27 civil FACE cases in 17 states, a Justice Department spokesperson told Rewire in an email. The spokesperson said the DOJ receives “a great deal of information” from national abortion provider groups, as well as from victims, local law enforcement, and media reports.

As Rewire has reported previously, both criminal and civil prosecutions under FACE tend to fluctuate based on which political party controls the White House: During President George W. Bush’s administration, for example, criminal prosecutions under the FACE Act declined by more than 75 percent to about two a year, compared to an average of ten prosecutions a year under the Clinton administration. During President Obama’s first term, the DOJ reported prosecuting 11 criminal cases under the FACE Act, charging 12 defendants.

During a Senate Judiciary Committee hearing in March on the oversight of the Justice Department, Attorney General Loretta Lynch testified that her agency increased criminal prosecutions and civil cases filed under the FACE Act within the “past five or six years.” But she did not give the total number of cases prosecuted under the act. She estimated that under the Obama administration, the DOJ has charged a total of 12 criminal cases criminally and nine civil ones.

Advocates and providers say these figures pale in comparison to the number of acts of violence and harassment annually committed against clinics and providers nationwide.

Since the NAF began tracking abortion clinic violence in 1977, the organization reports that as of 2015, there have been 185 arsons, 42 bombings, 26 attempted murders, and 11 murders, three of which occurred last year.

Advocates are currently waiting to see whether the government will bring a FACE complaint against Robert Lewis Dear Jr., who invoked anti-abortion animus upon arrest and during his first media interview after he admitted to shooting up the Colorado Springs Planned Parenthood clinic last November. During her testimony in March, Lynch said the DOJ is reviewing “a possible FACE Act violation” against Dear while his murder case proceeds in state court.

It appears, however, that this case will be in limbo for a while. Earlier this month, a judge ruled that Dear lacks the mental competency to stand trial, after forensic psychologists diagnosed him with a delusion disorder they claim is based on the accused shooter’s fringe political beliefs, among them that federal agents are spying on him. Dear, meanwhile, has been very clear that he does not want to plead insanity; rather, he wants to argue that the attack on Planned Parenthood was legally justified because he was fighting against the greater evil of abortion. For the time being, Dear will be treated at a state psychiatric hospital until, if ever, he is deemed competent to stand trial.

In any case, it might seem unnecessary to charge Dear with a federal felony crime of obstructing access to abortion when he’s already on trial for multiple murders. But some advocates say that charging these crimes under FACE is important symbolically because, as with hate crimes, the FACE Act helps draw the link between crimes like vandalism, arson, and murder, and a specific bias against a group of people. Being able to illustrate a pattern of anti-abortion crimes is necessary in order to bring awareness to law enforcement and the public and to potentially deter anti-choice extremists from threatening or committing acts of violence, they say.

It’s for this reason that physician assistant Susan Cahill wanted to bring a FACE claim against Zachary Klundt, who destroyed her All Families Healthcare clinic in Kalispell, Montana, in March 2014, forcing her to forever shutter her clinic.

According to testimony that surfaced during the sentencing hearing, Klundt had texted his mother hours before the break-in, asking her for information about the “abortionist,” and had told a psychiatrist evaluating him after the break-in that Cahill was a “murderer.” Notably, Klundt’s mother sat on the board of the anti-choice pregnancy center that purchased Cahill’s old building and evicted Cahill.

Yet despite this circumstantial evidence, Klundt testified that he smashed all of Cahill’s medical equipment and personal photos and poured iodine on her patients’ medical records because of serious drug addiction, not anti-abortion animus.

“Even though everybody knows why he did it, legally it wasn’t tried that way,” Cahill told Rewire.

Though third parties can bring civil suits under the FACE Act, Cahill said she likely would be unsuccessful trying to use the statute in this case, because Klundt was only found guilty of vandalism and the court did not make a specific finding about his motivations in committing this crime.

Instead, she is suing Klundt, his family, and the crisis pregnancy center that forced her from her old building, for negligence, nuisance, and “intentional infliction of emotional distress.” She said she hopes that if the case moves forward, discovery proceedings will surface what she suspects were Klundt’s anti-abortion motivations.

To be sure, not all anti-choice activists and abortion clinic protesters escalate to violence. And abortion opponents like Susan B. Anthony List national campaign chair Jill Stanek say the FACE Act goes too far in regulating the actions of protesters. Stanek told ​Rewire​ that most of these activists peacefully exercise their free speech rights to protest what they believe is a form of murder.

As an example, Stanek pointed Rewire to a FACE claim in 2010 in which the DOJ sued an activist in West Palm Beach, Florida, accusing her of blocking the flow of traffic at an abortion clinic while she tried to give pamphlets to a couple in a car. A federal judge dismissed the claim as baseless.

Stanek argued that it is a political strategy among abortion rights supporters to “play up” acts of anti-choice violence and threats. She added that abortion opponents also receive their share of attacks and threats, including herself. Upon returning from vacation in late January, Stanek said she found a brick thrown through her window with a note reading: “Quit the pro-life bullshit.” Her local newspaper in Mokena, Illinois, reported the alleged incident. Stanek posted photos she says depict the brick and busted window to Facebook.

While Stanek maintained that most abortion protesters organize peacefully and called people like Dear part of the “lunatic fringe,” she did concede that protesting in front of abortion clinics is, in part, an attempt by her movement “to stigmatize abortion doctors.” The goal is also, she said, to convince patients to turn away from clinics and for clinic staff to quit their jobs.

It’s this stigma and endless, sometimes hostile, presence in front of reproductive health clinics that, abortion providers told Rewire, can help breed eventual violence. But Stanek said the movement is not about to abandon this crucial aspect of their multi-pronged strategy to end legal abortion.

“As far as we’re concerned, the last front, the last place that we have a chance to save a baby is at the abortion clinic,” Stanek said. “Laws haven’t worked, pregnancy care centers haven’t worked, educating hasn’t worked. Now we have the mom going into the abortion clinic. And so that is what compels certain people to go to abortion clinics and try to get women to change their minds.”

Abortion Rights Advocates Say FACE Is Weak on Threats, Harassment

It was lunchtime during the summer of 2012 when Dr. Willie Parker walked outside of Jackson Women’s Health Organization in Jackson, Mississippi. It was his first day at the clinic, which happens to be bright pink and the last standing abortion clinic in the whole state. As such, it’s a regular fixture for protests.

As he walked to and from a nearby sandwich shop, Parker said he was accompanied by a protester who “berated” him the entire way. He felt intimidated and threatened.

Parker, who currently divides his time among six clinics in five states, told Rewire in a phone interview that the FACE Act is a “mixed bag,” arguing it does not fully protect providers, especially when they are not on clinic property. He added that abortion foes have learned all of the federal and local statutes to know how close they can physically reach patients and providers while staying inside the law.

“At what point am I out of the safety created by [the FACE] Act simply because I chose to walk across the street from an abortion clinic to get a sandwich?” he said.

Many abortion providers think FACE is a relatively weak law, particularly when it comes to harassment and threats made against them, an element of clinic violence many advocates say is often ignored at the federal level. Though it forbids “the threat of force,” such a provision is open to interpretation by the courts.

Drexel University law professor David Cohen, who co-authored a recent book about anti-abortion terrorism, told Rewire last year that the FACE Act should be amended to specifically include stalking and harassing abortion providers within the law’s current definition of “intimidate.” Additionally, Cohen recommends directing the courts to assess threats from the perspective of an abortion provider, and increasing penalties.

Threats to providers have drastically increased in the last year, say advocacy groups. They attribute this increase, in part, to the incendiary rhetoric that Planned Parenthood “sells baby parts,” a recurring mantra from the Center for Medical Progress’ smear campaign against the reproductive health-care network.

The NAF tracked 94 threats of direct harm in 2015, compared to just one threat in 2014. According to its latest report, NAF hired an outside security firm in mid-November last year to track online threats, which helped to identify more than 25,000 incidents of hate speech and threats within six weeks.

Meanwhile, researchers at FMF also witnessed a sharp rise in threats against abortion providers last summer. Smeal said researchers were so concerned that they postponed a clinic violence survey that they were prepping to come out earlier this year and instead tried to help clinics prevent threats from escalating into actual attacks.

“We were very, very concerned about the increasing level of threats,” Smeal told Rewire in an interview. “Most of us who have been involved in this for a long time thought it was one of the highest threat levels we’ve ever seen. We were waiting for the violent acts to occur.”

They didn’t have to wait long.

Dr. Savita Ginde, the medical director at the Planned Parenthood clinic in Colorado Springs, was one of the doctors featured in one of CMP’s videos. After the video streamed online, Ginde allegedly received online death threats, as well as picketers outside of her home. In November, Dear was arrested for shooting up her clinic, declaring afterward, “no more baby parts.” Ginde was not harmed.

The connection of threats to violence worries advocates like Smeal. Extremists do not always act on their threats, but they sometimes do, she said. Or they create a climate that motivates someone to act out what the crowd is cheering for.

It’s for this reason that the reproductive rights community eagerly anticipated the recent trial in the Justice Department’s civil lawsuit against abortion foe Angel Dillard in the hopes that the result might strengthen future enforcement against threats under FACE.

In fact, the opposite might have happened.

The DOJ sued Dillard in 2011 after she mailed a letter to family practitioner Dr. Mila Means. Means was, at the time, training to perform abortions in Wichita to fill the gap left by Dr. George Tiller, whom Scott Roeder murdered two years earlier, admitting it was because Tiller performed abortions. In the letter, Dillard, who has ties to Roeder, told Means that thousands of abortion opponents across the country were monitoring her movements and that should she begin offering abortions, she should take care to check beneath her car for explosives every day “because maybe today is the day someone places an explosive under it.” In the letter, Dillard also referenced Tiller speaking to Means from hell.

The agency interpreted this letter as a threat of violence that violated the FACE Act. Means ended up not opening an abortion practice in Wichita. She told Rewire after the trial that she backed out, in part, because of the cultural and political climate against abortion in Kansas. “The threats work,” she said.

This climate was evidenced in the Wichita jury’s decision reached earlier this month. While the eight jurors did conclude that Dillard’s letter constituted a “true threat” not automatically protected by free speech, they also accepted Dillard’s attorneys’ arguments that her threats were religious in nature rather than violent.

“The letter was intimidating, but it was a more spiritual threat, a more emotional threat,” Adam Cox, the presiding juror, told Rewire in an interview following the verdict.

Thus, they found the letter did not violate the law and did not warrant civil damages or a protective order to keep Dillard away from Means.

Smeal said she was disappointed by the verdict in the Dillard case.

“It just shows you how hard it is to enforce this law,” she told Rewire in a phone interview.

Smeal said she is working behind the scenes with other advocates and lawmakers on efforts to eventually expand and strengthen the FACE Act. In the meantime, she said, law enforcement at all levels should be employing other existing laws to prosecute but also try to prevent violent attacks against abortion providers.

Some advocates, for example, have called on the federal government to treat demonstrated acts of anti-abortion violence, bomb threats, or murder as domestic terrorism.

Since NARAL launched its campaign last fall demanding that the DOJ begin investigating anti-abortion violence as domestic terrorism, NARAL Vice President of Policy Donna Crane said her group has seen more congressional members speaking out about abortion clinic violence as domestic terrorism.

“We think [the campaign] has raised important questions about why all too often anti-choice violence at women’s health centers is seen somehow as different, maybe even somehow a little bit more acceptable,” Crane told Rewire in a phone interview. “We believe that it’s just another flavor of domestic terrorism, and it should be talked about as such and treated as such.”

Smeal said her organization is similarly not backing down from its campaign asking the House committee investigating Planned Parenthood to take to task the activist groups that have, she believes, contributed to a dangerous climate for abortion providers and their patients.

Already, Smeal said, supporters have sent the committee thousands of emails as part of this campaign. And though she said it is difficult to know what effect the FMF’s campaign has had so far, she said she knows congressional members are listening.

Earlier in May, House Minority Leader Nancy Pelosi and the committee’s ranking Democratic member Rep. Janice Schakowsky held a press conference asking Speaker Paul Ryan to disband the House select committee, arguing that its investigation is putting access to reproductive health care as well as the lives of doctors and fetal-tissue researchers in danger, a point Smeal’s group has been making for months now.

“We’re going to keep it up, because we’re worried [the committee is] endangering health-care providers,” Smeal said of her group’s campaign. “We want to continue to shed light on this anti-abortion violence and basically are doing that in every way we can.”