New Doctor in Kansas Being Threatened By Anti-Abortionists

Robin Marty

Even after agreeing not to do abortions in Witchita, Dr. Mila Means is being threatened with violence.

Dr. Mila Means agreed to not do abortions in her office after a judge ruled that her landlord was allowed to terminate her lease due to potential “nuisance” issues from being protested by anti-choice activists.  Yet, even not performing abortions, Dr. Means is still being threatened, much as her predecessor Dr. George Tiller was before her.

Via KTKA.com:

Documents filed Thursday in U.S. District Court allege that Angel Dillard, of Valley Center, violated the Freedom of Access to Clinic Entrances Act when she mailed a letter to Dr. Mila Means.

Officials released a copy of the letter, which says thousands of people are looking into the doctor’s background and studying her habits, routines, address, car and friends. It also states the doctor should check under her car daily for explosives.

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Dillard is now under a restraining order and is not allowed to come near the doctor’s work, home, or car, nor have any sort of contact with her.  But can you really expect someone who sends death threats to go away just because the police told her to stop?

First they protest, then they threaten.  We all have seen exactly how the violence escalates after that.

Analysis Maternity and Birthing

Pregnant Women Are Being Shackled in Massachusetts—Even Though It’s Been Illegal for Years

Victoria Law

According to a new report, not a single jail or prison facility in the state has written policies that are fully compliant with the law against restraining pregnant women behind bars.

Korianne Gamble was six months pregnant in November 2014 when she arrived at the Bristol County Sheriff’s Office Women’s Center, a jail in North Dartmouth, Massachusetts. Six months prior, the state had passed “An Act to Prevent Shackling and Promote Safe Pregnancies for Female Inmates.”

According to the new law, the jail should have been prohibited from using any type of restraint on Gamble during labor, and using of leg and waist restraints on her during and immediately after her pregnancy. It also guaranteed her minimum standards of pregnancy care and required—as with everyone incarcerated while in their second or third trimesters—that she be transported in the jail’s vehicles with seat belts whenever she was taken to court, medical appointments, or anywhere outside the jail.

But that wasn’t the case for Gamble. Instead, she says, when it came time for her to give birth, she was left to labor in a cell for eight hours before finally being handcuffed, placed in the back of a police cruiser without a seatbelt, and driven to a hospital, where she was shackled to the bed with a leg iron after delivering.

According to a new report, Gamble isn’t alone. Advocates have been monitoring pregnancy-related care since the law’s passage. After obtaining and analyzing the policies of the state’s prison and jail system, they found that no facility has policies that are fully compliant with the 2014 law. They issued their findings in a new report, Breaking Promises: Violations of the Massachusetts Pregnancy Standards and Anti-Shackling Lawco-authored by Marianne Bullock of the Prison Birth Project, Lauren Petit of Prisoners’ Legal Services of Massachusetts, and Rachel Roth, a reproductive-justice expert.

In addition to analyzing policies, they spoke with women who were pregnant while in custody and learned that women continue to be handcuffed during labor, restrained to the bed postpartum, and placed in full restraints—including leg irons and waist chains—after giving birth.

“The promise to respect the human rights of pregnant women in prison and jail has been broken,” the report’s authors concluded.

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Medical experts, including the American Congress of Obstetricians and Gynecologists, the American Medical Association and the American College of Nurse-Midwives, have all agreed that shackling during pregnancy is unnecessary, inhumane, and dangerous. Shackling increases the risk of falling and injury to both mother and fetus while also preventing medical staff from assessing and assisting during labor and delivery. In 2014, both the Massachusetts legislature and then-Gov. Deval Patrick (D) agreed, passing the law against it.

“The Massachusetts law is part of a national trend and is one of the most comprehensive in protecting pregnant and postpartum women from the risks of restraints,” said Roth in an interview with Rewire. “However, like most other states, the Massachusetts law doesn’t have any oversight built in. This report clearly shows the need for staff training and enforcement so that women who are incarcerated will be treated the way the legislature intended.”

Gamble learned all of this firsthand. In the month before her arrest, Gamble had undergone a cervical cerclage, in which a doctor temporarily stitches up the cervix to prevent premature labor. She had weekly visits to a gynecologist to monitor the development of her fetus. The cerclage was scheduled to be removed at 37 weeks. But then she was arrested and sent to jail.

Gamble told jail medical staff that hers was a high-risk pregnancy, that she had had a cerclage, and that her first child had been born six weeks prematurely. Still, she says she waited two months before seeing an obstetrician.

As her due date drew closer, the doctor, concerned about the lack of amniotic fluid, scheduled Gamble for an induction on Feb. 19, 2015. But, she says, jail staff cancelled her induction without telling her why.

That same evening, around 5 p.m., Gamble went into labor. Jail staff took her to the medical unit. There, according to Gamble, the jail’s nurses took her blood pressure and did a quick exam, but did not send her to the hospital. “They [the nurses] thought I was ‘acting up’ because my induction was canceled,” she told Rewire.

She was placed in a see-through cell where, as the hours progressed, her labor pains grew worse. “I kept calling to get the [correctional officers] to get the nurse,” Gamble recalled. By the time a nurse came, Gamble was bleeding. “The nurse made me pull down my pants to show her the blood—in front of a male [correctional officer]!” Gamble stated. Still, she says, no one called for an ambulance or made arrangements to drive her to the hospital.

At 1:45 in the morning, over eight hours after she first went into labor, the jail’s captain learned that Gamble was in labor. “[He] must have heard all the commotion, and he called to find out what was going on,” she said. He ordered his staff to call an ambulance and bring her to the hospital.

But instead of calling an ambulance, Gamble says jail staff handcuffed her, placed her in the back of a police cruiser without a seatbelt—in violation of the law—and drove her to Charlton Memorial Hospital. “My body was already starting to push the baby out,” she said. She recalled that the officers driving the car worried that they would have to pull over and she would give birth by the side of the road.

Gamble made it to the hospital, but just barely. Nine minutes after arriving, she gave birth: “I didn’t even make it to Labor and Delivery,” she remembered.

But her ordeal wasn’t over. Gamble’s mother, who had contacted Prisoners’ Legal Services and Prison Birth Project weeks earlier, knew that the law prohibited postpartum restraints. So did Gamble, who had received a packet in jail outlining the law and her rights from Prisoners’ Legal Services. When an officer approached her bed with a leg iron and chain, she told him that, by law, she should not be restrained and asked him to call the jail to confirm. He called, then told her that she was indeed supposed to be shackled. Gamble says she spent the night with her left leg shackled to the bed.

When the female officer working the morning shift arrived, she was outraged. “Why is she shackled to the bed?” Gamble recalled the officer demanding. “Every day in roll call they go over the fact that a pregnant woman is not to be shackled to anything after having a baby.” The officer removed the restraint, allowing Gamble to move around.

According to advocates, it’s not unusual for staff at the same jail to have different understandings of the law. For Gamble, that meant that when the shift changed, so did her ability to move. When the morning shift was over, she says, the next officer once again shackled Gamble’s leg to the bed. “I was so tired, I just went along with it,” Gamble recounted.

Two days after she had given birth, it was time for Gamble to return to the jail. Despite Massachusetts’ prohibition on leg and waist restraints for women postpartum, Gamble says she was fully shackled. That meant handcuffs around her wrists, leg irons around her ankles, a chain around her waist,g and a black box that pulled her handcuffs tightly to the waist chain. That was how she endured the 20-minute drive back to the jail.

Gamble’s jail records do not discuss restraints. According to Petit, who reviewed the records, that’s not unusual. “Because correctional officers don’t see it as out of the ordinary to [shackle], they do not record it,” she explained. “It’s not so much a misapplication of the extraordinary circumstances requirement as failure to apply it at all, whether because they don’t know or they intentionally ignore it.”

While Bristol County Sheriff’s Office Women’s Center’s policies ban shackling during labor, they currently do not prohibit restraints during postpartum recovery in the hospital or on the drive back to the jail. They also do not ban leg and waist restraints during pregnancy. Jonathan Darling, the public information officer for the Bristol County Sheriff’s Office, told Rewire that the jail is currently reviewing and updating policies to reflect the 2014 law. Meanwhile, administrators provide updates and new information about policy and law changes at its daily roll call. For staff not present during roll call, the jail makes these updates, including hospital details, available on its east post. (Roll call announcements are not available to the public.)

“Part of the problem is the difference in interpretation between us and the jurisdictions, particularly in postpartum coverage,” explained Petit to Rewire. Massachusetts has 14 county jails, but only four (and the state prison at Framingham) hold women awaiting trial. As Breaking Promises noted: “Whether or not counties incarcerate women in their jails, every county sheriff is, at minimum, responsible for driving women who were arrested in their county to court and medical appointments. Because of this responsibility, they are all required to have a written policy that spells out how employees should comply with the 2014 law’s restrictions on the use of restraints.”

Four jurisdictions, including the state Department of Correction, have policies that expressly prohibit leg and waist restraints during the postpartum period, but limit that postpartum period to the time before a woman is taken from the hospital back to the jail or prison, rather than the medical standard of six weeks following birth. Jails in 11 other counties, however, have written policies that violate the prohibition on leg and waist shackles during pregnancy, and the postpartum prohibition on restraints when being driven back to the jail or prison.

Even institutions with policies that correctly reflected the law in this regard sometimes failed to follow them: Advocates found that in some counties, women reported being restrained to the bed after giving birth in conflict with the jail’s own policies.

“When the nurse left, the officer stood up and said that since I was not confirmed to be in ‘active labor,’ she would need to restrain me and that she was sorry, but those were the rules,” one woman reported, even though the law prohibits restraining women in any stage of labor.

But shackling pregnant women during and after labor is only one part of the law that falls short. The law requires that pregnant women be provided with regular prenatal and postpartum medical care, including periodic monitoring and evaluation; a diet with the nutrients necessary to maintain a healthy pregnancy; written information about prenatal nutrition; appropriate clothing; and a postpartum screening for depression. Long waits before transporting women in labor to the hospital are another recurring complaint. So are routinely being given meals without fruits and vegetables, not receiving a postpartum obstetrician visit, and waiting long stretches for postpartum care.

That was also the case with Gamble. It was the middle of the night one week after her son’s birth when Gamble felt as if a rock was coming through her brain. That was all she remembered. One hour later, she woke to find herself back at the hospital, this time in the Critical Care Unit, where staff told her she had suffered a seizure. She later learned that her cellmate, a certified nursing assistant, immediately got help when Gamble’s seizure began. (The cell doors at the jail are not locked.)

Hospital staff told her that she had preeclampsia, a pregnancy complication characterized by high blood pressure. Postpartum preeclampsia is rare, but can occur when a woman has high blood pressure and excess protein in her urine soon after childbirth. She was prescribed medications for preeclampsia; she never had another seizure, but continued to suffer multiple headaches each day.

Dr. Carolyn Sufrin is an assistant professor of gynecology and obstetrics at Johns Hopkins Medicine. She has also provided pregnancy-related care for women at the San Francisco County Jail. “Preeclampsia is a leading cause of maternal mortality,” she told Rewire. Delayed preeclampsia, or postpartum preeclampsia, which develops within one to two weeks after labor and delivery, is a very rare condition. The patient suffering seizures as a result of the postpartum preeclampsia is even more rare.

Postpartum preeclampsia not only needs to be treated immediately, Sufrin said, but follow-up care within a week at most is urgent. If no follow-up is provided, the patient risks having uncontrolled high blood pressure, stroke, and heart failure. Another risk, though much rarer, is the development of abnormal kidney functions.

While Sufrin has never had to treat postpartum preeclampsia in a jail setting, she stated that “the protocol if someone needs obstetrical follow-up, is to give them that follow-up. Follow through. Have continuity with the hospital. Follow their instructions.”

But that didn’t happen for Gamble, who was scheduled for a two-week follow-up visit. She says she was not brought to that appointment. It was only two months later that she finally saw a doctor, shortly before she was paroled.

As they gathered stories like Gamble’s and information for their report, advocates with the Prison Birth Project and Prisoners’ Legal Services of Massachusetts met with Rep. Kay Khan (D-Newton), to bring her attention to the lack of compliance by both county jails and the state prison system. In June 2015, Khan introduced An Act to Ensure Compliance With the Anti-Shackling Law for Pregnant Incarcerated Women (Bill H 3679) to address the concerns raised by both organizations.

The act defines the postpartum period in which a woman cannot be restrained as six weeks. It also requires annual staff trainings about the law and that, if restraints are used, that the jail or prison administration report it to the Secretary of Public Safety and Security within 48 hours. To monitor compliance, the act also includes the requirement that an annual report about all use of restraints be made to the legislature; the report will be public record. Like other statutes and bills across the country, the act does not have specific penalties for noncompliance.

In December 2015, Gamble’s son was 9 months old and Gamble had been out of jail for several months. Nonetheless, both Gamble and her mother drove to Boston to testify at a Public Safety Committee hearing, urging them to pass the bill. “I am angered, appalled, and saddened that they shackled her,” Gamble’s mother told legislators. “What my daughter faced is cruel and unusual punishment. It endangered my daughter’s life, as well as her baby.”

Since then, both the Public Safety Committee and Health Care Financing Committee approved the bill. It is now before the House Committee for Bills in the Third Reading, which means it is now at the stage where it can be taken up by the House for a vote.

Though she has left the jail behind, Gamble wants to ensure that the law is followed. “Because of the pain I went through, I don’t ever want anyone to go through what I did,” she explained to Rewire. “Even though you’re in jail and you’re being punished, you still have rights. You’re a human being.”

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.”