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As access to abortion is eroded across the country by restrictive laws and an increasingly emboldened anti-abortion movement, abortion activists, patients, and providers are themselves engaged in a debate over how to deal with the crisis. Earlier this week, a coalition of socialists and grassroots organizers called for a day of counter-protest in response “40 Days for Life,” an annual anti-abortion campaign in which protesters station themselves outside of clinics around the country for 40 days. Such an action, Anne Rumsberger of NYC for Abortion Rights and Michelle Farber of Seattle Clinic Defense writes in the Socialist Worker, would be the first step in what they call a “militant, unapologetic reproductive justice movement.”

In response to Rumsberger and Farber’s call to action, some providers and advocates have argued that increasing the number of protesters at clinics—whether for or against abortion—will only amplify the chaos. The disagreement reflects similar rifts about strategy and tactics among activist groups and broad movements, though here the split is deeply connected to the question of patient safety and health.

The scope of the crisis is clear: in the past decade, lawmakers have passed more than 400 laws restricting access to abortion, creating abortion deserts in seven states that have just one remaining clinic and 27 major cities where residents have to drive more than 100 miles to reach a clinic. Most of these clinics deal with anti-abortion harassment, which has increased in recent years, and has even caused some clinics to shut down. In February, the Trump administration finalized a “gag rule” that will put millions of low-income patients, and their providers, at risk, by cutting funding for family planning centers that refer or inform patients about abortion.

In response, Farber is calling for a clinic defense movement similar to counter-protests in the late 198s0 and 1990s. “Our main goal is to keep the anti-choicers from being able to harass patients and providers,” Farber, a midwife who used to counsel patients at abortion clinics, told Jezebel.

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But some clinics say that counter-protests actually hurt their goal of furthering abortion access, adding stress to an already stressful situation for patients. In 1990, in one particularly large protest in Los Angeles against anti-abortion group Operation Rescue, 240 people were arrested at a clinic during what the Los Angeles Times described as “a violence-marred, seven-hour siege” as anti-abortion protesters scaled fences and an overwhelming police presence added to tensions.

But even if protest doesn’t rise to that level of confrontation, clinic defense remains a contested tactic among some providers. When Seattle Defense Clinic showed up at a Planned Parenthood clinic in Everett, Washington last January, the organization issued a statement asking supporters to “avoid giving voice to the opposition by holding counter-protests at our health centers.”

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Calla Hales, clinic director at North Carolina-based A Preferred Women’s Health Center, shares this view. Hales estimates that 350 people protest the Charlotte clinic every week. “Putting more bodies on a sidewalk with signs doesn’t actually help,” she told Jezebel.

“I think it’s really important to know that if you’re not working with the clinic, you’re actually making it worse for the clinic,” Hales said. “When a patient is coming—hell, even when I’m coming in sometimes, I can’t tell the difference of who is a protester and who is supposed to be helping.”

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In the chaos of entering the clinic, “your mind’s not really looking at what the signs are saying, you’re just seeing people standing outside the clinic with signs,” she said. (Farber told Jezebel she trusts patients will know the difference: “They can read, and they can see that there are clearly people there supporting them and they know that when they see us.”)

Well-intentioned as the action may be, Hale contends, “it’s nerve-wracking to have to maneuver through that,” adding: “Abortion clinics are not supposed to be circuses. They’re not events.”

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But Rumsberger and Farber cite several protests, including a 2017 incident at A Preferred Women’s Health Center in North Carolina in which 4,000 anti-abortion protesters showed up, as evidence that a powerful counter-protest response is necessary.

Farber conceded that a national day of action would mean de-centralized action, inviting anyone to participate as a clinic defender regardless of previous experience working with patients or training around clinic defense. But she added, “I think anyone who is organizing this is doing so very seriously and is generally led by committed, long-term activists.”

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As a former nurse practitioner at Planned Parenthood’s Seattle clinic, Farber says she noticed a stark contrast with patients on days when clinic defenders appeared. “It just made such a deep impact on me and really made me feel like it’s so important that patients and providers can see that people are standing with them, that they’re not alone, and also that there are people that are physically there to block the anti-choicer signs, to keep them from yelling and harassing, and that are pushing them away from the entrances so that people can access healthcare,” she said.

“We all want the same thing, but folks that are doing clinic defense are doing it because we’ve ignored the antis—who are banging on our doors, harassing us, and taking pictures of my license plate, and following me home on my bike—for too long,” Farber said. “They are counting on the fact that clinics tell people not to show up, and they feel so emboldened by that, and we just can’t ignore them anymore.”

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Hales shares this sense of urgency, but would instead ask counter-protesters to “take their protests elsewhere” and camp outside of crisis pregnancy centers, deceptive anti-abortion clinics often set up near abortion providers to steer patients away. “We’re definitely not trying to keep people from speaking out about clinic violence and clinic harassment,” Hales said, “but we just want them to keep in mind that being in front of a clinic causes an issue to patients.”

Anti-abortion extremists have already turned clinics into political battlegrounds. The question faced by abortion activists, patients, and providers is: How do you get them back?