Last month, Jackson Women’s Health Organization in Mississippi—also known as “Pink House,” the last abortion clinic in the state—was vandalized overnight in an attempt to cut the building’s power lines. In Kalispell, Montana last summer, All Families Healthcare suffered vandalism so severe that it was forced to close.

These facilities aren’t alone. According to the Feminist Majority Foundation’s (FMF) latest National Clinic Access Project Survey, released early this year, nearly 68 percent of reproductive health clinics nationwide experience frequent and regular anti-abortion activity and only 45 percent rated local law enforcement “good” or “excellent” in their response to the harassment.

A new book by lawyer-authors David S. Cohen and Krysten Connon, Living in the Crosshairs: The Untold Stories of Anti-Abortion Terrorism, gives these statistics a human face often missing in media coverage as it details the real, day-to-day experiences of abortion providers in this country. In addition to bringing to light stories of harassment, Crosshairs also calls for reforms in the legal system, making it an absolute must-read for anyone in media and/or reproductive rights advocacy.

Cohen and Connon’s first order of business in their introduction to Crosshairs—which precedes interview-based individual stories that refer to the subjects using pseudonyms; a broader look at the tactics harassers use; examples of legal responses; and potential ways to improve the current state of safety for clinic workers—is to expand the term “provider” beyond just the doctors who perform the procedures. Their national interview-driven research encompassed all those whose efforts provide patients with “a safe, caring, and medically-skilled environment in which to have an abortion.” This broader definition includes referring physicians, nurses, physician’s assistants, administrative staff, counselors, clinic owners, security guards, and volunteer escorts.

Members of every group have experienced harassment; since 1993, Cohen and Connon note, eight have been murdered. Although the names Dr. George Tiller, Dr. Barnett Slepian, Dr. David Gunn, and Dr. John Britton may be better known than those of security guard Robert Sanderson, receptionists Shannon Lowney and Lee Ann Nichols, and clinic escort James Barrett, each was targeted and killed because of their service to patients accessing abortion care.

In fact, all those involved in full-spectrum reproductive health services are vulnerable to abuse such as assaults; threats in person and by mail; targeting of private practices and other places of employment; bombings; home picketing; stalking of providers’ young children; kidnappings; Internet attacks; and intimidation of extended family and neighbors. Some people participating in harassment are individuals who have personal motivations; others are backed and organized by long-standing anti-abortion groups such as Operation Rescue and the Pro-Life Action League. Still others are from splinter groups like Abolish Human Abortion, who feel the “pro-life” movement has not been militant enough.

These widespread activities have consequences that extend beyond individual safety. Cohen and Connon note that the number of medical facilities performing abortions is down 40 percent since 1982. Although the reasons for this downturn are themselves diverse, and include legislative restrictions, the authors note that harassment likely plays a role. With abortion providers in only 11 percent of U.S. counties, it is long past time that we instituted safeguards for those who do the work of full-spectrum reproductive health care, lest we see access erode further.

Yet this pervasive culture of abuse is rarely covered in the media, as Cohen and Connon point out, with mainstream outlets typically only reporting on anti-abortion activity when someone dies. To make matters worse, our Supreme Court has declared one form of targeting to be “free speech.” The repressive climate of harassment has been going on so long that even providers are at times numb to the conditions under which they work, accepting it as part of the job. For example, the first person quoted in Crosshairs, Rachel Friedman, says she often doesn’t recognize how out-of-the-ordinary her professional life has become:

I often say that as an abortion provider, you lose your sense of perspective. You think everybody has the FBI on speed dial on their phone. Doesn’t everybody have it on their phone? You forget that it really is a very unique set of circumstances that you work under.

Perhaps because the stories we do hear on the subject tend to focus on doctors, the anecdotes detailing the treatment of their friends, family, and neighbors stand out in the book as especially horrifying. In one section, Rodney Smith, an abortion doctor for almost three decades, recounts the aftermath of Dr. George Tiller’s murder. United States marshals had arrived to protect him within an hour of the shooting. Then, in the middle of the night, someone called his adult daughter and said, “Your mother and father were both just killed.” (In reality, both were unharmed.)

Volunteer targeting is also routine, yet largely unreported on. Kristina Romero, regional director for a clinic group, tells the story of one of her long-time volunteers:

She was in her 80s, it was her birthday, and the protesters cut the heads off of a bunch of roses and put them on the fence around her home with a card that said, “Hopefully you’ll have another birthday and here’s your dead roses.”

Along with incessant harassment, providers have also grown accustomed to the inconsistent response of law enforcement. The story of medical director Inez Navarro details the best and the worst of those charged with protecting and serving.

Clinic picketers, note Cohen and Connon, often use personal information—including someone’s hometown or their children’s names—in taunts outside the clinic, which they acquire by following, Googling, or looking up the license plates of staff and volunteers. Out of the blue, Navarro noticed the picketers at her clinic shouting her name. A few weeks later, she started hearing “No one is going to protect you” from one of the louder regulars. She notified the police.

“If anything did happen, I wanted them to know there was a history, it wasn’t just a one-time random incident,” Navarro explains. The police laughed, she says; her complaint was never taken seriously. She was “irritated and pissed and emotional all at the same time.” Like many people reporting harassment for the first time, she assumed she would at least be heard.

“Maybe I had a naive faith that the police were there to protect me,” Navarro tells Cohen and Connon. “I can tell you right now, I no longer trust that this police force is here to help. That was kind of my eye-opening experience with them.”

After a man followed her home and chased her into her gated neighborhood complex, she was again told the police were “unable to pursue anything.” She and her husband decided to move to another jurisdiction, where they contacted that police department ahead of time. The response couldn’t have been more different. The proactive police chief gave Navarro his cell phone number; offered to help with anything they needed; identified their house for special emergency assistance so that 911 calls would be flagged; sent a detective to perform a security assessment; and marked both their license plates for notification should anyone search for their information.

According to research done by the authors, anti-choice harassers rely on these kinds of inconsistencies in policing—along with the silence created by stigma—to push boundaries and instill fear. FMF research backs up the interviews in Crosshairs: Its 2010 clinic survey reported that “[c]linics which rated their experience with law enforcement as ‘poor’ were twice as likely to experience high levels of violence in 2010 as clinics rating their experience as ‘good’ or ‘excellent.’”

Of the ten reforms Cohen and Connon offer to better protect providers, improving communication between health clinics and law enforcement is one that anyone can advocate for in their community. Police should also implement programs to educate their officers on the history of anti-choice violence so that they can understand what would reasonably create fear. Cohen and Connon also call to increase penalties under the FACE Act; prohibit home picketing; protect providers’ identities in government databases; and strengthen anti-stalking laws.

The authors don’t propose their suggestions are the only available avenues for improving provider safety, nor do they claim that individualized harassment could be entirely eliminated without stigma-ending culture change. In fact, the recognition of this latter need is part of the impetus behind their final recommendation for federal law enforcement: labeling provider harassment as terrorism.

Anti-abortion targeting already fits the FBI’s shorthand definition of “domestic terrorism,” which reads: “Americans attacking Americans based on U.S.-based extremist ideologies.” Many providers, too, emphatically use the word “terrorized” to describe the climate created by constant harassment as well as their collective memory of arson and assassinations.

Officially and overtly labeling individual and coordinated attacks against providers as terrorism would allow greater coordination among jurisdictions and levels of law enforcement, Cohen and Connon note. Cases would be treated in a uniform fashion across the country and policymakers would be able to track related activity and develop protective policies. Law enforcement officials would more consistently access the history and tactics of the “pro-life” movement—context that is invaluable to investigating and prosecuting threats.

Beyond the legal implications, Crosshairs points out that a terrorism label could bolster public sympathy concerning the trials providers face. Cohen and Connon write:

By shifting terminology to include targeted harassment within the concept of terrorism, society will further brand these actions as unacceptable, possibly reducing the amount providers face through a shift in societal norms.

Overall, after dozens of alarming accounts, many readers will likely approach the conclusion of Living in the Crosshairs wondering why anyone would continue doing this work under such conditions. Dr. Warren Hern speaks to this at the beginning of the final chapter without hesitation:

I love my work. I could have been a dermatologist and nobody would care. I didn’t choose this because I wanted controversy. I thought this was the right thing to do. I felt that doing abortions was the most important thing I could do in medicine … And if somebody asks, ‘Why do you do this?’ Well, it matters. It matters for the health of the woman. It matters for the health of her family. It matters for the health of our society, and now it matters for freedom.

Hern’s sentiments echo many other providers’ throughout the text, which they often offer to their interviewers unprompted. Those individuals cite varying reasons for why they’ve stayed in the field, including commitment to patients and health care, commitment to reproductive choice, a refusal to “let the terrorists win,” and the memory of pre-Roe v. Wade suffering.

All those providers featured in Crosshairs will leave readers inspired and motivated to make their vital work safe and free from attack. It is nearly impossible to finish Living in the Crosshairs: The Untold Story of Anti-Abortion Terrorism without a renewed desire to help protect people like Marsha Banks, who responded to decades of attacks, arson, and protest in her professional life this way: “It’s what I was born to do really, to be a human rights advocate. It’s human rights. How could anybody tell anybody what to do with their body? It’s as simple as that.”