Derenda Hancock has been a clinic escort at Mississippi’s only abortion clinic, Jackson Women’s Health Organization, since 2013. She has watched countless times as anti-abortion protesters place ladders against the fence in front of the bubblegum pink building and ascend while carrying poles with bullhorns attached for maximum sound projection. They bring full-sized speakers and microphones and graphic signs; they even copied the escorts’ vests to confuse patients.

“It’s heartbreaking,” said Hancock, a co-founder of the Pinkhouse Defenders clinic escort and defense group. “You’ll have a patient, a young woman look at you, sometimes in tears, and say, ‘Can’t you do anything about this?’”

The city of Jackson did say it would do something about the harassment: The city council passed a “buffer zone” ordinance in October 2019 that prohibited protesters within 15 feet of the entrance to a health-care facility and banned amplified sound within 100 feet of a health facility’s property line. Violators could face a $1,000 fine, 90 days in jail, or both.

But enforcement was nonexistent, said Kim Gibson, who also volunteers with the Pinkhouse Defenders. And following lawsuits, the council unanimously voted to repeal it on November 16.

Gibson recalls that when they were trying to get Jackson police to enforce the rule, an officer said something apt. “He told us that we’re an island on our own. We’ve been that for a hell of a long time as far as access goes,” she said, referring to the fact that Jackson Women’s Health Organization has been the state’s only abortion clinic since 2004. “But with everything here, this clinic is just an island on its own. It’s just a daily battle.”

Mississippi has the earliest abortion ban in effect in the country, barring abortions beyond 20 weeks’ gestation—meaning 20 weeks after the pregnant person’s last menstrual period, or 18 weeks after the date of conception. But it’s a de facto 16-week ban as Jackson Women’s Health Organization only provides abortion through 16 weeks’ gestation because of various state restrictions, including a ban on dilation and evacuation (D&E) procedures, according to the Center for Reproductive Rights, which represents the clinic in legal challenges. (Representatives for the clinic declined to be interviewed for this story.) Mississippi is also the only state in the country to require that abortion providers be board certified OB-GYNs; all of the clinic’s providers travel from out of state to provide care.

State lawmakers have tried to ban abortion even earlier in pregnancy, and the state is petitioning the Supreme Court to take up a case involving a 15-week ban passed in 2018 and a six-week ban from 2019. The case, Jackson Women’s Health Organization v. Dobbs, has been on the Court’s conference schedule nine times and rescheduled each time. It’s once again on the schedule for Friday. The case is a direct threat to Roe v. Wade and Planned Parenthood v. Casey, which together hold that states can’t prohibit abortion before fetal viability; a ruling could reverse or substantially weaken abortion jurisprudence.

While Joe Biden and Kamala Harris defeated the virulently anti-abortion incumbent Donald Trump in the presidential election, advocates in Mississippi are preparing for even more court battles, state legislative attacks, and emboldened protesters in 2021.

“I predict a lot of anti-choice legislation. I expect a lot of backlash,” said Laurie Bertram Roberts, the outgoing executive director of the Mississippi Reproductive Freedom Fund and executive director of Alabama’s Yellowhammer Fund. Since its founding in 2013, MRFF has helped people who need to travel out of state for abortion care, either because they’re over the 16-week limit or because they’re closer to a clinic in another state—perhaps one that doesn’t require two visits like Mississippi does.

Gibson said she is “dreading” the start of the next legislative session. “Today is 15 [weeks], tomorrow is six, the day after that it’s gone. … We always have a sword hanging over us.”

Oriaku Njoku, co-founder and executive director of ARC Southeast, a reproductive justice organization based in Atlanta that provides people in six states, including Mississippi, with financial and practical support, said she’s concerned about the repeal of Jackson’s buffer zone—not because it was ever enforced, but because of the message it sends.

“The antis were already wild to begin with—this just gives them some added validation that their hate is OK,” she said. “That’s really unfortunate.”

The buffer zone ordinance faced two legal challenges on free speech grounds: one filed in state court on behalf of Sidewalk Advocates for Life, and another filed in federal court by anti-abortion pastor Philip “Flip” Benham, the former director of Operation Save America.

Benham, who lives in North Carolina, argued that while he had not actually visited the clinic to protest between the time the buffer zone was instituted and when he filed the suit, he had planned to in 2020. The ordinance, he wrote, “prevents him from conveying his views to his desired audience in a number of overlapping ways, effectively censoring his pro-life message.”

The same day the city council repealed the ordinance, the city filed a motion in federal court to dismiss Benham’s suit. Benham argued in legal filings that the repeal doesn’t make his lawsuit moot and he wants the case to proceed. (Buffer zones appear to be a current target of anti-abortion activists: The group Alliance Defending Freedom is asking the Supreme Court to hear a case about a 2005 Pittsburgh ordinance.)

No matter what happens in the courts or the statehouse, the clinic defenders and abortion funds are gearing up to preserve access.

In the short term, the Pinkhouse Defenders are looking for more volunteers. The COVID-19 pandemic has kept some of their regulars away, and other supporters can’t make it on weekdays because of their work schedules.

MRFF will continue distributing free condoms and emergency contraception, funding abortions, and helping people travel out of state when necessary. The group also distributes masks and diapers and has a free pantry at its “Fund Shack” in Jackson, and Roberts said that, with enough funding, she’d like to add a community fridge.

Njoku says ARC Southeast is looking to build its practical support volunteer network all over the state, not just in Jackson—a goal that could be made easier with the advent of virtual trainings; they held their first virtual session in November. ARC Southeast will also be cultivating new and existing donors and explaining what’s happening in Mississippi and across the South and how they’re trying to help.

The group is also looking to hire two staff members in Mississippi in early 2021: a healthline coordinator and a programs coordinator to help with abortion funding and also “to combat some of the ridiculous legislation that gets introduced every year.”

If the worst-case scenario happens and access is halted in the state, Roberts says MRFF has a plan that’s confidential. But she knows that as access to abortion care dwindles, more people might seek to self-manage their abortions with pills.

“Part of our plan is making sure that people know how to use things like misoprostol safely if they make that choice,” Roberts said. “We know people are already doing it and we want to make sure that people know, for harm-reduction reasons, how to use it safely.” At the same time, she said, “I am deeply concerned about people being prosecuted and/or jailed for self-managed abortion.”

Njoku said ARC Southeast will be ready to mobilize its supporters to help (even more) people travel out of state if that’s necessary.

“If services would be paused for some particular reason, then that’s going to mean calling on this community of abortion funds, calling on this community of volunteers and activists to really show up for folks to make sure that they still get the care that they need,” Njoku said.

“Whatever types of opposition may come through, we are so in love with the South, and the people and the work that we’re going to keep doing whatever we can to show up for our people. Buffer zone or not, I believe that we’ll just keep doing what we can to make sure that people are treated with dignity and respect, no matter what.”

Roberts noted that one state’s access doesn’t live in a vacuum, so Mississippi advocates will be watching what their neighbors do.

“Abortion access for Mississippians doesn’t just hinge on Mississippi, it hinges on Alabama, Tennessee, Arkansas, Louisiana, Florida, Georgia, and Texas,” she said. “Every time they make a ban or close down clinics in one state, capacity has to adjust in another state, and it impacts patients in that state.”

Gibson highlighted the end game of this state interplay and relayed a warning: “There are other states like us with one clinic, and it’s slowly fanning its way out to other states. You see Ohio now having these difficulties, and one day, if things don’t change, they’re going to look like us, and other states are going to join us here. Once we don’t have a clinic and then those other places don’t have a clinic, well, then they’re going to go to those states that do have clinics.

“As we go, so do you.”

Hancock and Gibson have also founded We Engage, a group dedicated to ending abortion stigma and eventually eliminating the need for clinic escorts altogether.

“These people should not be stigmatized to the point where people are out there yelling at them on a bullhorn on a ladder,” Gibson said. “We shouldn’t exist.”