Update: This article has been updated to include additional information about the unsafe procedure performed by Kermit Gosnell that is referenced below.

On a recent Saturday morning, a middle-aged man kneels in the street in front of Planned Parenthood’s Locust Street Health Center in downtown Philadelphia. He’s one of a crowd of approximately 55 people huddled into two haphazard lines stretching approximately 15 feet from the entrance to the corner of 12th Street.

It’s just after 8 a.m.; patients are about to arrive. A young woman with her back pressed against the brick building leads a series of call-and-response prayers. Clinic escorts donning bright vests stand together silently. A civil affairs police officer looks on from across the street.

A couple approaches. They’re walking east, so they’re forced to pass through the gauntlet of protesters to get to the front door. The woman doesn’t stop walking or look at them. She strides forward, quickly. Her male companion doesn’t stop either, but he turns to glance, then glare at the crowd.

The couple continues toward an open iron gate, where they make a sharp right turn away from the crowd and toward the entrance. The way this facility is designed, a sidewalk gate leads to a garden patio area that serves as a foyer leading to the main door. When the couple walks into the building, the first person they will see is a security guard, a gray-haired man sitting in front of an appointment booklet, behind a sheet of bullet-proof glass.

Another woman enters the gauntlet. When she’s about ten feet from the gate, a protester steps out of the prayer line. She moves toward the woman, then walks alongside her.

The protester, Kyleen Finnegan, 29, is a volunteer with Generation Life, a local group that strives to “end abortion” by promoting chastity. Finnegan doesn’t know why the woman she’s talking to is going to the clinic—it could be for could be contraception, a routine appointment, or an abortion. But everyone is treated as if they are going to have an abortion.

Finnegan, visibly and happily pregnant, tells the woman that she can help her, and that everyone there loves her. She’s holding pamphlets that she offers women entering the clinic. On the inside flap, the paper is full of bullet points beneath the headings “Abortion can hurt you.” The problems range from the obvious, like cramping, to the outright erroneous, like “later infant disability.”

The information in the pamphlet was provided by the National Right to Life Educational Trust Fund.

Finnegan tells me later that she estimates that over the years, she has personally dissuaded approximately ten women from obtaining abortions, or at least from entering the clinic. Today was not one of those days. The woman she approached didn’t stop and didn’t take a pamphlet; she turned into the gate, entered the clinic, and signed in with the man behind the bullet-proof glass.

At a time when the U.S. Supreme Court is debating buffer zone laws that would protect patients visiting a reproductive health clinic from people like Finnegan, what people in the anti-choice movement might not understand is that a person doesn’t have to shoot a doctor or physically assault a patient to cause harm. It’s harmful to hand a women a piece of paper with false medical claims, and it’s harmful to be a presence that causes a woman to seek somewhere more underground.

It’s also not so much about the individual. What relatively peaceful anti-choice protesters also may not understand is that their behavior is relative: They’re a physical representation of threats that have already been made, and in some cases executed, in the past.

A Patchwork of Buffer Zones

In the early 2000s, Pittsburgh police were routinely called to mediate disputes between patients and protesters. In 2005, the Pittsburgh City Council passed a Medical Safety Zone Ordinance, Pennsylvania’s first buffer zone.

It established a 15-foot, fixed no-protest zone around clinic entrances, and a floating, eight-foot “personal bubble” around each person within 100 feet of the clinic.

The following year, a routine clinic protester challenged the ordinance. She claimed it infringed on her right to free speech and freedom of the press, since she was no longer able to try to push pamphlets into the hands of patients on their way into the clinic. She also claimed that the ordinance had been selectively enforced against her (a claim the court eventually dismissed).

In 2009, a judge noted that Pittsburgh had attempted to balance “two important competing interests”: the rights citizens have to obtain medical care unimpeded, and the First Amendment rights of protesters. The court essentially ruled that the buffer zone and bubble, taken together, was invalid, but upheld that the City of Pittsburgh had the right to implement either the fixed buffer zone or the bubble. They chose to keep the buffer zone, and both sides framed the ruling as a win.

In 2012, Harrisburg created a 20-foot buffer zone when protesters reportedly “harassed patients and staff outside the Second Street facility” after the clinic began offering medical abortions, resulting in at least six calls to the police.

Earlier this month, the York City Council proposed a 30-foot buffer zone around York health-care facilities.

But there is no buffer zone in Philadelphia, which is why Finnegan and other anti-choice protesters are able to get so close to women and their companions.

“We end up being the human buffer zone,” said Jane, a clinic escort who volunteers at Locust Street. (She asked that we not publish her last name.)

That may soon change.

State Sen. Larry Farnese (D-Philadelphia), an attorney, recently introduced a bill that would mandate a 15-foot buffer zone around entrances to health-care facilities in the state. SB 1208 is “content-neutral,” meaning it would apply to all health-care facilities, including hospitals and medical offices.

From the bill:

No person may knowingly congregate, patrol, picket or demonstrate in a zone extending 15 feet from any portion of an entrance to or exit from a health care facility or any portion of an entrance to or exit from a driveway or parking facility appurtenant to a health care facility.

The initiative is part of a pro-active package of women’s health bills recently unveiled by the legislature’s newly formed Women’s Health Caucus.

Installing a state-wide buffer zone is an uphill battle, politically speaking, given both the unprecedented number of state-level abortion restrictions across the country since the 2010 elections—and in Pennsylvania since the notorious 2011 Kermit Gosnell grand jury report.

But Sen. Farnese, a former volunteer clinic escort at the Philadelphia Women’s Center, told Rewire that he is determined. He’s motivated, he says, by what he witnessed as an escort before joining the state senate.

“There was literally a couple feet distance between the protesters and the front door … and at times [it was] extremely intimidating,” said Farnese, adding that he recalls protesters “shoving plastic baby things” in patients’ faces.

“Sometimes, [patients] were so upset and distraught that they just turned around [and left],” Farnese told Rewire. “These women are going to go somewhere. They’re going to exercise their right. The question is, are we going to allow them to exercise it safely?”

Farnese’s bill is still in the very early stages of the legislative process, awaiting approval by the Public Health and Welfare Committee.

Scare Tactics

At least one woman injured in Kermit Gosnell’s “house of horrors” clinic in West Philadelphia, where illegal, unsafe abortions took place, went there after feeling she was unable to face a mob of protesters at a clinic downtown.

Davida Johnson was 21 years old and coping with an unwanted pregnancy when she was “frightened away” by protesters at a downtown Philadelphia facility.

“The picketers out there,” Johnson told the Associated Press, “they just scared me half to death.”

According to Johnson, Gosnell slapped her before tying her down to perform an unsafe abortion, a ghastly procedure that left her with a “lifelong illness“:

A few months after the abortion, she began to have gynecological problems. An examination revealed venereal disease. She blames Gosnell, 69, for the lifelong illness, which she declined to identify, and for the four miscarriages she has subsequently suffered.

It’s not just patients who are intimidated by aggressive protesters.

“Buffer zones are important not only to protect women from harassment when they exercise their constitutional rights … [they] also are an important way to protect abortion providers,” David S. Cohen, a law professor at Drexel University, told Rewire.

Cohen is on the board of the Women’s Law Project, an organization that helped develop Farnese’s legislation, and is co-author of a forthcoming book on violence against abortion providers. He recently interviewed providers all over the country.

“[They] are acutely aware that other providers have been murdered at work by protesters who were able to get too close to clinic workers,” said Cohen. “Buffer zones don’t guarantee that providers won’t be harmed, but they undoubtedly help.”

Volunteer escorts say that protesters often try to intimidate them with the same techniques they see them use on patients.

“They’ll target young women, to try and tell us about the love of Jesus, and that it’s not too late for us,” said Jane.

“They’ve definitely been more aggressive toward men,” said Eli, a 31-year-old escort at Locust Street.

Eli says he’s been physically threatened himself, and has witnessed protesters try to bait male companions accompanying women into the clinic with hyper masculine taunts.

“[They say] ‘man up,’ ‘be a man,’ ‘be tough,’ ‘don’t be weak and let your woman do this,’ ‘don’t let this happen to your baby.’”

Jane started out volunteering inside the building. She decided to volunteer outside because of what she heard from patients while recovering from surgery.

“Women would ask me, ‘Are they still going to be out there when I leave?’”

While escorts report a gendered approach to “sidewalk counseling” strategies, the big-picture anti-choice protest strategy is gendered also: It may be women who do most of the suing, but it’s been mostly men who have done the shooting.

(Anecdotally, that strategy is reflected also in the introduction and sponsorship of anti-choice bills. Though women only make up approximately 17 percent of the Pennsylvania legislature, they’ve disproportionately introduced recent anti-choice legislation.)

Two Important, Competing Interests

Pennsylvania has always been ground zero in the abortion wars. Just one year after the Supreme Court ruled states could not outlaw abortion altogether, lawmakers in the state introduced measures to limit access to abortion. Early on, they even tried to mandate that a woman notify the man who impregnated her before having an abortion.

An intense 20-year back-and-forth over the legality of various incarnations of the Abortion Control Act resulted in Planned Parenthood v. Casey, the landmark ruling enabled states to pass laws restricting abortion as long as it did not present an “undue burden.” The ruling galvanized anti-choice lobbyists’ shift from focusing on overturning Roe v. Wade to the incremental, access-oriented strategy currently playing out in state legislatures around the country.

According to the Gosnell grand jury, it was the pressure of this hyper-political climate and fear of chiseling away women’s access to abortion that informed the woefully misguided decision made by “high-level government officials” in Gov. Tom Ridge’s administration to not inspect abortion clinics—which led, of course, to Kermit Gosnell.

Supporters and critics of Pennsylvania’s buffer zone bill are now watching the Supreme Court, which recently heard arguments in McCullen v. Coakley, a case examining the constitutionality of a 35-foot buffer zone in Massachusetts.

Rewire Senior Legal Analyst Jessica Pieklo has noted that buffer zones may be a “tough sell” to the high court, given Chief Justice John Roberts’ history of anti-choice activism—he advised President Reagan on anti-choice messaging—and the current composition of the Court.

Meanwhile, a well-documented history of 20 years of anti-choice violence—including eight murders—seems to have been virtually forgotten by the press covering the Supreme Court case. A recent article in the New York Times ignored this history while taking pains to note that the complainant, Eleanor McCullen, is “plump” and petite, and a kindly grandmother. “She is 77, and she said she posed no threat,” reported the Times.

Pro-choice advocates have criticized this overly sympathetic portrait of anti-choice protesters, pushing back that not all protesters are “plump grandmas.”

Certainly, Pennsylvania has experienced anti-choice activism far more threatening than a “plump grandma.”

In 2007, a long-time Pennsylvania anti-choice protester named John Dunkle earned a Freedom of Access to Clinic Entrances (FACE) Act violation. Signed into law in 1994, the FACE Act “makes it a federal crime to injure, intimidate, or interfere with those seeking to obtain or provide reproductive health care services,” though its enforcement is very questionable.

Dunkle “protested” on the Internet and, clinic administrators say, outside clinics as well. His violation was for posting the photograph and address of a local doctor online, as well as “literature suggesting that, ‘while it does not sound good to say go shoot her between the eyes, it sounds even worse to say let her alone.’”

The doctor was so frightened that she appeared in court in a disguise, as the anti-choice activist explained to the judge that his actions were just “part of a debate about how aggressive antiabortion activists should be in pursuing their cause.”

The doctor quit her job. Dunkle had to delete the Internet posts.

Jennifer Boulanger is the former director of Allentown Women’s Center and current director of communications for the Women’s Centers; she has written publicly about threats on her life stemming from her work in reproductive health. According to Boulanger, Dunkle didn’t stop showing up at clinics after those incidents. He continued to harass women outside the clinics, “despite a permanent injunction barring him from making death threats or otherwise intimidating clinic patients and staff.”

He also continues to maintain a blog, where he posts the names and prison addresses of people convicted of murdering doctors under the heading “prisoners for Christ” along with a call to arms:

I believe we should examine every legitimate means, including force, in our attempt to protect children from being tortured to death.

Several years ago, protests outside Allentown Women’s Center got so serious that clinic escorts bought blue plastic tarps, and started holding them up as a physical shield to enable patients to enter the clinic without being touched and jostled by protesters. In response, the protesters filed a lawsuit alleging that the clinic conspired with the City of Allentown and the Allentown Police Department to deprive them of their First Amendment rights.

A judge dismissed the case in 2011. The next year, Allentown Women’s Center moved to another facility six miles away, in part to try to shake protesters.

After the Allentown clinic moved to its new location, Dunkle was spotted in the parking lot, in a truck with gas cans in the back, according to Boulanger.

Finding Peace

Back on Locust Street, 20-year-old Collin Sceski stands quietly. Sceski, president of Villanovans for Life at Villanova University, says he doesn’t want to talk to patients. He doesn’t consider himself what the clinic protest movement calls a “sidewalk counselor”; he just wants to be a “peaceful presence.”

He drove into the city from the suburbs to stand outside Locust Street with a group of ten or so college friends, but doesn’t want to try to speak to patients at all.

Asked about buffer zones, Sceski said he thinks effective communication can happen 15 feet away. But he told Rewire, “that might not be the point.”

“It’s whether it’s right for them to say we have to be 15 feet away. If I believe that personally I’m better at communicating three feet away, I should have the right to stand three feet away,” he said.

“If there might be a crazy ‘pro-lifer’ who in the moment gets very upset, of course it’s OK to have things there to keep people safe,” he said. “But in a way, we already have laws against battery … we have laws against those things already.”

It’s true, there are laws against those actions, and, in the FACE Act, a law specifically targeting violence and intimidation toward patients seeking reproductive health-care services. The FACE Act is 20 years old this year. And yet, according to a 2010 report on clinic violence, “over the last 35 years, nearly 14 percent of counties with abortion providers have experienced some form of extreme violence defined as an arson attack, bombing, bomb threat, hoax device, murder, attempted murder, butyric acid attack, or vandalism.”

So, while laws provide a protocol for punishment, they seem to be doing a poor job preventing clinic violence. Meanwhile, the intentions and behavior of anti-choice protesters continue to be calibrated on a relative scale: On one end are the “plump grandmas,” like the woman challenging Massachusetts’ buffer zone in the Supreme Court. And on the other end are murderers.

Correction: A version of this article made reference to a Pennsylvania bill that would have required women to notify their father before having an abortion. In fact, the bill would have mandated that a woman notify the man who impregnated her. We regret the error.