I remember what I was doing when I learned that Dr. George Tiller had been murdered six years ago. It was the weekend of my college graduation and I was about to spend six weeks in my hometown of Sydney, Australia before moving to New York City. But Tiller's death—he'd been shot in the head, point blank, by an anti-abortion extremist in his Kansas church on a Sunday morning—gave me pause. What was I getting myself into? Could I stay in a country that murders its doctors? In Australia, abortion is rarely controversial, and while our laws are not as liberal as I’d like, abortion providers don’t live in fear. Gun laws are tight, so that even the people who wanted to shoot abortion doctors would have a hard time doing it.

When Tiller was killed, in 2009, a rush of anti-abortion legislation was just beginning.  And violence against abortion providers, those few who remain, was and remains a daily reality no matter where they live. A continual threat, part of the buzzing background noise that is American violence. 

Six years later nearly to the day, I’m still here in the U.S., and though no abortion provider has been murdered since 2009, harassment of these doctors continues. And not just the doctors; anti-choice extremists will target almost anyone who is associated with the provision of abortion: nurses, receptionists, the men and women who run clinic networks, clinic escorts, clinic security guards, landlords, and the neighbors and families of all those people. In their new book Living in the Crosshairs: The Untold Stories of Anti-Abortion Terrorism, David S. Cohen and Krysten Connon describe the scope and severity of attacks on abortion providers; they interviewed 87 of them about their experiences of anti-abortion violence, one of the largest studies of this group ever undertaken. Between early 2011 and mid-2014 Cohen and Connon interviewed people who work at all stages of abortion provision, from clinic volunteers to the doctors who perform terminations. Some were newcomers to the field, some had been providing abortions for decades.Cohen, a former abortion rights lawyer, is now a law professor, and Connon is an attorney in private practice in Philadelphia.

The harassment takes a breathtaking range of forms, and has serious effects on the providers’ lives, personal and professional. These people, in order to provide a medical procedure that is entirely legal, endure treatment that most of us would never imagine tolerating in the name of our jobs. “In almost every interview, a different type of targeted anti-abortion harassment emerged,” Cohen and Connon write, distinguishing between what they call general clinic protest—such as picketing outside a clinic in protest of abortion writ large—and targeted acts focused on individuals, such as death threats, stalking, and harassment of the provider’s family. Cohen and Connon explore the threats, and also the ways that providers respond to them.

The first chapter tells the stories of just seven of the 87, but cumulatively, they have faced “arson, murder, assault, stalking, talking, home picketing, business loss, death threats, community protest, religious and racial attacks, hate mail, and targeted internet postings.” While Tiller’s murder made headlines—and made me wonder if staying in the States was for me—Cohen and Connon spend much of their book describing the harassment that flies largely under the radar of the press and of many pro-choice people, but that has an enormous effect on abortion providers. Since 1993, eight people have been victims of fatal anti-choice violence, four of them abortion doctors—but thousands more have suffered in less dramatic and less talked-about ways.

Many providers reported that their family members—close and distant—had been targeted, too. “My kids would be home from school, and some antis would call them up, and when they answered the phone they were told they were going to be murdered,” one says. Another provider told a story about a frequent clinic protester recognizing her as she visited her mother in a nursing home. The protester followed her into her mother’s room and began shouting at her mother that her daughter was a murderer. One physician in a Midwest state announced that she would begin performing abortions and in response, protesters began picketing her god-brother’s house.

Providers are targeted at home, in their churches, and in their neighborhoods (protesters will place signs and fliers around the neighborhood decrying what the providers do for a living). Their kids are harassed at school. Some doctors and nurses who practice in hospitals as well as in abortion clinics are harassed by their hospital colleagues, their careers endangered by other doctors’ disdain. And, of course, they’re targeted at work. Half of the eight murders of abortion providers since 1993 occurred at work.

And the ways that protesters have come up with to interfere with providers’ work at their clinics is staggering in its length and diversity: “bombings, arson, anthrax scares, and mass blockades,” Cohen and Connon write. “Extremists have also thrown butyric acid into clinics, glued clinic locks shut, locked themselves into clinic property using items such as bicycle locks or chains, drilled holes into clinic roofs so that the clinic floods, invaded clinics, vandalized clinics, made threatening phone calls, tried to persuade patients to go to fake clinics, put spikes in driveways, talked outside clinics about bomb-making chemicals, laid down on sidewalks, jumped on cars, camped out in front of clinics for multiple-day stretches, and sent decoy patients into clinics to disrupt business.”

Between harassment at work and threats at home, church, and even at the supermarket and the airport, the intended message for providers is one they receive loud and clear: “You are not safe anywhere.” Except, perhaps, at conferences for abortion providers, which one provider says he “lives for.” There, he doesn’t have to obfuscate when people ask him about his work; he doesn’t have to worry that he’ll enrage them, or endanger himself. “I am surrounded by people who are like-minded, who know what we do and appreciate what we do for women in general.” Outside of that sanctuary, though, they are not safe anywhere.

Neither are their family members. In the early 80s, a clinic owner in Illinois and his wife were kidnapped and held for eight days; the kidnappers told Dr. Hector Zavalos that he and his wife would be released if he promised not to perform any more abortions. Another abortion provider’s son was kidnapped and held for several hours by anti-abortion activists who told him, according to a friend of the provider, “Your mother does this because she doesn’t know a better way, and if she really believed in abortion, you wouldn’t be here. She would have aborted you. I know you don’t want your mom to kill babies.”

Providers know that they are continually under threat, and they live their lives accordingly. Many of them wear bullet-proof vests on the way to work, though one provider reasoned that if she were to be shot, it would probably be in the head, so her kevlar was all but moot. “I just think that if they’re really going to try and shoot me, I’m going to see a little red light up here on my forehead. They’re going to assume that I have a vest on.”

Some vary the route they take to work so that they cannot be followed and people cannot learn their habits. Rodney Smith, who has spent decades providing abortions in the Midwest, lost his family home and everything in it when it was set alight in the 1990s. He told Cohen and Connen that his daily life is shaped by the precautions he takes: “He does not eat at the same restaurants on a regular basis,” and tries to finish eating within half an hour so that if he is spotted, so that “before somebody else can be there we’re not there.” He uses a pseudonym to make reservations and has “an arrangement with airlines so that he can fly on a different flight from the one he reserved without telling them ahead of time.”

Howard Stephens, a doctor who runs two clinics in East Midwest states, does whatever he can to conceal his appearance from the protesters around his clinic. He always wears a baseball cap and sunglasses while driving to work, whether it’s sunny out or not. “I always drive with one hand on the wheel and one hand over my face to they don’t have a really good chance to see me,” he says. “They do try to take pictures.” In winter, at his second clinic, which is in a more conservative state, he pulls on a hood and puts his scarf around his mouth and nose as he drives in to work. 

“It’s almost a visceral feeling,” Stephens says. “And even though I feel reasonably safe, you just never know. George Tiller was supposed to be safe in his church. You just never know.”

All of which suggests that the words “protest” and “protester” somewhat inadequate. Cohen and Connon, in telling the stories of these dozens of providers and the fear they are made to feel on a daily—hourly, minutely—basis, make a compelling case for talking about targeted anti-abortion harassment not as a harassment or protest, but as terrorism. That’s not a new argument, and in fact, the Department of Homeland Security agrees with them—or did: DHS released a report in 2009 labelling anti-abortion extremist tactics as terrorism, but after a swift and loud backlash, they backtracked. A few weeks later, George Tiller was shot. The FBI’s definition of domestic terrorism is “Americans attacking Americans based on US-based extremist ideologies.” Many providers, and plenty of protesters, call targeted harassment “terrorism,” and Cohen and Connon argue that it should be seen, and labelled, as such.

In some senses, the “culture of terror,” as one provider puts it, is effective: providers are afraid, as are their friends, family, and neighbors—and they arrange their lives around the threats they face. But in the most important sense, it’s not: providers don’t stop providing abortion. Just two of the 87 providers interviewed for this book stopped providing abortion, and only one of those two held firm to that decision. The other, confronted with the opportunity to perform an abortion for a young woman with AIDS who couldn’t find another doctor to help her end her pregnancy, stepped in to help and hasn’t stopped providing abortions since. For almost all the providers, the harassment they face only deepens their sense of commitment and their desire to help people in need. Despite the hounding, despite the death threats, despite the danger to their families, they don’t leave.

I haven’t left, either. I still live in the US, even as access to abortion has been chipped away by legislation and clinic closings. Even as the violence against the people I would need if I ever found myself pregnant and unwilling to stay that way persists. Six years ago, I felt the one-time shock and horror at what was done to one abortion provider, but the reality of daily existence for the men and women in his community is one of continual violence and constant fear. I still live here, albeit in a place where access to abortion is better than in most. I’m still here—but it’s hard to forget that Dr. George Tiller isn’t.