Matt Stroshane/Getty Images, Fusion

Last week, three people were killed and nine others were injured after a gunman opened fire at a Planned Parenthood clinic in Colorado Springs, Colo. For many watching the news at home, the five-hour standoff was a frightening look at clinic violence playing out in real time.

But for Cheryl Chastine, a family physician who provides abortion care in the Midwest, it was the culmination of a summer plagued by violent rhetoric and a string of arsons targeting clinics.

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“When I first heard about the shooting, my reaction was, ‘Well, this is it,’” she told Fusion. “I had been expecting something like this to happen ever since the release of the videos from the Center for Medical Progress. I expected that it was only a matter of time until someone on the fringes of the anti-abortion movement or the fringes of society took those arguments to their logical conclusion by initiating a lethal attack.”

In Wake Forest, N.C., clinic escort Shana Broders followed the shooting while staying in constant touch with her friends who also volunteer as escorts. She wasn’t surprised by the violence, either.

“Some of the news organizations were trying to say he was actually robbing a bank and he ran down there. I mean, he went to the Planned Parenthood. He went nowhere else. He barricaded himself in a women’s clinic with an assault rifle,” she said. “I don’t know where you get confused as to the fact that he wanted to take out Planned Parenthood people. So there was a lot of anger. And you know we weren’t surprised.”

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For Chastine and Broders, like so many other clinic workers, the threat of violence is a real and daily part of what it means to ensure abortion care remains accessible. According to data from the National Abortion Federation, 11 people have been murdered in acts of anti-abortion terrorism since 1993. In that same time period, there have been 26 attempted murders.

As a result, clinics take security seriously. Over the course of the standoff in Colorado Springs, police watched Robert Dear’s movements through a live security feed from the building. Advanced camera systems like that are common at many clinics. So are the bulletproof vests the clinic staff had on hand.

“There are security protocols. I would say that probably every clinic has those in place,” Chastine explained. “It’s a consideration any time you’re assessing a building to potentially be a clinic site. The security of a building is also a consideration when evaluating a clinic as a potential place to work.”

Personal safety—inside and outside the clinic—is just as much of a concern.

Over the summer, Broders was personally targeted by demonstrators outside the reproductive health clinic in Raleigh where she volunteers to help patients and their companions reach the building through crowds of protestors.

Protesters called the elementary school where she works as a math and science teacher, circulated photos of her online accusing her of being a murderer, and threatened to come to her school on a parent-teacher night.

In the wake of Friday’s shooting, she remembered the words of one anti-abortion protester who, when Fusion asked him about the harassment campaign against Broders, said that while he doesn’t directly condone violence, he believed that anyone who supports an abortion clinic brings any possible "costs" upon themselves.

“If someone believes in abortion and thinks it’s great, and they want to help other people, they’re willingly putting themselves into the work," Russell Hunter, a co-founder of Abolish Human Abortion, told Fusion at the time. "They’re like counting the costs—‘I’m going to go help people kill other people’. It’s dangerous.”

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“They absolutely are egging this on,” Broders said. “They want violence to come. I believe that. They want to terrify people to the point that they don’t want to perform abortions, work at a clinic, or escort at a clinic.”

Chastine has been similarly targeted. “I’m not sure what to do in terms of my personal safety,” she said of trying to cope with the danger. “And that’s a calculation that all of us as providers are already making every day: What do we do on a day-to-day basis? Do we vary the routes we come and go? Do we carry a weapon? Do we wear body armor?”

She also hopes that the visibility of the deadly attack in Colorado Springs may change how the public responds to violent rhetoric, both outside of clinics and in stump speeches they hear as this election year winds on.

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In the months since the release of the secretly recorded videos in which Planned Parenthood employees discuss the organization’s participation in fetal tissue donation programs, Ted Cruz has accused the family health provider of “killing unborn children in order to sell their body parts.” Carly Fiorina has falsely claimed to have seen video of clinic workers watching a “fully formed fetus on the table, its heart beating, its legs kicking, while someone says, 'We have to keep it alive to harvest its brain.'"

Arizona Rep. Trent Franks, in one of multiple hearings on Planned Parenthood held by House Republicans, described the videos as:

Corporate officers and employees of Planned Parenthood casually discussing their rampant practice of harvesting and selling the little body parts from many of the hundreds of thousands of innocent babies they are guilty of killing in their abortion clinics across this nation.

That language matters, Chastine said.

“The tone and fervor of the language that is being used by very prominent political figures and anti-abortion movement figures is such that they can’t possibly be considered blameless when someone carries out the logical conclusions of what they’re saying,” she said.

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Broders said she has received messages of support from many people since the shooting—even from distant acquaintances—despite living in a deeply conservative southern baptist community. But on the day after the shooting, when she returned to the clinic, she found the same crowds of around thirty protesters as always, yelling the same abusive messages as she went about her day: “It was very different though because everyone was edgy, and like I said the protesters were just ramped up, like they were just vibrating almost.”

But Broders never considered staying away from the clinic on the Saturday after the attack. “I’m not afraid,” she said. “And I’m not going to let them keep me home. I don’t operate in that manner, I don’t operate out of fear. I don’t believe that anyone can. How do you live a life operating out of fear? Friday’s events were horribly scary and negative.”

Chastine shared the sentiment. “The work has to go on,” she said. “The purpose of this attack was to stop services. So the best way that we can counter that sentiment is to go to work and continue providing care for the patients who need it.”