The first death threats came at 3 a.m. It was November 1973 and I had just started performing abortions at a small nonprofit clinic in Colorado. Now the phone was ringing at my home in the dead of night. I had built my small house deep in the mountains, in a place of solitude and beauty, where I could see the stars at night.

How did they find me here? I was terrified. I started sleeping with a rifle by my bed. I expected to be shot as I walked out the door in the morning or as I came home at night.

The terror of those days came back to me last week when a gunman — disconnected from society but bathed in anti-abortion propaganda — attacked the Planned Parenthood clinic in Colorado Springs, killing three and wounding nine others. Early news of this attack reached me as my son and I were about to start skiing down a mountain slope with fresh snow. A beautiful day began with horror in the pit of my stomach, and it was not the first time.

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That fear has been with me for 42 years and is constantly renewed.

When I started as the founding medical director of that nonprofit clinic in Colorado, shortly after the Supreme Court legalized abortion in Roe v. Wade, I faced hostility even from many members of the medical community. My request for hospital privileges was met with vociferous opposition, until one highly respected physician — an obstetrician who had seen too many women die of illegal abortion — backed me up. I got the right to admit patients to the hospital if needed.

That wasn’t the end of it, though. A group called Fight the Abortion Clinic told the Colorado Board of Health that we were running a butcher shop. I presented statistics from our first month of operation and explained the safety measures I had built into the medical procedures. The board dropped the subject.

The personal attacks continued. The next summer, the Denver chapter of the National Organization for Women decided to honor me for supporting women’s rights. As I was given my award, a group of anti-abortion demonstrators began screaming and calling me vile names, their faces contorted with hate. Their ferocity was terrifying. It made the hair stand up on the back of my neck. How could anybody be so opposed to what we were doing?

The patients were grateful. One woman in her 30s was trembling when I walked into the operating room to examine her. “Why are you shaking?” I asked. “What’s wrong?”

“It’s so different,” she said. “You’re a doctor. The lights are on. The place is clean. The windows are open. I feel safe.” She went on to explain that she had had an illegal abortion once under hideous circumstances and had almost died.

The patients were usually exuberant, healthy young women who wanted to live their lives, get an education, learn a profession, know themselves, and experience independence before they started a family. Many were women who already had families but who could not bear the stress of raising more children. Others had broken or abusive relationships. Some were sick from the effects of pregnancy. Their lives were in danger.

It was soon clear to me that performing abortions was the most important thing I could do in medicine. I started a private practice in Boulder specializing in outpatient abortion services. This had not been my plan. I was trained in public health and wanted to follow an academic career of teaching and research in epidemiology. But the patients and their needs were more important.

I was doing my part to make the Roe v. Wade decision meaningful, but much more than that, I was saving women’s lives. I was making a difference. The days of death from illegal, unsafe abortion were over, at least as far as I could do something about it.

Several times, I was invited to debate the abortion issue. At first, I enjoyed the debates and treated both my opponents and the occasions with respect. But the anti-abortion groups became more and more threatening and aggressive, calling me a “murderer” and “baby killer.” On one occasion, at the University of Colorado Denver, they started to climb over the front table at me and I had to be taken out a back exit under police escort.

I decided that showing up at my office to see patients was a sufficient statement of my side of the abortion “debate.”

I’d had an unlisted home phone number for years, since those first frightening calls at 3 a.m. But now I started getting innumerable death threats at my office. The man who had started the Fight the Abortion Clinic committee tried to run over me with his car in my parking lot.

In 1981, I married a young woman who understood and supported my work. I was in love, I wanted a partner in life, and I wanted to have a family. The threats and the attacks terrified her and caused us both a great deal of stress. Since we didn’t have a house in town and I needed to be near the clinic in case of patient emergencies, we stayed sometimes at a small apartment at the back of my office. The anti-abortion fanatics began showing up by the back door at dawn, praying, singing, calling my name, and screaming slogans. It was hideous and frightening. The constant stress was one of the reasons the marriage ended, and I was devastated.

Things got even worse after that.

In 1988, five shots were fired through the front windows of my office, narrowly missing a staff member. My patients and staff are now protected with bulletproof windows.

In 1991, anti-abortion leader Randall Terry gathered his disciples around him in the street in front of my office and prayed for my execution.

In 1993, Dr. David Gunn was assassinated in Florida. A few months later, my friend Dr. George Tiller was shot in both arms by Shelley Shannon as he drove out of his office in Wichita, Kan. That week, Randall Terry went on national Christian radio and invited his listeners to assassinate me.

In 1994, Dr. John Britton and his bodyguard were assassinated in Florida. Later in the year, Dr. Gary Romalis was shot in his kitchen in Vancouver and nearly bled to death. In December, John Salvi killed two abortion clinic workers in Brookline, Mass.

Shelley Shannon sent me a letter from the Kansas state prison telling me that I would be next. I knew she meant it.

An anti-abortion fanatic wrote me a letter telling me to forget wearing a bulletproof vest: They would go for a head shot.

In early 1995, the American Coalition of Life Activists held a press conference to unveil a hit list of 13 abortion doctors. I was on the list. So was Dr. Tiller. Their poster declared us guilty of “crimes against humanity.”

Within hours, federal marshals were protecting me. I wrote a letter to the New York Times in which I tried to describe what it felt like to be on that hit list, which included not just our names but our addresses. I wrote that it went “a long way toward destroying one’s life.”

In 1998, Dr. Barnett Slepian was assassinated in his New York home. I watched the news of this, horrified, as I was getting dressed to go to a professional meeting in Denver where I could be at risk. I was not sure I should go to the meeting, but I went anyway. I was wary and apprehensive, so after a short while, I left. I was afraid.

On May 31, 2009, Dr. Tiller was assassinated in his church by Scott Roeder. I was put under 24-hour armed guard at my office and at home by US federal marshals. Death threats against me continued. My wife, a physician from Cuba, was terrified. Our young son could not play outside with his friends.

My family could not even ride together to a memorial service in Denver for my friend, George Tiller. The marshals took me everywhere in a bulletproof truck. Our son was in tears at the service and clung to me after I spoke. My 92-year-old mother, who had worried for my safety for decades, was there — and was even more fearful that I would be next.

Why do I continue doing abortions? Because it matters.

The women need my help. A large proportion of my patients now are women with desired pregnancies who have learned late in pregnancy that the fetus is afflicted with a catastrophic anomaly or genetic abnormality. It is a wrenching personal tragedy for the women and their partners.

Performing safe abortions in a humane, dignified, and caring atmosphere matters for the health and safety of the women. It matters for the health of their families. It matters for the health of our society. And now, it matters for freedom. If women are not free to make decisions about their own lives and health, they are not free. And if women are not free, none of us are free.

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