With the Supreme Court’s unanimous decision on McCullen v. Coakley — the Massachusetts buffer zone case that required those who are not patients, companions of patients, or someone associated with the abortion clinic to remain at least 35 feet from the clinic entrance — patients trying to access safe, legal abortion care will see even more barriers between themselves and the clinic doors. Although relatively few states have buffer zones enacted across their borders, and a handful of others have buffer or smaller bubble zones on a city-by-city basis, the ruling won’t just affect those areas scrambling to learn if their own ordinances are illegal, or even those who were considering buffers of their own, but every clinic in the country, especially those in low clinic access states in the Midwest, Mountain region, and the South.

In my time working with abortion providers and abortion rights advocates over the last few years, I’ve seen first hand what is considered “counseling” by abortion opponents at unprotected clinics. In Louisville, Kentucky, one of only two clinics left in the Bluegrass state, I witnessedover 100 abortion opponents lining the sidewalk leading up to the clinic, stopping just at the property line in front of the door, chanting rosaries, calling to patients, preaching sin and eternal damnation through a microphone just a few feet from the waiting room window. I watched a woman shout through the window that the patients inside would die on the exam room table, that they would bleed to death inside, and no one would help them because the money was already paid up front. I saw protesters with bloody, graphic signs swarm patients just trying to get out of the car door and cross the mere 10 feet from curb to clinic property.

That’s what it is like at a clinic with no buffer zone.

Louisville is by no means alone. In Jackson, Mississippi, I saw a protester chase a pregnant woman down the street from parking lot to clinic door, refusing to stop when he was asked to leave her alone, pleading, “Mommy, Mommy, I have a life — don’t kill me!” In St. Louis, Missouri, I watched “sidewalk counselors” block the entrance to the parking lot so that patients couldn’t get in without taking their pamphlets and speaking with them. Even in my own progressive state of Minnesota, I witnessed an anti-abortion activist screaming at a woman on her way out — not in, but out — of a clinic, telling her she will never be whole or complete again now that she killed her baby.

I’ve seen photos of patients posted on websites, faces unobscured and with messages to pray for them so they find God and forgiveness for their sin. I’ve read stories of plastic fetal models thrust in people’s faces. I’ve heard protesters demand that male companions, “Be a man, go back in that clinic and get that woman and bring her out.”

Anti-abortion activists ask me, “If sidewalk counselors are doing something illegal, why aren’t they being arrested?” But a patient who was harassed prior to an abortion isn’t likely to file charges, knowing it will open her up to more harassment. Not all clinics have cameras installed that can document every transgression a protester commits. Law enforcement isn’t always willing to make the arrests even when there’s compelling evidence. And, if the 80’s era “rescue movement” is any indication, the end goal is to have so many infractions that police cannot keep up with them all, making it easier to just dismiss them rather than prosecute.

Patients seeking a legal medical procedure should have the right to obtain that procedure without harassment or intimidation, and that will become more difficult with today’s Supreme Court decision. The question isn’t how many clinics the decision will adversely affect, but exactly how much harassment a pregnant person is willing to face in order to access her constitutional right to an abortion.