“We know from experience, it’s not like the people protesting clinics in banned states just pack up and go home,” said Melissa Fowler, chief program officer for the National Abortion Federation.

The group and the hundreds of abortion clinics it represents have been on “heightened alert” since the opinion leaked, Fowler said. The organization has staff who specialize in security on call around the clock. They go out to clinics to do drills with employees and volunteers on scenarios such as bomb threats or active shooters and advise them on things like where to position security cameras. They also conduct safety assessments at the homes of physicians, monitor online threats and consult with local law enforcement.

In some places, local police are working with clinics to try to tamp down potential for violence. In Jacksonville, Florida, the sheriff’s office said last month they would station an officer outside the clinic, and police in Little Rock, Arkansas, installed a camera atop a crane near an abortion clinic that has been the site of protests, hoping to deter bad actors.

Immediately following the leak and for days afterward, police in Cherry Hill, New Jersey, initiated extra patrols around The Women’s Center location, Kifferly said.