In 2009, George Tiller was shot dead in Kansas. Today, as America’s discord over abortion reaches fever pitch, Julie Burkhart is keeping the flame alive

Julie Burkhart remembers all too vividly the morning of 31 May 2009. It was a Sunday and she was in a meeting in Washington DC when, shortly after 10am, her phone started buzzing incessantly with calls from her home town of Wichita, Kansas.

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When she got through to one of her co-workers she thought at first he was making a surreal joke. George Tiller, her mentor with whom she had worked side-by-side for the past eight years at the frontlines of America’s abortion wars, had been accosted at Sunday service in his Wichita church and shot dead.

Burkhart remembers colleagues asking her what she was going to do next. “That still perplexes me,” she said, talking to the Guardian from her Wichita office. “My only thought was, ‘How about I go bury my head in the sand and never come out?’”

Now 10 years to the day after that horrifying event, Burkhart reflects on the ultimate sacrifice Tiller made to bring reproductive healthcare to women who needed it. “The more I got to know him, the more respect I had for him, and the more he taught me as a person. He gave so much. Ultimately, he gave his life.”

The lessons Tiller gave were not just personal. Today they resonate across the nation at a time when America’s discord over abortion has once again reached fever pitch.

Virulent anti-abortion legislation is sweeping like a forest fire through many Republican-controlled states. Rightwing lawmakers, mostly male, have passed defiant laws openly designed to force challenges up to the US supreme court and thus undo Roe v Wade, the landmark 1973 ruling that enshrined a woman’s right to abortion.

On Wednesday, Louisiana became the latest state to pass an abortion law prohibiting terminations after the sixth week of pregnancy. Legislators defended the ban on the medically spurious grounds that fetuses have a heartbeat at six weeks (in fact embryos do not have working hearts at that stage).

That women can still make their own reproductive choices, despite the increasingly hostile mood, is in no small part down to the efforts of Burkhart and others like her. Her imperative to bury her head in the sand didn’t last long after Tiller’s death.

She decided she could not walk away from the calamity. Soon she was busily setting up a new organisation from the kitchen table of her Wichita home with the mission of carrying on Tiller’s work. She called it Trust Women after one of Tiller’s little sayings.

“Trust women,” he used to remark. “I’m a woman-educated physician,” was another of his phrases. His favorite mantra was “attitude is everything”.

Facebook Twitter Pinterest Dr George Tiller shortly before his death in May 2009. Photograph: Mike Hutmacher/AP

It’s hard to overemphasise the courage that Burkhart displayed when she announced she would reopen Tiller’s abortion clinic. After all, mortal risk had followed Tiller around for years. Long before he was killed in his church, Tiller endured relentless harassment and threats.

In 1993, a female anti-abortion protester shot Tiller in both arms. He was back at work the next day.

After that, he wore a bulletproof vest under his shirt. One of the chilling details of Tiller’s assassination was that the assailant, Scott Roeder, must have been aware of the doctor’s concealed protection – he shot him point-blank in the head.

Knowing all that, how could Burkhart find the strength to step into Tiller’s shoes? “I can’t tell you the level of concern I faced from people across the nation,” she said. “People would say to me, ‘Julie, you’re going to invite violence back into the community. Somebody might harm you.’”

Her reply was: “We cannot let fear dictate our lives. People in Wichita and beyond need access to healthcare and it would be irresponsible of us not to reinstate that.”

Burkhart bought the clinic from Tiller’s widow in 2012, had it renovated and secured at the cost of about $1m, and reopened it four years after his death. Even before it had opened its doors, anti-abortion protesters were back outside on the street hurling abuse at staff, intimidating women and bombarding the local authorities with complaints to have it shut down.

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That was just the start. A while after the clinic was reopened Burkhart discovered that a recorded phone conversation had been posted online between Roeder, now serving a life sentence for Tiller’s murder, and another anti-abortion extremist with the violent Army of God. Roeder, speaking on a prison phone, remarked that Burkhart had put a target on her back – a not-so-thinly veiled death threat that she passed directly to law enforcement.

Protesters started turning up outside her home bearing placards that read: “Prepare to meet thy God” and “Where’s your church?”. The reference was not lost on Burkhart: “Anybody who knows anything knows Dr Tiller was murdered in his church,” she said.

That brought a different quality of terror into her life. “I thought, I hope they are not going to shoot anyone in the house, I have a teenaged daughter and a husband. So we kept away from windows in our home, stopped looking outside. Even today, if someone we don’t know comes up to the house or drives by, it’s very disconcerting.”

Burkhart’s response to the scare tactics was to redouble her efforts. Trust Women opened its second outpost in Oklahoma City in September 2015, the first new abortion clinic in Oklahoma state in 40 years.

That, too, was a struggle. Anti-abortion extremists followed construction workers around as they built the clinic, filming them on video cameras and yelling at them through bullhorns. Despite the antipathy, everybody stayed on the job and the building was completed.

Then there were the doctors. Both Kansas and Oklahoma proved such politically hostile environments that physicians living in the area were impossible to recruit.

“I still don’t have any doctors who live in Wichita or Oklahoma City, they are all flown in,” Burkhart said.

This day-to-day, routine, mundane harassment – sustained terrorization you might call it – has gone on for years. It is what passes as normal for abortion providers these days. But on top of that a new layer of abnormal, of toxic hatred and implicit violence, has been added to Burkhart’s lot – by the incumbent of the White House.

Burkhart doesn’t see Donald Trump as a true believer in the anti-abortion movement. He lacks the religious zeal that drives many of the extremists. Rather, she sees his interventions as a form of political expediency, giving his base what they crave most.

What we’re seeing in state legislatures up to the US supreme court, it feels like we are reaching boiling point Julie Burkhart

The US president’s motives are to some degree beside the point – what matters is the impact of his actions and the fallout from his language. Whether he is accusing doctors of “executing babies” or Democrats of passing laws that would “allow a baby to be ripped from the mother’s womb moments before birth”, Trump is not only peddling untruths, he is playing with fire.

At least 11 people have been killed by extremists in attacks on abortion clinics since 1993. The most recent was in Colorado Springs in 2015.

“Trump could definitely trigger the person who thinks, ‘I have got to take matters into my own hands’. Language has meaning. Words are important,” she said.

Alongside the worrying rhetoric, Burkhart has observed that since Trump began whipping up anti-abortion sentiment the energy in the anti-abortion movement has moved away from street protests and into courtrooms and legislative chambers.

“Anti-choice folks don’t have to march in the streets any more and blockade clinics. They have worked their way into our state legislatures, Congress, courtrooms – and our White House,” she said.

“What we’re seeing in state legislatures, in the judiciary from state level up to the US supreme court, it feels like we are reaching boiling point. Several of us have been talking with each other, asking what does that mean? What happens when things boil over?”

It was with such dark thoughts in mind that Trust Women opened its third abortion clinic as an insurance policy against the worst. Four months after Trump’s inauguration, the organization opened a clinic in Seattle with the rationale that even should Roe v Wade be overturned, the prevailing liberal politics of Washington state should allow abortion care to continue.

“Trump had been elected, Roe was in danger of being chiseled back. We knew there had to be a place where we could operate legally knowing Trump’s intentions,” she said.

That’s a bleak outlook, and Burkhart admits to at times feeling worn down by the constant strife. At low moments she reminds herself of her mentor’s mantra: “Attitude is everything.”

And she takes herself back to the basics of why she got into this branch of healthcare in the first place. “There are so many reasons people decide that pregnancy is not for them. It’s so personal. Ask 50 of our patients, and you would hear 50 different stories,” she said.

“At some point I would hope we could all collectively decide that everybody’s life is worth fighting for, that quality healthcare should be accessible for everyone and not just those with money. That’s what I come back to: do we value people or do we not?”