For an organization that has been under assault all year — accused of selling fetal tissue and terrorized by a gunman in Colorado — Planned Parenthood’s current marketing has a certain bravado.

Billboards in the Twin Cities proclaim: “Here for Good.”

But in Minnesota, at least, the pre-eminent provider of reproductive health and abortion services has quietly been amassing the resources to back up that claim.

While Minnesota abortions overall have declined by 30 percent since 2000, those performed by Planned Parenthood have increased, according to records reviewed by the Star Tribune. While competing clinics have closed, Planned Parenthood has opened a $16 million headquarters in St. Paul and tripled its endowment to $30 million.

“We are here for good,” said Sarah Stoesz, CEO and president of the local Planned Parenthood chapter, repeating a slogan that is deliberately defiant. “We provide reproductive health care to women regardless of their ability to pay, regardless of who they are.”

The quiet growth has made Planned Parenthood a dominant provider in the state: It performed 49 percent of elective abortions in Minnesota last year, compared to 17 percent in 2000. Combining its numbers with those of Whole Woman’s Health of Minneapolis, just two organizations provided 77 percent of abortions in Minnesota in 2014, along with a large share of contraception services, STD and pregnancy testing, family planning and teen counseling.

Lynn Sandquist, right, of Mounds View held an anti-abortion sign outside of Planned Parenthood headquarters in St. Paul while in the background guest escort volunteers Jon Hanson, left, and Molly Wesslund wait to greet and assist patients.

In many ways, that consolidation reflects broader trends in health care. Many small clinics and hospitals in Minnesota have struggled with new laws and costly technology, and some have merged with the Mayos and Allinas of the world.

But abortion providers face unique challenges as well: a declining revenue stream from fewer procedures — and protesters at their doors.

For Planned Parenthood, prominence brings both benefits and threats. Its grants and contributions soared past $28 million in 2013, twice the average for most recent years, allowing the organization to increase its endowment, open clinics in St. Paul and Richfield, and launch a mobile app. Its Rochester clinic also started offering medicinal abortions through a doctor on site or videoconferencing to St. Paul.

Yet the growth can make Planned Parenthood more of a lightning rod than ever. “What’s the old saying? The bigger they are, the harder they fall?” said Scott Fischbach, executive director of Minnesota Citizens Concerned for Life, which has routinely alerted its members to Planned Parenthoods’ rising abortion numbers and influence.

Fischbach said his organization isn’t changing the way it lobbies for changes in state policy, but its supporters now know that weakening Planned Parenthood weakens abortion overall in Minnesota.

Even though polls generally show the public to have a favorable view of Planned Parenthood, Fischbach said he believes a tipping point occurred this summer, when undercover videos alleged that a clinic in another state sold aborted fetal tissue illicitly to medical researchers.

“The rough summer they’ve had has been pretty harmful to them,” Fischbach said. “It gives us the opportunity to shine the light more on … what they are really doing.”

Stoesz argues the result was exactly the opposite: The videos are fraudulent, she said, and incensed Planned Parenthood donors, who then suggested and funded the local “Here for Good” campaign.

“We’ve always been a target,” she said. “We were born in controversy. We’ve lived in controversy for 100 years.”

‘It’s a reality’

In 1977, arson shut down Planned Parenthood’s Highland Park clinic — the most violent incident to date for the local chapter, which also covers the Dakotas.

But recent events have prompted more “inflammatory rhetoric,” Stoesz said, and safety concerns to match. The Nov. 27 clinic shooting in Colorado Springs, in which self-described “warrior” Robert Lewis Dear killed three people and wounded nine others, prompted a security review in St. Paul. A scheduled drill on responding to a violent assault took place days later.

Karla Schardin, a Planned Parenthood project manager, got a phone call about the Colorado shootings when they happened, and quickly called other clinics to see how they were responding. Amid anger and sorrow, she was heartened that co-workers kept seeing patients. “It’s not new news, unfortunately,” she said. “It’s a reality we have to exist in.”

The current headquarters on Vandalia Street, near University Avenue and the Green Line, oozes security. Patient parking is set back from the sidewalk where protesters stand, and a front-desk security guard scans visitor IDs.

“Can’t be too careful,” a guard told one recent visitor. “They’re shooting clinics now.”

“We’ve always been a target. We were born in controversy. We’ve lived in controversy for 100 years.” Sarah Stoesz, CEO and president of local Planned Parenthood chapter

Protests are common, especially on Thursdays, after a men’s group finishes its meeting at St. John the Baptist Church in New Brighton and members show up with signs.

But unlawful acts are rare. St. Paul police have reduced the number of “proactive” checks on the building, department data show, and respond to about 30 calls there each year for disorderly disturbances. Only 24 calls since 2011 resulted in police reports, including an assault, car vandalism, and an air-gun pellet hitting a window.

Last Thursday, five protesters stood on sidewalks, across from clinic volunteers in brightly colored vests.

“This is the big dog,” said Greg Schmitz, who used to protest at Regions Hospital in St. Paul until it stopped providing abortions in 2011.

Bill Jechorek yelled, “See your ultrasound” to women driving to the clinic, hoping to discourage abortions. “They need us here for the prayers and the witness,” he said.

Filling a breach

Elective abortions in Minnesota declined from 14,450 in 2000 to 10,123 last year, state records show, in line with a broad national trend. Stoesz credits Planned Parenthood for reducing the number of abortions by helping make contraception widespread. Leadership training, she said, also has made teens more responsible for their sexual health and less likely to seek abortions.

Over the same period, abortions by the local Planned Parenthood increased from 2,450 to 4,981 — partly because women like the new center, and partly because two abortion sites have closed since 2011, Stoesz said.

Concerned that opponents were pigeonholing Planned Parenthood as an abortion provider only, clinic leaders promoted statistics showing that abortions represent only 3 percent of its services. But that tactic increased the stigma of abortion, Stoesz said, so the organization hasn’t fought that perception as much. Still, she said she wishes other clinics would step up.

“There’s no strategy here to take over the market,” she said. “But because other providers won’t offer patients abortion care, we do step into the breach.”

Planned Parenthood’s growth has occurred amid few changes in state abortion policies. Minnesota requires that women wait 24 hours after clinic visits before undergoing abortions and receive information on fetal pain if they have reached their 20th weeks of pregnancy. But recent efforts by state lawmakers to cut state Medicaid funding for abortions failed.

The emergence of the controversial videos this summer renewed calls by some members of Congress to cut Planned Parenthood from federal Title X funding, which doesn’t cover abortions but funds reproductive health care for low-income women. Title X made up more than half of the $4.9 million in government grants to Planned Parenthood’s Minnesota chapter last year.

Stoesz said losing the federal funding would further cut services to needy women — a 10 percent cut in 2011 prompted the organization to close six rural clinics — even though Planned Parenthood has seen rising private support, including large donations in 2012 and 2013 from Warren Buffett’s charitable foundation.

Planned Parenthood nonetheless has plans to keep its doors open.

“We have 100 years of contingency plans on the shelf,” Stoesz said.