For seven years, Julie Burkhart worked alongside Dr. George Tiller until his death in 2009, when he was shot in a Kansas church by an anti-abortion extremist.
Since then, Burkhart has taken up the torch. "I will never regret it, because it was the right thing to do," said the 53-year-old clinic operator, who has faced endless obstacles to her work, including death threats and protests outside her home.
"Sometimes, no matter what the price is, you just have to do the right thing."
Doctors, nurses and clinic managers struggle daily like her to provide abortion access in the Midwestern and southern United States, where the religious right is deeply rooted in society.
The future of abortion will be up for debate before the US Supreme Court on Wednesday. Several abortion providers declined to comment to AFP for fear of potential consequences.
But not Julie Burkhart.
Even though, since Tiller's assassination, she has thought constantly about her own safety, and that of her family and staff.
After a murder attempt in 1993, Tiller -- one of the few gynecologists who performed late-term abortions -- began wearing a bulletproof vest. "Often, he would have his bulletproof vest on his couch in his office. I think that I became desensitized to the level of risk," Burkhart said.
Tiller's death, from a gunshot to the head by a man claiming he wanted to save unborn children, was a brutal reality check.
The killing was sharply condemned, even in the anti-abortion community, but the attacks continued. Three more people were killed in 2015 in a Colorado Springs clinic, bringing the death toll from anti-abortion violence to 11 since the procedure was legalized in 1973.
Over those decades, there have also been 26 murder attempts, 42 bomb attacks and more than 300 burglaries at various clinics, according to the National Abortion Federation.
- 'A rollercoaster' -
After Tiller's death, his widow sold his Wichita clinic. "My goodness, I can't blame her," said Burkhart, who worked as Tiller's spokeswoman and lobbyist from 2001 to 2009. "But right after she had made that decision, I thought we had to reopen it."
"I kept waiting for others to step up and do it, maybe a physician in the community," she said, adding that she also wanted to throw in the towel.
"I felt like I was on a super fast rollercoaster."
When no one stepped up, Burkhart felt a "sense of responsibility." She founded the Trust Women Foundation, bought back the Wichita clinic and opened a second one in neighboring Oklahoma.
In 10 years, she has had death threats, break-ins in the clinics and protests outside her house. At one point, the pressure was so high that she was forced to hire bodyguards just to take her teenage daughter to school.
All of this has frightened local doctors. Even those who worked with Tiller have refused to return. Today, Burkhart has to fly in doctors from other states, often from the typically more progressive east and west coasts.
- 'Isolating' -
Beyond security issues, local doctors are worried about being ostracized by their colleagues, losing their operating licenses in hospitals or being fired by their practices, Burkhart said.
Yet another obstacle is money: banks have refused to give her loans to reopen the Tiller clinic. "We had to raise money from contributors," she explained.
As for state authorities, they have passed law after law, officially to protect the patients' health. In reality, though, the regulations have created so many obstacles that the number of abortion clinics in Kansas has dropped from 23 in 1980 to only four for the whole state. There are just six in Oklahoma.
There's also a lot of social pressure. "It can feel rather isolating. People are not always wanting to associate with people like myself who provide abortion," confided Burkhart with a small sigh.
"Depending on what group of people I am engaged with, I might not tell them everything about myself. I might shield myself from that so I don't have to worry about judgment."
Dr George Tiller's coffin is carried during his funeral in Wichita, Kansas on June 9, 2009
Julie Burkhart (pictured 2016) worked for seven years with Dr George Tiller before he was murdered in Wichita, Kansas in 2009 by an anti-abortion extremist