London(CNN) Monika Neall was standing outside an abortion clinic in Manchester when she saw a woman in her mid-20s dart out the doors. The woman moved towards a parked car, then suddenly froze.
On the ground nearby lay plastic fetus models, candles and images of mothers gazing adoringly at babies. Panicking, she caught Neall's eye. "That's my car," she said, her voice starting to crack.
Most Saturday mornings, Neall puts on a pink vest and joins a small group of women from the volunteer organization Sister Supporter. They stand outside the Marie Stopes clinic in the northern English city to oppose the anti-abortion protests that are held there weekly.
On this particular weekend, Neall said, the anti-abortion protesters had blocked in the woman's car with their signs. "She was quite distressed and just clearly had no idea what to do about it at all," she told CNN.
Neall said she made sure that the protesters removed their placards, so the woman could get to her vehicle without being approached.
"We will be a physical buffer zone between the protesters on the front door of the clinic, so that if women need support, or even if they just need to see that somebody else is there, countering the message," Neall said.
According to activists, women trying to access reproductive health services in Manchester face some of the worst anti-abortion harassment ever seen in the UK.
"Over the past 14 years, anti-abortion gatherings outside the (Manchester) center, in particular, have been escalating in frequency and size and there has been an escalation in the harassing behavior as well," Franki Appleton, advocacy and public affairs adviser for Marie Stopes UK, told CNN.
"We've seen an increase in, I suppose you could describe it as Americanized tactics," she added.
The methods used by protesters vary. "There was a woman who used to sit on the front step of the clinic and just breastfeed her baby as a form of intimidation," Sister Supporter volunteer Beth Redmond told CNN.
Appleton said that the protests can include so-called "pavement counseling," when the demonstrators intercept people trying to enter the clinic and try to dissuade them from attending appointments.
Michael Freeley, a local representative from international anti-abortion group 40 Days for Life, told CNN that the group's main focus in its Manchester protests was "quietly praying outside the clinic for the mothers and the children and for the staff."
"Sometimes, some volunteers might approach someone going into the clinic and offer them a leaflet with some information on helplines where they could get help on adoption or just help with the pregnancy ... to provide other options," he added.
The group 40 Days for Life was originally started in Texas in 2004, but it now organizes "vigils" in countries in Europe, Africa and South America.
Freeley insisted that members of his group did not harass women outside the clinics.
Abortion has been legal in England, Wales and Scotland since 1967, but some groups still oppose the procedure. While some of the protests are associated with international anti-abortion movements, other groups are locally run, many of them linked to churches nearby.
To counter the protests, Sister Supporter is campaigning for an exclusion zone -- a public spaces protection order (PSPO) -- around the clinic. On June 20, a Manchester City Council committee supported the petition and recommended a formal consultation over the introduction of a PSPO.
The council found that "many protesters use deliberately disturbing and graphic images and models, including those purporting to be of dismembered fetuses" and that leaflets including "misleading information" had been distributed.
The committee also noted that protesters often follow, record and question women as they enter or leave abortion centers in the city.
The next stage of the process, the council said, will be to work with all the concerned parties and hold a public consultation. "The use of a PSPO is a serious matter, and it is our responsibility to ensure it would be used fairly and legally," they added.
Protests at the center occur throughout the year but intensify around the Christian holiday of Lent, where groups including 40 Days for Life gather around clinics every day.
Robert Colquhoun, director of international campaigns for 40 Days for Life, denied that members of his group harass women seeking abortions, telling CNN via email: "40 Days for Life local volunteers have organized peaceful, prayerful and legal vigils outside the Manchester Marie Stopes abortion center for 10 years now."
"During that time we have not seen a single substantiated case of harassment from any of our volunteers from any location in the United Kingdom."
Pam Lowe, a lecturer in sociology who researches women's reproductive health at the UK's Aston University, told CNN: "Very aggressive or violent incidents are extremely rare. But that doesn't mean to say that there isn't harassment, intimidation."
The behavior of most anti-abortion protesters amounts to "street harassment," she added. "They're drawing attention to the clinic, and this is deliberate, they specifically call themselves public witnesses, they want the public to be noticing the women going into the clinic," Lowe told CNN. "What it does is it makes this private decision into a public spectacle," she added.
Lowe told CNN that it is difficult to measure the level of clinic protests because of the different groups involved and the varying and unpredictable tactics used.
Indeed, the nature of the anti-abortion protests is drawing some women to join the counter demonstrations.
After becoming involved in abortion rights campaigning before the Irish abortion referendum in 2018, Sister Supporter volunteer Shanna Lennon said she was shocked to discover that women seeking abortions faced harassment in her home city of Manchester.
"I was totally shocked that it's happening so close to where I live," she said. "I very much thought it was something that only happened in America."
Abigail Sheldon was 19 when she got pregnant and decided to have an abortion. She initially wanted to have the procedure at the Manchester Marie Stopes center, located a few minutes from her house, but after some research discovered that a 40 Days For Life protest was taking place at the clinic.
"I asked my boyfriend to go down and just see what it was like, (to) see if it was intimidating," Sheldon told CNN. "He came back and was just like, 'we'll go to the hospital instead, I just don't want to put you through extra stress, not on a day that is already obviously going to be very difficult and hard.'"
After the procedure, Sheldon volunteered with Sister Supporter outside the clinic. Seeing the anti-abortion protesters outside makes her angry, she said.
"It's trying to make girls think that they haven't thought this through. Nobody goes into this situation, thinking that this is an easy decision. Nobody ever wants to have an abortion ... it's already a really devastating choice you have to make, it's already one of the hardest things you'll probably have to do in your lifetime," she said.
In 2018, 200,608 women living in England and Wales had abortions, and another 4,687 non-residents underwent the procedure here, according to government data.
Every year, thousands of Irish women also travel to northern English cities, such as Manchester and Liverpool, for the procedure. While abortion was legalized in the Republic of Ireland last year, it remains illegal -- even in cases of rape, incest and fatal fetal abnormality -- in Northern Ireland, where a restrictive law dating back to 1861 remains in place.
In September 2018, British Home Secretary Sajid Javid rejected calls to introduce national buffer zones to all abortion facilities in England and Wales.
In a written statement, Javid acknowledged that "protest activities can involve handing out model fetuses, displaying graphic images, following people, blocking their paths and even assaulting them," but concluded "that these activities are not the norm," with most anti-abortion activities being "more passive in nature."
According to reproductive health clinics and abortion providers, however, the events in Manchester are not isolated incidents.
The British Pregnancy Advisory Service (BPAS) reported protest activity at 47 clinics, healthcare centers or hospitals in the UK since 2017 -- in both towns and large cities, including Cardiff, Edinburgh, Leeds, Oxford and Brighton.
Adele Warton, treatment unit manager for a BPAS clinic in Bournemouth, told CNN that protests happen outside her clinic every week.
"Some of our protesters have been coming here for years. We've got a little old lady who knits little booties and puts them in the bush outside," she said. "They'll often be outside with big placards of fetuses post-abortion. It's very visually grim."
"The protesters will also speak to the staff -- one followed a staff member to her car with a dictaphone asking her how she feels about murdering babies. We've had damage done to cars ... we've had nails in tires. They have ... thrown what they call holy water on the entrance of our buildings."
The protests, Warton says, pose a risk to women's health.
"We've had instances where some clients are so distressed by protesters that they are too distressed to go ahead with their treatment and have postponed treatment to the next week. It's impacting the risk factor because further into the pregnancy, the risks become higher," Warton said.
Several British councils have already taken steps to stop such protests -- in April 2018, the West London borough of Ealing approved the introduction of the country's first PSPO around a Marie Stopes facility that provides abortion services. In March 2019, a PSPO was also introduced around a BPAS clinic in Richmond, London.
The presence of protests relating to abortion had a "detrimental impact on those accessing the clinic, working in the clinic and those living in, working in and passing through the area," a spokeswoman for Ealing council told CNN.
The Ealing PSPO is subject to an appeal made by the Good Counsel Network, an anti-abortion group which had coordinated some of the protests in the area, the council spokeswoman said.
Clare McCullough, a member of the Good Counsel Network, told CNN that the group did not harass women at abortion centers. "We have had a witness in Ealing for 24 years now. No warnings, cautions or arrests in that time says our behavior is not harassment," she said via email.
McCullough said her group offers alternatives to women considering abortion, as well as practical assistance and support, and that its members distribute leaflets detailing this outside abortion centers.
Alithea Williams, a spokeswoman for the anti-abortion group Society for the Protection of Unborn Children (SPUC) told CNN: "SPUC does not hold or organize prayer vigils outside abortion clinics, but we support the right of pro-lifers to witness and peacefully offer help to women in need."
"Bans like this are bad news for free speech, and, more importantly bad news for women, who will be denied help they do not get anywhere else," she said.
The women in Manchester disagree. Lennon told CNN: "Ideally, there would be nobody outside that clinic -- that is the dream. We all want our Saturday mornings back, you know, we'd love not to be there."