Experience of stigma and harassment among respondents to the 2019 Canadian abortion provider survey

Objective: We conducted a national survey to assess the experiences of stigma and harassment among physicians and nurse practitioners providing abortions and abortion service administrators in Canada. Study design: We conducted an exploratory, cross-sectional, national, anonymized, online survey between July and December 2020. Subsections of the survey explored stigma and harassment experienced by re-spondents, including the 35-item Revised Abortion Providers Stigma Scale and open-ended responses. We analyzed the quantitative data to generate descriptive statistics and employed a reflexive thematic analysis to interpret open-ended responses. Results: Three hundred fifty-four participants started the stigma and harassment section of the survey. Among low-volume clinicians (< 30 abortions/year, 60%, n = 180) 8% reported harassment; 21% among higher volume clinicians (& GE;30 abortions/year, 40%, n = 119) and 47% among administrators (n = 39), most commonly picketing. The mean stigma score was 67.8 (standard deviation 17.2; maximum score 175). Our qualitative analysis identified five themes characterizing perceptions of stigma and harassment: concerns related to harassment from picketing, protestors, and the public; wanting protestor bubble zones; aiming to be anonymous to avoid being a target; not providing an abortion service; but also witnessing a safe and positive practice environment.Conclusions: Being a low-volume clinician compared to higher volume clinician and administrator appears to be associated with less harassment. Clinicians providing abortion care in Canada reported mid-range abortion-related stigma scores, and expressed strong concerns that stigma interfered with their abortion provision. Our results indicate that further de-stigmatization and protection of abortion providers in Canada is needed through policy and practice interventions including bubble zones.Implications: While Canadian abortion care clinicians and administrators reported relatively low incidence of harassment, our results indicate that they are concerned about stigma and harassment. However, as this was an exploratory survey, these data may not be representative of all Canadian abortion providers. Our data identify a need to support abortion clinicians and to bolster protections for dedicated abortion services.& COPY; 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

This study surveyed physicians, nurse practitioners, and administrators in Canada who provide abortion services to assess their experiences of stigma and harassment. The results showed that low-volume clinicians experienced less harassment compared to higher volume clinicians and administrators. Canadian abortion care providers expressed concerns about stigma interfering with their provision of abortion services and called for further destigmatization and protection through policy and practice interventions.