EXECUTIVE SUMMARY

Anti-abortion extremists use physical violence less often than in the past, but are harassing physicians through social media, online doxxing, intimidation, threats, and attempts to ostracize providers from their peers and communities.

  • Violence from anti-abortion terrorists resulted in 11 murders, 42 clinic bombings, and 188 arsons over a four-decade period. But more recent actions have involved hate mail, harassing phone calls, and internet-based harassment against abortion clinics and providers.
  • The social media age has made harassment easier, including defamation, intimidation, and isolating physicians from their peers.
  • There no longer are hospital wards with sick and dying women from failed abortions, but in some places, such as Texas, women are being turned away when they need abortion care services.

More than one-third of abortion providers reported being harassed by anti-abortion individuals, including intimidation and invasive behavior. Some providers experienced intentional public exposure of their abortion work and discreditation, according to new research.1

The more violent harassment includes 11 murders, 26 attempted murders, 607 death threats, 42 clinic bombings, and 188 arsons that affected abortion providers and facilities from 1977 to 2018.1,2

Overt violence has declined since the 1990s, but nonviolent harassment has increased, the researchers found. This includes picketing, obstruction, hate mail, harassing phone calls, and internet-based harassment against abortion clinics. In some cases, people have picketed abortion clinic employees’ homes, copied their license plates, and stalked them.1

“We did a web-based survey of [current and past] abortion providers across the U.S. and collected [quantitative and qualitative] comments about their experience with abortion provider harassment,” says Corinne McLeod, MD, the study’s lead author and clinical instructor at Albany (NY) Medical Center.

Of the 321 physicians who responded to the survey, 35% reported harassment. The percentage reporting harassment was higher among providers who were more publicly visible through work in outpatient abortion clinics. For example, 40% of physicians providing outpatient abortions reported harassment vs. 7% of physicians reporting surgical abortion care in a hospital.

“In fairness, our study is probably not a complete representation of a sample of all abortion providers in the United States,” McLeod acknowledges.

One chief finding is that most harassment is invasive and intimidating rather than overtly violent.

“We found that although the historic perception of abortion provider harassment is the overly violent [actions] like bomb threats and shootings, the more common harassment people experience is more invasive and works at undermining people’s reputation,” she explains.

Harassment Moves Online

The social media age has made it easier for individuals to harass providers. Harassment includes defamation, intimidation, and isolating physicians from their peers.

“The internet has become a more powerful tool in this type of harassment,” says Rachel Flink-Bochacki, MD, MPH, FACOG, study co-author and assistant professor at Albany Medical Center. “We found most of the harassment people experienced was designed to harm their professional reputation and standing and to harm their standings in their communities. It was designed to isolate them from their communities, professionally and socially.”

The goal appears to be to deter physicians from providing abortion services because of fear of being divided from the rest of the community, Flink-Bochacki adds.

Of 321 respondents, 19% were not currently providing abortion care. More than half of the providers who had stopped performing abortions reported that it was because their employers explicitly forbid them from providing that service.

“A significant number were forbidden from providing abortions by their employers, even though they were trained and willing to do so,” McLeod says. “Some made choices about where they lived and chose [not to perform abortions] based on the political area.”

Some study respondents discussed fearing their families would be harassed, or they feared for their own safety. From what researchers could find, the fear of harassment was more common than the actual experience of it.

“It wasn’t that common that they had encounters with anti-abortion activists that made them feel physically unsafe,” Flink-Bochacki says. “It was more that they’d say, ‘We know where you live, and we could hurt you if we wanted to.’”

Threats of violence were more common than actual violence, but both are unacceptable. “Any harassment of doctors providing a legal healthcare practice is inappropriate,” Flink-Bochacki says adds.

The survey did not ask about police involvement, but one person reported receiving a death threat and obtaining a police tail for about a week. “For many physicians, harassment was par for the course, and they either provided abortion services because it was important to them, or they stopped providing it,” McLeod says.

Previous research into abortion provider harassment focused primarily on clinics and clinic staff. McLeod and colleagues wanted to know what individual doctors experienced and whether this affected their decision to continue to provide abortion services.

“We know a lot of doctors that may consider abortion are looking at the political landscape of where they work and may be dissuaded by threat of harassment,” McLeod explains. “We wanted to explore the prevalence of harassment and actual experience to disseminate that information and allow other physicians to be more informed.”

The respondents’ reported harassment included:

  • threatening phone calls in the middle of the night;
  • harassing emails and tweets;
  • clinic protestors identifying providers by name;
  • online posts of targeted doxxing of providers’ photographs, addresses, Social Security numbers, or medical licensing information;
  • breaking into the provider’s car to draw a hangar on the windshield;
  • vandalism, including nails in tires and rocks thrown through windows;
  • large protests in front of a provider’s home with trucks featuring graphic pictures of fetuses;
  • letters sent to neighbors about the physician’s abortion work;
  • shouting at a doctor at a restaurant;
  • stalking and death threats resulting in protective surveillance;
  • posting a photo of a provider’s daughter on an anti-abortion website.

Providers Fear Discussing Their Work

For these reasons, some abortion providers hide their work from people in their community. One person noted it is the safest option to protect their children from protestors.

Some physicians said they did not discuss their work in abortion care because it could potentially be harmful to their medical practice or business partners.

“We were looking at targeted harassment of [doctors] personally, and not just walking past protestors,” Flink-Bochacki says.

One provider was targeted with a bus ad that listed the provider’s name along with graphic anti-abortion photos to deter patients from attending that practice even for non-abortion care.

“A lot of institutions don’t want to get involved with that. They don’t want the negative attention and drama of providing this service,” Flink-Bochacki adds. “Hospitals don’t want those doctors to work there because they don’t want the attention.”

A broad example of general harassment is the Texas anti-abortion bounty law that gives anyone in the country the right to sue an abortion provider or anyone who assists the woman seeking an abortion.

“Texas leads the way in novel trap laws targeting regulation of abortion providers,” McLeod says.

Texas’ bounty-hunter system was heard by the U.S. Supreme Court, but not acted upon as of Nov. 30, 2021. The Texas law provides at least $10,000 to anyone who successfully sues an abortion provider. It might present the ultimate financial risk for doctors offering abortion services. But it is not the only anti-abortion action that seeks to end abortion through financial harassment.

“People may not have a $10,000 bounty to prevent abortion care, but [personal harassment] affects their lives, relationships with colleagues, and professional status,” Flink-Bochacki says.

The positive changes brought by nearly five decades of safe and legal abortion care have been eroded by anti-abortion terrorism and personal harassment of providers.

“We, fortunately, are not in an era where we have those abortion wards with a whole floor of the hospital [filled with] people who tried to abort and got injured,” McLeod says. “Even if it’s not at the point now where people are dying of sepsis, it’s still heartbreaking seeing people turned away from services they deserve to have.”

REFERENCES

  1. McLeod C, Pivarnik K, Flink-Bochacki R. Individual abortion providers’ experiences with targeted harassment in the United States. Contraception 2021 Oct 30;S0010-7824(21)00411-X. doi: 10.1016/j.contraception.2021.09.014. [Online ahead of print].
  2. National Abortion Federation. 2018 violence and disruption statistics.