Harassment and structural violence against abortion providers in Colombia: A national mixed-methods study.

OBJECTIVE

To examine the discrepancy between a single-item harassment screening and a behaviorally anchored stigma scale among Colombian physicians who provide voluntary termination of pregnancy (VTP), and to explore how providers who do not identify as victims describe their experiences.

METHODS

In a national mixed-methods study with a primarily quantitative approach, 163 VTP-providing physicians completed an anonymous survey (November 2024-January 2025) that included a single dichotomous harassment screen and a 19-item scale adapted from the Abortion Provider Stigma Scale. Responses were compared using chi-square tests, and open-ended testimonies were analyzed through inductive content analysis and presented in a joint display.

RESULTS

While only 25.2% of providers identified as victims, a much larger proportion reported specific negative experiences, such as being judged by other health workers (52.8%). Among the 122 providers who reported no harassment, 39.3% still reported being judged, and 18%-24% endorsed feelings of shaming, differential treatment, concealment, and negative experiences after disclosure. Items indicating positive experiences showed no significant gap. Testimonies indicated a normalization of stigma, framing it as an expected part of the work.

CONCLUSION

The notable gap in recognition suggests that single-item screening tends to underestimate the level of stigma in this group, which has important implications for how provider well-being is monitored and protected.