Responses to the threat of fake patients among U.S. abortion providers

Background: U.S. abortion clinics are targets of coordinated, anti-choice “sting” operations, in which fake patients attempt to expose improper patient counseling. The effects of this threat on abortion providers are unknown.

Methods: We analyzed data from an online survey of 311 abortion providers at 22 abortion care centers nationwide. We examined their responses to the threat of sting operations, using ANOVA to compare workers in states with/without such attempts. 

Results: Though only 39% of those surveyed work in states where stings occurred, 48% fear being targeted by a sting, and 58% suspect they had encountered a fake patient. Nevertheless 93% report that they know what to do if faced with this situation. Compared to those in states without sting attempts, providers in states with sting attempts were more afraid of being targeted (p<0.01); more suspicious of encountering a fake patient (p<0.05); and less confident that they knew how to respond to fake patients (p<0.05). 

Discussion: The threat of sting operations is pervasive among abortion providers, introducing a new stress to an already burdened workforce. Beliefs about encountering fake patients appear out of proportion to the risk of having such an encounter, which may negatively influence patient-provider relationships. Most providers feel confident about responding to stings; however, those in states where stings occurred may face higher threats to morale and need additional support.  Future research should address not only the impact of sting attempts on workers, but their potential to burden patients by introducing suspicion into therapeutic clinical relationships.