A New York Times report about a Washington, D.C., hospital’s gag order on an abortion provider demonstrates the pervasive nature of abortion stigma. MedStar Washington Hospital Center barred abortion provider Dr. Diane J. Horvath-Cosper from advocating for greater abortion access, citing fear of anti-choice violence, and the doctor has now filed a civil rights complaint against her employer.

Hospital officials had issued Horvath-Cosper’s gag order after anti-choice extremist Robert Lewis Dear carried out his deadly attack on the Planned Parenthood health center in Colorado Springs last November, according to the Times’ May 2 article. The hospital’s medical director ordered Horvath-Cosper “to end her advocacy” “out of concerns for security,” saying he didn’t want to draw attention to MedStar’s abortion services. Horvath-Cosper responded by filing her civil rights complaint.

Fears of anti-choice violence are not unfounded. Last summer, the Center for Medical Progress (CMP) released a series of deceptively edited videos baselessly alleging that Planned Parenthood sold fetal tissue -- earning CMP and its founder, David Daleiden, the title of Media Matters’ 2015 Misinformer of the Year. Although CMP’s work has been largely discredited, the videos sparked an unprecedented spike in the rate of anti-choice violence against abortion providers and clinics.

Horvath-Cosper knows these risks, but she argued that when providers and advocates “cower and pull back” from public dialogues about abortion, it creates a dangerous vacuum that is filled by “those who have demonized this totally normal part of health care.” As the Times noted, Horvath-Cosper is far from alone in her belief that allowing right-wing media and anti-choice groups to dominate the conversation about abortion is dangerous. Instead, the paper explained, she is part of a larger group of providers “who argue that silence about their work only feeds the drive to stigmatize and restrict abortion.”

Abortion stigma is the “shared understanding that abortion is morally wrong and/or socially unacceptable." This belief is reinforced through media coverage, popular culture, and by many people’s lack of accurate information about the procedure itself. Right-wing media and anti-choice groups have worked relentlessly to capitalize on this lack of public knowledge by consistently demonizing abortion providers and fearmongering about the safety of abortion procedures. Right-wing media have referred to abortion as sickening, “grisly,” “selfish,” and on par with terrorism. They have also attacked abortion providers, calling them “villains” and comparing them to Nazis.

Despite abortion being both common and overwhelmingly safe, anti-choice groups have consistently attempted to “exploit the stigma of abortion.” Anti-choice legislators have similarly relied on fearmongering about the safety of abortion to pass medically unnecessary restrictions. The consequences of losing access to abortion care are severe. For example, in a study conducted after the passage of Texas’ anti-choice law HB 2, researchers found that 100,000 to 240,000 women between the ages of 18 and 49 had attempted to self-induce an abortion, demonstrating that increased barriers to accessing abortion in Texas put women at risk.

But challenging abortion stigma by encouraging greater public dialogue is not new to reproductive health advocates. The organizations Sea Change, #ShoutYourAbortion, and the 1 in 3 Campaign all encourage people to speak out about their experiences with abortion through a variety of mediums.

Speaking to NPR, Horvath-Cosper underscored the importance of providers challenging abortion stigma and continuing to provide abortion care when possible. “The message that we’ve all gotten in society is that abortion is shameful, and that people who have abortions should be shamed, and I think that’s something we need to work against,” she said.

According to ThinkProgress, “if anything, this silencing has further inspired Horvath-Cosper to vocalize her defense of abortion and abortion providers.” As Horvath-Cosper explained in a May 3 press release:

“Especially at a time when abortion is marginalized and under attack, I’m compelled to speak out about the importance of abortion as a legal and safe medical procedure that’s critical to women’s health,” said Horvath-Cosper in a Tuesday press release. “Abortion has become so stigmatized in this country. As a doctor, I have a responsibility to urge that abortion be recognized as the integral part of women’s medical care that it is.”

During a conversation with Slate journalist Jennifer Conti, Horvath-Cosper again reaffirmed this commitment. In a text to Conti, Horvath-Cosper wrote: “Our silence has never and will never protect us. Patients deserve better than shame and secrecy.”