The socio-political climate in which abortion services occur differs significantly between the US and Canada. These different environments may impact recruitment, retention and quality of life for abortion clinicians as well as their approaches to medical practice of these services. Building on previous surveys of National Abortion Federation member clinics in the US in 1997 and 2002, we implemented the third cross-sectional survey of abortion practice and clinicians’ experiences with stigma, harassment and resilience. For this third round of surveys, we expanded the sample to include all publicly identifiable clinics in the US and Canada. The objectives of this study were: to assess the extent to which abortion providers are aging and how stigma and harassment may impact providers in the US compared to Canada; to evaluate the extent to which clinicians follow evidence-based guidelines for abortion procedures in the US and Canada; and to explore variations in practice by clinic-level and clinician-level characteristics.