Abortion clinics and providers suffered a sharp rise in murders, attempted murders, death threats, hate speech and internet harassment committed against them in 2015 according to a new report by The National Abortion Federation.

Threats of direct harm against abortion providers soared from a single reported incident in 2014 to 94 the following year; documented cases of online hate speech rose from 91 to 25,839 in 2015, and the number of facility pickets climbed from 5,402 to a record-breaking 21,715. The number of clinic blockades, meanwhile, nearly doubled in 2015 from the level the year before.

Violent incidents, which had been on the decline in previous years, peaked in the aftermath of the November shooting of a Colorado Springs Planned Parenthood clinic.

The NAF detailed the long history of violence against abortion providers leading up to the Planned Parenthood attack.

“Since 1977, there have been 11 murders, 26 attempted murders, 42 bombings, 185 arsons, and thousands of incidents of criminal activities directed at abortion providers,” the report states. “Three of those murders happened in November 2015, when Robert Dear opened fire at an abortion facility in Colorado Springs, killing three people and wounding nine others.”

The report also claimed that the “alarming” rise in violent incidents “directly correlates to the release of inflammatory videos aimed at demonizing providers” released by The Center for Medical Progress last year.

According to Slate, the verdict on the causality of the videos remains unclear, with the Los Angeles Times remarking that, “There is no evidence that [the attack] was a direct result of the anti-Planned Parenthood fervor.”

The Times, however, emphasized the continuous threat faced by abortion providers in the United States.

“Still, it is important to remember that as long as abortion has been legal in the U.S., abortion clinics throughout the country have been subject to arson and bombings,” they wrote.

The National Abortion Federation highlighted the importance of reversing this disturbing trend.

“We cannot continue to allow anti-abortion extremists to use violence to advance their own personal, political agendas,” they wrote. “Nor can we continue to allow them to contribute to a climate that encourages violence against abortion providers.”