**Background:** The growth of global health programs in Canadian and U.S. universities has increased student demand for internationally based fieldwork, yet supportive resources for health, safety, and well-being—particularly regarding sexual and gender-based violence (SGBV)—remain inadequately developed. Previous research indicates that women students disproportionately experience SGBV during fieldwork, with detrimental long-term impacts on careers and mental health. The concept of 'hidden labor'—unrecognized supplementary physical, emotional, and cognitive work—has been explored in disability scholarship but not explicitly applied to women in global public health fieldwork. This study aimed to document and understand the lived experience of U.S. and Canadian women graduate students participating in global public health fieldwork, focusing on safety-related challenges and the hidden labor required to manage SGBV threats.
**Methods:** The study employed van Manen's phenomenology of practice, guided by Merleau-Ponty's existential reflection (relationality, corporeality, spatiality, temporality, materiality). Data creation occurred between January and October 2018. Inclusion criteria: self-identification as a woman; from the U.S. or Canada; graduate-level study (Master's or doctoral) at a U.S. or Canadian institution; conducted global public health fieldwork for at least 4 consecutive weeks in the Global South between 2000 and 2016. A purposive sample of 25 women participated: 7 in two to three in-depth phenomenological interviews (IDPIs, 90–210 minutes each) and 18 in guided writing exercises (GWEs). Participants attended 14 different universities and completed fieldwork between 2010 and 2016 across more than 20 countries in sub-Saharan Africa, Latin America, the Middle East, South Asia, and Southeast Asia. Sociodemographic data (e.g., race, age, sexual orientation) were not collected per phenomenological methodology. The overarching research question was: 'What was it like to practice global health abroad during your graduate public health training?' Data creation and analysis were iterative and holistic. Findings are presented as a composite 'woman graduate student's story' based on individual and composite experiences.
**Key Results:** The study identified two intersecting influences that create hidden labor: (1) loss of environmental familiarity (insufficient preparation, travel safety concerns, loss of peer support, language barriers, cultural influences) and (2) subordinate position as a student (SGBV perpetrated by those in power, lack of supervision, financial insecurity, underpaid/unpaid work). Women described extensive hidden labor through negotiations and strategies including: cultivating support networks (university, work, partners, peers, roommates); managing language, clothing, and appearance to blend in or become invisible; 'managing and laying traps' through avoidance, isolation, and hypervigilance; and mindset strategies such as questioning, coping, reframing (e.g., a 'silver lining mantra'), and setting boundaries. A critical finding was that women's successful mitigation of SGBV through intense hidden labor often left them with no specific 'incident' to report, captured in the participant statement: 'You can't report your feelings.' Reporting was further inhibited by power dynamics, fear of career harm, and inappropriate supervisor responses. The study notes that most participants appeared to be able-bodied, cis-gender, heteronormative, or White/White-passing women, and that many important identities (LGBT2Q+, racial minorities) were underrepresented.
**Clinical Implications:** The study provides new meaning structures and language to describe women's hidden labor in global public health fieldwork, including the concepts of 'managing' and 'laying traps.' It calls on universities and global health organizations to restructure institutional supports before, during, and after international placements, emphasizing that no simple checklist suffices—a comprehensive, flexible approach tailored to individual student needs is required. The findings highlight ethical and practical implications for student well-being, academic communities, and host communities in LMICs. The study underscores the need for accountability from both Global North universities and host institutions, and for open, reciprocal conversations that allow women to authentically share their experiences. Limitations include the underrepresentation of diverse identities and the inherent power dynamics in phenomenological research. The authors call for further research capturing stories of men, non-cis-gender individuals, and historically oppressed groups, as well as faculty and staff experiences.