Abortion Stigma Research Articles (Page 1)

'The lesser evil'-Abortion and reproductive stigma among Ethiopian university students.

Abortion stigma in healthcare: physicians’ perspectives

Abstract Abortion stigma is a morally and politically divisive issue, often framed through reductive binaries that equate support for abortion with empathy and opposition with moral deficiency. This study explores how prosocial personality traits (i.e., the Light Triad), religiosity, and political ideology interact in shaping stigmatizing attitudes toward abortion. A sample of 304 participants engaged in a survey from October to November 2024, completed measures assessing abortion stigma, Light Triad traits, religiosity, and political orientation. Structural equation modeling revealed that higher Light Triad traits predicted lower abortion stigma. However, this relationship was moderated by political ideology: among conservatives, prosocial traits had a diminished—or even reversed—association with stigma. These findings challenge the notion that moral reasoning on abortion is unidimensional and highlight the role of ideological context in directing moral concern. The study underscores the need for stigma‐reduction strategies that consider not only individual empathy but also group norms and ideological commitments that shape how that empathy is expressed.

Aotearoa New Zealand (NZ) achieved abortion law reform in 2020, allowing people to choose abortion without legal restriction up to 20weeks gestation. Abortion can now be provided by a range of health practitioners in a variety of settings. While some progress has been made, we are yet to see abortion care being provided within the full extent of the law. To describe the journey of people accessing first-trimester abortion care in NZ to identify how abortion services can be developed to deliver optimal first-trimester abortion care. This was a qualitative study informed by phenomenology. Participants were recruited via a separate national survey to participate in in-depth interviews. Analysis was undertaken using a reflexive inductive approach to identify themes. Seven people were recruited. Analysis revealed four themes: (1) decision making (to have an abortion, choice of method, and coercive contraceptive decision making); (2) barriers to access (abortion service navigation, lack of access in rural areas including requirement to travel, abortion requirements); (3) abortion as a societal issue (abortion is isolating, 'slut-shaming', abortion is the taking of a life); and (4) empathy and advocacy. Despite decriminalisation of abortion in NZ, barriers remain. Work is required to improve access to accurate and non-judgemental information to inform decision-making. People value kind, non-judgemental clinicians and supportive whanau/friends play a major role in optimising the experience. Abortion stigma persists and has a negative impact on the abortion experience. Abortion services need support to ensure they are responsive to the needs of health consumers and reduce barriers to care.

Abortion remains a contentious legal issue, and beliefs about its social acceptance are complex and divisive. Few Americans hold absolutist views, leaving ambiguity around which circumstances are deemed acceptable. This study examines abortion perceptions in healthcare, where providers may navigate biases that (un)consciously perpetuate stigma. Interviews with 27 Planned Parenthood employees revealed stigma surfaced in communication about abortion services, highlighting perceptions of patient irresponsibility. Findings highlighted the abortion stigma hierarchy, a system positioning some abortions as more acceptable and less stigmatized than others. This hierarchy deepens scholarship on abortion stigma while illustrating the broader complexity of stigmatizing perceptions.

To critically review post-abortion contraception literature from the UK based on Bacchi's 'What's the Problem Represented to Be?' (WPR) approach. A systematic search of six electronic databases - complemented by a grey literature search encompassing reports, policy documents and government publications - identified a total of 31 publications: 19 peer-reviewed articles and 12 items of grey literature. Multiple - and sometimes conflicting - 'problem representations' coexisted across the texts, operating at different levels of abstraction. Applying the WPR approach, six 'problems' were identified: existing abortion rates and repeat abortion; risky groups; meeting service users' needs; organisational capacity; knowledge of contraceptive methods; and abortion stigma. While some problem representations focused on service user needs, care satisfaction and organisational capacity, the dominant framing positioned abortion rates - particularly subsequent abortions - as the central 'problem'. It is implied that too many abortions are being had and that a key purpose of post-abortion contraception is to address this issue. Abortion was often framed as an individual's failure to use (effective) contraception (correctly). This places the burden on individuals, further exacerbates abortion stigma and obscures structural constraints. Several conceptual slippages were identified, including using 'unplanned', 'unintended' and 'unwanted' pregnancy synonymously. Such practices risk collapsing and misrepresenting different kinds of lived experiences, creating barriers to the provision of person-centred abortion and contraceptive care. We recommend greater critical reflection on the language and assumptions within post-abortion contraception discourse to ensure research, policy and practice remain person-centred, evidence-informed and committed to principles of reproductive justice.

The Global Gag Rule (GGR) prohibits non-governmental organisations receiving US international family planning funding from using these funds to provide or refer for abortion services or advocate for abortion law liberalisation. In 2017, President Trump renamed the policy Protecting Life in Global Health Assistance (PLGHA) and expanded it to all US global health assistance funding. On 28 January 2021, President Biden revoked PLGHA. Limited research explores the expanded GGR's influence when revoked in countries dependent on US global health assistance. We examined how PLGHA influenced the sexual and reproductive health and rights (SRHR) landscape of Malawi during its enforcement and since its revocation by President Biden in January 2021. We conducted semi-structured qualitative interviews between July and August 2021 with 17 current and past recipients of US global health assistance and civil society organisations working in SRHR in Malawi. While PLGHA was in effect, participants observed the stalling of a liberalised abortion bill in Parliament, enhancement of anti-abortion attitudes and hindrance of national sovereignty in Malawi. In some cases, participants reported that over-implementation of the policy restricted legal access to post-abortion and contraceptive care. The Biden administration's revocation of PLGHA seemed to exemplify support of SRHR globally but did not reverse anti-abortion sentiment emboldened by prior enforcement of the policy. The threat of PLGHA being reinstated by a future US president was associated with hesitation among participants to invest in public health programmes and advocacy efforts. Participants felt that PLGHA's enforcement was associated with impaired abortion law reform, prevented organisations from providing safe post-abortion care and reinforced abortion stigma in Malawi. Participants felt these impacts endured even after the policy's revocation in January 2021. A permanent repeal of the GGR would allow organisations and the Malawi government to fully invest in public health interventions promoting SRHR.

Safe abortion hotlines operating in highly restrictive abortion settings provide critical information about safe self-managed medication abortion. The Mobilizing Activists around Medical Abortion (MAMA) Network has pioneered this model in the African region and supports various safe abortion hotlines across the continent. The aim of this study was to document the experiences of callers using a safe abortion hotline in Kenya and to better understand the role that safe abortion hotlines can play in facilitating access to abortion information. In this paper, we present findings from interviews with 19 hotline callers seeking information about medication abortion from a hotline in Kenya, between February and May 2019. Emergent themes included support from hotline counselors, readiness to self-manage, abortion experiences, preference for medication abortion, and the role of hotlines in reducing abortion stigma. Our findings shed light on important components related to the quality of the care provided by the hotlines and their role in destigmatizing abortion care, while serving as an example of the crucial work of feminist activists in expanding pregnant people's health and autonomy in highly restrictive abortion settings.

Abstract In the Democratic Republic of Congo (DRC) unsafe abortion claims thousands of lives every year. Under the 2018 Maputo protocol ratification, officials are implementing abortion services, yet abortion stigma contributes to delays in access to care. A recognized approach, person-centred care, can improve the quality and access to care in DRC. The aim of this study was to understand the experiences of women who received an abortion with midwives, nurses or physicians recently trained in comprehensive abortion care (CAC) using person-centred approaches in the capital city of Kinshasa. A qualitative design with semi-structured interviews captured the complexity and richness of twenty-five women who accessed CAC with trained healthcare providers. Participants were interviewed two weeks post-abortion. The analysis was thematic and applied person-centred abortion care frameworks. Participants emphasized the importance of emotional and psychological support from healthcare providers, and care that was empathetic, informative, reassuring and rapport building over time. They valued services tailored to their needs including care delivered virtually or outside of traditional clinical settings before, during, and after the abortion process. Relational continuity across the care journey, was central to their experiences and helped reduce feelings of isolation and stigma. Person-centred abortion care approaches can be expanded to explore how the care process, particularly the nexus between healthcare provider and client, shapes the overall experience. In DRC this includes prioritizing programs to support continuity of healthcare provider, and community-based care including the option for abortion self-management.

BackgroundMedication abortion (MA) may be accessed covertly in private pharmacies and clinics due to abortion-related stigma. Stigmatization may lead to information asymmetry, resulting in price discrimination. The existing literature on abortion in Ghana has primarily focused on factors associated with abortion stigma. However, the potential variations in MA cost have not been explored. Thus, we aim to explore the potential disparities in MA cost based on women’s socio-demographic status in Ghana.MethodsWe used data from a study that recruited women who accessed MA using mifepristone and misoprostol combination from selected private pharmacies and clinics in Ghana. The study employed a non-inferiority and prospective design, and women were recruited as they exited the selected facilities after obtaining the MA pills. Our final analysis included 929 pharmacy clients and 1,045 clinic clients. To understand the variability in MA cost, we initially conducted two decomposition analyses using the variance and Blinder-Oaxaca techniques, followed by linear regressions to identify the socio-demographic factors that predict MA cost.ResultsThe average costs of MA were approximately US$ 46.00 and US$ 24.00 for the clinic and pharmacy groups, respectively. Additionally, the cost varied between pharmacy and clinic groups and within each group. A greater segment of the variation among the clinic group stemmed from between facilities (78 percent), whereas, among the pharmacies, the bigger share came from within facilities (57 percent). Regression results further indicate that the cost of MA increased among women with higher education, those who have not been in a union with a partner and those who accessed MA in clinics.ConclusionsMA cost in Ghana is largely based on providers' discretion and at the facility's management level. Additionally, the cost differs by women’s socio-demographic attributes. To reduce the disparities in MA costs, developing guidelines to address the health system challenges regarding MA provision and access is important. Educational programs on MA access, provision and legal framework could also reduce abortion-related stigma and cost variations.

Introduction: Increasing the proportion of abortions performed in Australian hospitals would reduce abortion stigma, increase training opportunities for health care workers, and expand access to no cost abortions and in rural and regional areas. Method: This article uses a descriptive-interpretive method to map hospital-based abortion provision across Australia, drawing on four data sources: grey and scholarly literature, government and referral websites, materials from a 2023 Senate Inquiry, and interviews with 51 health professionals and advocates. Results: There are three main approaches to hospital-based abortion provision in Australia: universal hospital provision of procedural abortion (Northern Territory, South Australia and Tasmania); the outsourcing of public provision to private clinics (the Australian Capital Territory, Queensland and, to a very minor degree, Western Australia); and systems that leave decision-making about abortion provision to individual hospitals (New South Wales and Victoria). Discussion: Hospital-based abortion provision in Australia is uneven and inequitable and underpinned by problematic criteria of moral deservedness that determine who receives care. Quality care is further compromised by a lack of method choice in the second trimester of pregnancy.

Social workers have played a crucial role in abortion care for decades, addressing clients' diverse abortion care needs. Social workers have ethical duties to provide unimpeded access to information and supports to clients, in pursuit of social justice. This scoping review comprehensively synthesizes published literature on social work's role in abortion care. The review adhered to Arksey and O'Malley's five-stage framework. The following databases were searched for literature published between 1973-2023: PsycINFO, MEDLINE, CINAHL, Social Work Abstracts, Social Services Abstracts, and Scopus. Search results were uploaded to Covidence for de-duplication and screening. Out of 2,980 articles screened in title and abstract review, followed by full-text review, 78 articles were included. A majority the 78 studies (n = 67) were set in the United States. The remainder were from the United Kingdom, Australia, Canada, New Zealand, and two studies involved multiple countries. Six themes emerged to summarize the literature base: (1) Social workers' attitudes regarding abortion and abortion-seekers; (2) Abortion stigma and barriers in social work; (3) Social work and reproductive justice; (4) Social work and ethical considerations regarding abortion; (5) Social work and abortion policy and advocacy; and (6) Social work and family planning: roles, approaches, and practice frameworks. Social workers have long played intrinsic roles in abortion care, including counseling, providing access to concrete supports and mitigating barriers to abortion care, and abortion rights advocacy. Social justice and professional ethical commitments underpin social work's role in abortion care. However, existing gaps in abortion education, training, and practice frameworks are impeded by the dynamic legal landscape and stigma attached to people seeking abortion care. Reproductive justice offers a framework, that overlaps with the field's social justice tenets, to raise consciousness among social work students, professionals, and researchers, and to address gaps in abortion education, training, and scholarship.

Objective: The aim of this study is to examine the abortion-related stigma among international students studying in Northern Cyprus. Materials and Methods: This study is a descriptive and cross-sectional type of research. The population of the research consisted of international university students studying in Northern Cyprus between 30.08.2021 and 13.04.2022. The Sample size of this study consisted of 272 university students. The Data of the research were collected using a web-based online and face-to face survey that was prepared the student information form, and the Stigmatizing Attitudes, Beliefs, and Actions Scale (SABAS). In this study data was used the descriptive statistics tests and Kolmogorov-Smirnov test, Kruskal-Wallis H test, and Mann-Whitney U test. Results: It was determined that 28% of international students are 18-20 years old, 50% of them are female, 87.5% of them are from Africa, and 56% of them are Christian. In this study, it was found that the students used condoms the most and 13.0% of the them had abortion. They take average 34,98±14,16 points from total score of SABAS. In the study, there are a statistically significant difference between department, gender, and the total points of SABAS. Conclusion: The abortion stigma of international students was found low. In this direction, it is recommended to improve sexual and reproductive health services in universities.

IntroductionAbortion-related stigma negatively affects healthcare professionals providing abortion care, threatening workforce well-being and service provision. This global study, part of the Royal College of Obstetricians and Gynaecologists’ ‘Making Abortion Safe’...

ABSTRACTAimTo explore the experiences of midwives' when caring for women undergoing pregnancy termination after 14 weeks in Australia and New Zealand and the challenges they encounter.Design and MethodsContent analysis was used to analyse 1389 responses to 10 open text questions embedded in a web‐based cross‐sectional survey. Current understandings of grief and stigma were applied to the data. The SRQR guideline was used for reporting.ResultsData were grouped into four main categories: ‘Failed by the system’, ‘Emotionally and morally challenged’, ‘Midwifery at the core’ and ‘Caring for myself’. Midwives strongly supported women's reproductive health choices and described delivering compassionate, woman‐centred care during pregnancy termination. Midwives reported receiving minimal pre‐registration education. Grief and sadness were prevalent emotions. Midwives described witnessing and experiencing abortion stigma. Other challenges that affected midwives' experiences included a lack of emotional and practical support. Self‐care strategies did not provide enough relief to midwives to overcome the emotional impact of providing care.ConclusionMidwives believe they deliver the very best of midwifery care to women who undergo pregnancy termination after 14 weeks but are affected by significant grief. Midwives not only witness stigma but also experience this as care providers. Failed by the healthcare systems that employ them, they lack appropriate support to overcome the emotional and moral challenges they encounter.Patient or Public ContributionNo patient or public involvement.

IntroductionThis study aimed to examine the interactions between abortion stigma and depressive symptoms among women who underwent termination of pregnancy for fetal anomalies over time.MethodsThis study is a longitudinal, observational study with two measurement points. A total of 241 women with fetal anomalies filled out the Individual Level Abortion Stigma Scale and the Edinburgh Postnatal Depression Scale before and after terminating pregnancy. Cross-lagged panel analysis was conducted to analyze the interactions between abortion stigma and depressive symptoms over time.ResultsThe level of abortion stigma before terminating pregnancy positively influenced depressive symptoms after terminating pregnancy (β = 0.12, P < 0.05). The depressive symptoms before terminating pregnancy positively influenced the level of abortion stigma after terminating pregnancy(β = 0.08, P < 0.05).ConclusionsAbortion stigma and depressive symptoms before terminating pregnancy should be evaluated, and comprehensive intervention must be taken to alleviate them. Healthcare professionals need to pay attention to the reciprocal relationships between abortion stigma and depressive symptoms and seek intervention to reduce both

Prevailing abortion stigma may contribute to how people feel prior to receiving an abortion, and these feelings may influence healthcare decision making. We analyzed data from a patient intake questionnaire regarding feelings at the time of first abortion appointment. We described responses, co-occurrence of sentiments, and associations between responses and abortion characteristics. We abstracted data from a random 20% sample of medical charts at an abortion facility in Ohio for patients who sought abortions from 2014-2018 (N=762). We analyzed data from an intake questionnaire used to assess patients' sentiments prior to their abortion. The questionnaire had 10 intake items to which patients could respond "yes," "maybe," or "no." The questionnaire also asked, "How are you feeling today?" and listed several emotions for patients to select. About 37% of patients responded with exclusively positive emotions, 27% with mixed emotions, and 27% with exclusively negative emotions. Reporting mixed (adjusted odds ratio [95%CI]: 0.33[0.16-0.71]) and negative only (0.38[0.18-0.32]) sentiments was associated with a decreased odds of receiving an abortion. Responding "yes" (vs. "no") to being afraid an abortion will hurt was associated with a decreased odds of having a procedural abortion vs. a medication abortion (0.62[0.40-0.96]). Responding "yes" to "I am not sure if I am making the right decision" was associated with a longer time between consultation and the abortion (adjusted incident rate ratio [95%CI]: 2.16[1.48-3.16]). Sentiment toward abortion is complicated and deserves nuanced attention, rather than being grouped into a strictly positive or negative experience. Assessing patient sentiment prior to an abortion procedure may be valuable for providing patient-centered abortion care.

Recent moves by the majority of U.S. states to restrict abortion rights marked a new stage in the movement for reproductive justice, the intersectional human rights framework inaugurated by Black feminists in the 1990s. Political organizing to engage voters and shift public opinion in favor of abortion rights implicates a number of key psychological processes, including prejudice and intergroup contact, despite a relative lack of attention to abortion stigma in mainstream psychology. Moreover, research on campaigns’ capacity to shift voter attitudes has largely focused on how such campaigns influence their targets; that is, potential voters. As part of a long-term collaboration with a statewide sexual and reproductive health advocacy group in Tennessee, we interviewed 18 canvassers who participated in a form of canvassing that focuses on dialogue and perspective-taking, rather than argumentation. These canvassers were trained in the reproductive justice framework and conducted hundreds of conversations in the months leading up to the landmark Dobbs decision. Thematic and situational analyses of our interviews yielded insight into how canvassers understand abortion stigma's multidimensional effects and the impact of deep values conversations on their own political views and life histories, as well as how political organizers can better engage their supporters and detractors.

For decades, sociological research has examined the role of stigma in contributing to health disparities, yet such research seldom grapples with the interplay between individuals and structures. There is a particular paucity of research on abortion that concurrently examines individual experiences with stigma and structural barriers. In this article, we use telehealth abortion as a case, which now accounts for one in five abortions in the United States. We conducted 30 interviews and approach the data using a structural stigma framework in tandem with conceptualizations of felt, internalized, and enacted stigma. Findings advance a sociological theory of structural abortion stigma: a combination of structural barriers, internalized beliefs, and interpersonal shame. Telehealth reduces structural barriers to abortion and mitigates internal and interpersonal experiences of stigma. The latter is achieved by the ability to avoid the traditional abortion clinic, which many interviewees view as the site where stigma is produced and experienced.

Access to safe abortion is critical for women’s health, but women are stigmatised for seeking out an abortion due to social norms regarding gender roles and sexuality. This abortion stigma is likely more prevalent in U.S. cultures of honour (primarily southern and western states), where women’s reputation for sexual purity is paramount to their status. To test this possibility, we examined the relationship between honour and abortion-related outcomes at both the state and individual levels. At the state-level, we found that abortion rates were lower in honour (v. dignity) states after controlling for covariates. At the individual-level, we found that endorsement of feminine honour norms was associated with abortion stigma (Study 2) and indirectly linked with support for abortion concealment through anticipated stigma and shame (Study 3). Lastly, using a series of vignettes describing different scenarios in which a woman received an abortion (e.g. rape, relationship difficulties), we found that feminine honour endorsement was associated with decreased support for abortions and stigmatising attitudes toward the woman receiving an abortion (Study 4). Findings elucidate the relationship between honour norms and social stigma around abortion and enhance insights into how cultural processes may influence women’s decision making and access to care.