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Abortion Stigma: A Reconceptualization of Constituents, Causes, and Consequences

      Abstract

      Stigmatization is a deeply contextual, dynamic social process; stigma from abortion is the discrediting of individuals as a result of their association with abortion. Abortion stigma is under-researched and under-theorized, and the few existing studies focus only on women who have had abortions. We build on this work, drawing from the social science literature to describe three groups whom we posit are affected by abortion stigma: Women who have had abortions, individuals who work in facilities that provide abortion, and supporters of women who have had abortions, including partners, family, and friends, as well as abortion researchers and advocates. Although these groups are not homogeneous, some common experiences within the groups—and differences between the groups—help to illuminate how people manage abortion stigma and begin to reveal the roots of this stigma itself. We discuss five reasons why abortion is stigmatized, beginning with the rationale identified by Kumar, Hessini, and Mitchell: The violation of female ideals of sexuality and motherhood. We then suggest additional causes of abortion stigma, including attributing personhood to the fetus, legal restrictions, the idea that abortion is dirty or unhealthy, and the use of stigma as a tool for anti-abortion efforts. Although not exhaustive, these causes of abortion stigma illustrate how it is made manifest for affected groups. Understanding abortion stigma will inform strategies to reduce it, which has direct implications for improving access to care and better health for those whom stigma affects.
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      References

      1. Arthur, J. (2000). “The only moral abortion is my abortion:” When the anti-choice choose. Available: http://mypage.direct.ca/w/writer/anti-tales.html.

        • Ellison M.A.
        Authoritative knowledge and single women’s unintentional pregnancies, abortions, adoption, and single motherhood: Social stigma and structural violence.
        Medical Anthropology Quarterly. 2003; 17: 322-347
        • Finer L.B.
        • Frohwirth L.F.
        • Dauphinee L.A.
        • Singh S.
        • Moore A.M.
        Reasons U.S. women have abortions: Quantitative and qualitative perspectives.
        Perspectives on Sexual and Reproductive Health. 2005; 37: 110-118
        • Freedman L.
        • Landy U.
        • Darney P.
        • Steinauer J.
        Obstacles to the integration of abortion into obstetrics and gynecology practice.
        Perspectives in Sexual and Reproductive Health. 2010; 42: 146-151
        • Furedi A.
        Issues for service providers: A response to points raised.
        Journal of Medical Ethics. 2001; 27: ii28-ii32
        • Goffman E.
        Stigma: Notes on the management of spoiled identity.
        Prentice-Hall, New York1963
        • Grossman D.
        • Holt K.
        • Peña M.
        • Lara D.
        • Veatch M.
        • Córdova D.
        • et al.
        Self-induction of abortion among women in the United States.
        Reproductive Health Matters. 2010; 18: 136-146
        • Harris L.H.
        Second trimester abortion provision: Breaking the silence and changing the discourse.
        Reproductive Health Matters. 2008; 16: 74-81
        • Henshaw S.K.
        Unintended pregnancy in the United States.
        Family Planning Perspectives. 1998; 30 (24–29 & 46)
        • Joffe C.
        Doctors of conscience: The struggle to provide abortions before and after Roe v. Wade.
        Beacon Press, Boston1995
        • Joffe C.
        Roe v. Wade at 30: What are the prospects for abortion provision?.
        Perspectives on Sexual and Reproductive Health. 2003; 35: 29-33
        • Joffe C.
        Dispatches from the abortion wars: The costs of fanaticism to doctors, patients, and the rest of us.
        Beacon Press, Boston2009
        • Jones R.K.
        • Finer L.B.
        • Singh S.
        Characteristics of U.S. abortion patients, 2008.
        Guttmacher Institute, New York2010
        • Jones R.K.
        • Kooistra K.
        Abortion incidence and access to abortion services in the United States, 2008.
        Perspectives on Sexual and Reproductive Health. 2011; 43: 41-50
        • Kumar A.
        • Hessini L.
        • Mitchell E.M.
        Conceptualising abortion stigma.
        Culture, Health & Sexuality. 2009; 11: 625-639
        • Littman L.L.
        • Zarcadoolas C.
        • Jacobs A.R.
        Introducing abortion patients to a culture of support: A pilot study.
        Journal of Women’s Mental Health. 2009; 12: 419-431
        • Major B.
        • Appelbaum M.
        • Beckman L.
        • Dutton M.A.
        • Russo N.F.
        • West C.
        Abortion and mental health: Evaluating the evidence.
        American Psychologist. 2009; 64: 863-890
        • Major B.
        • Gramzow R.H.
        Abortion as stigma: Cognitive and emotional implications of concealment.
        Journal of Personality and Social Psychology. 1999; 77: 735-745
        • Morgan L.
        • Michaels M.
        Fetal subjects; Feminist positions.
        University of Pennsylvania Press, Philadelphia1999
        • Owings M.F.
        • Kozak L.J.
        Ambulatory and inpatient procedures in the United States.
        Vital and Health Statistics. 1998; 13: 139
        • Quinn D.M.
        • Chaudior S.R.
        Living with a concealable stigmatized identity: The impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health.
        Journal of Personality and Social Psychology. 2009; 97: 634-651
        • Rapp R.
        Testing women, testing the fetus: The social impact of amniocentesis in America.
        Routledge, New York2000
        • Russo N.F.
        The motherhood mandate.
        Journal of Social Issues. 1976; 32: 143-153
        • Russo N.F.
        • Denious J.E.
        Controlling birth: Science, politics, and public policy.
        Journal of Social Issues. 2005; 61: 181-191
        • Shellenberg K.M.
        Abortion stigma in the United States: Quantitative and qualitative perspectives from women seeking an abortion (Doctoral Dissertation).
        The Johns Hopkins University, Baltimore, Maryland2010
      2. Shostak, A. B., Koppel, R., & Perkins, J. (2006). Abortion clinics and waiting room men: Sociological Insights. Available: http://www.menandabortion.com/articles.html.

        • Siegel R.B.
        The right’s reasons: Constitutional conflict and the spread of woman-protective antiabortion argument.
        Duke Law Journal. 2008; 57: 1641-1692
        • Singh S.
        • Wulf D.
        • Hussain R.
        • Bankole A.
        • Sedgh G.
        Abortion worldwide: A decade of uneven progress.
        Guttmacher Institute, New York2009
        • Taylor J.
        The public life of the fetal sonogram.
        Rutgers University Press, New Brunswick, NJ2008
        • Weitz T.A.
        Rethinking the mantra that abortion should be "safe, legal, and rare".
        Journal of Women’s History. 2010; 22: 161-172
        • Yanow S.
        Confronting our ambivalence; The need for second-trimester abortion advocacy.
        Conscience. 2009; (Available:)

      Biography

      The six authors were Ellertson Fellows from 2008–2010.
      Alison Norris, MD, PhD, is a Postdoctoral Fellow the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD. She pursues multi-method research on sexual and reproductive health in under-served women and men.

      Biography

      Danielle Bessett, PhD, is an Assistant Professor of Sociology at the University of Cincinnati, Cincinnati, OH. Her research interests are in medical and family sociology, focusing on sexual and reproductive health issues and inequality.

      Biography

      Julia R. Steinberg, PhD, is an Assistant Professor of Health Psychology in the Department of Psychiatry at UCSF. Her research interests are at the intersection of psychology and reproductive health.

      Biography

      Megan L. Kavanaugh, DrPH, is a Senior Research Associate at the Guttmacher Institute, New York, NY. Her research portfolio has focused on unintended pregnancy, contraceptive use, post-abortion contraception and attitudes about abortion.

      Biography

      Silvia De Zordo, PhD, is a Visiting Researcher at Goldsmiths College-University of London. Her research interests are in social and medical anthropology, focusing on sexual and reproductive health issues and inequality.

      Biography

      Davida Becker, PhD, is a Research Scholar at the Center for the Study of Women at the University of California, Los Angeles. Her research focuses on the accessibility and quality of reproductive health services and disparities in reproductive health outcomes.