Reproductive Health| Volume 28, ISSUE 1, P59-67, January 2018

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Evaluation of Abortion Stigma in the Workforce: Development of the Revised Abortion Providers Stigma Scale

Published:November 10, 2017DOI:



      We report on the development of a scale measuring abortion providers’ experiences of stigma.

      Study Design

      Using previous measures, qualitative data, and expert review, we created a 49-item question pool. We administered questions to 315 abortion providers before participation in the Providers Share Workshop. We explored the factor structure and item quality using exploratory factor analysis. We assessed reliability using Cronbach's alpha. To test construct validity, we calculated Pearson's correlation coefficients between the stigma scales, the Maslach Burnout Inventory, and the K10 measure of psychological distress. We used Stata SE/12.0 for analyses.


      Factor analysis revealed a 35-item, five-factor model: worries about disclosure, internalized states, social judgment, social isolation, and discrimination (Cronbach's alphas 0.79–0.94). Our stigma measure was correlated with psychological distress (r = 0.40; p < .001), and with Maslach Burnout Inventory's emotional exhaustion (r = 0.27; p < .001), and depersonalization (0.23; p < .001) subscales, and was inversely correlated with Maslach Burnout Inventory's personal accomplishment subscale (r = −0.15; p < .05).


      Psychometric analysis of this scale reveals that it is a reliable and valid tool for measuring stigma in abortion providers, and may be helpful in evaluating stigma reduction programs.
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      Lisa A. Martin, PhD, is at the University of Michigan, Dearborn, Women's and Gender Studies Program and Department of Health & Human Services. Her research applies an interdisciplinary approach to historical, social, political, and individual-level factors that influence U.S. abortion policies.


      Jane A. Hassinger, MSW, is a researcher at University of Michigan's Institute for Research on Women and Gender. She is a certified psychoanalyst and Clinical Social Worker whose research interests include developing interventions aimed at reducing stigma and improving workplace teams' functioning.


      Meghan Seewald, MA, is at the University of Michigan, Ann Arbor, in the Department of Obstetrics & Gynecology. Her research interests include the experience of stigma among health care providers, with an emphasis in both qualitative and quantitative analysis.


      Lisa H. Harris, MD, PhD, is an Associate Professor of Obstetrics and Gynecology and Women's Studies at University of Michigan (UM) and is trained as a clinical obstetrician-gynecologist and cultural historian. Her research focuses on ethical issues in obstetrics and gynecology.