Abortion Stigma Among Low‐Income Women Obtaining Abortions in Western Pennsylvania: A Qualitative Assessment

Abstract

CONTEXT Abortion stigma may cause psychological distress in women who are considering having an abortion or have had one. This phenomenon has been relatively underexplored in low-income women, who may already be at an increased risk for poor abortion-related outcomes because of difficulties accessing timely and safe abortion services. METHODS A qualitative study conducted between 2010 and 2013 used semistructured interviews to explore pregnancy intentions among low-income women recruited from six reproductive health clinics in Western Pennsylvania. Transcripts from interviews with 19 participants who were planning to terminate a pregnancy or had had an abortion in the last two weeks were examined through content analysis to identify the range of attitudes they encountered that could contribute to or reflect abortion stigma, the sources of these attitudes and women’s responses to them. RESULTS Women commonly reported that partners, family members and they themselves held antiabortion attitudes. Such attitudes communicated that abortion is morally reprehensible, a rejection of motherhood, rare and thus potentially deviant, detrimental to future fertility and an irresponsible choice. Women reacted to external and internal negative attitudes by distinguishing themselves from other women who obtain abortions, experiencing negative emotions, and concealing or delaying their abortions. CONCLUSIONS Women’s reactions to antiabortion attitudes may perpetuate abortion stigma. Further research is needed to inform interventions to address abortion stigma and improve women’s abortion experiences.

Aborto inseguro no Brasil: revisão sistemática da produção científica, 2008-2018

“…Delays in adequate obstetric care are associated with a higher occurrence of severe maternal outcomes 87 . Taking into consideration the illegality of abortion, one may assume that these delays occur either because women delay seeking services due to lack of social support 88 , fear of admitting an illegal practice 82 or due to the stigma associated with abortion 88,89 ; or because of the difficulty accessing health care services or a timely offer of care 88 . Studies conducted in the Northeast showed low quality of the care offered to women hospitalized due to complications from abortion, measured through an analysis of the service structure and of women's perception of the care they received 90,91,92 .…”

Abortion-related emergency department visits in the United States: An analysis of a national emergency department sample

“…Post-abortion visits to the ED may also be driven by stigma, worry, or distrust of abortion providers. A perception that abortion is unsafe [ 30 – 32 ] may lead women to worry about mild symptoms, such as cramping and bleeding, even though they are an expected result of abortion. Such perceptions may stem from abortion portrayals in the media and popular culture.…”

Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion

“…People who have had an abortion and hold anti-abortion attitudes may have internalized stigma. Several participants in one qualitative study in the U.S. who had sought an abortion described anti-abortion attitudes [16]. Similarly, some people seeking abortion in England and Wales described negative views about abortion and believed they had done something morally wrong, views that were accompanied by feelings of guilt and shame [17].…”

“…While participants attributed their feelings of shame to their rejection of motherhood, those who resisted abortion stigma, justified their abortions by claiming they were being responsible mothers, in that they chose abortion in order to focus on their existing children. Participants in both studies reconciled their internalized anti-abortion attitudes with their desire to have an abortion by distinguishing their personal circumstances around their abortions from those of other people's abortions [16,17].…”