Reducing stigma in reproductive health

Abstract

Stigmatization marks individuals for disgrace, shame, and even disgust-spoiling or tarnishing their social identities. It can be imposed accidentally by thoughtlessness or insensitivity; incidentally to another purpose; or deliberately to deter or punish conduct considered harmful to actors themselves, others, society, or moral values. Stigma has permeated attitudes toward recipients of sexual and reproductive health services, and at times to service providers. Resort to contraceptive products, to voluntary sterilization and abortion, and now to medically assisted reproductive care to overcome infertility has attracted stigma. Unmarried motherhood has a long history of shame, projected onto the "illegitimate" (bastard) child. The stigma of contracting sexually transmitted infections has been reinvigorated with HIV infection. Gynecologists and their professional associations, ethically committed to uphold human dignity and equality, especially for vulnerable women for whom they care, should be active to guard against, counteract, and relieve stigmatization of their patients and of related service providers.

‘Repeat abortion’, a phrase to be avoided? Qualitative insights into labelling and stigma

“…More research is needed into women's experiences of more than one abortion across their reproductive lifespan in order to develop further understandings of longer-term post-abortion behaviour and experiences of abortion stigma. Nevertheless, the way in which language is used can have a stigmatising effect,14 and the use of the term ‘repeat abortion’ also implies value judgements about abortion generally. ‘Repeat abortion’ carries connotations of ‘repeat offender’, suggests a cycle of repeated risky sexual and contraceptive behaviour and of not learning from previous ‘mistakes’.…”

The Link Between Everyday Discrimination, Healthcare Utilization, and Health Status Among a National Sample of Women

“…[27][28][29][30] Additionally, specific health issues common among women of reproductive age, such as sexually transmitted diseases, 50 unwanted pregnancy, 51 and abortion, 52 are also known predictors of perceived discrimination in healthcare. 53 Collectively, these experiences disproportionately occur among socially disadvantaged groups of women. Unfortunately, our study did not fully explore interactions between race, socioeconomic status, and sociodemographics or fully consider the robust range of health, social, and reproductive factors likely related to women's experiences with discrimination and health service utilization.…”

Clinical, Ethical, and Legal Considerations in Pregnant Women With Opioid Abuse

“…10 The moral connotation of an addict is a degenerate, "sinful" person, a burden to society with frequent involvement with crime, joblessness, theft, and the legal system. 3,11 The visual aesthetics associated with "addicts" as emaciated, riddled with track marks, and with poor dentition serve as powerful icons of this poorly understood problem. The effects of stigmatizing addiction can take different forms.…”

“…11 This misguided approach stems from a purported desire to deter negative behavior in pregnancy despite the fact that imprisonment is not associated with improved health outcomes and may trigger the obstetric emergency of acute withdrawal. 14 As of May 2015, 18 states consider substance abuse in pregnancy to be child abuse, and there are increasing reports of women arrested for positive urine toxicology screens in pregnancy.…”