The economics of abortion and its links with stigma: A secondary analysis from a scoping review on the economics of abortion

Abstract

Background Although abortions are a common aspect of people’s reproductive lives, the economic implications of abortion and the stigmas that surround abortion are poorly understood. This article provides an analysis of secondary data from a scoping review on the economic impact of abortion to understand the intersections between stigma and economics outcomes at the microeconomic (i.e., abortion seekers and their households), mesoeconomic (i.e., communities and health systems), and macroeconomic (i.e., societies and nation states) levels. Methods and findings We conducted a scoping review using the PRISMA extension for Scoping Reviews. Studies reporting on qualitative and/or quantitative data from any world region were considered. For inclusion, studies must have examined one of the following microeconomic, mesoeconomic, or macroeconomic outcomes: costs, benefits, impacts, and/or value of abortion-related care or abortion policies. Our searches yielded 19,653 items, of which 365 items were included in our final inventory. As a secondary outcome, every article in the final inventory was screened for abortion-related stigma, discrimination, and exclusion. One quarter (89/365) of the included studies contained information on stigma, though only 32 studies included stigma findings directly tied to economic outcomes. Studies most frequently reported stigma’s links with costs (n = 24), followed by economic impact (n = 11) and economic benefit (n = 1). Abortion stigma can prevent women from obtaining correct information about abortion services and laws, which can lead to unnecessary increases in costs of care and sizeable delays in care. Women who are unable to confide in and rely on their social support network are less likely to have adequate financial resources to access abortion. Conclusions Abortion stigma has a clear impact on women seeking abortion or post-abortion care at each level. Programmatic interventions and policies should consider how stigma affects delays to care, access to accurate information, and available social and financial support, all of which have economic and health implications.

The microeconomics of abortion: A scoping review and analysis of the economic consequences for abortion care-seekers

“…By systematically scoping the global evidence for the first time across these four economic domains, this article establishes the substantive understandings and methodological approaches that have been used to understand the microeconomics of abortion-related care. Mesoeconomic and macroeconomic findings are reported elsewhere as are the links between the economics of abortion and stigma [1][2][3].…”

Information flow as reproductive governance. Patient journey analysis of information barriers and facilitators to abortion care in the republic of Ireland

“…The economics of abortion ( Coast et al., 2018 ), training for health care workers, and the availability of clinics ( Sethna & Doull, 2013 ) have all been used as mechanisms for “different historical configuration of actors – such as state, religious, and international financial institutions, NGOs, and social movements – […] to produce, monitor, and control reproductive behaviours and population practices” ( Morgan & Roberts, 2012 , p. 243). These configurations are entangled with and reinforce moral regimes of abortion ( Moore et al., 2021 ).…”

What’s needed to improve safety and quality of abortion care: reflections from WHO/HRP Multi-Country Study on Abortion across the sub-Saharan Africa and Latin America and Caribbean regions

“…Evidence on various approaches to reduce abortion stigma have clearly shown that it hinders access at all levels of level care. 19 Future programmes must consider how stigma can affect delays to care, access to accurate information, and available social and financial support, all of which have economic and health implications. It will be important to use new approaches to reach women that are not reaching facility-level care.…”