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Journal ArticleDOI

Abortion stigma: a reconceptualization of constituents, causes, and consequences.

TL;DR: Five reasons why abortion is stigmatized are discussed, including the violation of female ideals of sexuality and motherhood, and additional causes of abortion stigma are suggested, 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.
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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Journal ArticleDOI
TL;DR: Most states that experienced the largest proportionate declines in the number of clinics providing abortions had enacted one or more new restrictions during the study period, but reductions were not always associated with declines in abortion incidence.
Abstract: CONTEXT National and state-level information about abortion incidence can help inform policies and programs intended to reduce levels of unintended pregnancy. METHODS In 2015–2016, all U.S. facilities known or expected to have provided abortion services in 2013 or 2014 were surveyed. Data on the number of abortions were combined with population data to estimate national and state-level abortion rates. The number of abortion-providing facilities and changes since a similar 2011 survey were also assessed. The number and type of new abortion restrictions were examined in the states that had experienced the largest proportionate changes in clinics providing abortion services. RESULTS In 2014, an estimated 926,200 abortions were performed in the United States, 12% fewer than in 2011; the 2014 abortion rate was 14.6 abortions per 1,000 women aged 15–44, representing a 14% decline over this period. The number of clinics providing abortions declined 6% between 2011 and 2014, and declines were steepest in the Midwest (22%) and the South (13%). Early medication abortions accounted for 31% of nonhospital abortions, up from 24% in 2011. Most states that experienced the largest proportionate declines in the number of clinics providing abortions had enacted one or more new restrictions during the study period, but reductions were not always associated with declines in abortion incidence. CONCLUSIONS The relationship between abortion access, as measured by the number of clinics, and abortion rates is not straightforward. Further research is needed to understand the decline in abortion incidence.

501 citations

Journal ArticleDOI
TL;DR: The national abortion rate has resumed its decline, and no evidence was found that the overall drop in abortion incidence was related to the decrease in providers or to restrictions implemented between 2008 and 2011.
Abstract: CONTEXT Following a long-term decline, abortion incidence stabilized between 2005 and 2008. Given the proliferation of state-level abortion restrictions, it is critical to assess abortion incidence and access to services since that time. METHODS In 2012–2013, all facilities known or expected to have provided abortion services in 2010 and 2011 were surveyed. Data on the number of abortions were combined with population data to estimate national and state-level abortion rates. Incidence of abortions was assessed by provider type and caseload. Information on state abortion regulations implemented between 2008 and 2011 was collected, and possible relationships with abortion rates and provider numbers were considered. RESULTS In 2011, an estimated 1.1 million abortions were performed in the United States; the abortion rate was 16.9 per 1,000 women aged 15–44, representing a drop of 13% since 2008. The number of abortion providers declined 4%; the number of clinics dropped 1%. In 2011, 89% of counties had no clinics, and 38% of women of reproductive age lived in those counties. Early medication abortions accounted for a greater proportion of nonhospital abortions in 2011 (23%) than in 2008 (17%). Of the 106 new abortion restrictions implemented during the study period, few or none appeared to be related to state-level patterns in abortion rates or number of providers. CONCLUSIONS The national abortion rate has resumed its decline, and no evidence was found that the overall drop in abortion incidence was related to the decrease in providers or to restrictions implemented between 2008 and 2011.

307 citations

Journal ArticleDOI
TL;DR: More research, using validated measures, is needed to enhance understanding of abortion stigma and thereby reduce its impact on affected individuals.
Abstract: Context Although stigma has been identified as a potential risk factor for the well-being of women who have had abortions, little attention has been paid to the study of abortion-related stigma. Methods A systematic search of the databases Medline, PsycArticles, PsycInfo, PubMed and Web of Science was conducted; the search terms were “(abortion OR pregnancy termination) AND stigma*.” Articles were eligible for inclusion if the main research question addressed experiences of individuals subjected to abortion stigma, public attitudes that stigmatize women who have had abortions or interventions aimed at managing abortion stigma. To provide a comprehensive overview of this issue, any study published by February 2015 was considered. The search was restricted to English- and German-language studies. Results Seven quantitative and seven qualitative studies were eligible for inclusion. All but two dated from 2009 or later; the earliest was from 1984. Studies were based mainly on U.S. samples; some included participants from Ghana, Great Britain, Mexico, Nigeria, Pakistan, Peru and Zambia. The majority of studies showed that women who have had abortions experience fear of social judgment, self-judgment and a need for secrecy. Secrecy was associated with increased psychological distress and social isolation. Some studies found stigmatizing attitudes in the public. Stigma appeared to be salient in abortion providers’ lives. Evidence of interventions to reduce abortion stigma was scarce. Most studies had limitations regarding generalizability and validity. Conclusion More research, using validated measures, is needed to enhance understanding of abortion stigma and thereby reduce its impact on affected individuals.

233 citations

Journal ArticleDOI
TL;DR: In this article, a social-psychological framework for understanding the stigma of having an abortion and identifying individual stigma management strategies women use to mitigate negative intrapersonal and interpersonal consequences of abortion stigma is presented.
Abstract: Drawing on interviews with U.S. women, this article offers a social–psychological framework for understanding the stigma of having an abortion and identifies the individual stigma management strategies women use to mitigate negative intrapersonal and interpersonal consequences of abortion stigma. We also contribute to contemporary understandings of abortion stigma by theorizing how aspects of abortion stigma—such as its concealability and episodic expression—interfere with women's potential to collectively manage or dismantle abortion stigma. Finally, we discuss how our conceptual framework can be used to inform the development of a measure of the stigma experiences of women who have had an abortion, which can help improve health and well-being outcomes for women.

160 citations


Cites background from "Abortion stigma: a reconceptualizat..."

  • ...As the centrality and salience of abortion shifts over time, abortion stigma may take on an episodic quality and the potential for distress may decrease (Norris et al. 2011)....

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Journal ArticleDOI
TL;DR: It is demonstrated that the reasons women seek abortion are complex and interrelated, similar to those found in previous studies, and important that policy makers consider women’s motivations for choosing abortion.
Abstract: Background: The current political climate with regards to abortion in the US, along with the economic recession may be affecting women’s reasons for seeking abortion, warranting a new investigation into the reasons why women seek abortion. Methods: Data for this study were drawn from baseline quantitative and qualitative data from the Turnaway Study, an ongoing, five-year, longitudinal study evaluating the health and socioeconomic consequences of receiving or being denied an abortion in the US. While the study has followed women for over two full years, it relies on the baseline data which were collected from 2008 through the end of 2010. The sample included 954 women from 30 abortion facilities across the US who responded to two open ended questions regarding the reasons why they wanted to terminate their pregnancy approximately one week after seeking an abortion. Results: Women’s reasons for seeking an abortion fell into 11 broad themes. The predominant themes identified as reasons for seeking abortion included financial reasons (40%), timing (36%), partner related reasons (31%), and the need to focus on other children (29%). Most women reported multiple reasons for seeking an abortion crossing over several themes (64%). Using mixed effects multivariate logistic regression analyses, we identified the social and demographic predictors of the predominant themes women gave for seeking an abortion. Conclusions: Study findings demonstrate that the reasons women seek abortion are complex and interrelated, similar to those found in previous studies. While some women stated only one factor that contributed to their desire to terminate their pregnancies, others pointed to a myriad of factors that, cumulatively, resulted in their seeking abortion. As indicated by the differences we observed among women’s reasons by individual characteristics, women seek abortion for reasons related to their circumstances, including their socioeconomic status, age, health, parity and marital status. It is important that policy makers consider women’s motivations for choosing abortion, as decisions to support or oppose such legislation could have profound effects on the health, socioeconomic outcomes and life trajectories of women facing unwanted pregnancies.

147 citations


Cites background from "Abortion stigma: a reconceptualizat..."

  • ...; licensee BioMed Central L Commons Attribution License (http://creativec reproduction in any medium, provided the or their abortion experiences or engage in policy discussions as a represented group [3-5]....

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References
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Journal ArticleDOI
TL;DR: In this article, the authors discuss the relationship between information control and personal identity, including the Discredited and the Discreditable Social Information Visibility Personal Identity Biography Biographical Others Passing Techniques of Information Control Covering.
Abstract: CONTENTS 1. Stigma and Social Identity Preliminary Conceptions The Own and the Wise Moral Career 2. Information Control and Personal Identity The Discredited and the Discreditable Social Information Visibility Personal Identity Biography Biographical Others Passing Techniques of Information Control Covering 3. Group Alignment and Ego Identity Ambivalence Professional Presentations In-Group Alignments Out-Group Alignments The Politics of Identity 4. The Self and Its Other Deviations and Norms The Normal Deviant Stigma and Reality 5. Deviations and Deviance

17,631 citations

Book
01 Jan 1963
TL;DR: In this article, the authors discuss the relationship between information control and personal identity, including the Discredited and the Discreditable Social Information Visibility Personal Identity Biography Biographical Others Passing Techniques of Information Control Covering.
Abstract: CONTENTS 1. Stigma and Social Identity Preliminary Conceptions The Own and the Wise Moral Career 2. Information Control and Personal Identity The Discredited and the Discreditable Social Information Visibility Personal Identity Biography Biographical Others Passing Techniques of Information Control Covering 3. Group Alignment and Ego Identity Ambivalence Professional Presentations In-Group Alignments Out-Group Alignments The Politics of Identity 4. The Self and Its Other Deviations and Norms The Normal Deviant Stigma and Reality 5. Deviations and Deviance

13,742 citations

Journal ArticleDOI
TL;DR: Rates of unintended pregnancy have declined, probably as a result of higher contraceptive prevalence and use of more effective methods, and efforts to achieve further decreases should focus on reducing risky behavior, promoting the use of effective contraceptive methods and improving the effectiveness with which all methods are used.
Abstract: Context Current debates on how to reduce the high U.S. abortion rate often fail to take into account the role of unintended pregnancy, an important determinant of abortion. Methods Data from the 1982, 1988 and 1995 cycles of the National Survey of Family Growth, supplemented by data from other sources, are used to estimate 1994 rates and percentages of unintended birth and pregnancy and the proportion of women who have experienced an unintended birth, an abortion or both. In addition, estimates are made of the proportion of women who will have had an abortion by age 45. Results Excluding miscarriages, 49% of the pregnancies concluding in 1994 were unintended; 54% of these ended in abortion. Forty-eight percent of women aged 15-44 in 1994 had had at least one unplanned pregnancy sometime in their lives; 28% had had one or more unplanned births, 30% had had one or more abortions and 11% had had both. At 1994 rates, women can expect to have 1.42 unintended pregnancies by the time they are 45, and at 1992 rates, 43% of women will have had an abortion. Between 1987 and 1994, the unintended pregnancy rate declined by 16%, from 54 to 45 per 1,000 women of reproductive age. The proportion of unplanned pregnancies that ended in abortion increased among women aged 20 and older, but decreased among teenagers, who are now more likely than older women to continue their unplanned pregnancies. The unintended pregnancy rate was highest among women who were aged 18-24, unmarried, low-income, black or Hispanic. Conclusion Rates of unintended pregnancy have declined, probably as a result of higher contraceptive prevalence and use of more effective methods. Efforts to achieve further decreases should focus on reducing risky behavior, promoting the use of effective contraceptive methods and improving the effectiveness with which all methods are used.

1,543 citations

Book
01 Jan 1999
TL;DR: Testing Women, Testing the Fetus as discussed by the authors explores the "geneticization" of family life in all its complexity and diversity, and examines how women of diverse racial, ethnic, class and religious backgrounds perceive prenatal testing, the most prevalent and routinized of new reproducing technologies.
Abstract: Rich with the voices and stories of participants, these touching, firsthand accounts examine how women of diverse racial, ethnic, class and religious backgrounds perceive prenatal testing, the most prevalent and routinized of the new reproducing technologies. Based on the author's decade of research and her own personal experiences with amniocentesis, Testing Women, Testing the Fetus explores the "geneticization" of family life in all its complexity and diversity.

905 citations

Journal ArticleDOI
TL;DR: The authors hypothesize that increased anticipated stigma, greater centrality of the stigmatized identity to the self, increased salience of the identity, and possession of a stigma that is more strongly culturally devalued all predict heightened psychological distress.
Abstract: The current research provides a framework for understanding how concealable stigmatized identities impact people's psychological well-being and health. The authors hypothesize that increased anticipated stigma, greater centrality of the stigmatized identity to the self, increased salience of the identity, and possession of a stigma that is more strongly culturally devalued all predict heightened psychological distress. In Study 1, the hypotheses were supported with a sample of 300 participants who possessed 13 different concealable stigmatized identities. Analyses comparing people with an associative stigma to those with a personal stigma showed that people with an associative stigma report less distress and that this difference is fully mediated by decreased anticipated stigma, centrality, and salience. Study 2 sought to replicate the findings of Study 1 with a sample of 235 participants possessing concealable stigmatized identities and to extend the model to predicting health outcomes. Structural equation modeling showed that anticipated stigma and cultural stigma were directly related to self-reported health outcomes. Discussion centers on understanding the implications of intraindividual processes (anticipated stigma, identity centrality, and identity salience) and an external process (cultural devaluation of stigmatized identities) for mental and physical health among people living with a concealable stigmatized identity.

648 citations


"Abortion stigma: a reconceptualizat..." refers background in this paper

  • ...Abortion stigma is usually considered a “concealable” stigma: It is unknown to others unless disclosed (Quinn & Chaudior, 2009)....

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  • ...Consequently, those stigmatized by abortion cope not only with the stigma once revealed, but also with managing whether or not the stigma will be revealed (Quinn & Chaudior, 2009)....

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  • ...Nevertheless, even a concealed stigma may lead to an internal experience of stigma and health consequences (Quinn & Chaudior, 2009)....

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