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This valid and reliable scale can be used in research examining abortion stigma and related outcomes (e.g., women's health, relationships and behavior). The scale can also be used to evaluate programs and interventions that aim to reduce the stigma experienced by women who have abortions.

CONTEXT Social norms and stigma may play an important role in reproductive health behavior and decision-making for young women in the U.S. South, who disproportionately experience unintended pregnancies. Research has yet to describe the presence and manifestations of social norms and stigmas around unintended pregnancy, parenting, adoption and abortion from the perspective of this population. METHODS Six focus groups and 12 cognitive interviews (n=46) were conducted with young (19-24), low-income women in Birmingham, Alabama from December 2013-July 2014, recruited from two public health department centers and a community college. Semi-structured interview guides were used to facilitate discussion around social perceptions of unintended pregnancy and subsequent pregnancy decisions. The sessions were audio-recorded, transcribed, and analyzed using a theme-based approach. RESULTS Respondents described community expectations for pregnancy to occur in the context of monogamous relationships, where both partners were mature, educated and financially stable. In contrast, participants reported that unintended pregnancy outside of those circumstances is common, and that the community expects young women to bear and raise their child when faced with an unintended pregnancy. Social views about women who choose to do so are more positive than those about women who choose abortion or adoption, which the participants generally perceived as unacceptable alternatives to parenting and discussed in terms of negative labels, social judgment, and non-disclosure. CONCLUSIONS Findings inform the development of interventions to reduce stigma and create the social environment in which young women are empowered to make the best reproductive decisions for themselves.

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