Can stories reduce abortion stigma? Findings from a longitudinal cohort study

Abstract

Women often hide or selectively disclose abortion experiences due to stigma. Secrecy can help women avoid stigma but may also result in isolation and a lack of social support and contribute to broader social silence. This study assesses whether a book-club intervention can support abortion disclosure among book club participants and improve participants' affective responses towards women who have abortions and abortion providers. A total of 109 women from 13 all-female book clubs located in 9 US states read and discussed a non-fiction book that included stories about pregnancy and abortion, participated in a book club discussion and completed baseline, immediate post-intervention and endline surveys. In 10 out of the 13 book club discussions, at least one member disclosed having had a previous abortion. Overall, 15 of the 19 women who privately reported having a previous abortion self-disclosed one or more abortions during the book club discussion. Following the book club intervention, women reported having more positive feelings toward women who have abortions and abortion providers. Greater improvement and longer lasting effects were seen in groups where there was also an in-person disclosure of abortion experience. Findings suggest that exposure to the stories of women who have had abortions can reduce abortion stigma.

Pregnant Women's Experiences of Crisis Pregnancy Centers: When Abortion Stigmatization Succeeds and Fails

“…Exposure did not compel all respondents to accept a negative valuation of abortion; whether they were currently considering abortion and whether they already held negative beliefs about abortion mattered, too. These findings can offer insight into why baseline “warmth” toward abortion mattered in Cockrill and Biggs's () stigma‐reducing intervention: warmth may represent an absence of internalized abortion stigma, offering more receptive ground for actions aiming to (further) decrease stigma.…”

“…Other interaction‐focused work on the topic has studied the effectiveness of interaction‐based interventions aimed at reducing stigmatization of women who have abortions, including through discussions in book clubs (Cockrill and Biggs ) and among abortion patients (Littman, Zarcadoolas, and Jacobs ). These interventions are broadly based on the contact hypothesis (Allport ; Pettigrew and Tropp ; Williams Jr. ), which theorizes that contact with members of a stigmatized group can increase empathy and tolerance and decrease stigma.…”

“…Evidence for this theory is mixed, however, with some research showing increased prejudice of minority groups accompanying contact (Pettigrew and Tropp ). Further, evaluations of abortion stigma interventions have pointed to complex factors influencing their effectiveness, such as the importance of a group's baseline “warmth” toward abortion, with higher levels associated with more positive outcomes of the intervention (Cockrill and Biggs ). Factors like baseline “warmth” and its corollary, hostility, fall outside of traditional applications of the contact hypothesis.…”

Factors Shaping Women’s Pre-abortion Communication with Members of Their Social Network

“…Social support plays an important role in helping to counter stigma (15,16). Efforts to foster private discussion about abortion experiences, for example though book clubs, have been demonstrated to improve feelings about women who have abortions and abortion providers (17).…”

Ensuring our research reflects our values: The role of family planning research in advancing reproductive autonomy

“…By deliberatively and creatively formulating questions that reflect an emphasis on women’s autonomy and lived experiences, researchers can proactively move the conversation about reproductive health. Examples of such innovative work in our field in recent years include the Turnaway Study [29, 30], research investigating abortion stigma and its impact on women’s reproductive experiences [31, 32], women’s lived experiences of abortion and abortion decision-making [33, 34], and women’s experiences with contraceptive decision-making and counseling [21, 35]. Formative work that actively explores women’s own views on their reproductive health, as well as including community and patient stakeholders in the development of research questions, can help to ensure that researchers are guided by the needs of groups they are working to benefit.…”