Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion

Abstract

Objective To prospectively assess perceptions of abortion stigma after receiving or being denied an abortion over 5 years, the factors associated with perceived abortion stigma, and the effects of perceived abortion stigma on psychological well-being. Methods We recruited people seeking abortion from 30 facilities across the US, and interviewed them by phone one week post-abortion seeking, then semiannually for 5 years. We used adjusted mixed effects regression analyses to examine the abortion stigma trajectories of those who obtained an abortion near a facility's gestational age limit (Near-limits) compared to those denied an abortion because they were just over the limit and carried their pregnancies to term (Turnaway-births). Results Of the 956 people recruited, we removed 28 due to ineligibility or missing data, leaving a final sample of 928. In unadjusted analyses, at one-week post-abortion seeking, over half of those seeking abortion perceived that if others knew they had sought an abortion, they would be looked down upon at least "a little bit" by people close to them (60%) or by people in their community (56%). In longitudinal adjusted analyses, people denied an abortion and who carried their pregnancies to term (Turnaway-birth group) reported significantly lower baseline perceived abortion stigma from people close to them (-0.38; 95% CI,-0.59,-0.16) and from people in their community (0.30; 95% CI,-0.52,-0.08), than Near-limits, differences that remained statistically significant for 1.5 years. Overall perceived abortion stigma declined significantly (p < .001) for both study groups. High perceived abortion stigma at baseline was associated with higher odds of experiencing psychological distress years later (adjusted Odds Ratio, 3.98; 95% CI, 1.39, 11.37).

Developing and validating the Psychosocial Burden among people Seeking Abortion Scale (PB-SAS)

“…People who reported concerns about the reactions from parents, friends and other people in their lives are likely perceiving some stigma around the pregnancy decision. This finding echoes other work which has demonstrated that most people seeking abortion perceive and internalize stigma around the abortion and that this contributes to higher levels of psychological distress up to five years after abortion-seeking [ 9 , 52 ]. Similarly, other research has found that when young people involve an unsupportive parent, they are more likely to anticipate poor coping after the abortion [ 53 ].…”

“…Being confronted with an unintended pregnancy in the face of competing demands, concerns about the well-being of loved ones, lack of social support, and/or lack of financial or emotional resources to obtain pregnancy-related care or to parent a new baby may contribute to feelings of distress. Furthermore, people considering abortion may experience abortion stigma which is associated with negative post-abortion emotions and mental health symptoms [ 8 , 9 ].…”

Laws Restricting Access to Abortion Services and Infant Mortality Risk in the United States

“…Additionally, social stigma attached to abortion may also have an effect on mental health of women seeking to terminate their pregnancy. For example, researchers observed that women who were denied an abortion and, therefore, carried their pregnancies to term experienced psychological distress a year later [34], which can detrimentally affect the health of their infants. Researchers may want to explore casual methods to understand whether abortion laws cause infant mortality.…”

Application of the sociology theory ethnomethodology to medical education: Utilization of small group learning to combat unconscious bias in patient care

“…The belief is termed “an incorrigible proposition,” defined as a firm fundamental perspective one maintains about the world, which can never be proven wrong to the believer, as counterevidence will be ignored or rationalized [ 8 , 10 , 11 ]. In subsets of the healthcare provider population, existence of incorrigible propositions contributes to sustenance of stigmas towards various diseases (tuberculosis, leprosy, sexually transmitted diseases) and procedures (abortion or cosmetic surgery) [ [12] , [13] , [14] , [15] , [16] , [17] ]. Likewise, incorrigible propositions partially account for why coronary artery disease is treated less aggressively amongst women and minority ethnicities [ 1 , 3 , 18 ].…”