Abortion Stigma is Simply Discrimination: Here Is How We Get Rid of It


Last week, I attended the annual International Federation of Gynecology and Obstetrics conference in Italy. During the five days I was there, nearly 500,000 women had abortions. Many of these women faced stigma, a mechanism of social control used to dehumanize and devalue women who need, or decide, to terminate pregnancies.

When we began to examine the social construct of abortion stigma several years ago, we found that very little had been published. And yet, it’s really the root of all barriers that women—and even providers—face to obtain or perform abortions.  Why do we legally deprive women of a health care service that could safe their lives? Why are women forced to undergo a waiting period in order to get an abortion? Why are abortion clinics often separate from other reproductive health care clinics? Why do women trade safety for secrecy and turn to “back-alley” providers? And the questions go on…

Stigma contributes to the idea that women who have abortions are not the norm, although they are. The social construct of abortion stigma creates an “us-versus-them” mentality—in spite of the fact that in the United States one in three women have abortions and a much higher share of all women globally terminate a pregnancy sometime during their reproductive lives, abortion is still constructed as something that is wrong, inappropriate, or deviant. Discriminating against women is therefore considered normal; 26 percent of women live in countries where abortion is legally restricted and many more live in places where they have to justify their abortion. If this isn’t discrimination, I don’t know what is.

“How can this decision be wrong?” asks Dr. Nozer Sheriar, a gynecologist in India. “How can any decision, choice or action taken by 43 million women each year around the world be wrong?” If all the women in the world who have had an abortion live together in one country, he points out, it would be the third most populous country in the world. Think about the level of discrimination against a group so large.

My colleague and fellow presenter at FIGO 2012, Tracy Weitz, has also spoken out about abortion stigma in the United States, arguing that even in the pro-choice community, we further the stigma by creating hierarchies of women—some who deserve an abortion, some who do not. And who gets to decide who can have an abortion? Doctors, institutions and policymakers do. We insist on talking about abortion with language such as “safe, legal and rare,” which reinforces the notion that abortion is wrong and abnormal. And even abortion providers and clinics—sometimes unknowingly—create an atmosphere that stigmatizes women. Some American women have shared that paying for their abortion felt “like a drug deal” and others say the security, while justified, made it “seem all the more like a shameful, secretive thing.”

But there are ways to change the norm. In Mexico City, says Dr. Patricio Sanhueza, they’ve taken steps to de-stigmatize abortion services by making clinics open and bright, without overt heavy security. “Understanding the story of the woman in the providers’ minds has created less prejudice,” he adds.

Kelly Culwell of International Planned Parenthood Federation says in their work they’re taking cues from clinics treating HIV clients and working to change provider-client interactions. “We are planning to have signs and statements that support women—that say ‘stigma-free services.’”

Part of breaking the stigma is removing the silence and we are doing it loudly and clearly. By talking about abortion stigma we can recognize how it is created and perpetuated and what our individual roles and responsibilities are in working toward stigma-free language, concepts, and services. At Ipas, we’ve developed a stigma scale to measure stigmatizing attitudes, beliefs, and actions at individual and community levels, and to evaluate stigma reduction interventions. We’ve already collected data from Ghana and Zambia and will develop interventions based on the findings and we’ll do more interviews and investigations using the scale in India, Mexico, Kenya, and Uganda.  

Fighting stigma is a daunting challenge—but the first battle is to start at home. We’re all guilty of stigmatizing women who seek abortions. Advocates must continue to change the narrative around abortion: Women are the center. They should have the power and the right to make their own decisions and to not be judged—by society, by their communities, by the health system, nor by us.

Like this story? Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

To schedule an interview with contact director of communications Rachel Perrone at rachel@rhrealitycheck.org.

  • marlowe28

    This continual misrepresentation of the meaning of the phrase “safe, legal and rare” is beyond annoying. In 2008, some feminists actually chastized Hillary Clinton for affirming that goal and decided that Barack Obama was the superior defender of women’s rights. How’s that working out? Don’t forget to ask the sixteen-year-olds who have to see a doctor to get a presription for Plan B even though every reputable professional in the field says that it’s unnecessary. And include the women of Washington, DC, who had their right to use their own tax money to provide poor women with abortions trades away in order to gain votes for Obama on an issue unrelated to women’s rights.

    The “rare” part of the former Democratic description of their approach to abortion did not stigmatize abortion. It recognized that having an abortion is a complex issue. For most women, there is an emotional and a financial component to the decision not to mention the time commitment. The word “rare” signalled the Democrats’ commitment to appropriate sex education for girls, accessible, affordable birth control and a real commitment to social policies that would allow women who choose an abortion due to economic issues to no longer have to make that choice.

    Please stop perpetrating the falsehood that Bill or Hillary Clinton, who both supported that language, or any of the Democrats who signed on to that goal were judging women who choose to have an abortion. 

  • marlowe28

    This continual misrepresentation of the meaning of the phrase “safe, legal and rare” is beyond annoying. In 2008, some feminists actually chastized Hillary Clinton for affirming that goal and decided that Barack Obama was the superior defender of women’s rights. How’s that working out? Don’t forget to ask the sixteen-year-olds who have to see a doctor to get a presription for Plan B even though every reputable professional in the field says that it’s unnecessary. And include the women of Washington, DC, who had their right to use their own tax money to provide poor women with abortions trades away in order to gain votes for Obama on an issue unrelated to women’s rights.

    The “rare” part of the former Democratic description of their approach to abortion did not stigmatize abortion. It recognized that having an abortion is a complex issue. For most women, there is an emotional and a financial component to the decision not to mention the time commitment. The word “rare” signalled the Democrats’ commitment to appropriate sex education for girls, accessible, affordable birth control and a real commitment to social policies that would allow women who choose an abortion due to economic issues to no longer have to make that choice.

    Please stop perpetrating the falsehood that Bill or Hillary Clinton, who both supported that language, or any of the Democrats who signed on to that goal were judging women who choose to have an abortion. 

  • julie-watkins

    but I also know that one of the worst abortion flame wars I participated in had a guy lecturing the whole email list that “people who say ‘rare’ don’t mean it” — and I was able to shut him up and push him out because he couldn’t quote where *I* had said that.

    The stigma isn’t meant by the people who say “rare”, it’s a weak link the anti-choice people were able to take advantage of, so it’s better to skip the word.

  • johann7

    This continual misrepresentation of the meaning of the phrase “safe, legal and rare” is beyond annoying.

    I disagree, I think it DOES construct abortion as intrinsically undesirable. What if (it’s not even really hypothetical) there exists some subset of women who, say, don’t like how hormonal contraceptives affect them, so they opt to use condoms as their primary method of contraception with termination of any pregnancies as a fall-back. I see nothing wrong with this, and given that typical-use failure rates for condoms are about 20%, women in this group would likely have to terminate a few pregnancies over the course of their lifespans. For that matter, we could consider a woman who doesn’t want to use any sort of contraception – she should still be able to decide to both have PIV sex AND not be pregnant without reproach (though that might get expensive in a hurry). “Rare” implies that these women are doing something wrong, that their approach to sex and reproduction management is sub-optimal and they *should* be behaving differently. No dice: “rare” still speaks to a latent view that abortion is something to be avoided, which is stigmatizing, and it’s why at least the progressive, sex-positive feminist wing of the reproductive rights coalition has ditched the language and simply moved on to an assertion of female bodily agency/autonomy/integrity.

     

    Also, if the intent is not clear, that’s at least as much the fault of the speaker. If people aren’t getting that “rare” doesn’t mean what they think it does, that alone is enough of a reason to adopt new language, especially when we’re talking political rhetoric that needs to appeal to a wide audience.

  • purplemistydez

    I hate when people say abortion should not be used as birth control or rare.  There are no limits on many abortions a woman should be able to get.  If we did, how many abortions would be the cut off point?   Still can’t force a woman to bear an unwanted pregnancy.  Plus we do not the medical issues or the home life a woman has.  1, 5, 20 abortions, it does not matter.  Women still retain their right to their bodies and what is done to it.

  • adolmd

    Part of breaking the stigma is being visible that YOU support abortion as an option. and talking about the attacks on repro rights. Wear a Silver Ribbon if you TRUST WOMEN with personal health decisions. http://www.oursilverribbon.org

    make your own, or make a donation and we can send you one. and you can also get a twibbon on your avatars.

  • nyer

    Thanks for this important effort.  There are tons of great arguments to support this, as you’ve begun to outline, but the fact that millions of women around the world are doing it is irrelevant and doesn’t make it right.  Probably millions of men around the world are paying for sex with children and adults to keep the sex slavery business going, but that doesn’t make it right.  Better to stick with human rights, health, economic and other solid arguments in support of abortion rights.

  • lauracarroll

    Thanks for the bold article, and kudos to your and Ipas efforts to de-stigmatize the narrative and actions surrounding abortion. It inspired my post appearing on huffpo today! http://huff.to/TKkDK3

    To truly de-stimatize means looking at the larger and embedded social and cultural set of beliefs related to women and their reproductive lives – it means challenging some core assumptions about a pronatal society.  This needs to happen for women to reach true reproductive freedom, and create a better world for us all ~Laura Carroll, author, The Baby Matrix

  • Pingback: Stuff & Things | Ginger Mandy

  • Pingback: Confronting Abortion Stigma - RH Reality Check

  • Pingback: Word Of The Month: Stigma |