Abortion stigma in the United States: Quantitative and qualitative perspectives from women seeking an abortion

Objectives. Abortion stigma has been shown to be predictive of negative emotional reactions after an abortion. Limited research has been conducted on abortion stigma in the United States (US). The objectives of this dissertation were to use quantitative and qualitative methodologies to learn about stigma among abortion patients in the US.;Methods. The quantitative data came from the Guttmacher Institute's 2008 Abortion Patient Survey (APS). The APS is a clinic-based survey that collects data on abortion patient characteristics. The sample consisted of 4,613 women. The proportion of abortion patients who perceive and/or internalize stigma was estimated. Stratified multivariate logistic regression was to estimate the association between women's characteristics and perceived and internalized stigma by race and ethnicity.;For the qualitative component, 49 in-depth interviews were conducted with women at abortion clinics. Women were recruited from three different regions of the US. Analyses of the transcripts were conducted to assign meaning to themes and concepts, and to explore patterns of similarities and differences across interviews.;Results. Two-thirds of abortion patients perceived stigma from other people. Less than half (40%) perceived stigma from friends and family, and 12% from their healthcare provider. Over half needed to keep the abortion a secret, and one-third cared about other people's opinions about abortion. The proportion of women reporting perceived and internalized stigma varied significantly by race/ethnicity. Region of residence, number of previous abortions, not having one's mind made up about the abortion at the time of making the appointment, and not having the man involved know about the abortion were found to be associated with stigma across the race/ethnicity groups.;Qualitatively, many abortion patients perceived high levels of abortion stigma. Women perceived stigma from friends and family, people in their community and general society. Although most patients did not experience overt stigmatization, perceived stigma was sufficient to create negative feelings of self and need for secrecy about the abortion.;Conclusion. Study results provide evidence of perceived and internalized stigma among abortion patients, as well as personal characteristics strongly associated with stigma. Future research should aim to understand the impact of abortion stigma on women's health and well-being.