Study documenting how women and men who disclosed abortions perceived others' reactions and determinants of those perceptions and found that whereas most people disclosing an abortion received support or sympathy, a substantial minority received stigmatizing reactions, which could plausibly have a negative impact on health.

‘To decide in order to live’ is a radio novela about the histories of women and men who take important decisions in the face of difficult situations in their lives. These decisions break down barriers and are possible because they are based in human rights. The characters and situations are based on real-life – life stories that echo in your heart.

A comparative case study investigating the efficacy and acceptability of laws and policies that permit conscientious objection and ensure access to legal abortion service.

A qualitative study exploring pregnancy intentions among low-income women in Western Pennsylvania. Authors found that women's reactions to antiabortion attitudes may perpetuate abortion stigma

A synthesis of qualitative literature that reports findings about abortion stigma paints a picture of how stigma appears in different geographic regions, and across the different levels of the ecological model.

A systematic literature review found that more research, using validated measures, is needed to enhance understanding of abortion stigma and thereby reduce its impact on affected individuals.

A systematic review of articles and reports focused on indicators of quality abortion care found that there is little agreement about indicators for measuring quality; more work is needed to ensure efforts to assess quality are informed and coordinated.

A video panel describing the different contexts of women who seek abortion after the first trimester.

Although abortion is now legal in Kenya under expanded circumstances, access is limited and many providers and individuals still believe it is illegal. This study aimed to characterise Kenyan women’s perceptions and experiences with abortion and post-abortion care (PAC) services in Nairobi regarding barriers to care, beliefs about abortion, and perceived stigma. In response to stigma, participants developed a sense of agency and self-reliance, which allowed them to prioritise their own healthcare needs over the concerns of others. To adequately address perceived stigma as a barrier to abortion- and PAC-seeking, significant cultural norm shifting is required.

Although Benevolent Sexism (BS)—an ideology that highly reveres women who conform to traditional gender roles—is cloaked in a superficially positive tone, being placed upon a pedestal is inherently restrictive.

Although illegal abortion is believed to be widely practised in Haiti, few data exist on such practices. This study aimed to learn about illegal abortion access, methods, and perceived barriers to abortion-related care. Additionally, the study aimed to identify the proportion of unscheduled antepartum visits to a public hospital that were attributable to unsafe abortion in Cap Haitien, Haiti. Among the focus groups, there was widespread knowledge of misoprostol self-managed abortion. Women described use of multiple agents in combination with misoprostol. Men played key roles in abortion decision-making and in accessing misoprostol.

An evaluation was conducted to assess women's access to abortion services as part of an ongoing program to operationalize the new exemptions for legal abortion. Abortion stigma and court order requirement are major barriers to access services.

Analysis explores how stigma contributes to unethical behavior by physicians resulting in care that is delayed or refused.

Analysis of nationally representative data to estimate the prevalence of negative abortion attitudes in South Africa and to identify racial, socioeconomic and geographic differences.

Analysis of social media used and perceived stigma suggest that stigma has a similar dampening effect on face-to-face and Twitter interactions.

Analysis of Texas abortion law exploring how language in legislative documents use generates abortion stigma.

Approximately 47 000 women die each year worldwide as a result of the complications of unsafe abortion, almost exclusively in low- and middle-income countries with restrictive abortion laws. In these countries, very few women who comply with the conditions imposed by the law can access safe abortion services in the public health system. The main obstacle is the unwillingness of gynecologists and obstetricians to provide abortion services by claiming conscientious objection, which is often used to hide their fear of the stigma associated with abortion. This happens because many colleagues are unaware that without access to legal services these women will resort to an unsafe abortion and its consequences. This violates the statement from FIGO's Committee for the Ethical Aspects of Human Reproduction and Women's Health, which asserts that: “The primary conscientious duty of obstetrician–gynecologists is at all times to treat, or provide benefit and prevent harm, to the patients for whose care they are responsible. Any conscientious objection to treating a patient is secondary to this primary duty.”

Article about the movement towards a democractic vote for abortion rights in Ireland

Article analysis of the consequences of unsafe abortion in Malawi based on 485 in-depth interviews. Stigma related to unwanted pregnancy and to abortion discussed.

Article commentary discussion the stigmatization of abortion within the context of medicine.

Article commentary exploring what a world without abortion stigma might look like at the individual, community, and institutional level.

Article conceptualizing abortion stigma roots, manifestations and impacts. Lays out a research agenda to measure and map abortion stigma and impact on health.

Article describing rates of internalized stigma in the USA; comparison by race/Hispanic ethnicity.

Article describing small rural community context in Ghana, contrasting social restrictions around abortion to national-level laws that permit it.

Article describing sociohistorical and geopolitical context for Indonesia's abortion laws and culture.

Article describing the development of a scale to measure individual-level abortion stigma. Includes an analysis of the characteristics of women who report abortion stigma.

Article describing the development of the Stigmatizing Attitudes, Beliefs, and Actions Scale grounded in qualitative research in Ghana and Zambia

Article describing the history and development of abortion counseling in the United States.

Article discussing abortion stigma and how it manifests. Includes an analysis of legal restrictions and abortion stigma in US Supreme Court decisions.

Article discussing abortion stigma, drawing from social science literature to describe groups affected by abortion stigma.

Article discussing barriers to safe abortion internationally

Article discussing implications for privileging faith-based organizations for international development aid.

Article discussing qualitative findngs contextualizing unsafe abortion in rural Ghana, identifying shame and stigma as a key theme.

Article discussing the manifestation and consequences of stigma in reproductive health.

Article examines circumstances underlying adolescent girls' decisions to have abortions outside of the health care setting. Stigma identified as a barrier to safe abortion.

Article examines how the US Supreme Court's abortion decisions contribute to abortion stigma.

Article examines the economic consequences of the stigmatisation and illegality of abortion and its almost complete removal from public health services in Poland since the late 1980s

Article examining abortion stigma in five countries. Stigma was perceived in both legally liberal and restrictive settings.

Article examining abortion discourse among Bolivian doctors.

Article examining abortion practice in the Carribean. Findings suggest that an increasing number of women are self-inducing abortions with misoprostol to avoid doctors, high fees and public stigma

Article examining evidence-based practices for providing emotional care for other stigmatized services. Discusses these strategies and applying them to abortion care settings.

Article examining lay narratives and their implications about abortion among men and women in central Kenya.

Article examining stigma construction in "post-abortion recovery groups" and its linkages to anti-abortion activism

Article examining stigmatizing attitudes towards abortion among HIV positive women who choose to end a pregnancy and those who choose to give birth.

Article explores relationship between stigma and abortion complications in the US, where unsafe abortion is rare.

Article explores the experience of doctors and how they are prevented and prohibited from performing abortions in both explicit and implicit ways.

Article explores the role that stigma the role of a clinician as a social, economic, and political agent in determining how conscientious objection is practiced.

Article exploring experience of stigma among health care providers. Findings suggest that the experience of stigma for those providing abortion care is not a static or fixed loss of status. It is a dynamic situation in which those vulnerable to stigmatization can avoid, resist, or transform the stigma that would attach to them by varying degrees within selective contex

Article exploring HIV-positive women's abortion decisions in South Africa. Findings suggest that stigma and discrimination affect connections between abortion, pregnancy and HIV/AIDS, and that abortion may be more stigmatised than HIV/AIDS

Article exploring how low-income abortion clients in US states where public funding was and was not available perceived the role of public funding.

Article exploring how men and women make decisions about pregancy and abortion in Peru. Stigma surrounding abortion and some pregnancies identified.

Article exploring psychometric properties of a scale to measure stigma experienced by abortion providers.

Article exploring the experience of young women terminating pregnancy in a tertiary hospital abortion clinic in India.

Article exploring the sources, experiences and consequences of abortion stigma among women who had abortions, their male partners, and the general population.

Article looking at social stigma, motherhood, and physicians' experience in Ghana.

Article offers a social-psychological framework for understanding how women manage the stigma of having an abortion.

Article presenting a sociological framework for understnading how new cultural constructions that draw equivalences and remove blame shape public and structural stigma over time.

Article presenting findings from a nationally representative survey about stigmatizing attitudes in Mexico.

Article presenting results from qualitative inquiry into attitudes towards abortion and unwanted pregnancy in in Amukpe, Nigeria.

Article presenting theoretical framework for describing the narratives of abortion decision-making in Ethiopia.

Article presents a refined conceptual framework for abortion stigma and proposes a learning agenda to guide research and programmatic efforts to address abortion stigma.

Article presents a theoretical overview of stigma and a taxonomy of four types of stigma (public, self, by association, and structural).

Article presents an application of stigma theory to nurses attending abortions.

Article proposes three major strategies that would help to destigmatise abortion in the Ghana.

Article providing results from qualitative pilot study of post-abortion intervention designed to mitigate the effects of abortion by creating a "culture of support." Results suggest that women felt positively about the intervention.

Article reporting characteristics of women seeking abortion in Iran based on Iran Low Fertility Survey and exploring reasons for and consequences of abortion using in-depth interviews. Stigma discussed.

Article reporting findings from an evaluation of the Provider Share Workshop intervention to reduce stigma experienced by abortion providers in the US.

Article reporting findings from interviews with Ghanain physicians, which identifies stigma as a key factor leading to abortion complications.

Article reporting on a validation of the key ingredients of contact-based interventions to address stigma associated with mental illness.

Article reporting qualitative findings illustrating stigma as a factor in post-abortion care.

Authors adapted global stigma and discrimination measurement tools and field tested them for use in Thailand, including a health facility questionnaire to capture staff attitudes, and the policy environment, and a brief questionnaire for people living with HIV to capture their experiences.

Authors developed an analyzed multi-dimensional measures of norms and stigmas around all pregnancy decisions in the U.S. South.

Authors explored reproductive agency in relation to unsafe abortion among young women seeking post-abortion care and found that reproductive agency was constrained by gender norms and power imbalances and strongly influenced by stigma.

Authors present a illustrative evidence on the health consequences of stigma and a conceptual framework describing the psychological and structural pathways through which stigma influences health.

Authors propose a framework to understand stigma using a multilevel approach that can be tailored to stigmatized statuses.

BACKGROUND: The aim of this post-intervention assessment was to measure the effects of community intervention on the knowledge and attitudes of women regarding safe abortion in Ethiopia. METHODS: In 2014, following implementation of an educational intervention on sexual and reproductive health from December 2012 to December 2013, 800 women were interviewed about their knowledge, attitudes and practices regarding abortion. Multivariate regression analyses of respondents' demographics, sources of abortion information, knowledge and attitudes about safe abortion were conducted. RESULTS: More women in the intervention community knew safe abortion was available in the community (76% vs. 57%; p < 0.001). Women in the intervention community had greater odds of feeling that women should have access to safe abortion services (adjusted odds ratio [aOR]: 1.55, 95% confidence interval [CI]: 1.06, 2.28) after adjusting for socio-demographic characteristics. They had significantly greater odds of feeling comfortable and confident talking to a healthcare provider (aOR: 2.44, 95% CI: 1.55, 3.84) and/or her partner (aOR: 2.47, 95% CI: 1.58, 3.85) about abortion. CONCLUSIONS: Increased mobilization of community networks in disseminating sexual health and abortion information was followed by increased knowledge of abortion services in the intervention community and improved reproductive choices for women.

Barriers related to knowledge and information, along with logistic, emotional, financial, cultural and religious barriers culminated in delays in obtaining comprehensive abortion services. Religion influenced social stigma, which manifested most powerfully in the obstructive behavior of health care providers and health insurance companies. Lack of understanding of current laws on abortion and conscientious objection was evident on the part of patients, health care providers and insurers.

Based on content analysis of online pregnancy forums, researchers identified attitudes towards abortion as a factor in women's decision-making about genetic screening.

Based on qualitative interviews with unmarried women in Iran, researchers found that the stigma surrounding sexuality activity creates limitations for unmarried women in accessing reproductive health services, even when services are available.

Based on themes from an inroads-member discussion, this proposed framework integrates concepts of stigma with the WHO framework for quality care.

Best practice tools for health facilities to counter stigma related to HIV status, gender identity, sexual orientation, and behaviors such as sex work or drug use.

Blog post explores how popular culture can play a role in either upholding stigma or dismantling it.

Blog post highlights steps for identifying, adapting and implementing scales to measure abortion stigma.

Blog post reporting an interview with Katie Gillum about using video to destigmatize and normalize women's experiences with abortion.

Book chapter examines how legal actors advovate, regulate and adjudicate abortion and its relationship to stigma.

Briefing that provides information, ideas and tools to help facilitate dynamic workshops. Aimed at CBOs and NGOs working HIV and AIDS. Not specific to stigma, but an essential skill in stigma busting.

Briefing that provides information, ideas and tools to help facilitate dynamic workshops. Not specific to stigma, but an essential skill in stigma busting.

Commentary and agenda for action for getting misoprostol in women's hands.

Commentary discussing legitimacy paradox: when abortion providers do not disclose their work, their silence perpetuates a stereotype that abortion work is unusual, or that legitimate, mainstream doctors do not perform abortions.

Commentary examining conceptualization of abortion stigma and argument for precision in understanding stigma in order to carry out better research to understand and measure it, design interventions to mitigate it, and evaluate those interventions.

Comparison of reported HIV stigma experienced by women requesting contraception at inegrated sexual health clinics vs. family planning-only clinics in the UK. Perceived stigma is higher at integrated clinics than family planning-only.

Content analysis of television plotlines found that abortion is presented differently depending on legal setting, and that abortion provision is linked to violence

Cross-sectional examination of midwives' attitudes toward abortion in Ethiopia to understand their decisions about service provision.

Currently, abortion can be lawfully performed in China at any gestational stage for a wide range of social and medical reasons. This article critically explores the Chinese regulatory model of abortion in order to examine its practical effects on women

Description of an 8-week course on managing stigma based on social psychology and social neuroscience research. Includes conceptualization of stigma and recommendations for intervention.

Description of the implementation of 5 Safe Abortion Information Hotlines in countries where abortion is restricted.

Description of the making of a film to share knowledge about barriers to safe abortion in Asia and to facilitate conversations about the right to safe abortion.

Despite the presence of abortion services in Great Britain, a diverse group of women still experiences logistical and personal barriers to accessing care through the formal healthcare system, or prefer the privacy of conducting their abortions in their own homes.

Diagnosis of fetal anomaly is a significant life event and social stigma can negatively impact on the well-being of women opting for an abortion. This study investigated the psychometric properties of a measure of stigma among women who had had an abortion after diagnosis of fetal anomaly in a German setting.

Discourse analysis of abortion expressed in two main Ugandan daily newspapers.

Discussion about the similarities and differences between abortion and multi-fetal pregnancy reduction, including the tug-of-war over naming, highlights ongoing contestation about the relationship between the law, ethics, and women's bodies.

Discussion of conscious objection and its relationship to fear of experiencing stigma and discrimination by providing abortion care. Discusses a need for a paradigm shift in order to ensure access to services.

Discussion of role of stigma in both abortion and surrogacy and a common legal paradigm: state regulation on the pregnant body, rooted in traditional gender roles.

Discussion of the need for collaboration across sectors to support sexual health on the basis of human rights laws and standards. Discusses the role of stigma.

Discussion of the role of "conscious" in abortion provision.

Discussion of the role of stigma in abortion and surrogacy, including they way that legal restrictions perpetuate social stigma. Examination of Paula Abrams' article "The Bad Mother: Stigma, Abortion, and Surrogacy"

Downloadable toolkit with facilitator instructions for activities designed for participants to understand, identify and challenge HIV stigma.

Drawing on ethnographic fieldwork in Senegal, the author illustrates how post-abortion care accomplished reproductive governance where abortion is prohibited. Although post-abortion care offers life-saving care to women with complications of illegal abortion, it institutionalizes abortion stigma by scrutinizing women's bodies and masking induced abortion within and beyond the hospital.

Drawing on ethnographic research, this article describes how Burkina Faso's post-abortion-care policy emerged, resulting in widespread support for PAC but stifled debate about further legalisation of abortion.

Drawing on intra-categorical intersectionality, the supportability aspect starts from the event of a pregnancy to unravel the interwoven embodied and social realities implicated in women experiencing pregnancy as personally supportable/unsupportable, and socially supported/unsupported.

Early reports heralded the development of abortion pills as promising a reproductive revolution. Some twenty-five years on, this article considers the extent to which this promise has been fulfilled in the context of the Republic of Ireland. It focuses in particular on the work of two online collectives, Women on Web and Women Help Women. Drawing on a small number of interviews with activists, support groups, service providers, doctors, and government officials, the article assesses, first, the extent to which abortion pills have empowered women and, second, their offer of privacy. It argues that while home use of pills has had enormous importance in furthering each of these goals and, more generally, women’s health, it does not offer a panacea for current deficiencies in reproductive health care. The empowerment offered by abortion pills is necessarily precarious and partial, with the privacy offered by the pills operating not just as part of that empowerment but also as a significant limitation on it. The article also suggests that privacy readily collapses into secrecy, feeding a carefully choreographed silence regarding abortion, which allows the state to ignore its existence and thus to avoid responsibility for women’s reproductive health.

Examination of frequency and reasons that women were denied abortion care in Columbia, South Africa, Tunisia and Nepal.

Examination of the effect of criminilization of abortion on women's reproductive health, including the role of the judicial system in persecuting women and increasing stigma.

Examination of women’s emotions about abortion. Authors found that women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years.

Exploration and illustration of the variations in Muslim belief and practice related to abortion.

Exploration of knowledge and decision-making surrounding abortion among university students in Ghana.

Exploration of the experiences of nurses providing genetic termination for fetal abnormality in Canada.

Exploration of women’s experiences from Nepal and Bangladesh illustrates that even where services are provided legally, women can still face multiple barriers to access to services, and problematic quality of care.

Focos is a digital platform in Spanish with the objective of making visible the practice and experience of abortion in Mexico. Focos es una plataforma digital que tiene por objetivo visibilizar la práctica de aborto inducido en México, como un evento reproductivo frecuente.

Following an unintended pregnancy, the study participants had experienced different levels of fear and threat depending on their personal, family, and socio-cultural backgrounds. An unintended pregnancy can threaten women's lives through social deprivations, growing instability, and putting both mother and baby at risk for physical and psychosocial problems.

Guided by the biopsychosocial model, the study revealed that fear of societal stigma, shame, and rejection by partners, as well as self-imposed stigma constituted some of the pre and post abortion experiences the respondents

Here is considered a harm reduction approach to first-trimester abortion as a way for physicians to honor clinical and moral obligations to care for women, negotiate ever-increasing abortion restrictions, and support women who consider abortion self-induction.

Here, we identify eight pitfalls that practitioners must avoid as they plan to integrate a social norms perspective in their interventions, as well as eight learnings. These learnings are: 1) Social norms and attitudes are different; 2) Social norms and attitudes can coincide; 3) Protective norms can offer important resources for achieving effective social improvement in people’s health-related practices; 4) Harmful practices are sustained by a matrix of factors that need to be understood in their interactions; 5) The prevalence of a norm is not necessarily a sign of its strength; 6) Social norms can exert both direct and indirect influence; 7) Publicising the prevalence of a harmful practice can make things worse; 8) People-led social norm change is both the right and the smart thing to do.

In 1988, the Supreme Court of Canada decriminalized abortion in R. v. Morgentaler. Almost immediately thereafter, the Maritime province of Prince Edward Island (“P.E.I.”) passed a legislative resolution opposing the provision of abortion services on the Island except to save the life of a pregnant woman. P.E.I. is a small pastoral province of rolling hills and ocean coves in the St. Lawrence Gulf, and since 1988, through various regulatory actions, its government has honored this policy promise to keep the Island abortion-free and to preserve its moral landscape

In 2014-2015, the authors conducted a mystery client study with 17 postabortion support providing organizations in Ontario. Although all counselors effectively used active listening techniques such as supportive utterances and attentive silences, the interactions with lay counselors from religious talklines and CPCs contained shaming and stigmatizing language and medically inaccurate information. These interactions appear to be premised on the counselors' belief that abortion is traumatic and always requires a grieving process, regardless of the client's expressed feelings and needs. The expanded provision of postabortion support by CPCs in Ontario represents a new method for these organizations to pathologize abortion. Our findings suggest that their services are judgmental and shaming, thereby contributing to abortion stigma.

In a country in which abortion is paid for and supplied by a government department, one might expect there to be substantially reduced stigma around performing abortion work. It is therefore significant that not only do patients experience stigmatisation, but those who choose to work in abortion care also do so, even though it is part of a national commitment to universal health care. Although there are many examples of exceptional care provided to women who request abortion from NHS providers, and the rationale for providing state-funded abortion care is laudable, nevertheless the gesture is diminished by its continued invisibility in the very system that upholds it.

In Luanda, Angola, researchers analyzed women's perceptions of how their partners, friends, communities, and the media perceived contraception, and examined associations between those perceptions and respondents' abortion stigma. These results suggest that increasing partner support of family planning may be one strategy to help reduce abortion stigma. Results also suggest that some abortion stigma in Angola stems not from abortion itself, but rather from judgment about socially unacceptable pregnancies.

In regard to their pregnancy and abortion experiences, servicewomen cited concerns about confidentiality, stigma and negative effects on their career, which prevented half of participants from seeking care from the military.

In this paper, the positioning theory is used to show how the ways in which Zimbabwean health service providers' position women and themselves are rooted in cultural and social power relations. In light of recent efforts by the Zimbabwean Ministry of Health and foreign organisations to improve post abortion care, this study also explores the implications that these positionings have for post abortion care.

In-depth interviews with women in Bangladesh revealed that women have positive experiences with menstrual regulation, but are strongly influenced by health providers in which method to use.

Informed by overlapping theoretical frameworks of human rights and reproductive justice, this study examined a large, nationwide survey of social work students in the United States (N = 504). Linear regressions indicated that students' endorsements of permissive sexual attitudes and support for birth control are inversely associated with holding anti-choice abortion views.

Inpatient insertion of long-acting reversible contraceptives (LARC) (intrauterine devices and implants) is increasingly offered to women immediately after childbirth. Enthusiasm for this approach stems from robust safety, effectiveness, and cost-effectiveness data and responsiveness to women's needs and preferences. Although clinical evidence for immediate postpartum LARC is well-established, the ethical implications of enhancing access to this care have not been fully considered. Contraceptive policies and practices often embody a tension between fostering liberal availability and potentially coercive promotion of some methods. Historical contraceptive policies and contemporary disparities in LARC use point to the need to consider whether health policies and health care practices support all women's reproductive wishes. Immediate postpartum LARC services need to be designed and implemented with the goal of ensuring autonomy and equity in postpartum contraceptive care. To this end, these services should include strategic plans to promote universal availability, prevent coercion, and enable device removal.

Internalized stigma is associated with long-term psychological distress following a TOPFA. Perceived stigma at the time of the TOPFA may contribute to increased trauma and grief symptomatology, but results need to be validated in longitudinal studies.

Introduction to a special issue on abortion stigma in the journal Women and Health.

investigation of social perceptions of abortion. Findings suggest shifting attention from characteristics of the stigmatized to observers' characteristics to understand stigmatization process.

Investigators explored how viewing the film interacted with viewers’ previous understandings of later abortion. Findings reveal the potential of onscreen pseudo-experiences as a means for social change, but also reveal their limits and varying impacts.

Investigators focused on pre-abortion mental health and suggest that addressing stigma among women seeking abortions may significantly lower their psychological distress.

Ipas offers this toolkit to address and help mitigate abortion stigma. It is designed to help community members, community health workers, activists and staff of community-based organizations and others address abortion stigma in various settings and contexts.

Journalist explores themes of stigma, law and access in rural women's experiences of abortion in Australia, and the role that telemedicine and abortion pills can play.

Leveraging close elections to generate quasi-random variation in the religious identity of state legislators in India, lower rates of female foeticide are found in districts with Muslim legislators, which results in an arguement that reflects a greater (religious) aversion to abortion among Muslims. This study finds no evidence of greater postnatal neglect of girls once more girls are born. These findings show that politician preferences over abortion influence abortion-related outcomes, most likely through greater enforcement of laws against sex determination.

Literature review looking at 36 studies across sub-Saharan Africa and SE Asia, focusing on reservations towards abortion held by providers.

Mixed method study exploring sources of authoritative knowledge shaping women's pregnancy-related decision-making and role of social stigma.

Mixed-methods study exploring the experiences of women who have had more than one abortion. Women who have experienced more than one abortion expressed intensified abortion shame.

My Body My Life’ is a public engagement project that seeks to address this stigma around abortion by bringing real stories of abortion into the open.

OBJECTIVES: Authors report on the development of a scale measuring abortion providers' experiences of stigma. STUDY DESIGN: Using previous measures, qualitative data, and expert review, a 49-item question pool was created and administered to 315 abortion providers before participation in the Providers Share Workshop. Authors explored the factor structure and item quality using exploratory factor analysis and assessed reliability using Cronbach's alpha. To test construct validity, authors calculated Pearson's correlation coefficients between the stigma scales, the Maslach Burnout Inventory, and the K10 measure of psychological distress. RESULTS: Factor analysis revealed a 35-item, five-factor model: worries about disclosure, internalized states, social judgment, social isolation, and discrimination (Cronbach's alphas 0.79-0.94). The stigma measure was correlated with psychological distress (r = 0.40; p < .001), and with Maslach Burnout Inventory's emotional exhaustion (r = 0.27; p < .001), and depersonalization (0.23; p < .001) subscales, and was inversely correlated with Maslach Burnout Inventory's personal accomplishment subscale (r = -0.15; p < .05). CONCLUSIONS: Psychometric analysis of this scale reveals that it is a reliable and valid tool for measuring stigma in abortion providers, and may be helpful in evaluating stigma reduction programs.

Observational study examining abortion stigma and the psychological implications of concealment.

On both sides of the border, poor information about the health systems, services affordability, and perceived stigma resulted in barriers to access SRH services, with women preferring to access private doctors in their destination country or delaying uptake of until their next trip home.

Paper explores an innovative strategy in the field of legal mobilization demonstration how law can be shaped not just by public officials and universities but also by social actors engaged in the creation and diffusion of legal knowledge.

Paper explores how international and regional human rights norms have evolved significantly to recognize that the denial of abortion care in a range of circumstances violates women’s and girls’ fundamental human rights.

Paper offering a panoramic view of laws and policies on abortion around the world, giving a range of country-based examples.

Participants described negative feelings towards women seeking induced abortions, and their own desire to avoid associated "sin". This highlights the effects of unintended pregnancy and induced abortion on young Filipino men, including their own experience of abortion stigma.

Personal narrative from a woman who obtained an abortion from a private provider in the UK; focuses on stigma perpetuated by providers and policy.

Pilot study of the Providers Share workshop. Pilot study findings suggest can reduce the experience of abortion stigma for participants. Authors present conceptual model of dynamics of stigma.

Qualitative analysis of how pro-choice and opposition movements frame abortion narratives.

Qualitative analysis of parents in the UK who choose to terminate pregnancies for fetal abnormality. Examines whether or not--and to what extent--parents shared news of their decisions with their social networks (including their children).

Qualitative analysis of women and men in low-income areas in 5 countries to better understand how couples manage pregnancy risk.

Qualitative content analysis to examine if and how the print media in contributes to the stigmatization of abortion.

Qualitative exploration of abortion decision-making among women living with HIV in Cape Town, South Africa. Abortion may be more stigmatised than HIV despite a liberal abortion law. Participants were generally satisfied with the abortion care received.

Qualitative exploration of abortion patients' perspectives on regulations of abortion services in the United States.

Qualitative exploration of Kenyan women's conceptualization of safety. Rather than dangerous, poor quality abortion procedures and providers are key to women's self- preservation, management of stigma, and protection of their livelihoods.

Qualitative exploration of perceptions and practices of illegal abortion among young adults in the Philippines.

Qualitative exploration of women who have experienced abortion in the UK. Perception that abortion is taboo affected disclosure and perception of response of others.

Qualitative exploration of women's pathways to abortion in South Carolina,

Qualitative exploration of women's views and experiences viewing ultrasound images before abortion.

Qualitative investigation examining secrecy and disclosure around abortion in Burkina Faso

Qualitative longitudinal study of satisfaction, grief, and coping among women who terminated a pregnancy due to fetal anomaly; conclusions include associates between real and perceived stigma.

Qualitative study exploring abortion clinic patients’ opinions about receiving abortions from general women’s health care providers in the Heartland of the United States

Qualitative study looking at what happens when women are denied abortions in South Africa. Most common reason for being denied an abortion was for a pregnancy that has progressed beyond the legal cutoff for termination.

Qualitative study that explores the experience of low socioeconomic status teenage women in Hong Kong who had had abortions.

Report documenting Sea Change's research surveying public abortion storytellers in the US, with recommendations for sharing your abortion story and for support storytellers.

Researchers analyzed the abortion related plot-lines in American film and television. They found that stories are not representative of real risks and outcomes and may contribute to social myths.

Researchers describe hardships experienced by abortion patients, examining administrative health cases from 2010-2015 in the United States. Case data were analyzed to assess types and numbers of hardships experienced by age, race and geographic origin

Researchers examine fictional depictions of abortion to describe how women who seek abortions are portrayed on television, recognizing that onscreen fictional stories can shape the public's beliefs.

Researchers explored private discourse by documenting the nature of women's discussions about abortion in a book club.

Researchers explored social norms and stigma related to unintended pregnancy and decision-making in Alabama.

Researchers interviewed women who received an abortion at a clinic and found that they reacted negatively to some processes and structures.

Respondents from both Nigeria and Zambia demonstrate tempered support of (continued) childbearing among HIV-positive women while anti-abortion attitudes remain strong. Access to ART did not impart a strong effect on these attitudes. Therefore, pronatalist attitudes remain in place in the face of HIV infection.

Results show that PSW fulfills the dual role of a supportive group intervention-helping create connections and foster resilience-and a research tool, producing rich, multi-perspective narratives of the abortion provision team. This method provides useful insight into supporting abortion care workers specifically, and may also prove useful in the study and support of other stigmatized workers generally.

Results showed that the extent of active concealment predicted self-reported psychological and physical QOL over and above general levels of outness and outness to specific others, neither of which were significant predictors with concealment in the model. By examining the need for active concealment, researchers may be better positioned to predict and intervene to improve health outcomes for people with concealable stigmatized identities.

Review article looking at the political context in which abortion counselling becomes stigmatized in Britain.

Safe and legal abortions are rarely practiced in the public health sector in Kenya, and rates of maternal mortality and morbidity from unsafe abortion is high. Study participants described a variety of factors that influence women's experiences with abortion in their communities. According to participants, limited knowledge of sexual and reproductive health information and lack of access to contraception led to unplanned pregnancy among women in their community. Participants cited stigma and loss of opportunities that women with unplanned pregnancies face as the primary reasons why women seek abortions. Participants articulated stigma as the predominant barrier women in their communities face to safe abortion. Other barriers, which were often interrelated to stigma, included lack of education about safe methods of abortion, perceived illegality of abortion, as well as limited access to services, fear of mistreatment, and mistrust of health providers and facilities.

Seminal piece defining and conceptualizing stigma as the co-occurrence of its components–labeling, stereotyping, separation, status loss, and discrimination–and further indicating that for stigmatization to occur, power must be exercised.

Several Central and Eastern European countries have recently enacted retrogressive laws and policies introducing new preconditions that women must fulfill before they can obtain legal abortion services. Mandatory waiting periods and biased counseling and information requirements are particularly common examples of these new prerequisites. The present article considers these requirements in light of international human rights standards and public health guidelines, and outlines the manner in which, by imposing regressive barriers on women's access to legal abortion services, these new laws and policies undermine women's health and well-being, fail to respect women's human rights, and reinforce harmful gender stereotypes and abortion stigma.

Some abortion patients do not agree with abortion legality, and this subset could experience a degree of cognitive dissonance, which could influence the method by which they seek to abort.

Story explores the moral case that abortion and reproductive justice advocates make for abortion

Study explores challenges to providing abortion care from the perspective of health providers in Ghana

Study explores how race and reported history of abortion are associated with abortion stigma and miscarriage stigma

Study instruments assessed individual-level abortion stigma (the perception that others treat abortion as shameful, dirty, and socially taboo) using the Abortion Provider Stigma Scale, job strain through the Job Content Questionnaire, and emotional burnout through the Depersonalization, Emotional Exhaustion, and Personal Accomplishment subscales of the Maslach Burnout Inventory. Study results show that hospital-based abortion workers experience lower risk for burnout than comparable workers in freestanding clinics, accounting for abortion stigma and job characteristics.

Study of low-income women in Mexico receiving abortions; explores mental frameworks used to manage abortion stigma.

Study presents a valid, reliable instrument for assessing SRH stigma and its impact on family planning, the Adolescent SRH Stigma Scale can inform and evaluate interventions to reduce/manage stigma and foster resilience among young women in Africa and beyond.

Study that investigated medical abortion provision and referral by general practitioners in Australia, and found that some interested GPs were concerned about stigma.

Systematic literature review to determine barriers and facilitators to accessing first trimester abortion care in the developed world.

The 72% response they would attend or denounce the woman who underwent an abortion outlawed. The remaining 28% showed negative attitudes, from informing the couple or parents (18%), scold women (2%) or reporting it to the authorities (8%). In 39%, they felt that the medical profession who practice discriminates abortions; 28% admit stigmatize partener and 27% feel stigmatized if performing abortions.

The aim of the study was to understand midwives' readiness to be involved in legal induced abortions, should the law become less restricted in Ghana. Different views were expressed regarding readiness to engage in abortion services. Some expressed it as being sinful and against their religion to assist in abortion care, whilst others felt it was good to save the lives of women.

The author posits key differences between a discourse analytic approach to women's accounts of abortion and that taken by the growing body of research exploring women's experience of abortion stigma, and suggests that research on stigma often risks reifying it by failiing to consider how identities are continutially re-negotiated through language use.

The current study uses data from 353 women seeking abortions at three community reproductive health clinics to examine predictors of pre-abortion psychological health. Childhood and partner adversities, including reproductive coercion, were associated with negative mental health symptoms, as was perceived abortion stigma. Before perceived abortion stigma was entered into the model, 18.6%, 20.7%, and 16.8% of the variance in depressive, anxiety, and stress symptoms respectively, was explained. Perceived abortion stigma explained an additional 13.2%, 9.7%, and 10.7% of the variance in depressive, anxiety, and stress symptoms pre-abortion.

The difficulties journalists described when reporting on abortion were often rooted in abortion stigma and the political polarization around the issue. This pattern was true even for reporters who worked to counter abortion stigma through their reporting.

The emergence of Islamist movements and religious symbolic repertoires in the aftermath of the Tunisian revolution has elicited the political, moral, and practical contestation of women’s right to abortion. While, after several heated debates, the law was eventually not modified, several practitioners working in government family planning clinics have changed their behaviour preventing women getting abortions. Pre-existing state and medical logics, political uncertainties, and new religious and moralising discourses have determined abortion practices in the government health-care facilities generating unequal treatments according to women’s marital status, class, and education. This paper will investigate the multiple logics affecting abortion practices in post-revolutionary Tunisia, focusing on the dissonant logics mobilised by health-care professionals as well as structural socioeconomic factors.

The existence of abortion stigma and the shifting of the government structure from unitary system to federalism in absence of a complete clarity on how the safe abortion service gets integrated into the local government structure might create challenge to sustain existing developments.

The objective of this study is to assess the opinions of service providers on tailoring sexual and reproductive health services to the needs of adolescents. All respondents expressed the opinion that it is a good idea to tailor sexual and reproductive health services to the needs of adolescents. They admitted that very limited sexual and reproductive health programs targeting adolescent needs were available in the study area. Service providers also reported very low levels of health facilities use by adolescents for sexual and reproductive health information and services. Health professionals attributed the poor sexual and reproductive health services utilization by adolescents to stigma from the society and attitudes of service providers.

The objective was to investigate the effect of mandated abortion counseling requirements intended to dissuade women from having abortions on patients' individual-level abortion stigma. Women who heard the mandated counseling had reduced stigma scores. A larger study is needed to better characterize this effect.

The phrase ‘termination of pregnancy’ has recently been adopted by a number of British medical institutions as a preferred descriptor of induced abortion. How it is used by abortion care providers is unclear, although the ongoing stigmatisation of abortion may play a role. This study found that ‘Termination of pregnancy’ is the most commonly used term to describe induced abortion in patient consultations in Scotland. This and the term ‘abortion’ appear to play different roles, with the former being used euphemistically, and the latter as a more emphatic term.

The purpose of this review is to summarize studies published in the last year examining women's experiences with abortion care and to describe facilitators and barriers to person-centered care. Institutions and providers may be limited in their ability to provide patient-centered abortion care because of deeply embedded social stigma, institutional regulations and legal restrictions.

The Republic of Ireland has one of the world's most restrictive abortion laws, allowing abortion only to preserve a pregnant woman's life. This study examined the impact of the law on women's options for accessing abortion, their decision-making regarding whichpathway to follow, and their experiences with their chosen approach. Despite the country's restrictive abortion law, women in Ireland do obtain abortions, using methods that are legal and safe elsewhere. However, the law negatively impacts women's ability to discuss their options with their healthcare professionals and to seek follow-up care, and can have serious implications for their physical and emotional health.

The results from our evaluation are overwhelmingly positive. The Circles offered women a place to talk about their abortion in an affirmative and supportive environment,unlike the context of their daily lives where stigma generated silence and affected their well-being. For those who had never told family or friends, the Circles proved transformative as they could break the silence and speak of their experiences with women who had lived similar situations. Seeing themselves reflected in other women created a sense of community for the participants. This was confirmed in the results of the ILAS Scale, which show that the intervention was successful in reducing the ‘isolation’ dimension of individual abortion stigma.

The role of language in reflecting and perpetuating stigma is also an important consideration when mandating the use of any particular term. ‘TOP’ offers no advantages in either specificity or clarity while posing clear disadvantages for research visibility and the potential to reinforce stigma.

The study aimed to understand better the ways that women who have had multiple abortions talk about and view those experiences. Women described intensified feelings of shame and both internalized and externalized stigma surrounding their decision to have more than one abortion. However, the overwhelming majority were confident in their decisions

The term "elective abortion" is variably defined, misrepresents the complexity and multiplicity of indications for abortion and perpetuates stigma.

The term "elective" enables the creation and perpetuation of abortion stigma, and contributes to a hidden curriculum for abortion training in medical education that distracts from core content, incorporates social judgment of patients into medical practice, and promotes normative gender concepts.

The way abortion is presented in the media can have a major influence on people’s thinking. This guide has been written for those working in the media to encourage accurate reporting of the facts about abortion, and honest portrayals of abortion as part of real people’s lives and relationships.

Thematic analysis of the interviews revealed three main themes: (1) protective paternalism, (2) complementary gender differentiation, and (3) the categorization of women. These themes connect strongly with benevolent sexism, providing evidence that abortion is still a stigmatized procedure. This stigma has shifted from viewing women who have abortions in an overtly negative way to viewing them as pitiable and poor decision makers.

There exist critical points in the service where stigmatizing ideas and attitudes continue to be reproduced, such as the required five-day waiting period and in interactions with hospital staff who do not support access to the service. We also document the prevalence of stigmatizing ideas around abortion that continue to circulate outside the clinical setting.

These findings suggest that the level of power and control a woman experiences in her intimate relationship is associated with perceived or experienced stigma associated with her abortion. Stigma-reduction interventions related to abortion may consider focusing on women who have lower levels of reproductive autonomy, including those experiencing reduced partner communication or low decision-making power.

This analysis explores the gaps in access and quality that persist despite an enabling legal environment. Authors note that stigma plays a noteable role, and that community health workers may be important change agents in decreasing stigma.

This analysis offers that the field of abortion advocacy start taking seriously the emotional reactions that abortion engenders -- including disgust.

This analysis posits that contemporary post-structural work on class provides a framework to examine how social classifications occur; who has the power to classify; and how classifications might be resisted. This framework is demonstrated with emerging findings from a life history study of abortion experiences in England. The applications of this to the work on abortion are potentially rich, because the act of ending a pregnancy invites classification from many quarters, from the legal (legal/illegal) to the medical (early/late) to the moral (deserved/undeserved). This work, therefore, speaks to public health concerns about access to and stigma around abortion and social inequalities.

This annotated bibliography considers a subset of studies on the social and gender norms that influence access to safe abortion, focusing on adolescent girls.

This article analyzes the scientific output on abortion and social stigma and the potential of the stigma category for abortion care in Brazil.

This article describes the relatively new field of research on structural stigma, which is defined as societal-level conditions, cultural norms, and institutional policies that constrain the opportunities, resources, and well-being of the stigmatized

This article documents the creation of a community-level abortion stigma scale, developed and tested in Mexico.

This article explores obstetricians-gynaecologists' experiences and attitudes towards abortion and argues that the increasing medicalisation of contraception as well as of reproduction has reinforced the stigmatisation of voluntary abortion in a context of declining fertility rates.

This article explores the culture around abortion in South Africa post-legalization. Women continue to terminate unwanted pregnancies as they always have: away from the glare of public censure, in the shadows of the reproductive arena.

This article explores the factors that serve as a barrier to reproductive health services for people with disabilities in the Philippines. Substantial efforts to reduce stigma are required.

This article focuses on three struggles over time in abortion and human rights law: struggles in morality, health, and justice. The article focuses on the passage of time in pregnancy and thus legal regulation by gestational age. It offers a more complex understanding of what these struggles over time mean for morality, health, and justice, which underlie human rights protections in abortion law and policy.

This article is the first to examine the stigma attached to abortion and surrogacy and consider how law may stigmatize women for failing to conform to social expectations about maternal roles.

This article presents a case for promoting a harm reduction model in Uganda, with evidence that it may reduce maternal mortality and morbidity due to unsafe abortion while addressing related stigma and discrimination and advancing women's reproductive health rights.

This blog posts explores the needed linkages between movements to expand rights for sex workers and right to abortion.

This brief proposes a draft framework for analyzing the interplay between stigma and quality of care, including suggested signs of stigma-free care.

This commentary encourages further examination of what triggers disgust, its measurement, and ways of mitigating it, which could be useful for reducing abortion stigma, in future legal cases and in abortion research, advocacy, and communications.

This Coursera lecture explores abortion stigma, defining the terms, and exploring examples of how it manifests from diverse areas around the world.

This essay considers factors determining provision of second trimester abortion and argues that silence about second trimester abortion care is harmful to providers, the pro-choice movement, and to women who need abortion care.

This fact sheet details a buddy system as a method of overcoming stigma and other barriers to access that youth face.

This guide is intended for advocates interested in supporting expanded access to safe abortion care in their countries. It will help you and your colleagues develop a strategy that considers the unique considerations for abortion-related advocacy.

This guide provides tips about what to consider when developing materials about abortion.

This is a collection of personal testimonies in Spanish and Náhuatl gathered by the Red Necesito Abortar (Monterrey, Nuevo León, México), with technical support provided by Centro Las Libres. Together, these frank testimonies from people who have accompanied or been accompanied through their abortion experiences offer powerful material that can be used in discussions, workshops, and other forums aimed at eliminating abortion-related stigma.

This journal follows the lives of ten resilient and courageous women as they recount how they escaped FGM, fought for abortion rights for their minor daughters, how they underwent unsafe abortions despite laws criminalising them or decided to raise children in spite of being victims of rape.

This paper examines the ways in which young women articulated strategies of resistance to internalised abortion stigma. Being able to construct their abortion decision as morally sound was an important element of stigma resistance.

This paper scrutinises the concepts of moral reasoning and personal reasoning, problematising the binary model by looking at young women’s pregnancy decision-making. Data from two UK empirical studies are subjected to theoretically driven qualitative secondary analysis, and illustrative cases show how complex decision-making is characterised by an intertwining of the personal and the moral, and is thus best understood by drawing on moral relativism.

This piece explores stigma as a barrier for physicians to even be trained in abortion care.

This practitioners Toolkit on Women’s Access to Justice, developed by UNDP, UN Women, UNODC, and OHCHR provides evidence-based guidance for a coherent and consistent policy and programming approach to overcoming barriers women face in accessing justice. This guidance will help to ensure UN system coordinated responses when addressing legal and justice challenges that women face within the context areas of marriage, family, and property rights; ending violence against women; and women in conflict with the law. Designed primarily for staff of the UN system, the toolkit presents a menu of options for scaling-up work and responding to current deficits in women’s access to justice programming and the growing demand for technical assistance in this area. This toolkit consolidates and complements existing resources and aims at enhancing the impact of UN support by stimulating bolder gender-responsive justice interventions for the full realization of the rights of women and girls.

This purpose of this article is to discuss the abortion seeking experience in relation to stress, trauma, and trauma-informed care. This article discusses a trauma-informed lens for considering the abortion seeking experience in the United States, and a trauma-informed social work framework for interacting with clients during the abortion experience is presented as a practice approach for reducing and eliminating trauma and trauma triggers. Then the potential benefits of this approach is presented. The article concludes with some additional recommendations for a trauma-informed approach to aspects of social work advocacy.

This qualitative study found higher levels community-level stigma in areas where the prevalence of unsafe abortion is higher, and that abortion stigma is a barrier to accessing safe services.

This report paints a picture of how stigma appears in different geographic regions, and across the different levels of the ecological model.

This report presents analysis of two years worth of news coverage (and over 3,000 articles) about abortion to pinpoint how abortion stigma manifests in the news. Authors found that news coverage perpetuated stigma in many ways, including through the frequent use of inflammatory language in quotes from anti-abortion advocates, the lack of firsthand stories from people who have had abortions, and the near absence of scientifically accurate information about the safety, prevalence, and support for abortion.

This report shares the results of interviewswith 14 experts in the field of resilience and support for young families.

This report synthesizes the state of the field of abortion research in Latin America and the Caribbean (in Spanish).

This review and analysis identified global factors that affect the likelihood of women to be able to access safe abortion and found that women have more access when abortion is less stigmatized, legal, and covered by a public health system.

This review of Katie Watson's book, "Scarlet A: The Ethics, Law, & Politics of Ordinary Abortion" explores both the richness and limitations of the author's focus on a plurality of perspectives in dialogue to shift the public discourse on abortion.

This study aimed to measure individual-level abortion stigma (ILAS) and determine its correlates among women receiving safe elective abortion services. Among 382 respondents, 43% expressed high ILAS. Women’s age and education, provider’s cadre and type of abortion procedure were significant correlates in the model.

This study assessed the applicability to medical professionals in Ethiopia of an abortion stigma assessment tool developed for community members, and examined the relationship between stigma and willingness to provide safe abortion care (SAC). The Stigmatizing Attitudes, Beliefs and Actions Scale (SABAS) was fielded to a convenience sample of 397 Ethiopian midwives. Scale reliability and validity were assessed, and associations were examined using multivariate linear and logistic regression. Levels of stigma were low compared to those reported elsewhere, and 49% of midwives were willing to provide SAC. SABAS‘ limitations found here suggest the need for an adapted scale for medical professionals.

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. ollowing 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.

This study describes the process and results of galvanizing access to medical abortion in Zambia where abortion has been legal for many years, but provision severely limited. It highlights the challenges and successes of scaling up abortion care using implementation science to document 2 years of implementation.

This study examined how anticipation, perception, internalization, and stigma-related isolation are related to psychological distress and somatic (physical) symptoms. This question was examined through an online volunteer sample of women in Ireland who have had an abortion. The findings complement and extend the existing literature on the relations between stigmatized identities, psychological distress, and physical health problems, particularly regarding women who have accessed abortion. They also indicate that those involved in policy-making and activism around reproductive rights should avoid inadvertently increasing the stigma surrounding abortion.

This study explored the meaning of abortion provision work to providers, how providers experience and manage stigmatization of their work, and how these experiences and stigma management strategies differ for providers in various work roles, clinics and clinic settings.

This study explores the content of abortion provider stigma. It finds that study participants held two kinds of believes about abortion providers: (1) providers are agentic and intentional actors and (2) providers are non-agentic victims of a larger system. These findings lead to a new component of abortion provider stigma: the belief that abortion providers are harmed by abortion and that they are to be pitied for this. This stigmatizing attitude both constructs the provider as untrustworthy and unable to properly care for women.

This study found that abortion values clarification and attitude transformation (VCAT) workshops improve participants’ knowledge and attitudes about abortion as well as their intentions to support abortion care, especially among those who come to the workshops with the least knowledge and most negative attitudes.

This study investigated the hashtag #ShoutYourAbortion that was created to combat the stigma that can be associated with the medical procedure of abortion. When devising health campaigns, it is essential to consider the tone of the campaign and whether it is likely to provoke citizens who may have opposing views. Moreover, future campaigns could communicate information surrounding the dangers of unsafe abortions and the broad spectrum of reasons that women may seek abortion, for example, when the child and/or mothers health is at risk.

This study investigates stigmatising attitudes related to adolescent pregnancy, abortion and contraceptive use among healthcare providers working with postabortion care (PAC) in a low-resource setting in Kenya. Stigmatising attitudes towards young women in need of abortion and contraception is common among PAC providers.

This study sought to estimate the rate of abortion visibility in the city of Kerman, Iran-that is, the percentage of acquaintances who knew about a particular abortion. For estimating the visibility rate, it is crucial to use the network scale-up method, which is a new, indirect method of estimating sensitive behaviours more accurately.

This study uses a Foucauldian feminist approach to show how resistance to religious and patriarchal norms can be fostered through adult community abortion education. 

This tool describes a strategy for providing youth friendly spaces within health facilities to reduce stigma and other barriers to access that youth face.

This tool details a strategy for using social media to reduce stigma and other barriers to care that youth face.

This tool details a strategy to reduce stigma and other barriers to access that young people face by partnering with educational institutions.

This toolkit (with inputs from Georgia, Lithuania, Republic of Macedonia, Poland and Romania) offers a framework for youth-led storytelling.

This toolkit has been developed for trainers and educators who want to deliver workshops or training on abortion to young people, especially those training young peer educators.

This toolkit is designed to address the harmful impact of stigma while providing techniques to fight it by ensuring that responses to anyone with unwanted pregnancy are supportive, engaging, and empowering.

This video details a broad history of abortion, placing it in cultural and medical context.

This video explores how representations of abortion in film and television can shape individual and cultural understanding of abortion.

This video lecture provides an overview of the findings from the Turnaway Study.

This website - The Stigma Toolkit - documents the research, tools, and strategies that have been instrumental thus far in changing the culture around reproduction. It includes products and tools from Sea Change and beyond, and was created to live on as a resource to the field and to anyone hoping to learn more about shifting stigma

This white paper defines abortion stigma, discusses how to measure stigma and presents an overview of interventions to address stigma

This workbook is about engaging the courts to promote social change.

Though most women in this study had at least one person to turn to for assistance with abortion decision making, many participants avoided confiding in some or all members of their social network about their abortion decision due to concerns of judgment and stigma.

To some extent, harm reduction for reducing unsafe abortion is a well-trodden path, deployed and studied in various contexts for well over a decade. But the United States presents a distinctive context.

To understand the motivations around and practices of abortion referral among women's health providers, authors analyzed clinician's responses to open-ended questions on abortion referral thematically and found that abortion stigma impacts referral as clinicians explained that patients often desire additional privacy and clinicians themselves seek to avoid tension among their staff.

Toolkit to assist activists to think through their communication strategies in a way that supports movement building.

Unmarried, young women constitute a significant proportion of women who undergo unsafe abortion in Ethiopia. Based on material from an ethnographic study, the experiences of young, unmarried women who had been admitted to the hospital in the aftermath of an unsafe, clandestine abortion are explored in this article. The routes the young women followed in their search of abortion services and the concerns and realities they had to negotiate and navigate are at the fore. Despite their awareness of the dangers involved in clandestine and illegal abortion, the young women felt they had no choice but to use medically unsafe abortion services. Two reasons for this are highlighted: such services were affordable and, significantly, they were considered socially safe in that the abortion remained unknown to others and the stigma of abortion and its consequences could hence be avoided. In situations in which choices had to be made, social safety trumped medical safety. This indicates a need for abortion services that address both the medical and social safety concerns of young women in need of such services.

Unpublished undergraduate thesis comparing cultural context for abortion legislation between the U.S. and the Netherlands.

User submissions to a text-based SMS Q&A platform demonstrate an unmet need for basic SRHR information. Users benefited from a mechanism to ask about stigmatized topics in privacy.

Using interviews with 10 obstetrician–gynaecologists and 44 other leaders familiar with Ethiopia’s reproductive health policy context, as well as other primary and secondary sources, this research examines why, counter to theoretical expectations from the sociology of medical professions literature and experience elsewhere, the Ethiopian Society of Obstetricians & Gynecologists (ESOG) actively supported reform of national law on abortion.

Using theAdolescent Sexual and Reproductive Health (SRH) Stigma Scale, authors investigated factors associated with perceived SRH stigma among adolescent girls in Ghana. The Adolescent SRH Stigma Scale comprised 20 items and 3 sub-scales (Internalized, Enacted, Lay Attitudes) to measure stigma occurring with sexual activity, contraceptive use, pregnancy, abortion and family planning service use. Authors assessed relationships between a comprehensive set of demographic, health and social factors and SRH Stigma with multi-level multivariable linear regression models. RESULTS: In unadjusted bivariate analyses, compared to their counterparts, SRH stigma scores were higher among girls who were younger, Accra residents, Muslim, still in/dropped out of secondary school, unemployed, reporting excellent/very good health, not in a relationship, not sexually experienced, never received family planning services, never used contraception, but had been pregnant. In multivariable models, higher SRH stigma scores were associated with history of pregnancy and excellent/very good self-rated health, while lower stigma scores were associated with older age , higher educational attainment, and sexual intercourse experience. CONCLUSIONS: Findings provide insight into factors contributing to SRH stigma among this young Ghanaian female sample. Further research disentangling the complex interrelationships between SRH stigma, health, and social context is needed to guide multi-level interventions to address SRH stigma and its causes and consequences for adolescents worldwide.

Video and accompanying slides detailing how abortion is conceptualized across many frameworks and levels in the ecological model.

Video lecture examining the role that securing abortion access through the right to privacy in the US has in reinforcing and being reinforced by fear of personal disclosure. Delivered to a UK audience at Birmingham Univeristy. Hosted on Youtube.

Video lecture gives an overview of federal and state laws on abortion access in the United States.

Video lecture offers an overview of abortion stigma and how it impacts women's health.

Video outlining a history of abortion in the United States since legalization.

We argue that the social construction of target populations is an important, albeit overlooked, political phenomenon that should take its place in the study of public policy by political scientists. The theory contends that social constructions influence the policy agenda and the selection of policy tools, as well as the rationales that legitimate policy choices. Constructions become embedded in policy as messages that are absorbed by citizens and affect their orientations and participation. The theory is important because it helps explain why some groups are advantaged more than others independently of traditional notions of political power and how policy designs reinforce or alter such advantages.

We expected and found that the decision to abort increased moral outrage toward a woman (Study 1 and Study 2) and her male partner (Study 2). Moreover, we found that the decision to abort reduced a woman’s (Study 1 and Study 2) and man’s (Study 2) humanness through the mediation of elicited moral outrage.

Webinar hosted by the Abortion Care Network with guidance for how to make a video about abortion.

White paper from Global Doctors for Choice examining the prevalence and impact of consciencious refusal. Rviews policy efforts to balance individual conscience, autonomy in reproductive decision making, safeguards for health, and professional medical integrity.

Women are attempting informal sector abortion because they seek privacy and fear mistreatment and stigma in health facilities.

Women undergoing more than one TOP within 2 years may experience particular challenges and vulnerabilities. Service provision should recognise this and move away from stigmatising discourses of 'repeat abortion'.

Authors (Ruth Zurbriggen, Nayla Vacarezza, Graciela Alonso, Belen Grosso, María Trpin) expand knowledge on what for some is a controversial issue: Medical abortion during the second trimester of pregnancy. Based on their extensive practice of providing information and accompanying later abortion, the Socorristas have developed this text, which systematically captures their experience and knowledge on the topic. The book presents the experiences and reflections of 23 women who had second-trimester medical abortions and 16 feminist activists who support and accompany this practice. The study was conducted by Colectiva La Revuelta, which is part of Socorristas en Red, the national Socorrista network in Argentina. The English translation was supported by Women Help Women and inroads.

This study presents results from focus group discussions that explored community members’ attitudes towards women who induce abortion and their care-seeking behaviour in programme areas. Results indicate that while abortion stigma was widespread, community members’ attitudes towards women who induced abortions were not one-dimensional. Although they initially expressed negative opinions regarding women who induced abortion, beliefs became more nuanced as discussion shifted to the specific situations that could motivate a woman to do so. For example, many considered it understandable that a woman would induce abortion after rape: perhaps unsurprising, given the prevalence of conflict-related sexual violence in this area. While community members believed that fear of stigma or associated negative social consequences dissuaded women from seeking PAC, a majority believed that all women should have access to life-saving PAC. This commitment to ensuring that women who induced abortion have access to PAC, in addition to the professed acceptability of induced abortion in certain situations, indicates that there could be an opening to destigmatise abortion access in this context.

This study (in Spanish) explores attitudes towards induced abortion among young people in Mexico. Their attitudes were more favorable than not towards induced abortion, but they didn't think that law reform would really impact the risk of unsafe abortion.

This systematic review of multi-level stigma reduction interventions examined studies that evaluated interventions that operated on more than one level of stigma, across a variety of stigmatized topic areas. Most reported declines in stigma, but effect sizes were limited.

This study tested the validity of a scale to measure providers attitudes about the morality of abortion.

There is broad consensus that abortion is stigmatized, but the role of interpersonal interaction in this process is underspecified. I examine interviews with 25 women in the United States who visited crisis pregnancy centers (CPCs)—antiabortion organizations that offer one‐on‐one “prolife counseling”—for how and when interactions matter for abortion stigmatization. I identify two primary ways CPC counselors stigmatized abortion and describe variation in their impact: counselors' efforts were “successful,” were misrecognized as ideologically‐neutral, or were resisted. The findings demonstrate the importance of women's current consideration of abortion and preexisting beliefs for understanding how interpersonal interactions contribute to abortion stigma.

Identifying how activists frame the topic of abortion is key to unpacking their understanding of “abortion” in Peru. It is important to explore how and why certain frames are privileged in attempts to shift policy and social norms. In 2016, the authors conducted qualitative interviews with 10 activists in Lima, Peru to develop a deep understanding of these issues. Activists worked through different approaches and lenses, including law, medicine, sociology, psychiatry, journalism, non-governmental organisational management, LGBTQ rights, and indigenous rights. Four common frames emerged through the analysis and those frames shifted based on whether activists were speaking to the general public or to policymakers. Understanding Peru's activist framing of abortion can contribute to a deeper analysis of regional and global movements to legalise abortion, which also take into account local specificities.

In the context of abortion stigma, most abortion stories remain untold. The stories we do tell of abortion are often told to morally recuperate the status of the woman who has an abortion through a recourse to tragedy. Tragedy frames experiences where every choice produces some suffering, so decisions are geared toward maintaining individual integrity rather than adherence to absolute moral truths. This article argues that one dominant tragic abortion narrative, that of the disabled fetus, works to recuperate the moral status of “fit” mothers while actively constructing disabled lives as unlivable and undesirable. The option to stigmatize disability in recuperating the moral status of the woman who has an abortion relies on eugenic logics that also construct a variety of women (racialized, poor, disabled, and young) as illegitimate reproductive subjects. The article analyzes narratives of Sherri Finkbine's 1962 abortion in relation to contemporary narratives of late‐term abortions involving nonviable fetuses to expose how investment in medical judgments of good births enables particular women to make use of tragic narratives to maintain their status as moral mothers without disturbing broader abortion stigma or eugenic logics.

This paper draws lessons and implications on scaling social norms change initiatives for gender equality to prevent violence against women and girls (VAWG) and improve sexual and reproductive health and rights (SRHR), from the Community for Understanding Scale Up (CUSP). CUSP makes the following recommendations for donors and implementers to scale social norms initiatives effectively and ethically: invest in longer-term programming, ensure fidelity to values of the original programmes, fund women’s rights organisations, prioritise accountability to their communities and demands, critically examine the government and marketplace’s role in scale, and rethink evaluation approaches to produce evidence that guides scale-up processes and fully represents the voices of activists and communities from the Global South.

A moderated moderation analysis aimed to demonstrate the effects of abortion stigma on abortion legality attitudes, and explore interactions between gender, religiosity, and abortion stigma. Results showed a significant main effect of stigma on legality attitudes, such that increased stigma was related to more negative attitudes. Furthermore, there was a significant three-way interaction of religiosity, gender, and stigma. For men, religiosity significantly predicted abortion legality attitudes at low stigma, but for women, religiosity was related to legality attitudes at all levels of stigma. These results have implications for prediction of abortion legality attitudes, policy support, and voting behaviors and can inform abortion stigma reduction programs.

Partners across the sexual and reproductive health sector have come together to launch the SafeAccess Hub – a digital platform sharing best practice guidance on safe abortion and post-abortion care. The aim is open up implementational knowledge from across the sector on what quality safe abortion and post-abortion care looks like. This way, those working on the frontline, providers and policy makers alike, can use this knowledge to expand access to life-saving services in their regions too.

A factsheet exploring Ipas’s work to understand, challenge and measure abortion stigma

Stigma is a well-documented barrier to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions globally. In order to halt the stigmatization process and mitigate the harmful consequences of health-related stigma (i.e. stigma associated with health conditions), it is critical to have an explicit theoretical framework to guide intervention development, measurement, research, and policy. Existing stigma frameworks typically focus on one health condition in isolation and often concentrate on the psychological pathways occurring among individuals. This tendency has encouraged a siloed approach to research on health-related stigmas, focusing on individuals, impeding both comparisons across stigmatized conditions and research on innovations to reduce health-related stigma and improve health outcomes. We propose the Health Stigma and Discrimination Framework, which is a global, crosscutting framework based on theory, research, and practice, and demonstrate its application to a range of health conditions, including leprosy, epilepsy, mental health, cancer, HIV, and obesity/overweight. We also discuss how stigma related to race, gender, sexual orientation, class, and occupation intersects with health-related stigmas, and examine how the framework can be used to enhance research, programming, and policy efforts. Research and interventions inspired by a common framework will enable the field to identify similarities and differences in stigma processes across diseases and will amplify our collective ability to respond effectively and at-scale to a major driver of poor health outcomes globally.

This paper systematically reviews implementation studies of health-related stigma reduction interventions in LMICs and critically assesses the reporting of implementation outcomes and intervention descriptions

Employing a conceptual model adapted from Weiss, the current paper demonstrates the commonalities among several major stigmatized conditions by examining how several stigma measurement instruments, such as the Social Distance Scale, Explanatory Model Interview Catalogue, Internalized Stigma of Mental Illness, and Berger stigma scale, and stigma reduction interventions, such as information-based approaches, contact with affected persons, (peer) counselling, and skills building and empowerment, were used successfully across a variety of conditions to measure or address stigma. The results demonstrate that ‘health-related stigma’ is a viable concept with clearly identifiable characteristics that are similar across a variety of stigmatized health conditions in very diverse cultures.

The aim of this study was to measure stigmatising attitudes and beliefs regarding abortion and contraceptive use among secondary school students in western Kenya. A self-reported classroom questionnaire-survey was administered in February 2017 to students at two suburban secondary schools in western Kenya. Two scales were used to measure the stigma surrounding abortion and contraceptive use – the Adolescent Stigmatizing Attitudes, Beliefs and Actions (ASABA) scale and the Contraceptive Use Stigma (CUS) scale. Abortion and contraceptive use are stigmatised by students in Kenya. The results can be used to combat abortion stigma and to increase contraceptive use among adolescents in Kenya.

In this study, we tested a novel method – the list experiment – that aims to reduce underreporting of sensitive events by asking participants to report how many of a list of experiences they have had, not which ones. We applied the list experiment to measure “self-managed abortion” - any attempt by a person to end a pregnancy on one’s own, outside of a clinical setting – a phenomenon that may be underreported in surveys due to a desire to avoid judgement.

The present study examined relationships between sexual disgust and abortion stigmatizing attitudes, and the mediating effects of hostile sexism and right-wing authoritarianism (RWA). These relationships were examined in two samples, culled online via Amazon's Mechanical Turk. Controlling for age and gender, both studies found that increased disgust was linked to increased abortion stigmatizing attitudes, with significant, independent indirect effects of both hostile sexism and RWA. Importantly, in both samples, hostile sexism and RWA mediated the connection between sexual disgust and abortion stigmatizing attitudes. Specifically, increased sexual disgust was related to more sexism, which was connected to increased RWA; in turn, more RWA was linked to more stigmatizing abortion attitudes. These findings provide numerous pathways for better understanding and combating abortion stigma.

This guide was designed to help reporters understand the issues surrounding sexual and reproductive health and rights (SRHR), including the right to safe abortion, so they can report on SRHR issues in an accurate, fair and balanced manner. Although the guide specifically targets print and online journalists, all journalists—including those who work in TV and radio—can benefit from the information provided. The guide can also be used by organizations and coalitions as a guide to training reporters on SRHR issues.

A spokesperson is the face of an organization and represents the organization when addressing an audience or speaking to the press. The topic of sexual and reproductive health and rights (SRHR) is sometimes sensitive or controversial, making the job of a spokesperson for an SRHR-focused organization very important. This tool is designed to help spokespeople excel at their jobs and craft messages that effectively reach their intended audiences.

Drawing on narrative data from research conducted on womxn’s and healthcare providers’ experiences of the pre-abortion healthcare encounter in the South African public health sector, we highlight how stigma may be resisted in social ways within this context. Everyday chatter and informal social support amongst womxn in the waiting room provided a counterpoint for health service providers’ ascription of shame to the womxn, and a sense of solidarity amongst the womxn. Health service providers narrated their decision to do abortion work through the socially affirming hero canonical narrative, and womxn described their counselling as helpful. These social and discursive practices resist the awfulisation of abortion and provide relief for the womxn and the healthcare providers in particular contexts.

Abortion Out Loud, formerly the 1 in 3 Campaign, harnesses the power of storytelling, grassroots organizing, leadership development, and policy advocacy to end abortion stigma and strengthen support for young people's access to abortion. Activists leading the Abortion Out Loud project in their community host abortion speakouts, lead public education campaigns, and work with campus and local officials to strengthen young people's access to abortion services.

The current study examined false memories in the week preceding the 2018 Irish abortion referendum. Participants (N = 3,140) viewed six news stories concerning campaign events—two fabricated and four authentic. Almost half of the sample reported a false memory for at least one fabricated event, with more than one third of participants reporting a specific memory of the event. “Yes” voters (those in favor of legalizing abortion) were more likely than “no” voters to “remember” a fabricated scandal regarding the campaign to vote “no,” and “no” voters were more likely than “yes” voters to “remember” a fabricated scandal regarding the campaign to vote “yes.” This difference was particularly strong for voters of low cognitive ability. A subsequent warning about possible misinformation slightly reduced rates of false memories but did not eliminate these effects. This study suggests that voters in a real-world political campaign are most susceptible to forming false memories for fake news that aligns with their beliefs, in particular if they have low cognitive ability.

Purpose: To investigate the opinions of Brazilian medical residents in Obstetrics and Gynaecology on abortion legislation according to their personal beliefs. Material and methods: A multicentre cross-sectional study. Residents at 21 university teaching hospitals completed a self-report questionnaire on their opinions in abstract terms, and about punishing women who abort in general and women they know. Results: In abstract terms, 8% favoured allowing abortion under any circumstances (fully liberal); 36% under socioeconomic or psychological constraints (broadly liberal); 75.3% opposed punishing a woman who has aborted (liberal in general practice); and 90.2% opposed punishing women they knew personally (liberal in personal practice). Not having a stable partner and not being influenced by religion were factors associated with liberal opinions. In personal practice, however, 80% of those who are influenced by religion were liberal. The percentage of respondents whose opinions were liberal was significantly greater among those who believed that abortion rates would remain the same or decrease following liberalisation. Conclusions: Judgements regarding the penalisation of women who abort are strongly influenced by how close the respondent is to the problem. Accurate information on abortion needs to be provided. Although about one third of the respondents were broadly liberal, the majority oppose punishment.

Harpers Bazaar profiles the Abortion Dream Team - a group of activists (and inroads members) working share information about self-managed abortion AND to change the broader cultural discourse around abortion in Poland

This piece has been published as a part of the Health Over Stigma campaign, which is aimed at dismantling the stigma surrounding sexual health of unmarried women, and demanding accountability from medical service providers for stigma-free, non judgemental sexual and reproductive healthcare services. In this piece, a senior gynaecologist who is associated with the campaign reflects on being a feminist gynaecologist in a patriarchal medical universe.

MAMA information materials for community distribution of protocols for medical abortion using Mifepristone and Misoprostol during the first 10 weeks of pregnancy. Downloadable in Chichewa, English, French, Igbo, Luganda, Swahili

MAMA information materials for community distribution of protocols for medical abortion using Misoprostol during the first 9 weeks of pregnancy. Downloadable in Chichewa, English, French, Igbo, Luganda, Swahili

This fact sheet outlines guidelines for medical management of abortion after 12 weeks. (The Later Abortion Initiative; Ibis Reproductive Health)

On Wednesday 6 th November 2019, Marie Stopes International launched a campaign – #SmashAbortionStigma – to shine a light on the widespread stigma faced by women who access safe abortion care. Worldwide, 25% of pregnancies end in abortion. Yet despite it being a common healthcare procedure, women still face judgement and stigma as a result of making choices that are right for them. Through the launch of the new, multi-channel campaign, #SmashAbortionStigma, we are addressing the need for open conversations on abortion by calling on people to break the silence. We’ll be using our social media channels, our website, and the voices of our supporters to amplify support for choice and show women that they’re supported and not alone. The more voices we have, the faster we can #SmashAbortionStigma, so we’d love your support with this campaign. You can find details on ways to get involved in this toolkit.

Health-related stigma remains a major barrier to improving health and well-being for vulnerable populations around the world. This collection on stigma research and global health emerged largely as a result of a 2017 meeting on the “The Science of Stigma Reduction” sponsored by the US National Institutes of Health (NIH). An overwhelming consensus at the meeting was reached. It was determined that for stigma research to advance further, particularly to achieve effective and scalable stigma reduction interventions, the discipline of stigma research must evolve beyond disease-specific investigations and frameworks and move toward more unified theories of stigma that transcend individual conditions. This introduction reflects on the value of taking this cross-cutting approach from both a historical and current perspective, then briefly summarizes the span of articles. Collectively, the authors apply theory, frameworks, tools, interventions and evaluations to the breadth of stigma across conditions and vulnerabilities. They present a tactical argument for a more ethical, participatory, applied and transdisciplinary line of attack on health-related stigma, alongside promoting the dignity and voice of people living with stigmatized conditions.

In this collection, BMC Medicine presents a series of articles on stigma research and global health that cut across sectors and fields with the goal of breaking down silos and improving our understanding of the role stigma plays in several disease areas.

Health-related stigma research can reduce the health inequities faced by stigmatized groups if funders and institutions require and reward community participation and if researchers commit to reflexive, participatory practices. A research agenda focused on participatory praxis in health-related stigma research could stimulate increased use of such methods.

A facility based descriptive cross-sectional study found that the majority of mid-level providers claimed to know the current abortion law; however, many failed to understand the specific provisions of the law. Type of profession and years of experiences were important in explaining providers’ knowledge related to abortion. Being male and having the knowledge significantly influenced providers’ attitude toward safe abortion. Knowledge related to abortion also influenced the practice of SAC. Efforts to improve mid-level as well as other health care providers’ knowledge on abortion are necessary, for example, through pre−/on-service training

This paper analyses interviews with providers who work in the public health system in the Metropolitan Area of Buenos Aires, Argentina. Between 2014 and 2017, authors conducted interviews with abortion providers in public facilities across healthcare services in the Metropolitan Area of Buenos Aires and found the way that health providers dealt with abortion stigma evolved over the course of time, as the abortion debate moved from the margins to the heart of political debate and public policies in Argentina between 2007 and 2017. Providers’ experiences changed as the social and legal context changed. FAL/12 – as a clear, legal ruling – was a landmark and turning point in the way health professionals in public health facilities conduct their activities, making it possible for them to move from providing silent and hidden abortion care, to acknowledging it with pride.

Social work has been largely silent on matters of reproductive rights, particularly in relation to abortion. This may partially be explained by abortion being secured as a part of health care in many countries. However, elsewhere, abortion remains in criminal codes with service access controlled via medico-legal barriers. This paper makes a case for the increased visibility of reproductive justice within education and professional activity, employing case studies from Australia, the Republic of Ireland and New Zealand to illustrate recent social work advocacy on abortion rights. Social work abortion activists report two themes: professional bodies have varied their approach to advocacy for abortion rights due to political sensitivities; and social work involvement in campaigns has reflected individual and grass-roots advocacy. Improved education about reproductive justice for social workers, alongside greater collective professional advocacy, are needed to contribute to campaigns together with women’s and human rights groups, as well as public health champions.

Rwanda amended its abortions law in 2012 to allow for induced abortion under certain circumstances. This study explores how Rwandan health care providers (HCP) understand the law and implement it in their clinical practice. HCPs express ambiguities on their rights and responsibilities when providing abortion care. A prominent finding was the uncertainties about the legal status of abortion, indicating that HCPs may rely on outdated regulations. A reluctance to be identified as an abortion provider was noticeable due to fear of occupational stigma. The dilemma of liability and litigation was present, and particularly care providers’ legal responsibility on whether to report a woman who discloses an illegal abortion. The lack of professional consensus is creating barriers to the realization of safe abortion care within the legal framework, and challenge patients right for confidentiality. This bring consequences on girl's and women's reproductive health in the setting. Implications for practice To implement the amended abortion law and to provide equitable maternal care, the clinical and ethical guidelines for HCPs need to be revisited.

This exploratory study looked into the experiences of abortion clients when completing the Individual Level Abortion Stigma Scale. They found that many participants have neutral and even positive experiences, but some do have negative experiences. These findings highlight the importance of carefully considering when it is appropriate to implement the ILAS and exploring safeguards for those participants who may have negative reactions.

We are at a crossroads in models of medication abortion care, forced by fear of COVID-19 infection but driven by implementing long overdue innovations based on science, common sense, and feminist praxis.

When health care workers refuse to provide safe abortion care (SAC) for religious, moral, or personal reasons, they jeopardize their clients’ health and violate the right to care. Scholars believe that health care workers’ professional commitments to patient care and to their profession’s goals can help them prioritize patient care over their personal biases. The Ethiopian government has assigned midwives a central responsibility to provide SAC, but there is no comprehensive understanding of Ethiopian midwives’ willingness to provide SAC and allied rationales, or the relationships between their sense of professional duty and willingness to provide. To answer these questions, a survey and focus groups with midwives in Ethiopia’s five most populated regions were conducted. Almost half of midwives were unwilling to provide SAC, and half disbelieved that it was midwives’ duty to do so. Most believed that midwives should be able to refuse to provide SAC based on religious or moral objections. Midwives were motivated to provide care by a belief that clients would die without care and by a sense of professional duty. When asked about how they would treat women requesting abortion care and contraceptives, many midwives said that they would encourage the woman to do what the midwife him- or herself thought best, rather than support her in making her own decision. These regionally representative findings suggest the need for new provider guidelines to clarify practices surrounding conscientious objection and refusal to provide safe abortion care and for programs to better train midwives to provide respectful counseling.

Leveraging the shared goal of systematic research on self-managed abortion, researchers and accompaniment groups have begun to explore if and when research collaboration can advance knowledge and understanding. In this commentary, the authors share the experiences and perspectives of activists and researchers in the development of a collaboration designed to collect transformative evidence about people’s experiences self-managing abortions with accompaniment group support, as well as the safety and effectiveness of the model. They consider this through the stages of the partnership from formation to structure and process to lessons learned.

This commentary aims to highlight the importance of understanding the context when designing digital tools for SRH self-care in humanitarian settings. We draw insights from the contextual analysis that was essential to the design process of Aya Contigo, a digital self-care tool that provides information and virtual accompaniment during the medical abortion process up to the first trimester. The overall research and design process included the following phases: (a) contextual analysis and stakeholder engagement and mixed-method exploratory research, (b) user-centred design principles to design and develop the mobile-based digital tool, and (c) mixed-methods feasibility and acceptability pilot study. We focus on findings from the exploratory research. In this phase, we conducted a contextual analysis through a desk review of Venezuela’s complex humanitarian emergency; a mapping of national SRH and abortion legislation, policies, programmes, and main stakeholders; and in-depth interviews with local activists, SRH service providers, and prospective users. We also facilitated workshops where stakeholders shared their inputs on the pertinence of digital self-care tools in the Venezuelan context.

In March 2022, the World Health Organization (WHO) released updated abortion care guidelines based on the most current evidence on abortion care, law, and policy. The updated version of the guidelines contains a range of new recommendations for clinical, service delivery, and law and policy components of abortion care. This brief summarizes the changes to recommendations about self-managed abortion (SMA) in the guidelines, linking those recommendations to research conducted by Ibis Reproductive Health in close partnership with safe abortion accompaniment groups.

Objective Prior work shows that ads related to abortion services often feature crisis pregnancy centers instead of abortion providers. We investigated whether a change in Google's advertising policy that required advertisers to disclose whether they provided abortion services increased the proportion of ads facilitating abortion self-referral. Study Design We used a standardized protocol to search online for abortion services before, during, and after the policy change; we performed searches in August 2016–June 2017, June 2019, and October 2019, respectively, using Google, Bing, and Yahoo search engines. We performed searches for the 25 most populous U.S. cities and the 43 state capitals not already included. We classified up to the first five ads as facilitating abortion referral, hindering abortion referral, or providing neutral content. We compared search engine results using a chi-square test. Results Among ads returned by Google, those shown after the policy change were significantly more likely to facilitate abortion self-referral (66.7% vs. 44.2%; P=0.003) and slightly less likely to hinder abortion self-referral (33.3% vs. 40.6%; P=0.33) compared to before the change. These findings were reversed for ads shown by Bing and Yahoo; ads returned after the change were significantly less likely to facilitate abortion self-referral (24.6% vs. 32.8%; P=0.01) and significantly more likely to hinder self-referral (28.3% vs. 21.6%; P=0.03) compared to before the change. Conclusion A policy requiring advertisers to disclose whether they provide abortion services was associated with increasing the proportion of ads facilitating self-referral. Similar policies should be considered by all search engines.

State-level restrictions on abortion access may prompt greater numbers of people to self-manage their abortion. The few studies exploring perspectives of providers towards self-managed abortion are focused on physicians and advanced practice clinicians. Little is known about the wider spectrum of abortion care providers who encounter self-managed abortion in their clinic-based work. To gain a deeper understanding of this issue and inform future care delivery, we conducted in-depth interviews with 46 individuals working in a range of positions in 46 abortion clinics across 29 states. Our interpretative analysis resulted in themes shaped by beliefs about safety and autonomy, and a tension between the two: that self-managed abortion is too great a risk, that people are capable of self-managing an abortion, and that people have a right to a self-managed abortion. Our findings highlight the importance of increasing knowledge and clarifying values among all abortion care providers, including clinic staff.

In the months since President Biden revoked the GGR, evidence presented in this report indicates that there is a disconnect between the USG’s internal procedure for communicating the revocation and the information that is communicated externally to prime and sub-prime partners around the world. At times, the USG’s and prime partners’ failure to provide comprehensive and prompt guidance to recipients of U.S. global health assistance caused detrimental delays in the policy’s effective revocation. These same delays made it impossible for people to access the abortion care that they were legally entitled to during the nine months between when the policy was revoked in January 2021 and the last interviews were conducted in October 2021. Some organizations that were aware that the GGR had been revoked did not receive guidance that specified how to practically implement the revocation in their programming. Organizations needed urgent and immediate guidance from the USG in January 2021 that clearly instructed them to cease implementing the GGR and explained how to modify ongoing programs to align with the policy change as well as mitigate harmful impacts on communities around the world. Without clear communication, guidance, and compliance mechanisms to monitor the implementation of this policy change, the GGR will continue to impede justice, infringe on national sovereignty, and inflict harm on communities around the world. Without permanent repeal through legislative action, this vicious cycle will continue every time there is a change in U.S. presidential administrations between Democrats and Republicans, as has been the case for nearly 40 years.

Reproductive autonomy is a pivotal part of women’s access to equal citizenship, yet it has not been included in any international nor regional human rights treaty. In the past decades, the U.N. Committees, notably the CEDAW Committee, and regional human rights bodies, particularly the Inter-American System for the Protection of Human Rights, have timidly advanced reproductive justice through their jurisprudence, including through the use of reparations. Drawing from the standards of reparations developed in the field of transitional justice, human rights bodies increasingly rely on reparations to enhance the transformative effects of their decisions. These reparations intend to include a gender-perspective in their design and aim to ensure the non-repetition of human rights violation, not only to the victim, but to society. Constitutional courts in Latin America are increasingly relying on the standards of reparations in their own decisions, including in those on reproductive justice. In this Article, I analyze two recent rulings from Latin American constitutional courts–one from Colombia and one from Ecuador–to understand how courts can use reparations to advance reproductive justice. I analyze these particular rulings for two reasons: (1) Both rulings have the potential to develop reproductive jurisprudence in the region where high courts have traditionally imported international and comparative law to resolve legal debates over reproductive rights; and (2) Both rulings challenge the traditional concept of reparations and offer an opportunity to rethink how the remedy can be deployed in a human rights context.

The abortion landscape is fragmented and increasingly polarized. Many states have abortion restrictions or bans in place that make it difficult, if not impossible, for people to get care. Other states have taken steps to protect abortion rights and access. To help people understand this complex landscape, our interactive map groups states into one of seven categories based on abortion policies they currently have in effect. Users can select any state to see details about abortion policies in place, characteristics of state residents and key abortion statistics, including driving distance to the nearest abortion clinic.

The intense politicization of abortion in U.S. public discourse obscures its status as a health and health care issue. Medical centers may therefore not be doing the careful preparation needed to manage the health system–wide impact of abortion’s criminalization. [This commentary and analysis] is a framework for preparation in a state where abortion will become illegal.

This resource is intended to support advocates who are working to achieve universal access to comprehensive, person-centered abortion care and an enabling environment for people to exercise their sexual and reproductive health and rights.

Policy surveillance offers a novel and important method for comparing law across jurisdictions. We used policy surveillance to examine abortion laws across the globe. Self-managed abortion, which generally takes place outside formal healthcare settings, is increasing in prevalence and can be safe. We analysed provisions that do not account for the prevalence of self-managed abortion and evidence of its safety. Such provisions require that abortion take place in a formal healthcare setting. We also analysed criminal penalties for non-compliance. Our method included development of a legal framework, an iterative process of refining coding schemes and procedures, and rigorous quality control. We limited our analysis to liberal abortion laws for two reasons. Abortion laws globally trend towards less restrictive. In addition, we aimed to focus on how laws relate to abortion outside a formal healthcare setting specifically and excluded laws that prohibit abortion more broadly. We found that in all countries with liberal national abortion laws, the law permits only healthcare professionals or trained health workers to perform legal abortion and the majority require the abortion to take place in a specified health facility. With policy surveillance methods we can illuminate characteristics of law across many jurisdictions and the need for widespread reform, toward laws that reflect scientific evidence and the way people have abortions.

The battle to protect abortion rights in the United States has not been this fierce in fifty years. From a precipitously growing number of states passing draconian laws that drastically limit—and in some states, entirely ban—access to safe and legal abortion services to a Supreme Court that is poised to overturn Roe v. Wade, reproductive freedom is under siege at every turn. Overturning Roe will have devastating consequences for all people, but most acutely for historically marginalized communities, including people with disabilities. Nonetheless, when disability is invoked in discourse concerning abortion, it is typically done to either support or oppose abortions based on fetal disability diagnoses. Critically, by framing disability and abortion only in the context of disability-selective abortions, activists, scholars, legal professionals, and policymakers fail to recognize that it is actual disabled people—not hypothetical fetuses with disability diagnoses—who abortion restrictions will harm. Indeed, disabled people disproportionately experience pervasive and persistent disadvantages that increase their need for abortion services. They also experience considerable structural, legal, and institutional barriers that already put access to safe and legal abortion out of reach for many. In response, this Article proposes a vision to help activists, scholars, legal professionals, and policymakers as they imagine the next steps in the battle to protect abortion rights in a way that fully includes people with disabilities. To do so, first, the Article situates the current battle to protect abortion rights within the social context and institutions that propagate reproductive oppression of people with disabilities by examining how reproduction has been weaponized over time to subjugate disabled people as well as presenting contemporary examples of such injustices. Thereafter, it explores disabled people’s unique needs for abortion services and the myriad ways they are disproportionately and adversely affected by restrictions on abortion rights. Next, the Article presents disability reproductive justice, a jurisprudential and legislative framework, and its application to the fight for abortion rights. Finally, drawing from disability reproductive justice, it suggests normative and transformative legal and policy solutions for challenging the current assault on abortion rights and its impact on disabled people.

This Article launches a critical dialogue about the abortion privilege. On the one hand, most abortion patients are low income or live below the poverty line and are disproportionately women of color. Many of these patients encounter multiple restrictions on abortion and must travel lengthy distances to abortion care facilities. These patients take center stage in abortion rights cases and in abortion rights discourse. On the other hand, there is a smaller but not insignificant group of abortion patients for whom abortion care is paid for by private or public health insurance or available out-of-pocket funds. Many of these patients live in states where abortion is unrestricted, and abortion care facilities are accessible often in the county in which they live. These patients experience abortion as a form of ordinary health care and rarely show up in abortion rights cases and abortion rights discourse. They have the abortion privilege. This Article reveals the abortion privilege and contends that its recognition and thoughtful incorporation into abortion rights law and discourse could help redistribute the oppressive load women without the same privilege carry in connection with the right and help shore up the abortion right.

Purpose Health care professionals’ attitudes and behaviours play a fundamental role in the provision of timely comprehensive abortion care as a maternal health intervention and save hundreds of thousands of women’s lives, annually. This study explores underlying factors influencing Tanzanian and Ethiopian health care professionals’ attitudes and behaviours towards comprehensive abortion care between 2015 and 2020. Materials and methods The study inductively explored Ethiopian and Tanzanian health care professionals’ behaviours using a comparative case study design and a textual analytical approach. Published and unpublished literature, documents and newspapers were used as data sources. The two cases were selected because of their different approaches towards the governance of abortion care, one gradually legalising while the other persistently restricting. Results Results demonstrated that there are both subjective (beliefs, attitudes, images, pre-dispositions) and objective (institutional incapacity) factors that impact the actions of health care professionals in the work environment. Conclusions The study concluded that the intervention of subjective factors results from the institutional failure to effectively bridge the divide between governance and accessibility of safe abortion care.

Where abortion is legal, it is often regulated through a grounds-based approach. A grounds-based approach to abortion provision occurs when law and policy provide that lawful abortion may be provided only where a person who wishes to have an abortion satisfies stipulated ‘grounds’, sometimes described as ‘exceptions’ or ‘exceptional grounds’. Grounds-based approaches to abortion are, prima facie, restrictive as they limit access to abortion based on factors extraneous to the preferences of the pregnant person. International human rights law specifies that abortion must be available (and not ‘merely’ lawful) where the life or health of the pregnant woman or girl is at risk, or where carrying a pregnancy to term would cause her substantial pain or suffering, including but not limited to situations where the pregnancy is the result of rape or incest or the pregnancy is not viable. However, international human rights law does not specify a grounds-based approach as the way to give effect to this requirement. The aim of this review is to address knowledge gaps related to the health and non-health outcomes plausibly related to the effects of a grounds-based approach to abortion regulation. The evidence from this review shows that grounds have negative implications for access to quality abortion and for the human rights of pregnant people. Further, it shows that grounds-based approaches are insufficient to meet states’ human rights obligations. The evidence presented in this review thus suggests that enabling access to abortion on request would be more rights-enhancing than grounds-based approaches to abortion regulation.

The Oceania region is home to some of the world's most restrictive abortion laws, and there is evidence of Pacific Island women's reproductive oppression across several aspects of their reproductive lives, including in relation to contraceptive decision-making, birthing, and fertility. In this paper we analyse documents from court cases in the Pacific Islands regarding the illegal procurement of abortion. We undertook inductive thematic analysis of documents from eighteen illegal abortion court cases from Pacific Island countries. Using the lens of reproductive justice, we discuss the methods of abortion, the reported context of these abortions, and the ways in which these women and abortion were constructed in judges' summing up, judgements, or sentencing. Our analysis of these cases reveals layers of sexual and reproductive oppression experienced by these women that are related to colonialism, women's socioeconomic disadvantage, gendered violence, limited reproductive control, and the punitive consequences related to not performing gender appropriately.

Background In 2018, the right to lawful abortion in the Republic of Ireland significantly expanded, and service provision commenced on 1 January, 2019. Community provision of early medical abortion to 9 weeks plus 6 days gestation delivered by General Practitioners constitutes the backbone of the Irish abortion policy implementation. We conducted a study in 2020–2021 to examine the barriers and facilitators of the Irish abortion policy implementation. Methods We collected data using qualitative in-depth interviews (IDIs) which were conducted in-person or remotely. We coded and analysed interview transcripts following the grounded theory approach. Results We collected 108 IDIs in Ireland from May 2020 to March 2021. This article draws on 79 IDIs with three participant samples directly relevant to the community model of care: (a) 27 key informants involved in the abortion policy development and implementation representing government healthcare administration, medical professionals, and advocacy organisations, (b) 22 healthcare providers involved in abortion provision in community settings, and (c) 30 service users who sought abortion services in 2020. Facilitators of community-based abortion provision have been: a collaborative approach between the Irish government and the medical community to develop the model of care, and strong support systems for providers. The MyOptions helpline for service users is a successful national referral model. The main barriers to provision are the mandatory 3-day wait, unclear or slow referral pathways from primary to hospital care, barriers for migrants, and a shortage and incomplete geographic distribution of providers, especially in rural areas. Conclusions We conclude that access to abortion care in Ireland has been greatly expanded since the policy implementation in 2019. The community delivery of care and the national helpline constitute key features of the Irish abortion policy implementation that could be duplicated in other contexts and countries. Several challenges to full abortion policy implementation remain.

This guide has been produced as resource material for the mentoring programme on rights-based knowledge creation in sexual and reproductive health, conducted by the South Asia Hub of SRHM. It is meant to provide an introduction for researchers, practitioners and activists on how to use a human rights-based approach to knowledge creation in the area of sexual and reproductive health.

Introduction Despite playing an integral part in sexual and reproductive health care, including abortion care, nurses are rarely the focus of research regarding their attitudes about abortion. Methods A sample of 1,820 nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses were surveyed about their demographic and professional backgrounds, religious beliefs, and abortion attitudes. Scores on the Abortion Attitudes Scale were analyzed categorically and trichotomized in multinomial regression analyses. Results Almost one-third of the sample (32%) had moderately proabortion attitudes, 29% were unsure, 16% had strongly proabortion attitudes, 13% had strongly antiabortion attitudes, and 11% had moderately antiabortion attitudes. Using trichotomized Abortion Attitudes Scale scores (proabortion, unsure, antiabortion), adjusted regression models showed that the following characteristics were associated with proabortion attitudes: being non-Christian, residence in the North or West, having no children, and having had an abortion. Conclusions Understanding nurses’ attitudes toward abortion, and what characteristics may influence their attitudes, is critical to sustaining nursing care for patients considering and seeking abortion. Additionally, because personal characteristics were associated with antiabortion attitudes, it is likely that personal experiences may influence attitudes toward abortion. A large percentage of nurses held attitudes that placed them in the “unsure” category. Given the current ubiquitous polarization of abortion discourse, this finding indicates that the binary narrative of this topic is less pervasive than expected, which lends itself to an emphasis on empathetic and compassionate nursing care.

Recent shifts in the abortion provision landscape have generated increased concern about how people find abortion care as regulations make abortion less accessible and clinics close. Few studies examine the reasons that people select particular facilities in such constrained contexts. Drawing from interviews with 41 Ohio residents, we find that people's clinic selections are influenced by the risks they associate with abortion care. Participants' strategies for selecting an abortion clinic included: drawing on previous experience with clinics, consulting others online, discerning reputation through name recognition and clinic type, and considering location, especially perceptions about place (privacy, legality, safety). We argue that social myths inform the risks people anticipate when seeking health care facilities, shaping care seeking in ways that are both abortion-specific and more general. These findings can also inform research in other health care contexts where patients increasingly find their options constrained by rising costs, consolidation, and facility closure.

Diverse models of self-managed medication abortion exist—ranging from some interaction with medical personnel to completely autonomous abortion. In this commentary, we propose a new classification of self-managed medication abortion and describe the different modalities. We highlight autonomous abortion accompanied by feminist activists, called “acompañantes,” as a community- and rights-based strategy that can be a safe alternative to clinical abortion services in clandestine as well as legal settings. To improve access, abortion needs to be decriminalized and governments must acknowledge and facilitate the diversity of safe abortion options so women may choose where, when, how, and with whom to abort.

For decades, Ipas has trained doctors, midwives and nurses to safely and respectfully perform abortions and provide counseling on contraceptive options to ensure high-quality abortion care and continues to produce training materials and clinical guidance to support those efforts. As abortion self-care rises globally, so too does our investment in materials and resources developed for women to use to safely and successfully manage their abortion with pills. As the World Health Organization (WHO) strongly reaffirmed in the new Abortion Care Guideline, abortion using medication or vacuum aspiration is a common, safe, and simple health-care intervention when carried out “…in the case of a facility-based procedure – by a person with the necessary skills” and for self-managed abortion, “…individuals with a source of accurate information” (WHO, 2022). To that end, we are pleased to introduce a set of abortion care videos designed to better train health care providers to improve their abortion care and help women safely self-manage their abortion using pills. There are 11 videos for health workers and 3 videos for women. These videos were filmed in facilities in Africa and Asia and are consistent with the latest WHO and Ipas clinical guidance.

The objective of this guideline is to present the complete set of all WHO recommendations and best practice statements relating to abortion. While legal, regulatory, policy and service-delivery contexts may vary from country to country, the recommendations and best practices described in this document aim to enable evidence-based decision-making with respect to quality abortion care. This guideline updates and replaces the recommendations in all previous WHO guidelines on abortion care.

This commentary accompanies the WHO Abortion Care Guidelines. Using this holistic approach to the provision of quality abortion care, the Abortion Care guideline carries a consistent message: access to quality abortion care is both a health and human rights issue. The recommendations and best practice statements in this guideline are only the first step and they still need to be operationalised and implemented. Achieving implementation of the recommendations and best practice statements, while keeping the woman at the centre of quality abortion care, will spur movement towards attaining the highest attainable standard of sexual and reproductive health.

Access to abortion throughout much of Mexico has been restricted. Fondo Maria is an abortion accompaniment fund that provides informational, logistical, financial, and emotional support to people seeking abortion care in Mexico. This cross-sectional study examines the factors that influenced decision-making and contributed to delays in accessing care and explores experiences with Fondo Maria’s support among women living outside Mexico City (CDMX). We describe and compare the experiences of women across the sample (n = 103) who were either supported by Fondo Maria to travel to CDMX to obtain an abortion (n = 60), or self-managed a medical abortion in their home state (n = 43). Data were collected between January 2017 and July 2018. Seventy-seven percent of participants reported that it was difficult to access abortion care in their home state and 34% of participants indicated they were delayed in accessing care, primarily due to a lack of financial support. The majority of participants (58%) who travelled to CDMX for their abortion did so because it seemed safer. The money/cost of the trip was the most commonly cited reason (33%) why participants who self-managed stayed in their home state. Eighty-seven percent of participants said Fondo Maria’s services met or exceeded their expectations. Our data suggest that people seeking abortion and living outside CDMX face multiple and overlapping barriers that can delay care-seeking and influence decision-making. Abortion accompaniment networks, such as Fondo Maria, offer a well-received model of support for people seeking abortion in restrictive states across Mexico.

This study is a discourse analysis of an online abortion-storytelling platform in Mexico called Lightbulbs. The platform contributes to reducing stigma by showing a diversity of experiences and contesting stereotypes through participants’ own voices, which is powerful in a context where public discourse about abortion is polemic and rarely based on personal experience. Yet, tensions exist regarding what kinds of stories are less visible or silenced in online storytelling. We conclude with implications for reproductive rights activists who may unwittingly undermine the potential of storytelling for transformative justice in relation to access to safe and legal abortion

There is a great deal of misinformation and stigma surrounding abortion, even though it is a common reproductive health service. Teaching about abortion encompasses many things: managing the beliefs of students and teachers; state regulations around teaching or talking about abortion in schools; available resources; and the cultural miseducation and stigma around abortion. As social media becomes more accessible and widely used, educators can use it as a tool for teaching sensitive issues and navigating some of the restrictions and difficulties teaching about abortion comes with. This article explores current considerations and issues around abortion education and how TikTok can be used to teach this sensitive topic both inside and outside of the classroom, especially with adolescents and young adults. With its 1 billion monthly active users, TikTok is a potential educational space for teaching about abortion by spreading accurate information, engaging the audience, and working to open lines of communication to combat abortion stigma

Introduction: This study employs sentiment analysis (SA) to examine the semantic structures of restrictive and protective abortion bills enacted in 2019. SA is a Natural Language Processing (NLP) technique that uses automation to extract affective indicators (emotive language) from text data. Assessing these indicators can help identify whether legal texts are framed, or intentionally biased in their wording. Identifying framing is important for understanding potentially biased interpretations of these laws. Methods: We identified a sample of 2019 abortion bills using the legislative tracking tool Legiscan and included those that met specified criteria (N = 19 bills). We categorized each bill as restrictive (n = 12) or protective (n = 7). We ran aggregate (i.e., all bills) and separate (protective × restrictive) SA, generating scores that we interpreted qualitatively (higher scores indicated predominance of positive wording). Results: In the aggregate analysis, 56% of text comprised negative terms (44% positive). Restrictive bills contained more negative language than protective bills (67% vs 58%). Although SA scores varied from -222 to +13, two laws scored 0, indicating neutrality. For comparison, the US Constitution's score equaled 1. Conclusion: Our findings confirm SA is useful to examine legal documents for language biases. The abortion bills we assessed seem framed along political ideologies, although the sample provided evidence that neutral wording is possible. Policy implications: With the recent additions of conservative-leaning Justices to the US Supreme Court, Roe v. Wade is again at the center of partisan conflict. Thus, how abortion laws are framed draws further implications for how they may be interpreted when challenged in the court system.

We explore abortion access, abortion experiences, and abortion stigma. We emphasize global perspectives on abortion diversity and the relationship between pregnancy norms and expectations, abortion stigma, and practical constraints on reproductive freedom. Evolutionary psychological, clinical psychological, and social-psychological perspectives illuminate how abortion decisions are shaped by strategies to optimize survival and success, support services that emphasize the costs and risks of pregnancy termination, and pronatalist norms and punishment of departures from those expectations. We call for future abortion research that integrates multiple subfields in psychology and is rooted in an intention to effect public policy and social change that promotes reproductive autonomy.

This is a commentary on Adair and Lozano’s (2022) article, “Adaptive Choice: Psychological Perspectives on Abortion and Reproductive Freedom.” We offer a critique of its underlying premise that abortion must be justified and identify three substantive concerns. Then, we outline a better way to study abortion, one that draws on feminist and reproductive justice scholarship by: centering the lived experience of real people and their needs; holding that it is a fundamental human right of people to reproduce if and when they desire; and conducting research that benefits people, with a focus on those who are socially marginalized.

This is a commentary on Adair and Lozano’s (2022) article “Adaptive Choice: Psychological Perspectives on Abortion and Reproductive Freedom.” Here, I acknowledge the possibilities for the normalization of abortion that their approach presents. Then, drawing predominantly from South African politics and scholarship, I address how the (future) stories we tell about abortion may limit the potential for normalization and the eradication of stigma. I argue that scholars and activists need to engender a more radical, intersectional, and therefore critically reflexive, inclusive, bold abortion justice politics that envisions itself as one necessary part of the larger struggle for reproductive justice.

This is a commentary on Adair and Lozano’s (2022) article “Adaptive Choice: Psychological Perspectives on Abortion and Reproductive Freedom.” Here I focus on the ways that abortion seekers can achieve their goals outside the formalized health care systems of countries with governments that restrict abortion access or even outlaw it. Self-managed abortion (SMA), especially when supported by local feminist or community organizers, allows pregnant people to make an adaptive choice, safely circumvent the medicolegal system if necessary, and avoid abortion-related stigma. I highlight the work of Women Help Women, an international SMA network.

Objectives: Salient belief elicitations (SBEs), informed by the Reasoned Action Approach (RAA), are used to identify 3 sets of beliefs - behavioral, control, and normative - that influence attitudes toward a health behavior. SBEs ask participants about their own beliefs through open-ended questions. We adapted a SBE by focusing on abortion, which is infrequently examined through SBEs; we also included a survey version that asked participants their views on what a hypothetical woman would do if contemplating an abortion. Given these deviations from traditional SBEs, the purpose of this study was to assess if the adapted SBE was understood by participants in English and Spanish through cognitive interviewing. Methods: We examined participants' interpretations of SBE items about abortion to determine if they aligned with the corresponding RAA construct. We administered SBE surveys and conducted cognitive interviews with US adults in both English and Spanish. Results: Participants comprehended the SBE questions as intended. Participants' interpretations of most questions were also in line with the respective RAA construct. Conclusions: SBE survey questions were comprehended well by participants. We discuss areas in which SBE questions can be modified to improve alignment with the underlying RAA construct to assess abortion beliefs.

Objetivo Explorar las vivencias emocionales de las mujeres en torno a la interrupción voluntaria del embarazo (IVE) a través de la producción científica cualitativa existente. Método Revisión sistemática cualitativa basada en la búsqueda bibliográfica de estudios publicados desde 2010 en PubMed, Science Direct y Scopus. Se incluyeron 19 artículos con diseño cualitativo que se revisaron usando análisis de contenido de tipo inductivo. Resultados Se identificaron tres temas principales en torno a las experiencias emocionales: acceso a la IVE, impacto emocional durante la asistencia sanitaria y aspectos individuales, relacionales y socioculturales condicionantes de la vivencia. Los estudios mostraron la variabilidad de las experiencias emocionales, con los siguientes factores determinantes: acceso y tiempos de espera, características y funcionamiento del sistema sanitario, procedimiento de intervención, grado de presencia y participación de las pacientes en relación a aspectos técnicos y uso de tecnologías médicas, interacción con el personal sanitario y aspectos individuales, relacionales y socioculturales específicos. Las principales dificultades emocionales se relacionaron con el conflicto ético, la toma de decisiones, la relación con el entorno social y sanitario, y la experiencia del estigma. Como elementos facilitadores se refirieron la autonomía en la toma de decisiones y el apoyo emocional; como barreras, las manifestaciones del rechazo social y los mensajes negativos del entorno político, sanitario y sociofamiliar. Conclusiones Las experiencias emocionales en la IVE dependen de factores individuales, relacionales y asistenciales, vertebrados por desigualdades y sesgos de género. En el ámbito asistencial, el potencial de mejora reside en una atención sanitaria integral e individualizada, adaptada a las necesidades de las pacientes.

One out of four women in the United States will have an abortion by age 45. While abortion rates are steadily declining in the United States, the rate of medication abortions continues to increase, with 39% of all abortions being medication abortions. Our study is one of the first to analyze women's narratives after having had a medication abortion. Using relational dialectics theory, we conducted a case study of the nonpartisan website, Abortion Changes You. Our contrapuntal analysis rendered four sites of dialectical tension found across women's blog posts: only choice vs. other alternatives, unprepared vs. knowledgeable, relief vs. regret, and silence vs. openness. Each site of struggle characterized a different noteworthy moment within a woman's medication abortion experience: the decision, the medication abortion process, identity after abortion, and managing the stigmatizing silence before and after the abortion. We discuss theoretical and practical implications about how the larger politicized discourses prevalent within the abortion debate impact the liminality of women who are contemplating a medication abortion and affect their own narrative construction about the medication abortion experience.

CONTEXT Entertainment television can impact viewers' knowledge, attitudes, and reproductive health behaviors, yet little research has examined the impact of scripted abortion plotlines on viewers' abortion knowledge or social supportiveness for those having abortions. We examined the impact of an abortion storyline from Grey's Anatomy on US-based viewers. METHOD We conducted an online survey of likely Grey's Anatomy viewers prior to the episode's airing, assessing abortion ideology, knowledge, and support. After airing, we resurveyed respondents (including both those who had and had not viewed the target episode). We tested three hypotheses: episode exposure would (1) improve abortion knowledge and (2) increase support for medication abortion and decrease support for self-induced abortion, and (3) the effects on knowledge and supportive intention would be moderated by state support for abortion. We used independent samples t tests to examine hypotheses 1 and 2 and PROCESS macro to test the moderated effects (hypothesis 3). RESULTS The results of the pretest/posttest analysis indicated that exposure to the episode significantly improved medication abortion knowledge. Increases in medication abortion knowledge were tied to explicit educational dialogue and did not translate into an increase in general abortion knowledge or social supportiveness. Notably, abortion-related state policy significantly moderated the influence of exposure for respondents in states with policies favorable to abortion access. CONCLUSIONS These findings suggest that entertainment television can contribute to meaningful increases in viewers' knowledge about abortion, but that the potential for impact of entertainment-education is closely linked to episode content and moderated by state-level abortion policy.

In most settings worldwide, abortion continues to be highly stigmatised. Whilst a considerable body of literature has addressed abortion stigma, what is less commonly examined are the ways in which those with experience of abortion describe it in non-negative terms which may resist or reject stigma. Drawing on qualitative secondary analysis of five UK datasets using a narrative inquiry approach, we explore: the use of non-negative language around abortion, potential components of a normalising narrative, and constraints on non-negativity. As such, we present the first empirical UK study to critically examine how a dominant negative abortion narrative might be disrupted.

Objetivo Identificar variables y argumentaciones valóricas que configuran la percepción de la interrupción del embarazo como delito bajo cualquier causal, en una muestra comunitaria de una ciudad al sur de Chile durante el debate de la Ley 21.030. Método Estudio mixto, cuantitativo, observacional, de corte transversal correlacional y cualitativo. Una muestra cuantitativa de 289 personas de Temuco (Chile) contestó a un cuestionario sobre categorías sociales y su percepción de la gravedad de 15 conductas como delito. Para la fase cualitativa se realizaron 12 entrevistas semiestandarizadas sometidas a análisis de contenido, incorporando algunos elementos de la teoría fundamentada desde la perspectiva constructivista. Resultados Con independencia del sexo, más de la mitad de la muestra de estudio consideran el aborto como un delito entre grave y extremadamente grave. Las personas religiosas, sin importar el tipo de religión, políticamente conservadoras y con menor nivel educativo, presentan una percepción del aborto como delito de mayor gravedad. La participación con frecuencia en actos religiosos presenta un efecto mediador. Los resultados cualitativos establecen una perspectiva multidimensional y el dogma de la religión como argumento central para rechazar el aborto. Conclusiones La religión y una visión política conservadora afectan las construcciones tradicionales de género y maternidad, y por ende se observa una tendencia a rechazar el aborto. Estos resultados hacen hincapié en la necesidad de prestar especial atención a la aceptación de la Ley 21.030 sobre la interrupción voluntaria del embarazo para una aplicación efectiva.

Background Although abortion was legalized in South Africa in 1996, barriers to safe, legal abortion services remain, and women continue to seek abortions outside of the formal healthcare sector. This study explored the decision-making processes that women undertake when faced with an unintended pregnancy, the sources of information used to make their decisions and the factors that contribute to their seeking of informal sector abortion in Cape Town, South Africa. Methods We conducted 15 semi-structured in-depth interviews in English with women who had accessed an abortion outside of the formal health care sector. Women were recruited with the assistance of a community-based key informant. Data was analyzed using a thematic analysis approach. Results Participants were aware that abortions were legal and accessible in public clinics, however they were concerned that others would find out about their unintended pregnancy and abortion if they went to legal providers. Women were also concerned about judgment and mistreatment from providers during their care. Rather than seek care in the formal sector, women looked past concerns around the safety and effectiveness of informal sector abortions and often relied on their social networks for referrals to informal providers. Conclusions The findings highlight the decision-making processes employed by women when seeking abortion services in a setting where abortion is legal and demonstrate the role of institutional and societal barriers to safe abortion access. Abortion service delivery models should adapt to women’s needs to enhance the preferences and priorities of those seeking abortion care-including those who prefer facility-based care as well as those who might prefer self-managed medical abortions.

Although abortion rates appear to be declining in high-income nations, there is still a need for accessible, safe abortion services. However, limited attention has been paid to understanding the social contexts which shape access to abortion information and services for communities who are less engaged with sexual and reproductive health care more generally. This paper explores the views and experiences of 27 migrant and refugee young people (16-24 years old) living in Sydney, Australia, regarding unintended pregnancy and abortion. Pregnancy outside marriage was described by all participants as a shameful prospect as it revealed pre-marital sexual activity. Even when abortion was described as culturally and/or religiously unacceptable, it was believed many families would find an abortion preferable to continuing an unintended pregnancy outside marriage. However, a pervasive culture of silence regarding sexual and reproductive health may limit access to quality information and support in this area. To better meet the needs of these young people, greater attention must be paid to strengthening youth and community awareness of the availability of contraception including emergency contraception, pregnancy options, and access to abortion information and services.

This new report examines assets and barriers young people face when seeking abortion care, and seeks to determine what cultural change is necessary in youth abortion access. YAAT worked with Rivera Consulting to engage youth and supportive adults in a qualitative survey and interview approach, then developed recommendations for the field to continue the work of removing barriers to abortion access and supporting young people seeking abortion.

The inroads Queer Abortions Festival was held from 30 March to 7 April 2022 over a total of 5 sessions. Sessions were conducted in English and Spanish, ranging from 1.5 to 3 hours. The festival aimed to celebrate and bust the stigma of the lived experiences, intricacies, questions, and reflections surrounding queer abortions through various collaborative activities such as open learning spaces, zine-making, shared dialogue, and collective reflection. Each session of the workshop focused on building co-created spaces of learning between member facilitators and participants. As such, a participatory approach is embedded within the workshop materials, in order to encourage active learning and a diversity of responses. We are including workbooks of the workshop materials in English, French, and Spanish to facilitate broader learning opportunities for your organization and/or abortion stigma-busting community.

The online training for inroads members Mapping and Mobilizing Resources for Abortion Stigma Busting Work, held on 19 January and 1 February 2022, was conducted by Xiomara Carballo Briceño. Through a participatory process guided by collective care principles, inroads members who attended were able to strengthen their resource mobilization capacity through the exploration of key resource mobilization concepts such as: Mapping donor landscapes in the search for value-aligned funding. How to seek out and determine the most appropriate calls for proposals. What a donor pipeline is and how it may be used for resource mobilization continuity in organizational funding. Telling your organization’s story when crafting a proposal. Being aware of the power dynamics implicit within donor relationships.

The first inroads Stigma at the Intersections: Abortion, Disability, HIV and Access workshop was held on October 12,13, and 14. Learning Goals of the workshop: To underline stigma related to abortion, how it affects people with disabilities and other marginalised groups such as people living with HIV, sex workers, people who inject drugs, trans and queer community. To generate discussion and learning on abortion and disability that is genuinely intersectional and goes beyond and anti-abortion narrative of abortion on grounds of disability. To ensure that there is not simply room for this discussion, but that real, safe, and brave spaces are created with the intent of broadening this learning with, and not just on behalf of, of those of us with disabilities. To ensure that the autonomy, agency, and attitude of those of us with disabilities are heard, seen, and hold their rightful place in dismantling stigma. At this link, you can find a workbook version of the the workshop in English, French, and Spanish

We prepared a workbook version of the materials from the workshop about Exploring Definitions and Measurement Tools of Abortion Stigma to facilitate the learning experience of members that were not able to attend the live session. With this workbook, you will be able to: More precisely define stigma and how it manifests. Learn about the diverse tools to measure abortion stigma (SABAS, ILASS, CLASS, APSS), the intended use of each, and understand some of their strengths and weaknesses. Explore the different aspects to be considered when adopting and applying a measuring tool. Follow a step-by-step process to help you choose, prepare, and apply a measuring scale successfully.

The 150th anniversary of §218 of the German criminal code provides an opportunity to take a closer look as its diverse implications. As a board member of inroads, International Network for the Reduction of Abortion Discrimination and Stigma, the author points out the reciprocal relationship between abortion stigma and criminalization. inroads is a loose network of academics, advocates, activists and artists and provides a platform for activism and discussion on all facets of abortion stigma and its effective fight.

It was almost a decade ago that we started conducting research to assess abortion stigma in partnership with service delivery organizations in the Global South. We adapted various stigma scales to learn about perceptions of and experiences with stigma among people seeking abortion, as well as attitudes about abortion among community members. We wanted to learn about experiences responding to the ILAS directly from people who had an abortion. In this exploratory study, we conducted in-depth interviews by phone with 10 people from different parts of Mexico. Participants were recruited by the MARIA Abortion Fund for Social Justice (Fondo MARIA) if they were aged 18 and older, had an abortion in the prior 6 months, and said they had support from someone close to them at the time of the abortion.

Care-Mapping - a guide to facilitate a care-mapping workshop in your own organization. The workbooks have been designed and commissioned specifically with the inroads network in mind, as we pursue wider methods of exploring spaciousness and self-care in a time of increasing resistance and restriction towards reproductive justice, joy, and activism. Find the English, Spanish, and French workbooks at the link!

Objectives The objective of this study was to evaluate a person-centered abortion care mobile-based intervention on perceived social stigma, social support, mental health and post-abortion care experiences among Kenyan women who received abortion services at private clinics. Methods This randomized controlled study enrolled women who obtained an abortion from private clinics in Nairobi county, Kenya and randomized them into one of three study arms: 1) standard of care (follow-up by service provider call center); 2) post-abortion phone follow-up by a peer counselor (a woman who has had an abortion herself and is trained in person-centered abortion care); or 3) post-abortion phone follow-up by a nurse (a nurse who is trained in person-centered abortion care). All participants were followed-up at two- and four-weeks post-abortion to evaluate intervention effects on mental health, social support, and abortion-related stigma scores. A Kruskal-Wallis one-way ANOVA test was used to assess the effect of each intervention compared to the control group. In total, 371 women participated at baseline and were each randomized to the study arms. Results Using Kruskal-Wallis tests, the nurse arm improved mental health scores from baseline to week two; however this was only marginally significant (p = 0.059). The nurse arm also lowered stigma scores from baseline to week four, and this was marginally significant (p = 0.099). No other differences were found between the study arms. This person-centered mobile phone-based intervention may improve mental health and decrease perceived stigma among Kenyan women who received abortion services in private clinics. Conclusions Nurses trained in person-centered abortion care, in particular, may improve women’s experiences post-abortion and potentially reduce feelings of shame and stigma and improve mental health in this context.

Plain Language Summary: We conducted a study to explore and understand the social barriers women face in seeking and obtaining quality safe abortion care in Ethiopia. We implemented focus group discussions with both men and women in four different regions of Ethiopia. We analyzed our findings into themes around stigma, barriers, and the changing nature of attitudes around abortion. Our results show that women seeking abortions are still heavily stigmatized. We found that abortion was deemed unacceptable in most cases. However, we also saw promising indications that changes are taking place in Ethiopian society’s view of abortion, and several participants indicated progress toward a more supportive environment overall for women seeking abortion care. Still, this progress may be limited by variable knowledge of abortion laws. Most participants noted the importance of education and outreach to improve abortion attitudes and norms. We concluded that further awareness is needed in Ethiopia on the availability of quality abortion services in public health facilities and the indications for legal abortion. These efforts should consider gender equality to ensure enduring changes for women’s reproductive choice throughout the country.

Objective: Medical menstrual regulation (MMR) may offer a promising way to reach Senegalese women and girls in need of fertility management, especially in rural contexts. To assess the feasibility of introducing a MMR service in Senegal, the study aimed to (1) understand how women and girls manage their menses and fertility, and (2) document acceptability of MMR among women, youth, and health providers. Methods: Six focus group discussions and 34 in-depth interviews were conducted with women, youth, and health providers in Kaolack, Mbour, and Thiès, Senegal. Results: All participants characterized the pubescent period by a lack of sexual education, familial support, and access to reproductive health services. Reproductive health service utilization in Senegal was portrayed as highly stigmatized, creating barriers to contraception and reliable information on family planning. Unwanted pregnancy and clandestine abortion were depicted as common occurrences among many participants. Senegalese women and youth perceived MMR services as an acceptable method to manage a missed period with discretion, rid of moral and legal ramifications - and framed MMR as a needed mechanism to prevent abortion and avoid undesired pregnancies. The majority of health providers, with the exception of female health volunteers, were reluctant to endorse the service, comparing MMR to abortion. Conclusions: In a context fraught with restrictive abortion laws and limited uptake of modern contraception, MMR is an acceptable among potential service users. Nonetheless, introduction and implementation of MMR will be feasible in Senegal only if policymakers approve and support the service and health provider buy-in is achieved.

Objective We aimed to assess the impact of first-person abortion stories on community-level abortion stigma. Methods Between November 2018 and March 2019, we recruited participants and analyzed data from a nationally representative, probability-based online panel of U.S. adults, randomized to watch three first-person abortion video stories (intervention, n = 460) or three nature videos (control, n = 426). We measured community-level abortion stigma using the Community Abortion Attitudes Scale, Reproductive Experiences and Events Scale, and Community Level Abortion Stigma Scale at baseline, immediately after video exposure, and 3 months later. We dichotomized stigma change scores as decreased stigma compared with no change or increased stigma. Bivariate and logistic regression analysis accounted for complex survey methodology and sample weighting. Results Sample demographics reflected U.S. Census benchmarks (51% female, 68% White, 47% aged 18–44 years). Most participants (83.1%) completed the 3-month follow-up. Viewing the intervention videos was not associated with decreased stigma measured by Community Abortion Attitudes Scale or Community Level Abortion Stigma Scale immediately (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.59–1.09; OR, 1.28; 95% CI, 0.93–1.75) or at the 3-month follow-up (OR, 0.86; 95% CI, 0.62–1.19; OR, 0.98; 95% CI, 0.70–1.37). Intervention exposure was associated with decreased stigma as measured by Reproductive Experiences and Events Scale immediately (OR, 1.74; 95% CI, 1.23–2.46); however, this association was not observed at the 3-month follow-up (OR, 0.98; 95% CI, 0.70–1.37). Conclusions Exposure to first-person video stories may not decrease community-level abortion stigma among U.S. adults.

Objectives: Recognizing and tolerating complexity has been shown to be key in successfully navigating conflict about contested topics. Abortion conversations are often highly polarized and lacking nuance. Yet many Americans experience some level of discomfort with abortion. We sought to understand if acknowledging ambiguity and complexity in abortion conversations could help manage discomfort and ultimately increase support for abortion.

Black feminists know that Roe was never enough. Black reproductive justce leadership and organizers continue to step up to bridge the gap of abortion access for Black women, girls, and gender-expansive people. We must follow in their footsteps and recognize that now is the time to organize, not despair! Nearly 50 years after Roe v. Wade, the most consequential abortion rights case, Black folks in the Midwest and South are forced to fight for expanded access, safe abortion options, and full bodily autonomy. Black women, girls, and gender expansive people are continually on the front end of government protection rollbacks and harmful legislative decisions that fail us, but Black feminisms help us get free! Black reproductive justice organizers will continue to follow in the steps of Black feminists by connecting Black people to the resources and information necessary to take power over their reproductive choices. This Abortion Is Freedom Action Toolkit includes resources that center Black feminist power and abortion access. The Abortion is Freedom Action Kit is a powerful tool for taking action in cities across the country.

This guide is designed to educate and provide practical tools for law enforcement, defense attorneys, child welfare workers, healthcare providers, medical examiners, and legislators to stop the criminalization of pregnancy.

Globally, people self-manage their medication abortions without clinical assistance. Feminist activist collectives (accompaniment groups) support people through self-managed abortion with evidence-based guidance. We sought to understand the impact of COVID-19 and related restrictions on the need for and experiences of self-managed abortion with accompaniment support across varied legal and social contexts. Between May and October 2020, we conducted in-depth interviews with individuals who self-managed abortions with support from accompaniment groups during the pandemic in Argentina, Indonesia, Nigeria, and Venezuela. We conducted a thematic analysis to understand the impact of COVID-19 on participants’ experiences with accompanied self-managed abortions. Across 43 in-depth interviews, participants in all four countries described how the COVID-19 pandemic created challenges at each step of their abortion process, from confirming the pregnancy, accessing abortion pills, finding a private, comfortable place, and verifying abortion completion. For most people, conditions related to the pandemic made it harder to self-manage an abortion; for a minority, being at home made aspects of the experience somewhat easier. Nonetheless, all participants reported feeling supported by accompaniment groups, and COVID-19 and related lockdowns reinforced their preference for accompaniment-supported self-managed abortion. These findings highlight the essential role that accompaniment groups play in ensuring access to high-quality abortion care in a multiplicity of settings, particularly during the COVID-19 pandemic. Efforts are needed to expand the reach of accompaniment groups to increase access to the high-quality abortion support they provide, filling a critical gap left by health systems and legal infrastructure.

Excessive regulation under state law has made it increasingly difficult for Americans to get a legal abortion. State lawmakers passed more than 100 restrictions on abortion in 2021, more than any previous year.1 Meanwhile, the Supreme Court shifted rightward with the appointment of three justices during the Trump administration, threatening constitutional protection for abortion and setting a course for state-level abortion bans. In light of these developments and new research, we revisit the groundbreaking research article “Demand for Self-Managed Medication Abortion Through an Online Telemedicine Service in the United States”2 and comment on its significance and implications since publication. This study by Aiken et al. examined the demand for remote medication abortion (a regimen consisting of mifepristone and misoprostol pills) among US residents in 2017 through 2018 and assessed variation in barriers to clinical abortion care by state policy context (hostile vs supportive). Metrics collected by AJPH demonstrated that this study garnered much attention from AJPH readers and the media (https://bit.ly/3kKAG0I). The article presented a model of abortion care that sidestepped long-standing barriers to clinical abortion care and presented evidence of a strong interest in and need for this model among US residents. The salience of the study has grown as the proportion of Americans who use medications to end their pregnancies has increased and as state-level legal barriers to abortion access have proliferated, with outright bans expected within months.3 The ongoing COVID-19 pandemic has also increased demand for at-home medication abortion because of concerns about the risk of contracting COVID-19 in a clinic or in transit; this has added to long-standing barriers to access for clinic-based abortion care, including long distances to the nearest clinic, arranging care for dependents, and more.4 Aiken et al. note the effect of abortion restrictions on increasing demand for at-home medication abortion and offer a preview into the future of abortion seeking for the growing number of Americans who will be legally unable to obtain abortion in a clinical setting.

Background Although abortions are a common aspect of people’s reproductive lives, the economic implications of abortion and the stigmas that surround abortion are poorly understood. This article provides an analysis of secondary data from a scoping review on the economic impact of abortion to understand the intersections between stigma and economics outcomes at the microeconomic (i.e., abortion seekers and their households), mesoeconomic (i.e., communities and health systems), and macroeconomic (i.e., societies and nation states) levels. Methods and findings We conducted a scoping review using the PRISMA extension for Scoping Reviews. Studies reporting on qualitative and/or quantitative data from any world region were considered. For inclusion, studies must have examined one of the following microeconomic, mesoeconomic, or macroeconomic outcomes: costs, benefits, impacts, and/or value of abortion-related care or abortion policies. Our searches yielded 19,653 items, of which 365 items were included in our final inventory. As a secondary outcome, every article in the final inventory was screened for abortion-related stigma, discrimination, and exclusion. One quarter (89/365) of the included studies contained information on stigma, though only 32 studies included stigma findings directly tied to economic outcomes. Studies most frequently reported stigma’s links with costs (n = 24), followed by economic impact (n = 11) and economic benefit (n = 1). Abortion stigma can prevent women from obtaining correct information about abortion services and laws, which can lead to unnecessary increases in costs of care and sizeable delays in care. Women who are unable to confide in and rely on their social support network are less likely to have adequate financial resources to access abortion. Conclusions Abortion stigma has a clear impact on women seeking abortion or post-abortion care at each level. Programmatic interventions and policies should consider how stigma affects delays to care, access to accurate information, and available social and financial support, all of which have economic and health implications.

When people can safely get an abortion, it not only improves their own quality of life, but that of their families, communities and even countries. In a recent collaboration with partners at Rutgers University and London School of Economics, Ipas conducted a global review of research on the impact of abortion access at the individual, community, and country levels. Findings show that when abortion access is achieved by making it legal, available and affordable, the trickle-down benefits are vast and far-reaching. This comprehensive assessment of global research specifically looked at the impact of abortion access and abortion policies on economic outcomes.

In 2021, 10,841 abortions were carried out in Norway, of which 95.3% were medical abortions. In this phenomenological study, we explore women’s experiences connected to performing a medical abortion at home. We conducted 22 interviews and analyzed the data using Giorgi’s descriptive phenomenological method. Our analysis revealed four crucial constituents: The logical and sensible choice—doubt beneath the surface; Secrecy and the dubious comfort of hidden shame; Emotional distancing as a coping strategy; and Moving on—and revisiting the meaning of the abortion. We discuss and reflect on these findings drawing on insights from existential phenomenology and contemporary research.

Stigma toward women who have had an induced abortion was measured in 458 adult Mexicans and was related to the respondents’ place of residence, religiosity, beliefs about motherhood, ambivalent sexism, age, and personal acquaintance with a woman who had aborted. All participants completed a set of questionnaires that were validated in Mexico. The variables that predicted stigma were religiosity, hostile sexism, age, and beliefs about motherhood as giving meaning to life. The results of this study could facilitate designing strategies to reduce such stigma and its negative consequences on the psychological and physical health of women who have aborted.

In the United States, a growing number of television shows have introduced storylines involving abortion and reproductive health which have the potential to inform and educate viewers. In light of this increase in both the number and diversity of representations, there remain questions regarding their impact on audience attitudes toward this contentious issue. Using a 3 (character disposition) x 2 (consent status) experiment (N = 520), this study examines the influence of a storyline from the television show 13 Reasons Why. By manipulating both the context of the sexual encounter (a narrative feature) and the main character’s affective disposition (a character feature), the study sought to better understand the role such contextual features play in shaping the audience’s response, both directly as well as through their influences on identification. The findings indicate a need for caution in presenting controversial issues on screen: a worrying asymmetry emerged, where negative contextual features promoted less favorable attitudes while positive features had no observable effect. Consequently, abortion depictions could potentially contribute to anti-abortion sentiments if the focal characters are not presented sympathetically and favorably. Thus, enhancing the appeal of these representations should be of paramount importance for conscientious storytellers and practitioners.

Abortion stigma shapes the environment in which abortion is delivered and received and can have important implications for quality in abortion care. However, this has not previously been clearly articulated and evidenced. We conducted a scoping review of existing qualitative evidence to characterise the relationship between abortion stigma and quality in abortion care. Using a systematic process, we located 50 qualitative studies to include in our analysis. We applied the interface of the WHO quality of care and abortion stigma frameworks to the qualitative evidence to capture manifestations of the interaction between abortion stigma and quality in abortion care in the existing literature. Four overarching themes linked to abortion stigma emerged: A) abortion as a sin and other religious views; B) regulation of abortion; C) judgement, labelling and marking; and D) shame, denial, and secrecy. We further characterized the emerging ways in which abortion stigma operates to inhibit quality in abortion care into seven manifestations of the relationship between abortion stigma and quality in abortion care: 1) poor treatment and the repercussions, 2) gatekeeping and obstruction of access, 3) avoiding disclosure, 4) arduous and unnecessary requirements, 5) poor infrastructure and lack of resources, 6) punishment and threats and 7) lack of a designated place for abortion services. This evidence complements the abortion stigma-adapted WHO quality of care framework suggested by the International Network for the Reduction of Abortion Discrimination and Stigma (inroads) by illustrating specifically how the postulated stigma-related barriers to quality abortion care occur in practice. Further research should assess these manifestations in the quantitative literature and contribute to the development of quality in abortion care indicators of that include measures of abortion stigma, and the development of abortion stigma reduction interventions to improve quality in abortion care.

"The app Safe Abortion offers clear, non-judgmental information about abortion using simple language and illustrations. Safe Abortion is a multilingual app that works entirely offline after download and does not collect any personal information about its users. Designed for abortion seekers and their supporters, the app includes a pregnancy calculator, summarized and in-depth information about abortion methods, especially pills, shareable infographics and printable PDFs, country specific information and much more. The app is updated periodically to reflect international standards of abortion care and the practical expertise of hundreds of health workers, abortion accompaniers and activists, and people of reproductive age who provide feedback on the app and its use through iterative user testing. The Safe Abortion app is developed by Hesperian Health Guides, an organization committed to health justice with nearly 50 years of experience developing actionable and accessible health information r. From our first book Where There Is No Doctor to our numerous online and print resources, Hesperian strives to develop resources that people of all walks of life can use and act upon to achieve their right to health."

"La app Aborto Seguro ofrece información sobre el aborto clara y sin prejuicios utilizando lenguaje sencillo e ilustraciones. Aborto seguro es una aplicación multilingüe que funciona sin conexión a internet una vez que se descarga y no recopila ninguna información personal de sus usuarios. Diseñada para las personas que buscan abortar y quienes las apoyan, la app incluye una calculadora de embarazo, información detallada sobre los métodos para abortar, especialmente con pastillas, infografías para compartir, PDF imprimibles, información por país y mucho más. La app se actualiza periódicamente para reflejar los estándares internacionales de atención y la experiencia práctica de cientos de personas que trabajan en la salud, acompañantes de aborto, activistas y personas en edad reproductiva que nos envían sus comentarios sobre la app y su uso por medio de pruebas con personas usuarias. La app Aborto Seguro fue desarrollada por Guías de Salud Hesperian, una organización comprometida con la justicia en la salud que cuenta con casi 50 años de experiencia en el desarrollo de información práctica y accesible sobre la salud. Desde la publicación de nuestro primer libro Donde no hay doctor hasta nuestros numerosos recursos impresos y en línea, Hesperian se esfuerza por desarrollar recursos que toda persona pueda usar para ejercer su derecho a la salud. "

A publication that examines global abortion trends; abortion measurement issues; innovations in abortion technologies; the harms of abortion restrictions; and the challenges and controversies surrounding abortion policies globally.

The double-volume book documents and analyzes how the Decriminalizing of Abortion in Northern Ireland was achieved. Under the leadership of editors & co-authors Emma Campbell & Fiona Bloomer, the multifaceted story is collectively shared, with each chapter written by those directly involved in the long-fought battle for abortion rights- including those with personal experience of seeking abortions, activists, academics, legal experts, political actors, NGOs, and volunteers.

A yearly report examining abortion plotlines on US TV. 2022 Highlight: For the first time since this research started a decade ago, at least one-third of TV abortion plotlines depicted barriers to abortion access.

The 33rd annual World Report summarizes human rights conditions in over 100 countries and territories worldwide in 2022, including the right to abortion healthcare and the impact of abortion stigma.

To facilitate the learning experience of inroads members and the abortion justice community at large, inroads is sharing a workbook version of the training Creative Storytelling Tools & Techniques for Destigmatizing Abortion. Find the workbooks in English, Spanish, and French.

inroads new publication documenting the journey and the thought process behind the Spacious Solidarity Dialogues. A space for international solidarity, healing, reflection, and connection among the abortion justice community.

Ipas created this facilitator’s guide for use with providers, health systems and communities to expand access to supportive, stigma-free abortion care. It is designed to be a flexible resource that can serve training needs for a variety of audiences and settings. It is not a structured curriculum, but rather a collection of activities and materials that can be used individually or in combination, based on the timing and agenda of individual workshops as needed.

Culture and community can play a role in views, stigma, and access related to abortion. No research to date has documented the influence of culture and community attitudes on Asian American (AA) experiences accessing abortion care in the United States (US). This paper aims to fill gaps in research and understand how cultural and community views influence medication abortion access and experiences among AAs. We used a community-based participatory research approach, which included collaboration among experts in public health, advocates, practitioners, and community partners to understand abortion knowledge, attitudes, and experiences among AAs. Using a semi-structured interview guide, we interviewed twenty-nine eligible people of reproductive age over 18 that self-identified as Asian American or mixed race including Asian American, Native Hawaiian, and/or Pacific Islander (AANHPI), and had a medication abortion in the US between January 2016 and March 2021. Interviews were analyzed and coded in NVivo 12 using a modified grounded theory approach.

Despite liberalised abortion laws in Colombia and Mexico City, ongoing abortion-related stigma and lack of knowledge of abortion laws can impede access to care. Organisations offering abortion services may support women seeking services by providing counselling and information. We conducted 30 in-depth interviews with women in Colombia and Mexico City after their abortion to understand their feelings of stigma, fears and concerns before accessing services, and how abortion counselling addressed those concerns. Women in both regions cited concerns about abortion safety, fears of judgement from community members and some reported self-judgement or guilt. Before arriving to care, women in Colombia were unsure if they qualified for legal abortion under the current law, and many reported fearing legal or social repercussions for seeking an abortion, whereas women in Mexico knew they could access a legal abortion in Mexico City. Women in all clinics reported satisfaction with the counselling services and felt most of their concerns were addressed. However, most women said they continued to fear judgement from members of the community after their procedure. Service-delivery organisations can provide supportive services and decrease women's fears and concerns, although interventions in communities are also needed to reduce stigma and improve information.

To assess abortion patients’ self-judgment in a setting with anti-abortion protestors. Methods We analyzed data from a survey of 196 Mississippi abortion clients who interacted with anti-abortion protestors, using ANOVA to compare feelings of self-judgment (measured on a 0-to-4 Likert-based scale) by religious identity. We assessed support for a law limiting protestor activity, using a chi-squared test. Results The mean self-judgment score was 1.1 among respondents with no religious identity (n=43), 1.4 among religious, not evangelical respondents (n=101), and 1.5 among evangelical respondents (n=62; p= 0.23). Most respondents (79%) supported a law limiting protestor activity. Discussion Overall, self-judgment was low and support for a law limiting protestor access was high.

To examine factors associated with physicians' level of concern and perceived consequences of publicly supporting abortion at Wisconsin's largest and only publicly funded medical school. Methods We surveyed physicians at the University of Wisconsin School of Medicine and Public Health about their knowledge, attitudes, and referral practices regarding abortion care. Among those who expressed support for abortion (N = 701), we analyzed perceived concerns about making their support public. Results Nearly a quarter (22%) of respondents felt very or extremely concerned that taking a strong public stance on abortion would alienate patients and 17% felt very or extremely concerned that doing so would alienate coworkers. More than a quarter (27%) felt very or extremely concerned that publicly supporting abortion would lead to harassment or harm. Those with greater concerns about expressing public support for abortion were comparatively less willing to refer for or participate in abortion care themselves. Conclusions Many physicians supportive of abortion reported concerns over publicizing their support for this common health care service. These concerns may render physicians less likely to refer patients for needed abortion care or weigh in on abortion policy.

To investigate the level of stigma and identify its influencing factors among women with termination of pregnancy for fetal anomaly(TOPFA) in China. Design: This was a cross-sectional study design. Setting and participants: A total of 469 women with TOPFA were recruited from a tertiary care hospital in China using a convenience sampling method. Measurement and findings: Women with TOPFA participating in the study completed the Demographic Characteristics Questionnaire, Individual Level Abortion Stigma Scale(ILASS), Acceptance and Action Questionnaire- II scale(AQQ- II), Cognitive Fusion Questionnaire scale (CFQ), Multidimensional Perceived Social Support Scale(MPSS), Responses to Stress Questionnaire (RSQ). Women with TOPFA reported moderate levels of stigma(1.49±0.60). Multiple linear regression showed that correlates influencing their stigma included gestational age (β =0.103, P < 0.05), psychological flexibility (β =-0.319, P < 0.01), social support(β =-0.190, P < 0.01), and disengagement coping(β =0.148, P < 0.05). Key conclusion and implication for practice: Gestational age and disengagement coping are positive predictors of stigma, but psychological flexibility and social support are negative predictors of stigma. Further attention should focus on developing targeted intervention strategies to improve protective and reduce harmful factors to confront the stigma-related challenges faced by women with TOPFA.

To describe medical student attitudes and exposure to abortion and pregnancy options counseling and influences of that experience on the provision of these services in their future practice. Study design: A survey was conducted of 3rd and 4th year medical students in 2019 at an US medical school in the Northeast. Results: One hundred and sixty-two students participated in the survey (response rate = 46 %, 162/353). Only 27 % reported receiving at least one educational lecture on abortion during medical school. Fifty-eight percent reported clinical exposure to surgical abortion. About 2/3 reported being somewhat likely to provide abortions in the future, despite most identifying as "pro-choice." There was significant association between clinical exposure to surgical abortion and desire to include abortion in future practice (P = 0.03). The most common objections to performing future abortions were personal values, religious objection, and lack of training/experience. Most respondents did not feel comfortable providing counseling for abortion or adoption. Combined, only 14.4 % reported that they would be at least somewhat likely to apply to obstetrics-gynecology or family medicine residency programs, including programs with opportunities for such training. Conclusions: Earlier work has shown that medical student intentions to provide abortions prior to residency are better predictors of future abortion provision than during residency. Thus, medical school is a critical time for exposure to abortion and pregnancy options counseling. Such exposure and medical student attitudes are areas of research that should be further studied to contribute to the expansion and normalization of these services.

Although debate remains about the saliency and relevance of pro-choice and pro-life labels (as abortion belief indicators), they have been consistently used for decades to broadly designate abortion identity. However, clear labels are less apparent in other languages (e.g., Spanish). Social media, as an exploratory data science tool, can be leveraged to identify the presence and popularity of online abortion identity labels and how they are contextualized online. Purpose This study aims to determine how popularly used Spanish-language pro-choice and pro-life identity labels are contextualized online. Method We used Latent Dirichlet Allocation (LDA) topic models, an unsupervised natural language processing (NLP) application, to generate themes about Spanish language tweets categorized by Spanish abortion identity labels: (1) proelección (pro-choice); (2) derecho a decidir (right to choose); (3) proaborto (pro-abortion); (4) provida (pro-life); (5) antiaborto (anti-abortion); and (6) derecho a vivir (right to life). We manually reviewed themes for each identity label to assess scope. Results All six identity labels included in our analysis contained some references to abortion. However, several labels were not exclusive to abortion. Proelección (pro-choice), for example, contained several themes related to ongoing presidential elections. Discussion and Conclusion No singular Spanish abortion identity label encapsulates abortion beliefs; however, there are several viable options. Just as the debate remains ongoing about pro-choice and pro-life as accurate indicators of abortion beliefs in English, we must also consider that identity is more complex than binary labels in Spanish.

I explore what silence surrounding abortion means to women in their everyday lives and the composition of their selfhood. My analysis is based on one-year of ethnographic fieldwork consisting of 20 interviews with women from the Faroe Islands and participant observation. Building upon theoretical frameworks of belonging and subjectivity studies, I discuss women's silent maneuverings from an understanding of freedom of choice and power as complex entities and expand on the dimensions of belonging and nonbelonging. I find that women's silent maneuverings are a navigational strategy made in a quest for belonging, and propose the concept of performed belonging.

Since liberalization of the Ethiopian abortion law, there have been significant improvements in the availability and utilization of facility-based abortion services in the country. However, nearly half of abortions still take place outside of health facilities, where the quality of procedures remains unknown. Abortion stigma is one reason that unsafe abortion persists. This study aims to evaluate the effect of community interventions conducted from 2016 to 2019 on the level and manifestation of abortion stigma and knowledge in a community in Oromia region, Ethiopia. Methods The study is a quasi-experimental mixed methods evaluation including intervention and comparison communities. Two cross-sectional structured household surveys with independent samples, participatory evaluation wheels, and participatory impact diagrams were conducted with women of reproductive age (15–49) living in the communities. The baseline was conducted in 2016 and the endline in 2019. Difference-in-differences analysis was used to estimate the effect of the intervention on abortion knowledge and Stigmatizing Attitudes, Beliefs, and Actions Scale (SABAS) scores in the intervention community. Results One thousand five hundred fifty-five women participated in the household survey and 28 women participated in participatory evaluation meetings. Over one-third (37%) of women surveyed in the intervention community were exposed to the intervention activities. Knowledge of one or more indications of legal abortion increased from 21 to 85% in the intervention community, compared to an increase from 30 to 57% in the comparison. Mean SABAS scores decreased by 9.3 points in the intervention community and increased by 5.3 points in the comparison community. Differences-in-differences models indicate that exposure to the intervention resulted in decreased stigma scores (coefficient = − 9.33, p < 0.001) and increased knowledge (coefficient = 0.26, p < 0.001). Conclusions This is one of the first studies to measure changes in community-level abortion stigma and knowledge over time in Ethiopia using a mixed method, quasi-experimental design. The results indicate that the community-based intervention improved abortion knowledge and reduced abortion stigma.

We conducted a scoping review to identify the types, volume and characteristics of available evidence and analyse the gaps in the knowledge base for evaluated interventions to reduce contraception and abortion stigma. Design: We conducted a search of five electronic databases to identify articles published between January 2000 and January 2022, and explored the websites of relevant organisations and grey literature databases for unpublished and non-commercial reports. Articles were assessed for eligibility, and data were extracted. Data sources: We searched MEDLINE, PubMed, Embase, Web of Science and PsycINFO. Eligibility criteria: Articles included were: (1) published between January 2000 and January 2022, (2) written in English, (3) reports of the evaluation of an intervention designed to reduce contraceptive and/or abortion stigma, (4) used any type of study design and (5) conducted in any country context. Data extraction and synthesis: Included studies were charted according to study location, study aim, study design, type of contraceptive method(s), study population, type of stigma, and intervention approach. Results: Some 18 articles were included in the final analysis (11 quantitative, 6 qualitative and 1 mixed methods). Fourteen of the studies focused exclusively on abortion stigma, and two studies focused on contraception stigma only; while two studies considered both. A majority of the studies aimed to address intrapersonal stigma. We found no interventions designed to address stigma at the structural level. In terms of intervention approaches, seven were categorised as education/training/skills building, five as counselling/peer support, three as contact and three as media. Conclusion: There is a dearth of evaluations of interventions to reduce contraception and abortion stigma. Investment in implementation science is necessary to develop the evidence base and inform the development of effective interventions, and use existing stigma scales to evaluate effectiveness. This scoping review can serve as a precursor to systematic reviews assessing the effectiveness of approaches

The impact of abortion stigma is broad. Stigma impacts abortion providers, abortion patients and the broader community. Understanding how race and culture affect aspects of abortion stigma may be an important piece of expanding access to and support of abortion. We conducted a systematic search for studies involving abortion stigma and race in PubMed, PubMed Central, Embase, PsycINFO, Sociological Abstracts, Social Services Abstracts, GenderWatch and Ethnic NewsWatch on 7 January 2020. Articles were eligible for inclusion if they explored stigma and included participant race and/or ethnicity, were in English, and included original research. Thirty studies were included in the final review, including 11 quantitative studies, 9 qualitative studies, 4 mixed methods studies and 6 dissertations. Most studies provided basic racial and demographic data but did not provide racial differences in experiences of abortion stigma. Three quantitative studies found that women of colour had different experiences of abortion stigma compared to White women. Non-peer-reviewed studies of qualitative PhD-level dissertation research found that race, culture, religion and immigration had unique and complex effects on abortion stigma experienced by Latinx women. While abortion stigma is common, we found that there is a lack of research contextualising the racialisation of the United States. Quantitative studies found that women of colour experience abortion stigma at lower levels compared to White women. However, qualitative analyses of experiences suggest that quantitative measures of abortion stigma may not capture unique aspects of abortion stigma as experienced by women of colour.

The abortion act in Thailand is approximately 60 years old. However, because of increasing problems due to unsafe abortions, the act was recently amended to accord a legal status for abortions. In the southernmost provinces of Thailand, most people follow the Islamic faith, according to which induced abortion is a sin for both the providers and the pregnant women. This may affect the attitude of the medical staff, such as registered nurses, who play an important role in abortion services. Our study aims to evaluate the knowledge of the amended abortion act, attitude toward abortions and the intentions behind them, and willingness to perform abortions among registered nurses. Methods A cross-sectional study was conducted from January 2022 to February 2022 wherein a self-administrated questionnaire was electronically distributed to 450 registered nurses practicing at a tertiary hospital in the southernmost province of Thailand. Linear regression analysis and Fisher’s exact test were conducted to evaluate the association between basic characteristics, knowledge scores, and attitudes toward induced abortion. Results A total of 375 nurses (83.3%) completed the survey. Most participants were Muslim (58.9%), and 18.7% of them correctly answered > 80% of the knowledge questions. Among all the participants, 41.4% had a favorable attitude toward induced abortion, of which 21.3% were willing to provide safe abortion services. Knowledge scores were independently associated with practicing in obstetrics-gynecology departments and a lower age. Participants practicing Buddhism and having good knowledge scores tended to have favorable attitudes toward abortion. Conclusions Nurses in the southernmost province of Thailand lack knowledge regarding the amended abortion act and do not have a favorable moral attitude toward abortion. Favorable attitudes toward abortions, support toward intentions behind abortions, and a willingness to provide abortion services were all lesser among the Muslim participants than among the Buddhist participants. Compared with participants who scored lower, those with higher knowledge scores had a better moral attitude toward abortion and, in turn, demonstrated a greater intention to provide abortion services. Encouraging nurses to gain better knowledge may improve their attitude toward abortion, which may positively influence future medical practices.

To assess the extent of unwanted abortion disclosure and levels of social support in the abortion decision and their association with depression, anxiety, and stress. Study design From January to June 2019, we surveyed people presenting for abortion at four clinics in California, New Mexico, and Illinois regarding their experiences accessing abortion. We used multivariable regression to examine associations between unwanted abortion disclosure and social support in the abortion decision, and symptoms of depression, anxiety and stress. Results Among 1092 people approached, 784 (72% response rate) eligible individuals initiated the survey, and 746 responded to the unwanted abortion disclosure item and were included in analyses. Over one-quarter (27%) told someone they would have preferred not to tell about their decision, mostly due to obstacles getting to the appointment—time to appointment (46%), travel distance (33%), and costs (32%). Three-quarters (74%, n=546) had at least one person in their life who supported the abortion decision “very much”; 20% had someone who supported the decision “not at all.” In adjusted analyses, unwanted abortion disclosure was associated with more symptoms of depression (B = 0.62, 95% confidence interval: 0.28, 0.95), anxiety (B = 1.79; 95% CI: 0.76, 2.82) and stress (B = 1.80, 95% CI: 0.64, 1.72). People also had more symptoms of depression and stress when one or more person (B = 0.64; 95% CI: 0.27, 1.02 and B = 0.75, 95% CI: 0.15, 1.35, respectively) or the man involved in the pregnancy (B = 0.67, 95% CI: 0.16, 1.18 and B = 0.96, 95% CI: 0.13, 1.78, respectively) supported their decision “not at all” (vs “very much” support). Conclusion Being forced to disclose the abortion decision due to logistical and cost constraints may be harmful to people's mental health. Implications Logistical burdens such as travel, time to access care, and costs needed to access abortion may force people seeking abortion to involve others who are unsupportive in the abortion decision having negative implications for their mental health.

Sexual and reproductive health (SRH) of unmarried youth is an important issue, particularly in Indian society, where premarital sex is socially restricted. It is an uncomfortable subject for most people, including healthcare providers, who are responsible for catering to the reproductive health needs of youth. This is because of the prevailing social norms, where sex outside marriage is discouraged and stigmatised. These social norms give importance to virginity, and children outside marriage are not welcome. The present qualitative study was conducted in public health facilities (primary and secondary) to explore the attitudes of healthcare providers in providing contraceptive services to unmarried youth. In-depth interviews were conducted with family planning (FP) service providers (frontline healthcare workers [ASHAs] nurses and FP counsellors) between October 2017 and September 2018. Almost a quarter of the providers were either hesitant or against providing contraceptives to unmarried youth. Providers stated that they preferred emergency contraceptive pills for unmarried girls if they had already engaged in unprotected sex. Providers expressed strong personal views against premarital sex because they believed it was against existing social norms. Some providers were concerned about the possible negative reactions of the community if they recommended any contraceptive to unmarried youth. A few providers even considered it illegal to provide contraceptives to unmarried youth, though there is no such law in the country. Findings further indicated that though the country had launched programmes for improving adolescents and youth SRH, service providers were still conflicted between medical eligibility and social beliefs.

We need more Americans to speak up about abortion—and to support the advocates, organizations, and decisionmakers working to protect and expand abortion access. That’s why Ipas worked with Eden Stanley, an audience-centered firm, to conduct broad public opinion research. Our findings reveal three priority demographic groups most likely to support organizations and political candidates championing abortion rights. Based on the values and beliefs of these groups, we’ve identified key messaging takeaways. In this brief, we share data and takeaways most relevant for U.S. advocates.

Women's attitudes towards abortion are often assessed infrequently in their lives. This measurement may not capture how lifetime events, such as reproductive experiences, potentially influence attitudes towards abortion. Although reproductive attitudes can fluctuate with life's circumstances, there is little research on how abortion attitudes may change when a woman suspects she might be pregnant. Using an intensive longitudinal dataset collected in Michigan, the Relationship Dynamics and Social Life (RDSL) study (2008-2012), we test the relationship between the timing of pregnancy scares and uncertainty and abortion attitudes using hybrid effects models. We find that women become less supportive of abortion while experiencing a pregnancy scare or uncertainty; however, this association exists only during a scare or uncertainty. These findings highlight that abortion attitudes may change when a woman suspects she might be pregnant. However, attitudinal change may not last past this period.

Attitudes towards abortion play a significant historical and contemporary role in U.S. politics. Research has documented the influence of racist and sexist attitudes in Americans’ political opinions, yet the role of these attitudes has largely been absent in psychological research about abortion. We hypothesized that racism and sexism, originating from historically-rooted stereotypes about Black women’s sexuality and motherhood, would be related to abortion attitudes. In Study 1, we recruited three samples—Black (n = 401), Latinx (n = 316), and White (n = 343) individuals diverse in age, gender, and abortion identity—to complete an online survey assessing abortion attitudes, symbolic racism, modern sexism, and religiosity. Results were consistent with hypotheses: antipathy and resistance to the equality of African Americans (racism) or women (sexism) related to individuals’ negative abortion attitudes, above and beyond religiosity, in all three samples. In Study 2, we partially replicated these findings using data from the 2012 American National Election Studies (ANES). Moreover, we extended Study 1’s findings by demonstrating that racism and/or sexism predicted opposition to abortion while controlling for political ideology among White (n = 2,344) and Black (n = 500) individuals but not Latinx individuals (n = 318). These studies demonstrated that exclusionary ideologies (i.e., racist and sexist attitudes) relate to individuals’ abortion attitudes. These findings may assist researchers and policy makers with interpreting a more comprehensive picture of the racist and sexist attitudes that individuals possibly draw upon when responding to questions about abortion, including voting, answering polls, or supporting political candidates.

The physician’s decision concerning pregnancy termination is influenced by a number of factors. The study aimed at obtaining the opinions of obstetricians and gynecologists with regard to the indications for pregnancy termination, the readiness to perform the procedure personally and the assessment of the determinants thereof. The survey study was conducted between 1 January 2020 and 31 December 2021 among physicians who performed diagnostic prenatal ultrasonography. A considerable majority of physicians participating in the study did not approve of termination without medical indications (62.5%). A marked majority of them considered the following cases as indications for pregnancy termination: severe fetal defects (90%), lethal defects (91.5%) and a disease threatening maternal life (91.5%). A small group of physicians declared that they were ready to perform a termination without medical indications (12.5%). However, they were ready to perform a pregnancy termination personally in cases of threat to maternal life (77.5%), severe fetal defects (75%), lethal fetal defects (75%) and a pregnancy being a result of rape (75%). No statistical significance was observed with regard to the influence of the respondents’ sex, the fact of having children or the workplace on the issue of indications for pregnancy termination. It seems justified to develop case-centered counseling concerning abortion, based on specialists in perinatology, law and ethics, especially in countries with more restrictive abortion law or strongly religious societies.

Whether you're a journalist, a content creator, or a pro-choice advocate looking to spread awareness, this guide is designed to help you talk about abortion and help end abortion stigma.

In this methodological study, the researchers aimed to test the validity and reliability of the Turkish version of the Stigmatizing Attitudes, Beliefs, and Actions Scale (SABAS) toward abortion, which is an 18-item Likert-type scale. It is important to determine the views and attitudes of individuals toward abortion in reducing stigma toward abortion. The sample consisted of 243 university students in Turkey who met the inclusion criteria of the study. The data were collected between July and October 2020 using a personal information form and the SABAS. The data were analyzed using IBM SPSS Statistics 22 and SPSS Amos 24. The mean age of the participants was 20.65 ± 1.51. The content validity index of SABAS was found as 0.98. The item-total score correlation coefficients of the scale ranged from 0.448 to 0.815. The Cronbach’s α coefficient of the scale was 0.907. In the confirmatory factor analysis, the goodness-of-fit indices of the scale showed an acceptable fit. After removing four items of SABAS, it was determined that the 14-item form was valid and reliable in evaluating stigmatizing actions, beliefs, and attitudes toward abortion.

The social norms approach (SNA), the new entrant from the behavioural sciences into the field of development practice, professes a scientific, more accurate, efficient and cost-effective methodology for identifying, measuring and changing harmful social norms. Despite its increasing popularity, no systematic, robust or long-term field evaluations are available to demonstrate the effectiveness and sustainability of using the SNA, nor its superiority over other, pre-existing methods. This article critiques the SNA from the perspective of development praxis, highlighting three concerns: the underlying cultural presumptions about development and its subjects; the problematic methodological design and its complexity; and the lack of contextual framing in the approach and its focus on individual behaviour to the exclusion of the structural constraints embedded in the social and economic environment. The recent drift to broaden the SNA framework is also discussed and assessed. To illustrate a contrasting approach, a case study is presented of MV Foundation, a civil society organization that works on changing social norms on issues of education and child labour. The article concludes that the SNA is arguably yet another instance of colonization of the field of development through hegemonic control of the creation of knowledge.

Across the world, abortion stigma works to shame and discredit those seeking or providing abortion—causing needless suffering every day for millions of people who consider or support this personal health-care decision. In collaboration with partners at Rutgers University and London School of Economics, Ipas conducted a comprehensive review of research from around the world on the impact of stigma on abortion access. Our findings identified global abortion stigma trends that make quality abortion care harder to access and limit people’s ability to get the accurate information and social and financial support they need.

El equipo de consejería de safe2choose diseñó una caja de herramientas en forma de curso en línea para apoyar la formación de consejeras de aborto en línea. El curso se propone crear un espacio de reflexión sobre conocimientos y habilidades para la consejería en línea. Debatiremos sobre el estigma del aborto, los conocimientos sobre salud sexual y reproductiva, las herramientas de seguridad digital y las herramientas de autocuidado para las consejeras. Este curso no pretende funcionar como un manual sobre cómo utilizar las píldoras abortivas, sino más bien proporcionar una caja de herramientas sobre habilidades para proporcionar consejería en línea sobre aborto seguro.

A growing number of people in the United States seek to self-manage their abortions by self-sourcing abortion medications online. Prior research focuses on people's motivations for seeking self-management of abortion and experiences trying to obtain medications. However, little is known about the experiences of people in the U.S. who actually complete a self-managed abortion using medications they self-sourced online. We conducted anonymous in-depth interviews with 80 individuals who sought abortion medications through Aid Access, the only online telemedicine service that provides abortion medications in all 50 U.S. states. Through grounded theory analysis we identified five key themes: 1) participants viewed Aid Access as a “godsend”; 2) Fears of scams, shipping delays, and surveillance made ordering pills online a “nerve-racking” experience; 3) a “personal touch” calmed fears and fostered trust in Aid Access; 4) participants were worried about the “what ifs” of the self-managed abortion experience; and 5) overall, participants felt that online telemedicine met their important needs. Our findings demonstrate that online telemedicine provided by Aid Access not only provided a critical service, but also offered care that participants deemed legitimate and trustworthy.

The SARS-CoV-2 virus causing the coronavirus disease (COVID-19) global pandemic heightened restrictions on sexual and reproductive health and rights (SRHR), especially concerning safe abortion access. The African region has been particularly susceptible to the impact of COVID-19 on sexual and reproductive health services. Using a framework of reproductive justice, we interviewed key informants from the Mobilizing Action around Medication Abortion (MAMA) Network regarding the impacts of structural violence and COVID-19 on SRHR programming in Africa, particularly programming on self-managed abortion. We identified themes of lacking infrastructures of support, emergent marginality, and neocolonial funding environments as facets of structural violence within the context of the MAMA Network, as heightened by the COVID-19 global pandemic.

This study assessed the effectiveness of a school-based stigma-reduction intervention focusing on stigmatising attitudes towards girls associated with abortion and contraceptive use. In February 2017, two gender-mixed secondary schools (n = 1368) in peri-urban areas of Kisumu County, Kenya, were assigned to receive either an 8-hour stigma-reduction intervention over four sessions (intervention school: IS) or standard comprehensive sexuality education (control school: CS). A classroom survey entailing two five-point Likert scales – the 18-item Adolescents Stigmatizing Attitudes, Beliefs and Actions (ASABA) scale, which measures abortion stigma, and the seven-item Contraceptive Use Stigma (CUS) scale – was conducted to collect data at baseline, 1-month and 12-months after the intervention. The intervention was to be considered effective if a mean score reduction of 25% was achieved for both the ASABA (primary outcome) and the CUS (secondary outcome) at the IS between baseline and 12-month follow-up. 1207 (IS = 574; CS = 633) students were included in analyses at 1-month follow-up, and 693 (IS = 323; CS = 370) at 12-months (the final-year students had left school). A decrease in mean score on both scales was observed at 1-month at both schools. At 12-months, the score decrease was 30.1% at the IS and 9.0% at the CS for ASABA, and 27.3% at the IS and 7.9% at the CS for CUS. At the IS, the score decrease for ASABA between baseline and 12-months was 23.3% among girls and 31.2% among boys; for CUS, the decrease was 27.3% and 24.3%, respectively. ASABA and CUS were positively correlated (r = 0.543; p < 0.001), implying a broader perspective on reproductive stigma. A four-session, school-based stigma-reduction intervention could lead to transformed values and attitudes towards gender norms among adolescents regarding abortion and contraceptive use. Stigma associated with abortion and contraception should become a priority for high-quality CSE programmes.

Background: Abortion is one of the leading causes of morbidity and mortality amongst Nigerian women in a country with restrictive abortion laws. Despite being illegal, abortions are still performed, and about 50% of abortions are performed by untrained persons in unhygienic conditions. This study assessed the determinants of attitude of undergraduates to legalisation of safe abortion in Nigeria. Methods: It is a descriptive cross-sectional study. We used a three-stage sampling technique to select 423 undergraduates using a pre-tested questionnaire. The predictors of attitude towards abortion and its legalisation were identified during multivariate analysis. Results: Good knowledge of abortion and its sequelae was found in about two-thirds (62.2%) of the participants, while over half (56.3%) had a negative perspective to abortion legalisation in Nigeria. Older participants were more likely to have positive perspectives to legalisation of abortion compared to their younger counterparts (odds ratio [OR] = 4.72, confidence interval [CI]: 2.61-8.55). Furthermore, respondents from upper social class and those with good knowledge were more likely to have positive perspectives to legalisation of abortion compared to their counterparts (OR = 5.63, CI: 3.12-10.16 and OR = 4.50, CI: 2.89-7.01). Conclusion: The study showed that respondents' knowledge of abortion was relatively low amongst the study population, and more than half of the respondents did not want abortion to be legalised. Increasing awareness on the importance of abortion and its complications in Nigeria will curb the menace of death due to abortion now and in the future.

Objectives This study aimed to evaluate whether belief in a just world is associated with community-level abortion stigma. Study design From December 2020 to June 2021, we conducted a national U.S. survey of 911 adults using Amazon Mechanical Turk. Survey respondents completed both the Community-Level Abortion Stigma Scale and Global Belief in a Just World Scale. We used linear regression to evaluate the association between just-world beliefs, demographic characteristics, and community-level abortion stigma. Results The mean Global Belief in a Just World Scale score was 25.8. The mean Community-Level Abortion Stigma Scale score was 2.6. The strength of just-world beliefs (β = 0.7), male gender (β = 4.1), a history of a previous pregnancy (β = 3.1), post college education (β = 2.8), and strength of religious beliefs (β = 0.3) were associated with higher community-level abortion stigma. Asian race was associated with lower community-level abortion stigma (β = −7.2). Conclusions After controlling for demographic characteristics, strong just-world beliefs were associated with higher community-level abortion stigma. Implications Understanding just-world beliefs may provide a potential target for stigma-reduction strategies.

Rationale: Policymakers need to know the abortion attitudes of those they represent. In addition, inaccurate knowledge of or negative attitudes toward abortion may lead to more abortion stigma, which may adversely affect abortion access and women's health. Objective: The first objective was to examine whether individual's abortion knowledge and attitudes changed during 2016-2020 in Delaware and Maryland. The second was to explore whether personally knowing someone who had an abortion in 2020 was associated with knowledge, attitudes, and changes in them from 2016 to 2020. Methods: Data were from the Delaware [Maryland] Survey of Women, a probability sample that was self-administered via web and mail (N = 1106). Women aged 18-44 from Delaware and Maryland were followed from 2016/2017 to 2019/2020. Outcomes were each two facets of abortion knowledge (perceived safety and perceived access) and abortion attitudes (acceptability and advocacy self-identification), and changes in these outcomes. The main predictor was whether women personally knew someone who had an abortion. Covariates included state, religiosity, pregnancy history, and sociodemographic factors. We used logistic models with inverse probability weights. Results: The percentage of respondents who changed between the first and third waves varied: 46% changed their views on safety and accessibility; 21% changed their views on acceptability; and 25% changed their advocacy self-identification. Knowing someone personally who had an abortion was associated with changing toward viewing abortion as very safe and towards pro-choice, and with not changing towards viewing abortion as wrong or identifying as pro-life. Conclusions: These findings suggest abortion knowledge and attitudes are not fixed but change over time, and knowing someone who had an abortion or having an abortion oneself was associated with changing toward positive attitudes and accurate knowledge. Sharing one's abortion experience with others one knows may reduce negative attitudes and inaccurate knowledge regarding abortion.

Background: Contextual factors can shape public opinion towards abortion. We investigated the association between the state-level abortion legislative climate and individual attitudes towards abortion legality and government restrictions of abortion access in the United States. Methods: Data come from the 2020 Cooperative Congressional Election Study (n = 61,000). Using multivariable logistic regression with generalized estimating equations, we explored whether state-level abortion policy climates (based on the Guttmacher Institute's 2020 rating of state abortion policies) were associated with individual attitudes (1) towards abortion legality, and (2) towards government restriction of abortion access, controlling for individual socio-demographic factors. Results: Eighty-eight percent of participants supported the legality of abortion in some or all circumstances. Conversely, 30% of the sample opposed all federal government restrictions on abortion. More than 60% of the sample lived in highly abortion-restrictive states. Participants living in states with a more supportive abortion legislative climate were more likely to support the legality of abortion in some or all circumstances (AOR = 1.07, (95% CI 1.05, 1.09). Participants in states with more supportive abortion policies were more likely to oppose federal governmental restrictions (AOR = 1.03, 95% CI 1.02, 1.04). Low religiosity, higher educational attainment, and politically liberal views were associated with increased support for abortion legality and increased opposition to government restrictions on abortion. Conclusions: State-level abortion policy contexts were positively associated with public attitudes towards abortion. While attitudes towards abortion legality are favorable across the country; there is also strong support at least one type of government restriction on abortion access. Results highlight a disconnect between multifaceted public attitudes towards abortion and polarized state contexts, suggesting that policymaking on abortion represents a higher level of polarization than exists at the individual level. Policymakers and legislators should more carefully consider the desires of the public when designing abortion legislation.

Prior to and since the 2022 Dobbs decision, U.S. state laws have endorsed individuals surveilling and punishing those associated with abortion care. This practice presents an urgent need to understand the characteristics of abortion stigma, particularly the perspectives of individuals with stigmatizing beliefs. To examine the concept and characteristics of abortion stigma, we interviewed 55 individuals about whether they thought there should be consequences for getting an abortion and, if so, what the consequences should be. Adults from three states (Michigan, Kansas, and Arizona) were purposively sampled to include a range of abortion identities and levels of religious engagement. We used reflexive thematic analysis to code and interpret the data. Participants imagined consequences including financial penalties, incarceration, and forced sterilization. Three themes highlighted how abortion was described as violating the law, women's gender roles, and religious doctrine; accordingly, abortion was imagined as deserving of negative consequences, although abortion was legal in all states during data collection. We argue that these imagined consequences relied on carceral logics and interconnected sexist, racist, and classist stereotypes that reflect and reproduce abortion stigma. This study deepens the understanding of abortion stigma from the perspective of the stigmatizer, underscoring the danger of legislation grounded in stigmatizing beliefs.

Legal, institutional, and payer policies regulating reproductive health care lack a shared language with medicine, resulting in great confusion and consternation. This paper critically examines the implications and ramifications of unclear language related to abortion care. Using a case-based approach, we highlight the ways in which language and terminology may affect the quality and accessibility of care. We also address repercussions for providers and patients within their team, institutional, state, and payer landscapes. In particular, we explore the stigmatization of abortion as both a word and a process, the role of caregivers as gatekeepers, the implications of viability as a limit for access, and the hierarchy of deservedness and value. Recognizing the role of language in these discussions is critical to building systems that honor the complexities of patient-centered reproductive decision-making, ensure access to comprehensive reproductive health care including abortion, and center patient autonomy. Healthcare providers are uniquely positioned to facilitate institutional, state, and national landscapes in which pregnant patients are supported in their autonomy and provided with just and equitable reproductive health care.

In public discourses in the United States, adoption is often suggested as a less objectionable, equal substitute for abortion, despite this pregnancy outcome occurring much less frequently than the outcomes of abortion and parenting. This qualitative study explores whether and how abortion patients weighed adoption as part of their pregnancy decisions and, for those who did, identifies factors that contributed to their ultimate decision against adoption. Study design We interviewed 29 abortion patients from 6 facilities in Michigan and New Mexico in 2015. We conducted a thematic analysis using both deductive and inductive approaches to describe participants’ perspectives, preferences, and experiences regarding the consideration of adoption for their pregnancy. Results Participants’ reasons why adoption was not an appropriate option for their pregnancy were grounded in their ideas of the roles and responsibilities of parenting and fell into three themes. First, participants described continuing the pregnancy and giving birth as inseparable from the decision to parent. Second, choosing adoption would represent an irresponsible abnegation of parental duty. Third, adoption could put their child’s safety and well-being at risk. Conclusions Adoption was not an equally acceptable substitute for abortion among abortion patients. For them, adoption was a decision that represented taking on, and then abdicating, the role of parent. This made adoption a particularly unsuitable choice for their pregnancy. Implications Rhetoric suggesting that adoption is an equal alternative to abortion does not reflect the experiences, preferences, or values of how abortion patients assess what options are appropriate for their pregnancy.

Research suggests that religious beliefs may contribute to abortion stigma, resulting in increased secrecy, reduced social support and help-seeking as well as poor coping and negative emotional consequences such as shame and guilt. This study sought to explore the anticipated help-seeking preferences and difficulties of Protestant Christian women in Singapore with regard to a hypothetical abortion scenario. Semi-structured interviews were conducted with 11 self-identified Christian women recruited through purposive and snowball sampling. The sample was largely Singaporean and all participants were ethnically Chinese females of a similar age range (late twenties to mid-thirties). All willing participants were recruited regardless of denomination. All participants anticipated experiences of felt, enacted and internalized stigma. These were affected by their perceptions of God (e.g., how they see abortion), their personal definitions of “life” and their perceptions of their religio-social environment (e.g., perceived social safety and fears). These concerns contributed to participants choosing both faith-based and secular formal support sources with caveats, despite a primary preference for faith-based informal support and secondary preference for faith-based formal support. All participants anticipated negative post-abortion emotional outcomes, coping difficulties and short-term decision dissatisfaction. However, participants who reported more accepting views of abortion also anticipated an increase in decision satisfaction and well-being in the longer term.

The purpose of this study was to explore the effect and paths of stigma on depressive symptoms in women who underwent termination of pregnancy for foetal anomaly (TOPFA). Background: Stigma may cause distress and depressive symptoms for women with TOPFA. However, few studies have examined the relationship between stigma and depression in women with TOPFA. Design: This study followed the STROBE checklist. A cross-sectional survey was conducted among 469 women with TOPFA. The path analysis used hierarchical multiple regression and structural equation model to examine the mediating role of social support and psychological flexibility on the relationship between stigma and depressive symptoms. Results: Hierarchical multiple regression analysis revealed the mediation effect of psychological flexibility between stigma and depressive symptoms. By contrast, social support did not present such effect. The structural equation model confirmed that stigma, directly and indirectly, affected depressive symptoms. Discussion: Many women with TOPFA have severe depressive symptoms and that stigma is an important influencing factor. Psychological flexibility plays an essential role in mitigating the effects of stigma on depressive symptoms. Relevance to clinical practice: Healthcare professionals should focus on measuring and intervening on stigma and psychological flexibility for alleviating the depressive symptoms of women with TOPFA. No Patient or Public Contribution.

As abortion restrictions expand in the United States, pregnant people will continue to experience delays and be forced to travel for abortion. The study aims to describe later abortion travel experiences, understand structural factors influencing travel, and identify strategies to improve travel. This qualitative phenomenological study analyzes data from 19 interviews with people who travelled at least 25 miles for abortion after the first trimester. Framework analysis used a structural violence lens. More than two-thirds of participants travelled interstate, and half received abortion fund support. Key considerations of travel include logistics, challenges during the journey, and physical and emotional recovery during and after travel. Restrictive laws, financial insecurity and anti-abortion infrastructure are forms of structural violence that created challenges and delays. Reliance on abortion funds facilitated access but also entailed uncertainty. Better resourced abortion funds could organise travel in advance, facilitate the travel of accompanying escorts, and tailor emotional support to reduce stress for those travelling. Clinical and practical support systems must be prepared to support people travelling for abortion, as later abortion and forced travel is increasing since the constitutional right to abortion in the United States was overturned. Findings can inform interventions to support the increasing number of people travelling for abortion.

The liberalization of Ethiopia’s abortion law in 2005 has expanded access to abortion. However, a significant proportion of abortions still occur outside of facilities with mild to severe complications. Barriers to accessing safe abortion care include limited knowledge of services and legality and abortion-related stigma. Research has documented how stigma and social norms around abortion influence the likelihood of clinicians to provide abortion services. Values clarification and attitude transformation (VCAT) workshops are widely used globally by a wide range of organisations to address negative provider and staff attitudes around abortion and other sexual reproductive health (SRH) services and catalyse more empathetic service delivery and advocacy around abortion. In partnership with Marie Stopes International, we undertook a study to evaluate the impact of VCAT workshops on service provision, client-centered care, and provider attitudes and knowledge in Marie Stopes Ethiopia’s (MSIE) private socially-franchised facilities.

Drawing on qualitative and quantitative data collected during a five-year multi-disciplinary European research project, in this article we show how restrictions on access to legal abortion, and particularly gestational age (GA) limits at the end of the first trimester of pregnancy, negatively affect women and pregnant people living in European countries where abortion is legal on request or on broad grounds. First, we examine why most European legislations establish GA limits and illustrate how abortion is framed in national laws and in the current national and international legal and political debates on abortion rights. We then show, based on research data we collected during our 5-year project and contextualized with existing data and statistics, how these restrictions force thousands of people to travel across borders from European countries where abortion is legal, delaying access to care, and increasing pregnant people's health risks. Finally, we explore, from an anthropological perspective, how pregnant people who travel across borders for abortion care conceptualize abortion access, and the relationship between the right to abortion care and the GA restrictions that limit this right. Our study participants criticize the time restrictions established by the laws in their countries of residence as failing to meet pregnant people's needs, highlight the crucial importance of easy, timely access to abortion care even beyond the first trimester of pregnancy, and suggest a more relational approach to the right to access safe, legal abortion. Abortion travel is also a matter of reproductive justice because access to care depends on specific resources including finances, information, support, citizenship status, and social networks. Our work contributes to scholarly and public debates about reproductive governance and justice, by shifting the locus of attention to GA limits and its impact on women and pregnant people, particularly in geopolotical settings where abortion laws are deemed liberal.

Medication abortion, a safe and effective method for terminating pregnancy in the first and second trimester, can reduce overall maternal mortality. However, little is known about how advocates for abortion view medication abortion in their communities, particularly where abortion is legally restricted. We conducted in-depth interviews (2018-2019; N=24) with health workers and community leaders in the Democratic Republic of the Congo, Kenya, Nigeria, Malawi, and Tanzania identified from the Mobilizing Activists Around Medication Abortion (MAMA) network. Interviews focused on the role of advocacy in medication abortion provision. Participants identified benefits of medication abortion to women, including privacy, accessibility, and safety, and community benefits, including perceived reduction in maternal mortality. Participants described challenges to providing support for medication abortion, including difficulties operating in legally restrictive environments and stigma. Findings highlight the role of grassroots advocacy to overcome challenges and provide an alternative model of abortion access and care to women.

OBJECTIVE To gain a deeper understanding of perspectives on abortion and early abortion bans in a restrictive US state. STUDY DESIGN We conducted a qualitative study using semi-structured Zoom interviews with residents of the US state Georgia’s 6th Congressional District. Potential participants first completed a screening tool to recruit people who held “middle-of-the-spectrum” views on abortion based on two abortion questions on a 5-point Likert scale. The interviews focused on participants’ thoughts and feelings on abortion and Georgia’s early abortion ban. We transcribed, coded, and analyzed the interviews, and present a subset of themes. RESULTS We interviewed 28 people from March to May 2020. Participants often described holding complex views on abortion shaped by a range of lived experiences, values, and identities. They lamented the “black-and-white” nature of the national abortion discussion, which they felt oversimplified the issue and did not represent their views. Participants discussed the importance of experiences that allowed them to empathize with people who choose abortion, even when they personally felt they would make a different decision in a similar situation. Based on these experiences, many participants emphasized the importance of separating their own views on abortion from what needed to be regulated for others. However, participants often demonstrated a lack of understanding about the extent to which HB481 makes abortion inaccessible in Georgia. CONCLUSION Our results indicate that, even in states traditionally labelled as restrictive or hostile towards abortion, many people express an openness to understand others’ experiences and hold complex and multifaceted views.

In the United States, abortion is safe and common, but highly stigmatized and frequently targeted by legislation that aims to restrict access. Numerous obstacles impede access to abortion care, including logistical barriers like cost and transportation, limited clinic availability, and state-mandated waiting periods. Accurate abortion information can also be hard to access. To overcome these barriers, many people seeking abortion turn to anonymous online forums, including Reddit, for information and support. Examining this community provides a unique perspective on the questions, thoughts, and needs of people considering or undergoing an abortion. The authors web scraped 250 posts from subreddits that contain abortion-related posts, then coded deidentified posts using a combined deductive/inductive approach. The authors identified a subset of these codes in which users were giving/seeking information and advice on Reddit, then engaged in a targeted analysis of the needs expressed in these posts. Three interconnected needs emerged: (1) need for information, (2) need for emotional support, and (3) need for community around the abortion experience. In this study map the authors reflected these needs onto key social work practice areas and competencies; taken alongside support from social work's governing bodies, this research suggests that social workers would be beneficial additions to the abortion care workforce.

Background: University faculty are considered trusted sources of information to disseminate accurate information to the public that abortion is a common, safe and necessary medical health care service. However, misinformation persists about abortion's alleged dangers, commonality, and medical necessity. Methods: Systematic review of popular media articles related to abortion, gun control (an equally controversial topic), and cigarette use (a more neutral topic) published in top U.S. newspapers between January 2015 and July 2020 using bivariate analysis and logistic regression to compare disclosure of university affiliation among experts in each topic area. Results: We included 41 abortion, 102 gun control, and 130 smoking articles, which consisted of 304 distinct media mentions of university-affiliated faculty. Articles with smoking and gun control faculty experts had statistically more affiliations mentioned (90%, n = 195 and 88%, n = 159, respectively) than abortion faculty experts (77%, n = 54) (p = 0.02). The probability of faculty disclosing university affiliation was similar between smoking and gun control (p = 0.73), but between smoking and abortion was significantly less (Ave Marginal Effects - 0.13, p = 0.02). Conclusions: Fewer faculty members disclose their university affiliation in top U.S. newspapers when discussing abortion. Lack of academic disclosure may paradoxically make these faculty appear less 'legitimate.' This leads to misinformation, branding abortion as a 'choice,' suggesting it is an unessential medical service. With the recent U.S. Supreme Court landmark decision, Dobbs v. Jackson Women's Health Organization, and subsequent banning of abortion in many U.S. states, faculty will probably be even less likely to disclose their university affiliation in the media than in the past.

Les recherches et les données montrent qu’il est possible de gérer un avortement médicamenteux, également appelé avortement par comprimés, en autonomie de manière sûre et efficace lorsque des informations précises sont à disposition. L’autogestion de l’avortement (AGA) consiste à avorter avec des comprimés sans ordonnance. Avec l’AGA, la personne enceinte gère elle-même une grande partie du processus, avec ou sans l’intervention d’un prestataire de santé. Ipas a créé ce guide d’animation à l’intention des prestataires, des systèmes de santé et des communautés afin d’élargir l’accès à des soins d’avortement qui apportent un soutien sans stigmatisation. Il a été conçu comme une ressource flexible qui peut répondre aux besoins de formation de toute une gamme de publics et de contextes. Il ne s’agit pas d’un programme structuré, mais plutôt d’un catalogue d’activités et de supports qui peuvent être utilisés individuellement ou en combinaison, en fonction du calendrier et du programme des ateliers individuels.

Plaider en faveur de l’accès à l’avortement est différent de tout autre problème mondial de soins de santé. Cette publication partage les idées et les leçons apprises par le personnel d’Ipas et nos partenaires du monde entier grâce à des décennies de travail de plaidoyer pour élargir l’accès à l’avortement. Le contenu décrit les principaux obstacles et opportunités que les défenseurs rencontrent, ainsi que les stratégies pour surmonter les défis communs.

Ce guide aide les femmes à déterminer si elles peuvent utiliser des comprimés d’avortement pour interrompre une grossesse non désirée, leur indique comment les utiliser et comment vérifier s’ils ont fonctionné.

Que des individus se trouvent dans l’incapacité d’interrompre une grossesse non désirée en toute confiance et en toute sécurité est un défi qui perdure encore aujourd’hui pour garantir l’accès universel aux soins complets de santé sexuelle et reproductive. Le présent cadre de durabilité des soins d’avortement est la réponse qu’apporte Ipas a ce besoin urgent. En recourant à une approche centrée sur l’être humain, ce cadre identifie les étapes de la conception, l’action et l’évaluation des programmes et reconnait que la durabilité des soins d’avortement est dynamique et qu’elle nécessite une réflexion novatrice sur la manière de coopérer et une approche nouvelle.

El Protocolo de Autocuidado y Apoyo al Proveer y Acompañar Aborto Seguro es una iniciativa de un grupo de trabajo del Consorcio Latinoamericano Contra el Aborto Inseguro (CLACAI), cuyo propósito es aportar en el desarrollo de recursos que contribuyan en el soporte y entornos habilitantes de quienes acompañan o brindan acceso a abortos seguros a las mujeres y personas con posibilidad de abortar, sin que ello implique riesgos que puedan menoscabar su bienestar y en especial, su salud mental y para que dicho acompañamiento o asistencia, reafirme el derecho que tienen de tomar sus propias decisiones

Es un paquete de publicaciones que tiene la intención de facilitar el acompañamiento a mujeres o personas en situación de aborto. Este cuadernillo tiene información sobre el aborto y la autogestión del aborto inducido con medicamentos. Adicionalmente, se encuentran recursos que pueden facilitar el acompañamiento a mujeres o personas en situación de aborto.

Es un paquete de publicaciones que tiene la intención de facilitar el acompañamiento a mujeres o personas en situación de aborto. Este cuadernillo tiene información sobre el uso de pastillas para el aborto seguro. El aborto con medicamentos es el método donde se usan pastillas para ocasionar la expulsión del contenido uterino. Los medicamentos utilizados para el aborto con medicamentos son mifepristona y misoprostol combinados o misoprostol solo. Adicionalmente, se encuentran recursos que pueden facilitar el acompañamiento a mujeres o personas en situación de aborto.

Es un paquete de publicaciones que tiene la intención de facilitar el acompañamiento a mujeres o personas en situación de aborto. Este cuadernillo contiene información sobre los cuidados postaborto. Consideran que esta información puede ser de utilidad si ha atravesado o atravesará por un procedimiento de aborto con medicamentos. Adicionalmente, se encuentran recursos que pueden facilitar el acompañamiento a mujeres o personas en situación de aborto.

Conscientious objection (CO) on the part of healthcare providers is a growing threat to safe abortion access. In South Africa, evidence suggests that this legal clause may be manipulated as a justification for public-sector healthcare providers to exempt themselves from their duties to provide essential reproductive health services as required by national laws and protocols. This qualitative study improves our understanding of the definitions, perspectives, and use of CO among providers, staff, and facility managers in South Africa, and CO’s effect on public-sector abortion availability. Using 18 focus group discussions and 23 in-depth interviews, we examined CO attitudes and behaviours of staff from health facilities that provide abortion care in Gauteng, Limpopo, KwaZulu-Natal, and Eastern Cape Provinces. We find that CO is invoked for a variety of reasons, some unrelated to the legal basis for objection. There have been progressive shifts in attitudes towards abortion over time, but stigma against women and girls who seek abortion remains substantial among staff at facilities providing abortion. Providers who offer abortion services also report high levels of discrimination and isolation from colleagues. Such factors, combined with operational barriers to offering quality abortion care (such as lack of training support or financial incentives) and lack of clarity on CO definitions and procedures, may incentivise some providers to invoke CO inappropriately. Dissemination of national guidelines on CO should be prioritised to reduce ambiguity, and interventions addressing abortion stigma should be considered for all facility staff to safeguard abortion availability in South Africa.

In 2021, Thailand decriminalized abortions to allow for legal abortions on request up to 12 weeks’ gestation and conditionally up to 20 weeks’ gestation, or in the case of sexual assault, maternal mental or physical harm, or fetal abnormality. We intend to say that healthcare practitioners’ positive attitudes toward abortion will destigmatize abortion for both themselves and their patients. We explored the knowledge, attitudes, and intended practices of nursing students toward safe abortion practices in light of the recent law reform. This was a cross-sectional study using a self-administered questionnaire. The questionnaire consisted of 4 parts: a demographic information questionnaire; and measures to assess their knowledge, moral attitudes, and intended practice regarding safe abortion care. Questionnaires were sent to 206 nursing students who had completed the Midwifery and Maternal-Newborn Nursing rotation in Bangkok, Thailand. The survey response rate was 90.8%. Mean (standard deviation) knowledge score was 6.72 (1.86) out of 10. Buddhist students were more likely to have a positive attitude toward abortions. Most students intended to practice safe abortions in pregnancies that affect maternal physical or mental health, or in pregnancies that resulted from unlawful sexual contact. Students were more ambivalent toward abortion practices for socioeconomic reasons. Better knowledge of abortion legislation was associated with a more positive attitude toward abortions and safe abortion practice intention. Approximately 1 year after the abortion law reform in Thailand, nursing students had incomplete knowledge of the amendment. Most students were inclined to provide abortion care services for certain conditions.

El estigma hacia las mujeres que han tenido un aborto inducido surge del entendimiento colectivo de que el aborto es una práctica moralmente equivocada y/o socialmente inaceptable. Kumar et al. (2009) lo definen como el atributo negativo hacia la mujer que interrumpe un embarazo, que la marca, interna o externamente, como inferior a los ideales de “femineidad”. Este estigma tiene importantes repercusiones en varios niveles que atentan contra la salud física y mental de las mujeres que deciden abortar. El objetivo de esta investigación fue estudiar el estigma hacia la mujer que ha abortado en dos ciudades con diferentes legislaciones, así como su relación con las actitudes hacia el aborto, ciertas creencias tradicionales y algunas variables psicosociales. La muestra estuvo compuesta por 458 participantes de 18 a 45 años, residentes de la Ciudad de México (CDMX) o de Xalapa, Veracruz. Se les pidió que además de sus datos sociodemográficos, contestaran los siguientes cuestionarios: a) Cuestionario de Estigma sobre el Aborto a Nivel Comunitario (Sorhaindo et al., 2016), b) Cuestionario de Actitudes hacia el aborto (Marván et al., 2018), c) Inventario de Sexismo Ambivalente (Glick y Fiske, 1996), y d) Escala de Creencias sobre la Maternidad (Mota et al., 2019). Además, los participantes contestaron una serie de preguntas para medir su grado de religiosidad, y se les preguntó si conocían a una mujer que hubiera abortado. Los hallazgos fueron los siguientes: Los residentes de Xalapa tuvieron niveles más altos de estigma que los de la CDMX. Tanto en CDMX como en Xalapa los participantes que presentaron mayores niveles de estigma tuvieron menos actitudes favorables hacia el aborto como un derecho de la mujer; y también fueron los que presentaron mayores puntajes en las siguientes variables: actitudes antiaborto, sexismo (tanto hostil como benevolente), creencias hacia la maternidad (como sentido de vida y como deber ser), y religiosidad (entendida tanto como la frecuencia de las prácticas religiosas, así como la importancia que tiene en la vida de las personas). Además, los participantes que tenían mayor edad fueron quienes presentaron mayor estigma. Sin embargo, solo en CDMX se encontró que aquellos participantes que no conocían a una mujer que ha abortado fueron los que presentaron más estigma, y que los hombres estigmatizaron más que las mujeres. Finalmente se encontró que tanto en la CDMX como en Xalapa las actitudes antiaborto predijeron el estigma hacia la mujer que ha abortado. Además, en la CDMX otra variable predictora fue la edad, mientras que en Xalapa fueron las actitudes proelección y las creencias hacia la maternidad como sentido de vida. Los resultados de este estudio podrían ayudar al diseño de estrategias para reducir el estigma hacia la mujer que ha abortado, así como las consecuencias negativas en la salud psicológica y física de las mujeres que interrumpen un embarazo.

Nos proponemos esbozar una genealogía del uso del misoprostol en Argentina y caracterizar los modelos de acompañamiento y consejerías en aborto desde organizaciones feministas y el sistema público de salud. Describimos los diversos procesos que dan lugar a la difusión de la práctica y los saberes sobre el uso abortivo del misoprostol en Argentina, particularmente la apropiación experimental que hacen las propias mujeres, las consejerías pre y post aborto del sistema público de salud y las iniciativas de difusión de la información y acompañamientos en aborto desde el feminismo. Estos procesos de transnacionalización y transferencias culturales de saberes y abordajes dan lugar a modelos locales aparentemente antagónicos: un modelo de salud pública, con la reducción de la mortalidad materna como argumento principal que le otorga biolegitimidad, y otro modelo centrado en el cuestionamiento a la caracterización hegemónica del aborto como un “mal”, que busca instalar un discurso herético. En la práctica, veremos cómo estos modelos coexisten conformando un continuum de discursos y prácticas militantes que buscan garantizar derechos y modificar los sentidos establecidos.

Esta tese de doutorado tem como tema as estratégias feministas de acompanhamento de abortos seguros na América Latina, mesmo em contextos de criminalização. Trata-se de um estudo de caso focado em organizações com atuação na Argentina e no México, bem como o diálogo que estabelecem com outros países da Região. O objetivo desse estudo foi analisar como quatro grupas feministas de acompanhamento de aborto (Socorristas en Red, Lesbianas y Feministas por la Descriminalización del Aborto, Fondo MARIA e Las Libres) surgiram, como se identificam e como atuam, de que maneira se situam no debate sobre aborto, quais são seus mecanismos operativos e quem são os seus principais antagonistas. Desde uma epistemologia feminista e uma abordagem transdisciplinar, a metodologia adotada foi composta por revisão bibliográfica, observação e entrevistas com as ativistas. Por fim, concluo que as grupas em análise, com suas estratégias feministas inovadoras e emancipadoras, contribuem para combater o estigma e têm como objetivo final a descriminalização social do aborto.

The purpose of this study is to examine the stigmatization of abortion in Colombia at the community level, using two main sources: statistical data and social media. The stigma associated with abortion is analysed in both official and non-official quantitative sources, which are used as evidence of expert knowledge in the abortion debate (Maldonado, 2019). In addition, a study of abortion narratives on Twitter was carried out to examine online public opinion on the issue. Through this approach, it was possible to explore the stigma associated with abortion in the production of knowledge and public opinion in Colombia. This study found that abortion stigma in Colombia is rooted in the social norms that control and organize traditional roles of femininity in the country, as well as behaviours that are considered deviant. As a result, abortion is seen as a practice that disrupts the Colombian social structure. Based on the research, we found that official and unofficial studies construct the following categories for framing abortion: voluntary interruption of pregnancy, loss, criminalization, abortion, social vulnerability, unsafe abortions, and miscarriages. Meanwhile, in the Twitter analysis, we found that public opinion still views abortion as a moral issue, in which variables such as criminalization and maternal care play an important role. Finally, we provide a suggested list of items to consider when developing an abortion stigma scale in Colombia. The survey proposal was derived from a cross-section of expert knowledge and public opinion. As a result, we believe that these items are representative of the most important aspects of stigma construction in the country and are therefore methodologically relevant.

Background: Deafness refers to partial or total loss of hearing, which, if not appropriately accommodated, may interfere with day-to-day living experiences. Deaf people encountered challenges in their efforts to access essential services, such as health care. While some attention has been given to general access to reproductive health services, less research has focused on the experiences of deaf women and girls when accessing safe abortion services. With unsafe abortion being a major cause of maternal deaths among women in developing countries, this study attempted to explore the perception of deaf women and girls in Ghana towards safe abortion services. Objective: The main aim of this study was to understand the perception and awareness safe abortion services among deaf women and girls in Ghana. In doing this, the contributors towards unsafe abortion practices among deaf women and girls were gathered. Method: Penchansky and Thomas' accessibility to health care theory availability, accessibility, accommodation/adequacy, affordability, and acceptability guides this study. A semi-structured interview guide based on components of the theory was used for data collection from 60 deaf persons. Results: The components of the theory were used as a priori themes that guided the data analysis. The results showed challenges associated with the indicators of health access. For instance, in terms of availability, it was revealed that deaf women had little knowledge about existing laws on safe abortion in Ghana. In relation to acceptability, deaf women were highly opposed to abortion for cultural and religious reasons. However, there was consensus that safe abortion could be conducted under certain conditions. Conclusion: The results of the study have implications for policymaking aimed at attaining equitable access to reproductive health care for deaf women. The need for policymakers to expedite public education and incorporate the needs of deaf women in reproductive health policies, as well as other study implications, are discussed.

Background Between 2010 and 2014, approximately 25 million unsafe abortions were performed annually across the globe. Africa alone accounted for 29% of all unsafe abortions, and 62% of the related deaths. Women living in poverty, especially adolescents, lack information about where and how to access safe abortion services. They often lack adequate insight to make informed decisions. The purpose of this study was to explore the empowered perspectives of women leaders in Rwanda about the recent policy change for safe abortion. The study identifies women leaders’ perceived barriers and their attitudes about resulting consequences toward safe abortion. Method In this qualitative study, seven focus group discussions and eight key informant interviews were performed in October 2019. A total of 51 women leaders participated, their age ranging from 38 to 60 years. Participants were drawn from three districts, namely Gasabo, Kicukiro, and Nyarugenge. For variability of data, participants came from parliament, government ministries, government parastatals, and civil society organizations. All interviews were conducted in Kinyarwanda and later translated into English. Data were analyzed using qualitative content analysis. Results The emerging theme Strong barriers and numerous consequences of safe abortion illustrates how women leaders perceive barriers to safe abortion and its related consequences in Rwanda. The theme is divided into two categories: (1) Perceived barriers of safe abortion and (2) Consequences of providing safe abortion. The sub-categories for the first category are Reluctance to fully support safe abortion due to perceived unjustified abortions”, Abortion-related stigma, Abortion is against cultural and religious beliefs, Emotional attachment to the unborn and Lack of awareness of abortion. The sub-categories for the second category are Perceived physiological trauma, Cause for barrenness/infertility, Increase in services abuse by adolescents/women, Increase of workload for healthcare providers, “Increase in sexual activities and STIs, and Abortion-related physiological trauma. Conclusion The subject of safe abortion evokes mixed reactions among participants, and is entangled with unsafe abortion in most cases. Participants stress that the word ‘abortion’ disturbs, regardless of whether it relates to being safe or unsafe. Participants believe the word ‘abortion’ outweighs the word ‘safe’. Societal expectations play a major role in the decision-making process of any adolescent or a family member faced with a pregnant adolescent regardless of the existing safe abortion law. Community mobilization and sensitization are crucial if safe abortion in accordance with abortion law is to be embraced. Messages that reinforce safe abortion as acceptable and address stigma, fears of trauma, and barrenness should be developed to educate adolescents, parents, and women leaders about safe abortion, to mitigate unsafe abortion-related complications.

The World Health Organization (WHO) defines an infodemic as the proliferation of false or misleading information that leads to confusion, mistrust in health authorities, and the rejection of public health recommendations. The devastating impacts of an infodemic on public health were felt during the COVID-19 pandemic. We are now on the precipice of another infodemic, this one regarding abortion. On June 24, 2022, the Supreme Court of the United States (SCOTUS) decision in Dobbs v. Jackson Women's Health Organization resulted in the reversal of Roe v. Wade, which had protected a woman's right to have an abortion for nearly 50 years. The reversal of Roe v. Wade has given way to an abortion infodemic that is being exacerbated by a confusing and rapidly changing legislative landscape, the proliferation of abortion disinformants on the web, lax efforts by social media companies to abate abortion misinformation, and proposed legislation that threatens to prohibit the distribution of evidence-based abortion information. The abortion infodemic threatens to worsen the detrimental effects of the Roe v. Wade reversal on maternal morbidity and mortality. It also comes with unique barriers to traditional abatement efforts. In this piece, we lay out these challenges and urgently call for a public health research agenda on the abortion infodemic to stimulate the development of evidence-based public health efforts to mitigate the impact of misinformation on the increased maternal morbidity and mortality that is expected to result from abortion restrictions, particularly among marginalized populations.

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Women’s agency is vital to access and use reproductive healthcare services, particularly in contexts where patriarchal beliefs and cultural norms limit women’s desire to act on their goals or affect their access to essential resources. However, less is known about what resources enable women to exercise agency to access these services. A comprehensive systematic review was conducted to summarise existing evidence on the determinants of women’s agency in accessing and using reproductive healthcare services. Various determinants were identified, including individual characteristics; household structure; reproductive health-related determinants; social relations; and economic factors. These determinants of women’s agency in accessing reproductive healthcare services were strongly associated with social norms and cultural beliefs. Several gaps in the literature included inconsistent definitions and measurement of women’s agency; lack of considering cultural sensitivities and socially acceptable practices in the conceptualisation and measurement of women’s agency; a narrow focus on services related predominantly to pregnancy and birth, with other aspects of services including sexual health and safe abortion being largely unreported. The literature focused on developing countries in Africa and Asia, leaving a significant gap in knowledge about women’s agency to access services in other geographical areas or among immigrant or refugee populations living in developed countries.

Respondent-driven sampling (RDS) is a potential strategy for addressing challenges in accurate abortion incidence estimation, but relies on often untested assumptions. We conducted an RDS study to estimate the cumulative lifetime abortion incidence in Soweto, South Africa, evaluate whether RDS assumptions were met, and compare RDS estimates of incidence to estimates adjusted for employment and age based on census data. A total of 849 participants were recruited from 11 seeds between April and December 2018. The assumptions that individuals can identify target population members and approximation of sampling with replacement was met. There were minor violations of the assumptions of seed independence from the final sample, and reciprocity of ties. Assumptions of accurate degree reporting and random recruitment were not met. Failure to meet assumptions yielded a sample with different employment characteristics than the target population, which was not resolved by standard RDS methods. The RDS estimate of cumulative lifetime abortion incidence was 12.1% (95% CI: 9.8%, 14.3%), and the employment-adjusted estimate was 16.9% (95% CI: 12.8%, 22.1%). We caution researchers in using RDS for representative estimates of abortion incidence. Post-survey weights to adjust for differences in characteristics between the sample and target population may yield more representative results.

On June 24, 2022, the US Supreme Court overturned Roe v. Wade in the Dobbs v. Jackson’s Women’s Health Organization case. The Supreme Court declared that the US Constitution does not protect the right to abortion, which allowed states to enact their own laws regarding abortion care and access. Funding restrictions on abortion care force people struggling to afford an abortion to make immediate financial sacrifices that have adverse short- and long-term affects on the health and well-being of themselves and their families. This brief highlights research demonstrating the detrimental financial and health implications of funding restrictions on abortion care for abortion seekers and their families.

Although studies have documented challenges people encounter when attempting to access abortion care in the United States, there is little research on the perspectives and experiences of foreign-born individuals, who may encounter unique barriers to accessing care. Since lack of data may be due to difficulty recruiting this population, we explored the feasibility of using social media to recruit foreign-born individuals who have sought an abortion into interviews to share their abortion experiences. Our target population was limited to English and Spanish-speakers due to budget constraints. As this recruitment method was unsuccessful, we attempted to recruit our target population through the crowdsourcing website, Amazon Mechanical Turk (mTurk) to take a one-time survey on their abortion experience. Both online recruitment methods yielded a significant number of fraudulent responses. Although we aimed to collaborate with organizations that work closely with immigrant populations, they were unavailable to assist with recruitment efforts at the time of the study. Future abortion research utilizing online methods to recruit foreign-born populations should consider incorporating information on their target populations' use of online platforms as well as cultural views on abortion in order to develop effective recruitment strategies.

Nuestro ejercicio cotidiano como acompañantes de abortos nos genera constantemente preguntas e invita a reflexionar. Muchas de nosotras ya habíamos pasado por varios procesos de aborto, o habíamos acompañado a mujeres que han abortado más de una vez. Sin embargo, hablar de AbortoS en Plural es algo que no se acostumbra. Por eso nos preguntamos: ¿cómo abordar y nombrar estas experiencias? ¿Por qué se juzga aún más a las mujeres por realizarse varios abortos? ¿Hay un número limitado de abortos posibles para una sola mujer? ¿A cuántos abortos tenemos derecho a lo largo de nuestra vida? Estos fueron los cuestionamientos que inicialmente nos planteamos en la construcción de este fanzine. Decidimos, entonces, reunirnos en un diálogo amplio entre Comadres y pensar juntas, cuestionarnos y debatir sobre posibles respuestas a estas dudas.

The course is designed for experienced facilitators and trainers, who are working in the field of abortion and post abortion care. On completion of this course you will: Have learned how to lead a full workshop with another facilitator. The course also includes background history of the PSW's development, and principles of group work and in-depth information about abortion stigma, which are at the heart of the PSW. The videos can be viewed multiple times to refresh your memory in the future. The course is designed to replace an in-person facilitators training, which would normally take place over several days. The content is divided into four main learning sections, and consists of 19 videos with animations, plus activities to build your understanding of the workshop.

Introduction Abortion attitudes are influenced by people’s socioeconomic and demographic circumstances and can be volatile during times of crisis. Brazil is an interesting case for examining abortion attitudes because of its strict abortion policies, changing religious landscape, high income inequality, and extreme uncertainty generated by the back-to-back Zika and COVID-19 crises. This study seeks to assess Brazilian women’s attitudes toward abortion and whether religion and income explain these attitudes in the context of novel infectious disease epidemics. Methods We used data from a population-based sample of 3996 women ages 18–34 in Pernambuco, Brazil, collected during the onset of the COVID-19 pandemic (May–September 2020). We conducted paired t-tests and multivariate-adjusted logistic regression models with adjusted Odds Ratios (aORs) and 95% CIs to assess differences in support for abortion in the case of fetal congenital Zika syndrome (CZS), maternal Zika infection during pregnancy, and maternal COVID-19 infection during pregnancy. Results Significantly more women support the right to abortion in the case of fetal CZS (50%) than in the case of maternal Zika infection (40%) and maternal COVID-19 infection (31%). Support for abortion varies by income and religion. Controlling for other demographic characteristics, high-income women have higher odds of supporting abortion in the case of fetal CZS (aOR = 1.92; 95% CI: 1.25–2.94) and maternal Zika infection (aOR = 2.07; 95% CI: 1.33–3.21) than low-income women. Evangelical women have lower odds of supporting abortion in the case of maternal Zika infection (aOR = 0.65; 95% CI: 0.45–0.93) and marginally lower odds of supporting the right to abortion in the case of maternal COVID-19 infection (aOR = 0.69; 95% CI: 0.47–1.00) than women of other religious affiliations. Conclusions and Policy Implications With increasingly conservative religious groups gaining size in Brazil, we expect to see increasing abortion restrictions. However, this research finds that a sizable portion of women across all incomes and religious affiliations support abortion, particularly in the case of fetal anomalies associated with Zika.

Objective We conducted a national survey to assess the experiences of stigma and harassment among physicians and nurse practitioners providing abortions and abortion service administrators in Canada. Study Design We conducted an exploratory, cross-sectional, national, anonymized, online survey between July and December 2020. Subsections of the survey explored stigma and harassment experienced by respondents, including the 35-item Revised Abortion Providers Stigma Scale and open-ended responses. We analyzed the quantitative data to generate descriptive statistics and employed a reflexive thematic analysis to interpret open-ended responses. Results Three hundred fifty-four participants started the stigma and harassment section of the survey. Among low-volume clinicians (<30 abortions/year, 60%, n=180) 8% reported harassment; 21% among higher volume clinicians (≥30 abortions/year, 40%, n=119) and 47% among administrators (n=39), most commonly picketing. The mean stigma score was 67.8 (standard deviation 17.2; maximum score 175). Our qualitative analysis identified five themes characterizing perceptions of stigma and harassment: concerns related to harassment from picketing, protestors, and the public; wanting protestor ‘bubble zones’; aiming to be anonymous to avoid being a target; not providing an abortion service; but also witnessing a safe and positive practice environment. Conclusion Being a low-volume clinician compared to higher volume clinician and administrator appears to be associated with less harassment. Clinicians providing abortion care in Canada reported mid-range abortion-related stigma scores, and expressed strong concerns that stigma interfered with their abortion provision. Our results indicate that further de-stigmatization and protection of abortion providers in Canada is needed through policy and practice interventions including bubble zones. Implications While Canadian abortion care clinicians and administrators reported relatively low incidence of harassment, our results indicate that they are concerned about stigma and harassment. However, as this was an exploratory survey, these data may not be representative of all Canadian abortion providers. Our data identify a need to support abortion clinicians and to bolster protections for dedicated abortion services.

Introduction Although abortion is not illegal (except sex-selective abortion) in China, abortion stigma may persistently exist, and few studies have examined abortion stigma in a Chinese sample. Furthermore, Chinese women’s gender roles have long been restricted by Chinese traditional culture and values of fertility and family. Therefore, this study aimed to understand how gender role norms are associated with stigmatized attitudes toward abortion. Methods From January to February 2022, a total of 798 Chinese participants (518 women and 280 men) aged 18–56 years (M = 29.8, SD = 5.14) who had had sexual intercourse and were involved in heterosexual romantic relationships completed an online survey assessing endorsement of ambivalent sexism, motherhood traditionalism, the sexual double standard, and abortion stigma. Hierarchical multiple regression was used to test the study hypotheses. Results The results showed that participants’ higher levels of identification with hostile sexism, motherhood traditionalism, and the traditional sexual double standard were associated with their higher levels of stigmatized attitudes toward abortion. Benevolent sexism was not significantly associated with stigmatized attitudes toward abortion. In addition, participants’ experience of abortion was significantly associated with their less stigmatized attitudes toward abortion. Conclusions The findings confirm that traditional gender roles demonstrate potentially detrimental effects on people’s attitudes toward abortion. Policy Implications Sexuality education should promote gender equality education and raise comprehensive awareness of sexual and reproductive health. Family planning services should place more emphasis on post-abortion mental health care.

Objectives: To explore the effect and pathway of abortion stigma on depressive symptoms before terminating the pregnancy in pregnant women with fetal anomaly. Methods: Based on literature review, a self-made general demographic information questionnaire, the Edinburgh Postnatal Depression Scale, the Individual Level Abortion Stigma Scale, the Acceptance and Action Questionnaire-II, the Cognitive Fusion Questionnaire-Fusion, the Responses to Stress Questionnaire and the Perceived Social Support Scale were used to investigate pregnant women with fetal anomaly before abortion in tertiary general hospitals and specialist maternity hospitals in Changsha, to develop a hypothesis model of the factors influencing depressive symptoms before terminating the pregnancy. The hypothesis model was verified by applying structural equation modelling analysis. Results: The structural equation model showed that the stigma directly or indirectly influenced depressive symptoms before terminating the pregnancy via psychological flexibility, social support and avoidance coping. The total effect value was 0.55 (P<0.05), the direct effect value was 0.22 (P<0.05), and the indirect effect value was 0.33 (P<0.05). Psychological flexibility and social support had protective mediating effects, while avoidance coping had harmful mediating effects. Conclusions: Abortion stigma has large positive effect on the depressive symptoms before terminating the pregnancy in pregnant women with fetal anomaly. Among direct and indirect effect, the indirect effect is major. Effective measures to reduce the stigma, increase psychological flexibility, improve social support and coping style will have an important influence on the prevention and reduction of depressive symptoms before terminating the pregnancy.

Abortion attitudes are typically contextualized as pro-life or pro-choice, yet these characterizations ignore the complex ideas that individuals hold about abortion. To address this gap, we conducted a thematic analysis of 28 semi-structured interviews with women in the UK, both with (n = 12) and without (n = 16) personal abortion experience. The theme “blind spots” captures patterns in our participants’ accounts, wherein complexity and even conflict would emerge within expressed abortion judgments. Our subthemes highlight those conflicts between more and less restrictive abortion attitudes that occurred when considering either the same (self or other) or different (self vs. other) attitudinal objects. Many participants were unaware of the conflicting and nuanced attitudes they held about abortion, evidenced by an inability to integrate these positions into a clear and consistent judgment, indicating that a dichotomy of abortion attitudes may be too simplistic.

Adolescents and young women in Mozambique experience high levels of unintended pregnancies, with induced abortion being a common outcome. Stigma and gender norms are likely to negatively impact experiences of pregnancy and abortion, and hamper access to information and services. We assessed knowledge, attitudes, practices, and experiences around pregnancy and abortion in six communities in Nampula and Zambézia provinces. We conducted 19 triad interviews with young women and girls, 19 focus group discussions with male and female adult community members, and 15 in-depth interviews with young women with abortion experience. Participants described how gender values, norms, and practices affect girls’ risk of unintended pregnancy and their experiences of pregnancy and abortion. The drivers of adolescent pregnancy included transactional sex and gender-based violence, including early marriage, and gender roles and expectations that lead parents and others to oppose contraception. Stigma around abortion, early or unintended pregnancy, and adolescent sexuality is fueled by gender norms and contributes to girls seeking unsafe abortions. Pregnancy and abortion decision making often involves male partners and family members. In conclusion, gender norms strongly influence the occurrence and outcome of unintended pregnancies and abortion in Mozambique. While abortion legislation was recently liberalized, gender values, norms, and practices inhibit young women’s and girls’ access to services and need to be addressed in policy and programming.

At a time when conservative state policymakers are launching coordinated attacks on reproductive and LGBTQ+ rights, data on the intersecting identities targeted by these types of legislation are especially important. Prior research has found that there is diversity in sexual orientation and gender identity among people who have abortions in the United States. New research from the Guttmacher Institute’s Abortion Patient Survey adds to this body of work, indicating that LGBTQ+ people, including individuals who do not identify as women, make up as many as 16% of US abortion patients. Ensuring that abortion research captures the needs and perspectives of the broad range of people with the capacity to become pregnant is critical for creating inclusive policies, fighting harmful legislation and providing patient-centered care.

The aim of this study was to explore service providers’ lived experiences with abortion care in the Republic of Ireland following liberalisation in 2018 via public referendum. Data were collected using semi-structured interviews conducted between February 2020 and March 2021. Thirteen interviews were completed with providers who were directly involved in caring for patients accessing liberalised abortion care in the Republic of Ireland. The sample includes six general practitioners, three midwives, two obstetricians, and two nurses. Interpretative phenomenological analysis identified five super-ordinate themes in the providers’ lived experiences: (1) public reactions to liberalised abortion care; (2) lessons from the service implementation; (3) getting involved in abortion care; (4) moments of moral doubt; and (5) remaining committed to the provision of care. Following liberalisation, providers recalled isolated experiences with anti-abortion sentiments, particularly from those who continue to oppose abortion care. They believed that implementation has been mostly successful in delivering a safe, robust, and accessible service in general practice, though identified ongoing challenges in Irish hospitals. Personally, the providers supported access to care and began providing because they perceived a duty to facilitate access to care. Many, however, reported occasional moral doubts about their work. Despite these, none had considered leaving abortion care and all were proud of their work. They said that patients’ stories were a constant reminder about the importance of safe abortion care. Further work is required to ensure that abortion is fully integrated and normalised and that all providers and patients have access to supports.

Aims. To assess clinical outcomes and complications in women with ≥1 prior caesarean delivery (CS) during mid-pregnancy medical abortion with misoprostol following mifepristone priming. Materials and Methods. Retrospective analysis of abortions at 13–28 weeks gestation using sequential mifepristone and misoprostol at a single centre from 1/2008–12/2018. Procedural outcomes were compared between cases with no prior CS, one prior and ≥2 prior CS. Results. There were 1399 consecutive women who underwent a medical abortion, with 304 (21.7%) having ≥1 prior lower segment CS (241 one, 49 two, 12 three, one four) and one a prior classical CS. Median gestation was 19 weeks (interquartile range (IQR) 17–21) among nulliparas, multiparas with no prior CS and multiparas with prior CS, P = 0.505. Compared with nulliparas (median procedural duration 10.8 h, IQR 7.5–16.5; adjusted hazards ratio (aHR) = 1.20 95%CI 1.04–1.40, P = 0.015), multiparas with prior CS had a shorter procedural duration (9.5 h, IQR 6.5–13.5) while multiparas with no CS had the shortest duration (7.0 h, IQR 5.0–9.8; aHR = 2.28 95%CI 2.01–2.58, P < 0.001). Complications were more frequent with prior CS: estimated blood loss (medians: 100 cc no CS vs 150 cc ≥1 CS, P = 0.002), blood loss >1000 cc (3.6% no CS vs 7.2% ≥1 CS; odds ratio (OR) = 2.11 95%CI 1.23–3.62, P = 0.007) and placental retention (17.3% no CS vs 25.3% ≥1 CS; adjusted OR = 1.44 95%CI 1.05–1.99, P = 0.024). Uterine rupture occurred in 4/304 women with ≥1 prior CS (1.3%). Conclusions. Mifepristone-misoprostol abortion in women with prior CS is generally safe but associated with an increased risk of procedural complications. Lowering of the misoprostol dosage with prior CS may reduce uterine rupture, although this hypothesis requires ongoing research.

One year ago, the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade and opened the door for states to ban or severely restrict the availability of abortion care. Today, people seeking abortion in large swaths of the country must travel to other states to get abortion services or obtain medication abortion through self-managed or other means. In many states, abortion is not banned, but laws impose gestational limits and other restrictions that limit access to abortion. This has left large parts of the U.S., particularly in the South and Southeast, without meaningful abortion access. In the states where abortion remains available under most circumstances, abortion providers have had to take on additional patients traveling to their states to get an abortion. Furthermore, the situation in many states remains uncertain, with new bans being implemented that are often followed by legal challenges creating a complicated landscape to navigate for patients and clinicians, particularly those who provide services to pregnant people. To understand the impact of the changing abortion landscape on clinical care, KFF conducted a nationally representative survey of office-based OBGYNs practicing in the United States who spend the majority of their working hours (60% or more) in direct patient care and provide sexual and reproductive health care to at least 10% of patients. The survey was fielded from March 17 to May 18, 2023, and responses were received from 569 OBGYNs. This survey examines the provision of sexual and reproductive health care provided by OBGYNs before and after the Dobbs decision, comparing the experiences of OBGYNs practicing in states where abortion is fully banned, states with gestational restrictions, and states where abortion remains available under most circumstances. All differences highlighted in the text of this report are statistically significant.

The report, Care Post-Roe: Documenting cases of poor-quality care since the Dobbs decision, shows that health care providers have seen increased morbidity, exacerbated pregnancy complications, an inability to provide time-sensitive care, and increased delays in obtaining care for patients in states with abortion bans. This has impacted both patients and providers and has deepened the existing inequities in the health care system for people of color.

The initial stages of the COVID-19 pandemic affected abortion care in the United States (US) in myriad ways. While research has documented systems-level pandemic-related impacts on abortion access and care delivery little information exists about the experiences of abortion seekers during this period. We sought to document the effects of COVID-19 pandemic restrictions US abortion seekers by analyzing posts on Reddit, a popular social media website. Methods. We compiled and coded 528 anonymous posts on the abortion subreddit from 3/20/2020 to 4/12/2020 and applied inductive qualitative analytic techniques to identify themes. Results. We identified four primary themes. First, posters reported several COVID-19-related barriers to abortion services: reduced in-person access due to clinic closures, mail delivery delays of abortion medications, and pandemic-related financial barriers to both self-managed and in-clinic abortion. The second theme encompassed quarantine-driven privacy challenges, primarily challenges with concealing an abortion from household members. Third, posters detailed how the pandemic constrained their pregnancy decision making, including time pressure from impending clinic closures. Finally, posters reported COVID-19-related changes to service delivery that negatively affected their abortion experiences, for example being unable to bring a support person into the clinic due to pandemic visitor restrictions. Discussion.This analysis of real-time social media posts reveals multiple ways that the COVID-19 pandemic limited abortion access in the US and affected abortion seekers' decisions and experiences. Findings shed light on the consequences of sudden changes, whether pandemic or policy related, on abortion service delivery.

In response to the Supreme Court's Dobbs v. Jackson Women's Health Organization ruling overturning Roe v. Wade and Planned Parenthood v. Casey and ending the constitutional right to abortion, protections to ensure equitable access to medication abortion care, including care via telehealth, are critical. Many states have already heavily restricted access to or completely banned abortion, and patients who are geographically isolated or lack the necessary resources to travel rely on services such as telehealth to access medication abortion care, sometimes as their sole option (Leonard,). Access to medication abortion care via telehealth will not on its own solve the current abortion access crises due to ongoing systemic barriers, use being limited to the first 10 weeks of gestation, and the continued need for clinic-based care (American College of Obstreticians and Gynecologists; Baker and Mathis, 2022). Nonetheless, telehealth medication abortion is an important avenue to increase access to abortion care during this crisis moment and, importantly, is supported by the scientific and medical evidence. While the FDA's review and subsequent revision of the REMS to enable access to medication abortion via telehealth was essential, significant barriers to access remain even in states that have not fully banned abortion. After the Dobbs decision, several states passed or reinstated broad bans on abortion. In states where abortion still remains legal, medication abortion via telehealth may be restricted by laws that require some or all of the procedure's components to take place in person, despite the FDA's decision and a large body of scientific evidence indicating such requirements are unwarranted (Kaiser Family Foundation, 2021; Marblestone). In addition, many providers continue to face unnecessary barriers to provision imposed by their employers or institutions (Razon, 2022). We argue that protections and supports for provisions of medication abortion care via telehealth are essential at the institutional, state, and federal levels.

Rural women in Australia are more likely than urban women to experience unintended pregnancy, yet little is known about how this issue is managed in a rural health setting. To address this gap, we conducted in-depth interviews with 20 women from rural New South Wales (NSW) about their unintended pregnancy. Participants were asked about accessing healthcare services and what was uniquely rural about their experience. The framework method was used to conduct an inductive thematic analysis. Four themes emerged from the data: (1) fragmented and opaque healthcare pathways, (2) a limited number of willing rural practitioners, (3) small town culture and community ties and (4) interrelated challenges of distance, travel and money. Our findings highlight how pervasive structural issues related to accessibility of health services intersect with small-town culture to create compounding obstacles for rural women, especially those seeking an abortion. This study is relevant to other countries with similar geographies and models of rural healthcare. Our findings point to the necessity for comprehensive reproductive health services including abortion to be an essential – not optional – part of healthcare in rural Australia.

One year after the US Supreme Court’s decision in Dobbs v. Jackson Women’s Health overturned Roe v. Wade, the status of abortion rights in many states is dismal and complex legal questions continue to create chaos and confusion. There are also bright spots that can chart a pathway to more state and federal protections for abortion. Despite consistent public opinion in support of legal abortion, abortion is banned in 13 states, leaving large regions of the country without abortion care and contributing to increased wait times at clinics in states where abortion remains legal. Some states are further testing the legal limits of the post-Roe landscape by passing extreme restrictions, such as a ban on helping a young person travel out of state to access legal abortion care. Relentless attempts to ban abortion everywhere, by any means available, place abortion rights front and center in a host of other policy issues, from questions about state ballot measure processes to legal maneuvers such as preemption and local government control.

Beyond the egregious violation of individual autonomy and human rights that the Dobbs v. Jackson Women's Health Organization Supreme Court decision manifests, the decision will harm reproductive health at the population level. The right to abortion care is intertwined with the health of the pregnancy, the health of the pregnant person, and the risk of death in pregnancy and the immediate postpartum period. Restricting pregnant individuals from accessing abortion when they have decided it is the best decision for themselves and their families will have significant impacts on maternal morbidity and mortality, an area where U.S. health metrics already signal a crisis. The negative impacts of abortion restrictions on maternal morbidity and mortality will be most deeply felt by birthing people of color, further compounding the intersecting oppressions and reproductive injustices these communities experience. The disparate impact of mortality, morbidity, and mistreatment in maternity care settings on Black and brown patients is correlated to the systemic barriers they face when accessing abortion care.

The World Health Organization (WHO) Clinical practice handbook for quality abortion care is intended to facilitate the practical application of the clinical recommendations from WHO’s 2022 Abortion care guideline. While legal, regulatory, policy and service- delivery contexts may vary from country to country, the recommendations and best practices described in both of these documents aim to enable evidence-based decision-making with respect to quality abortion care. This handbook is oriented to health workers who already have the requisite skills and training necessary to provide quality abortion care and/or treat complications of unsafe abortion. It is neither a substitute for formal training, nor a training manual. We hope this handbook will be useful to a range of health workers in different settings and in varying legal and health service contexts.

ANSIRH’s Abortion Facility Database collects data on all publicly-advertising abortion facilities in the U.S. This issue brief summarizes trends in telehealth service availability for medication abortion from 2020-2022 across all 50 U.S. states, with data accurately assessed for changes since the Supreme Court decision in Dobbs v. Jackson Women's Health Organization to remove the federal right to abortion.

ANSIRH’s Abortion Facility Database collects data on all publicly-advertising abortion facilities in the U.S. This issue brief focuses on how abortion facilities are increasing gestational limits for both medication abortion and procedural abortion from 2020-2022 across all 50 U.S. states, with data accurately assessed for changes since the Supreme Court decision in Dobbs v. Jackson Women's Health Organization to remove the federal right to abortion.

Debates about human rights, the sanctity of life and the rights of the unborn continue to play out internationally, often placing women seeking abortion in the crosshairs of politicians, faith leaders, community members and others who consider abortion a moral ill rather than a health need. Abortion accounts for up to 13.2% of maternal deaths globally, much of it preventable. While the World Health Organisation (WHO) recognises that access to safe abortion is critical for the health of women and girls, and while abortions that are performed in accordance with international standards by trained health workers carry a negligible risk of severe complications or death, almost half of all abortions conducted worldwide are unsafe, with most occurring in countries where abortion is either completely banned or permitted only to preserve the woman’s life or physical health.

The International Federation of Gynecology and Obstetrics’ (FIGO) Advocating for Safe Abortion Project works with member societies of obstetricians and gynaecologists (OBGYNs) at the international, regional and national levels to improve access to safe, quality abortion services. In 2022, we expanded our network to collaborate with 30 national member societies of OBGYNs across Africa. Together we — Advocate for women and girls’ sexual and reproductive health and rights (SRHR) globally, joining forces with our partners on impactful campaigns — Develop national member societies of OBGYNs’ advocacy and communications skills — We enhance the institutional strength of national societies to help them become leaders on SRHR and deliver plans that facilitate access to safe abortion care in their countries

A través de este micrositio, Católicas por el Derecho a Decidir Argentina comparte con especialistas, estudiantes, investigadores, feministas, feminismos, y el público en general, los materiales, herramientas y el recorrido que desde 2019 venimos trabajando junto a mujeres y diversidades indígenas, campesinas y afrodescendientes en el acceso a derechos sexuales y reproductivos con énfasis en el acceso a la interrupción voluntaria y legal del embarazo y la atención post aborto en el marco de la Ley 27.610. En este esfuerzo conjunto hemos trabajado con organizaciones que articulan y difunden el feminismo y el acceso a derechos humanos y se comprometen con el crecimiento y el desarrollo de sus comunidades y de los pueblos a lo largo y ancho de Argentina aportando al debate global sobre la ciudadanía plena en el marco de la inclusión y el bienestar común.

When Claire Kouba heard that the American Geophysical Union’s (AGU’s) annual meeting would be held in New Orleans in 2025, she was worried. After the U.S. Supreme Court’s June 2022 decision overturning Roe v. Wade, which guaranteed a constitutional right to abortion, Louisiana had banned the procedure with few exceptions. Kouba—a hydrogeologist at the University of California, Davis, and an AGU member since 2011—had attended the 2022 meeting in Chicago while early in her first pregnancy and may be trying to grow her family again in 2025. As she contemplated traveling to Louisiana, she found herself fearing for her own safety and that of other attendees who might need emergency medical care for complications such as miscarriage, ectopic pregnancy, and septic uterus.

While key barriers to abortion care accessibility have been established, little is known about the experiences of people having abortions in the Netherlands. Stories of individual abortion-seekers can help counteract stereotyping, diminish abortion stigma, and improve accessibility. This study’s research question is: What experiences do abortion-seekers in the Netherlands have with abortion care and what new insightscan the I-poem method of analysis provide? This qualitative feminist study used transcripts of semi-structured, in-depth interviews with abortion-seekers from previous research to create I-poems. Using a grounded theory method, the I-poems were coded deductively to validate previous findings, and inductivelyto generate new insights. The I-poems revealed that although abortion-seekers felt autonomous, their decision-making was complicated by doubt concerning their partner’s views and/or suitability as a parent, feelings of shame, and a lack of support. The abortion-seekers were often slowed by obstacles in policy andcare; waiting caused feelings of fear and panic and routine pre-abortion ultrasounds led to anxiety. They often did not know what to expect from their body or the abortion procedure. I-poems show how autonomous choice in abortion care is socially constructed rather than purely individual. Abortion providers must pay special attention to external factors complicating the decision-making process such as partner discordance (even in stable relationships) and anxiety due to waiting times and routine pre-abortion ultrasound. Future action on normalisation of information provided on all aspects of choosing an abortionis necessary to realise informed choice and reduction of abortion stigma.

In Our Own Voice: National Black Women’s Reproductive Justice Agenda, Interfaith Voices for Reproductive Justice, and SisterLove, Inc. present the 2023 Black Reproductive Justice Policy Agenda, an innovative, proactive policy agenda created in collaboration with more than 50 Black women’s organizations and Reproductive Justice activists. The agenda offers strategic policy solutions to address issues at the intersections of race, gender, class, sexual orientation and gender identity—within the situational impacts of economics, politics and culture—that make up the lived experiences of Black women, girls and gender-expansive individuals in the United States.

The Supreme Court of India’s judgement on 29th September, 2022, held that unmarried women have the same right to abortion as married women. The Medical Termination of Pregnancy Act, 1971 (MTP Act),Citation1 most recently amended in 2021 (Amendment Act),Citation2 governs the circumstances under which abortions are legally permitted in India. The law is an exception to criminalisation of abortion under the Indian Penal Code (IPC). The Amendment Act of 2021 is a substantially yet inadequately reformed version of the original MTP Act, including an extension of the gestational limit from 20 to 24 weeks for “certain categories of women”.