Abortion stigma persists at moderate levels in high-income countries

A systematic review of 19 studies examining abortion stigma in high-income countries found that it is present at moderate levels. Abortion stigma was stronger in males, people with lower income, political conservatives, and religious individuals. The paper was published in Sexual and Reproductive Health Matters.

Abortion stigma refers to the social discrediting and negative labeling of individuals who seek, provide, or support abortion services. It operates through moral judgments that frame abortion as deviant, irresponsible, or sinful. Stigma can be expressed interpersonally through gossip, shaming, exclusion, or hostility. It also functions through restrictive laws, institutional barriers, and policy discussions.

Individuals experiencing abortion stigma may internalize shame, guilt, or secrecy. This internalization can affect mental health, help-seeking behavior, and disclosure decisions. Stigma may vary across cultural, religious, and political contexts. It can be amplified in highly polarized environments where abortion is framed as a moral identity issue. Healthcare providers may also experience stigma, sometimes referred to as “courtesy stigma,” for offering abortion services.

Study author Jana Niemann and her colleagues wanted to examine the situation with abortion-related stigma among the public in high-income countries. They did this by conducting a systematic review of studies that investigated abortion-related stigma in these countries. More specifically, these authors were interested in definitions of abortion-related stigma various authors use, how this stigma is manifested among the public, and what factors are associated with it.

Study authors searched databases of scientific papers MEDLINE, CINHAL, PsychINFO, LIVIVO, and Cochrane Library using keywords like abortion/termination of pregnancy/voluntary interruption of pregnancy and stigma/discrimination.

The search found 19 studies. 12 of these studies were qualitative and 7 were quantitative. They initially found 10 quantitative studies, but three were excluded because the sample was inadequate or study authors deemed them to have a high risk of bias arising from uncontrolled factors that could have affected the results.

Results of quantitative studies revealed that abortion stigma in high-income countries persists at moderate levels. It is stronger among individuals who are more religious, politically conservative, with lower income, and among males. Individuals who had close contact with someone who had an abortion or who had no biological children tended to report lower levels of abortion stigma. On the other hand, individuals who had experienced a pregnancy themselves or whose partner went through pregnancy tended to hold more stigmatizing views.

Qualitative studies identified prevailing stereotypes such as the belief that abortion represents killing babies, that abortion is sinful and deserving of divine punishment, or that abortion providers are ignorant and morally corrupt. Studies also report that some members of the general public call for punitive measures against women who seek abortions and those involved in providing abortion care. Many participants of these studies reported perceiving that dominant public attitudes towards abortion are marked by moral judgement and strong condemnation.

“Overall, abortion stigma remains common in public life”, study authors concluded.

The study contributes to the scientific understanding of the abortion stigma in modern high-income societies. However, study authors note that most of the studies they found were from the United States. Because of this, more research is needed in other wealthy countries to make the findings fully generalizable.

The paper, “Abortion stigma amongst the public in high-income countries: a mixed-method systematic review,” was authored by Jana Niemann, Marie Bernard, Dennis Jepsen, Nadja Freymüller, Laura Weinhold, Céline Miani, and Claudia Luck-Sikorski.