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Article

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

Stigma occurs when a person is looked down upon by others who, through a system of negative and unfair beliefs, pass judgment on that individual. Even though abortion in the U.S. is very common, it remains highly stigmatized.  As part of the Turnaway Study, we examined perceived abortion stigma among people who obtained an abortion near a facility’s gestational limit and among people who were denied an abortion because they were past the facility’s gestational limit, and followed both groups over five years.

At one week post-abortion seeking, over half of the people in the study felt they would be looked down upon by their community (56%) or by someone close to them (60%), if they knew they had sought an abortion. Perceptions of abortion stigma were significantly higher among people who obtained an abortion near the facility’s gestational limit than among people who were over that limit, had been denied an abortion and carried their pregnancy to term. Contrary to the view that abortions later in pregnancy are more stigmatizing, we found no differences in perceived abortion stigma between those obtaining abortions near the limit versus in the first trimester. Perceptions of abortion stigma declined over the five-year study period among all study groups. However, differences in perceived abortion stigma between those who obtained and were denied an abortion persisted for nearly two years after seeking abortion, demonstrating the long-lasting impact of abortion stigma.

People’s individual, social and community contexts were significantly associated with perceptions of abortion stigma. We found higher levels of perceived abortion stigma among those who were younger, married, identified as Catholic or Protestant, had a history of depression or anxiety, and lived in the South where abortion is more restricted. People who identified as African American/Black reported significantly lower perceptions of abortion stigma than those who identified as non-Hispanic White. These contextual factors likely influence not only people’s views about abortion but also the social and community expectations to have children or to avoid childbearing.

While Turnaway study findings have firmly demonstrated that having an abortion is not associated with adverse psychological outcomes, in this analysis we found that perceptions of abortion stigma soon after seeking an abortion were significantly associated with experiencing psychological distress years later.  Abortion stigma had long-term consequences to people’s mental health, both among people who had abortions and people who were denied abortions, suggesting that perceptions of abortion stigma may have been internalized. Efforts to reduce the stigma around abortion may help to improve the psychological well-being of people in need of abortion.

For more on this study, “Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion,” visit PLOS ONE.

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ANSIRH is a program within the UCSF Bixby Center for Global Reproductive Health and is a part of UCSF's Department of Obstetrics, Gynecology & Reproductive Sciences.

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