A systematic review of 19 studies examining abortion stigma in high-income countries found that abortion stigma exists at moderate levels. Prejudice against abortion was stronger among men, people with low incomes, political conservatives, and religious people. The paper is Sexual and reproductive health issues.
Abortion stigma refers to the loss of public trust 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 may be expressed interpersonally through gossip, shame, exclusion, or hostility. It also operates through restrictive laws, institutional barriers, and policy debates.
People who experience abortion stigma may have internalized feelings of shame, guilt, and secrecy. This internalization can impact mental health, help-seeking behavior, and disclosure decisions. Stigma may vary depending on cultural, religious, and political background. This problem can be amplified in highly polarized environments where abortion is seen as a moral identity issue. Health care providers may also experience stigma, also known as “favorable stigma,” for providing abortion services.
Study author Yana Niemann and her colleagues wanted to investigate the prevalence of abortion-related stigma among citizens of 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 the definition of abortion-related stigma used by different authors, how this stigma is expressed among the general population, and what factors are associated with it.
The study authors searched databases of scientific papers including MEDLINE, CINHAL, PsychINFO, LIVIVO and the Cochrane Library using keywords such as abortion/abortion/voluntary termination of pregnancy and stigma/discrimination.
The search found 19 studies. Twelve of these studies were qualitative and seven were quantitative. They initially found 10 quantitative studies, but three were excluded because the study authors deemed them to be at high risk of bias from insufficient samples or uncontrolled factors that could influence the results.
Quantitative research reveals that stigma against abortion persists at moderate levels in high-income countries. This trend is stronger among people who are more religious, politically conservative, have lower incomes, and men. People who had an abortion or had close contact with someone who did not have a biological child tended to report lower levels of stigma against abortion. On the other hand, those who had experienced pregnancy themselves or whose partner had experienced pregnancy tended to have more prejudiced views.
Qualitative research identified common stereotypes, such as beliefs that abortion means killing a baby, that abortion is a sin and deserves divine punishment, or that abortion providers are ignorant and morally corrupt. The study also reports that some members of the public are calling for punitive measures against women seeking abortions and those involved in providing abortion care. Many participants in these studies reported that they perceived the prevailing public attitudes toward abortion as characterized by moral judgment and strong condemnation.
“Overall, stigma against abortion remains common in public life,” the study authors concluded.
This study contributes to the scientific understanding of stigma against abortion in contemporary high-income societies. However, the study authors note that most of the studies they found were from the United States. Therefore, further research is needed in other wealthy countries before the findings can be fully generalized.
The paper, “Abortion stigma among citizens of high-income countries: A mixed-methods systematic review,” was authored by Jana Niemann, Marie Bernard, Dennis Jepsen, Nadja Freimüller, Laura Weinhold, Celine Miani, and Claudia Rack-Sikorski.
