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Background: The Individual-Level Abortion Stigma (ILAS) scale is a tool to measure multiple dimensions of stigma among people who have abortions. Despite use of the scale globally, little is known about participant experiences completing the scale. We assessed reactions to and experiences with the scale among women who obtained abortions in Mexico, exploring how the items made them feel about themselves and their abortion. Methods: We conducted 10 in-depth interviews with women approximately 6 months after their abortion. We explored experiences answering the ILAS overall as well as each sub-scale (self-judgement; worries about judgement; isolation; community condemnation). We used thematic analysis to examine overall experiences with the ILAS and framework analysis to summarize responses by sub-scale. Results: Many respondents reported positive experiences responding to the scale or said it served a therapeutic purpose. Other participants said the scale caused strong or mixed emotions or generated doubts. Women generally described mixed and negative reactions to the “worries about judgement” and “community condemnation” sub-scales, and more neutral or positive reactions to the “isolation” and “self judgement” sub-scales. Nearly all respondents hypothesized that completing the ILAS at the time of their abortion would be more difficult than responding months after their abortion. Conclusions: People can experience both positive and negative effects when responding to abortion stigma scales. Use of the scales may cause discomfort and introduce concepts that further perpetuate stigma. This study highlights the importance of carefully considering when it is appropriate to implement the scale and exploring safeguards for participants.

In the United States, the \"right to choose\" an abortion is the law of the land. But what if a woman continues her pregnancy because she didn't really have a choice? What if state laws, federal policies, stigma, and a host of other obstacles push that choice out of her reach?     Based on candid, in-depth interviews with women who considered but did not obtain an abortion, No Real Choice punctures the myth that American women have full autonomy over their reproductive choices. Focusing on the experiences of a predominantly Black and low-income group of women, sociologist Katrina Kimport finds that structural, cultural, and experiential factors can make choosing abortion impossible-especially for those who experience racism and class discrimination. From these conversations, we see the obstacles to \"choice\" these women face, such as bans on public insurance coverage of abortion and rampant antiabortion claims that abortion is harmful. Kimport's interviews reveal that even as activists fight to preserve Roe v. Wade, class and racial disparities have already curtailed many women's freedom of choice.   No Real Choice analyzes both the structural obstacles to abortion and the cultural ideologies that try to persuade women not to choose abortion. Told with care and sensitivity, No Real Choice gives voice to women whose experiences are often overlooked in debates on abortion, illustrating how real reproductive choice is denied, for whom, and at what cost. 

Introduction This study aimed to examine the interactions between abortion stigma and depressive symptoms among women who underwent termination of pregnancy for fetal anomalies over time. Methods This study is a longitudinal, observational study with two measurement points. A total of 241 women with fetal anomalies filled out the Individual Level Abortion Stigma Scale and the Edinburgh Postnatal Depression Scale before and after terminating pregnancy. Cross-lagged panel analysis was conducted to analyze the interactions between abortion stigma and depressive symptoms over time. Results The level of abortion stigma before terminating pregnancy positively influenced depressive symptoms after terminating pregnancy (β = 0.12, P  < 0.05). The depressive symptoms before terminating pregnancy positively influenced the level of abortion stigma after terminating pregnancy(β = 0.08, P  < 0.05). Conclusions Abortion stigma and depressive symptoms before terminating pregnancy should be evaluated, and comprehensive intervention must be taken to alleviate them. Healthcare professionals need to pay attention to the reciprocal relationships between abortion stigma and depressive symptoms and seek intervention to reduce both

Background The abortion law in Uruguay changed in 2012 to allow first trimester abortion on request. Implementation of the law in Uruguay has been lauded, but barriers to care, including abortion stigma, remain. This study aimed to assess women’s experiences seeking abortion services and related attitudes and knowledge following implementation of the law in Uruguay. Methods We interviewed 207 eligible women seeking abortion services at a high-volume public hospital in Montevideo in 2014. We generated univariate frequencies to describe women’s experiences in care. We conducted regression analysis to examine variations in experiences of stigma by women’s age and number of abortions. Results Most of the women felt that abortion was a right, were satisfied with the services they received, and agreed with the abortion law. However, 70% found the five-day waiting period unnecessary. Women experienced greater self-judgement than worries about being judged by others. Younger women in the sample (ages 18–21) reported being more worried about judgment than women 22 years or older (1.02 vs. 0.71 on the ILAS sub-scale). One quarter of participants reported feeling judged while obtaining services. Women with more than one abortion had nearly three times the odds of reporting feeling judged. Conclusions These findings highlight the need to address abortion stigma even after the law is changed. Some considerations from Uruguay that may be relevant to other jurisdictions reforming abortion laws include: the need for strategies to reduce judgmental behavior from staff and clinicians towards women seeking abortions, including training in counseling skills and empathic communication; addressing stigmatizing attitudes about abortion through community outreach or communications campaigns; mitigating the potential stigma that may be perpetuated through policies to prevent “repeat” abortions; ensuring that younger women and those with more than one abortion feel welcome and are not mistreated during care; and assessing the necessity of a waiting period. The rapid implementation of legal, voluntary abortion services in Uruguay can serve in many ways as an exemplar, and these findings may inform the process of abortion law reform in other countries.

Abortion is a common and essential component of sexual and reproductive health care, yet social norms and stigma influence women's decision-making and create barriers to safe abortion care. This qualitative study in Kenya and India explores abortion-related fears, expectations and perceptions of stigma among women who have obtained abortion services. In 2017, we conducted 34 semi-structured interviews and 2 focus groups with women who had obtained abortion services in Maharashtra state in India and Thika and Eldoret in Kenya. Thematic analysis was informed by the individual-level abortion stigma framework and theory of normative conduct. We aimed to learn about the diversity of women's experiences, analysing pooled data from the two countries. Most participants reported that before seeking abortion they had little prior knowledge about the service, expected to be judged during care, and feared the service would be ineffective or have negative health consequences. Many reported that community members disapprove of abortion and that a woman's age or marital status could exacerbate judgement. Some reported limiting disclosure of their abortion to avoid judgement. Negative stories, the secrecy around abortion, perceived stigma, social norms, and fear of sanctions all contributed to women's fears and low expectations. These findings elucidate the relationship between social norms and stigma and how expectations and concerns affect women's experiences seeking care. The results have implications for practice, with potential to inform improvements to services and help organisations address stigma as a barrier to care. This may be particularly relevant for younger or unmarried women.

Background Abortion stigma is experienced by women seeking abortion services and by abortion providers in a range of legal contexts, including Uruguay, where abortion was decriminalized up to 12 weeks gestation in 2012. This paper analyzes opinions and attitudes of both abortion clients and health professionals approximately two years following decriminalization and assesses how abortion stigma manifests among these individuals and in institutions that provide care. Methods In 2014, we conducted twenty in-depth, semi-structured interviews with abortion clients ( n  = 10) and health care professionals (n = 10) in public and private facilities across Uruguay’s health system. Interviews were recorded, transcribed, and then coded for thematic analysis. Results We find that both clients and health professionals express widespread satisfaction with the implementation of the new law. However, 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. Conclusion Despite the benefits of decriminalization, abortion clients and health professionals still experience abortion stigma.

Testimonies of abortion experiences are largely silenced in many contexts around the world, including Poland, and stigma affects how abortion is represented. Pro-choice initiatives, which support abortion rights, aim to challenge stigma through the sharing of personal abortion experiences (i.e. abortion storytelling). However, these initiatives may simultaneously construct normative hierarchies of abortion and stigmatise abortion stories which do not fit context-specific, politicised norms. This study draws on data purposefully sampled from a pro-choice abortion storytelling initiative in Poland, conducted between 2020 and 2021, and organised by the Abortion Dream Team (ADT; Aborcyjny Dream Team), an influential Polish organisation campaigning for abortion access and rights. By conducting a qualitative document analysis of 73 first-person abortion stories shared in this initiative, I explored how abortion was represented, and whether, and how, these representations challenged abortion stigma and its manifestation in normative hierarchies of abortion. Using reflexive thematic analysis, I identified four main themes. My findings show that abortion is represented as a valid decision, both a positive and challenging experience, and an embodied process. The stories shared in the ADT storytelling initiative challenge stigma and deconstruct normative hierarchies of abortion by representing abortion as a complex experience imbued with multiple, and often contradictory, meanings. This study highlights the existence of positive and non-stigmatising representations of abortion in Poland and shows that abortion storytelling can challenge dominant narratives around abortion. These findings therefore have broader significance, as they suggest that abortion storytelling may serve as an effective tool to destigmatise abortion and advance abortion rights. DOI:10.1080/26410397.2025.2535835.

Background In Germany, to perform an abortion after 14 weeks of gestation, physicians are legally required to provide a medical indication due to a serious risk to the pregnant person’s life or health. This study explores legal, institutional, and societal factors influencing abortion care in Germany from the perspective of abortion providers and counsellors. Methods We conducted 42 semi-structured expert interviews with gynaecologists and abortion counsellors across Germany. Data were analysed using Mayring’s qualitative content analysis with a mixed inductive–deductive approach. Results In our analysis, we identified four overarching themes that influence care for medically indicated abortions in Germany: (1) Varying Availability and the Right to Refuse: Abortion services in Germany are unevenly distributed, with notable urban–rural divides. This restricts procedural options and leads to delays. The experts raised concerns over institutional refusals by entire hospital departments or publicly funded facilities. (2) Legal Regulation and Stigmatisation: Although medically indicated abortions are legal, their regulation under the Criminal Code fosters a sense of criminality among providers. Stigma can negatively affect professional support for patients in their decision either to terminate or continue a pregnancy. (3) Lack of Training and Standardisation: Abortion care is underrepresented in medical education and obstetric training, with few opportunities to acquire the necessary skills. The lack of national clinical guidelines further contributes to inconsistent interpretations of the medical indication and intransparency of processes. (4) Intersectional Aspects: Systemic inequities disproportionately affect structurally marginalised groups—including those living in rural areas, individuals with migration histories, language barriers, mental health conditions, or prior trauma. Experts described how opaque medical indication criteria, stigma, and lack of trauma-sensitive care result in delayed, inaccessible, or denied care. Conclusion In Germany, abortions on medical grounds are complicated by legal ambiguities, fragmented care provision, and frequent use of the right to refuse. While the right to refuse protects providers, its opaque application can exacerbate inequalities and delay access to care. Stigma – legal, institutional, and interpersonal – remains a major barrier, reinforced by the Criminal Code, inadequate training, and generational differences among healthcare professionals. Future legal frameworks should guarantee equal access to care irrespective of social and medical factors. National clinical guidelines on abortion beyond 14 weeks’ gestation and bereavement care are urgently required.

This study examines the stigmatizing attitudes, beliefs, and behaviors of physicians and senior medical students in Kayseri, a mid-sized city located in Central Anatolia, Türkiye, toward abortion, exploring the factors influencing these views. Given the limited research on abortion stigma among Turkish physicians, the study provides valuable insights into their role in shaping abortion access and perceptions. A cross-sectional study was conducted in December 2024 with 585 participants through face-to-face questionnaire administration during their workplace rest periods, including assistant and specialist physicians, general practitioners, and senior medical students. Data were collected using a questionnaire comprising sociodemographic questions and the Stigmatizing Attitudes, Beliefs, and Behaviors Scale Towards Abortion (STAS-SABAS). Statistical analysis included Mann-Whitney U, Kruskal-Wallis, and Spearman’s correlation tests. Results showed a mean stigma score of 26.48 ± 9.06, indicating low stigmatization levels. Male participants and those who supported abortion only for medical reasons had significantly higher stigma scores. Additionally, 18% of participants were unaware of Turkey’s legal abortion framework. Physicians unwilling to perform abortions despite training exhibited higher stigma levels. While 85.3% supported conscientious objection, those who did had higher stigma scores. The study highlights the need for enhanced reproductive health education to reduce stigma and improve abortion-related care. Raising awareness of legal rights and promoting nonjudgmental care can help ensure equitable abortion access.

IntroductionAbortion is a health practice that people might choose for a variety of reasons. In public discourse, a subtle hierarchy of legitimacy frequently emerges in relation to abortion’ motivations, thereby establishing an implicit distinction between abortions deemed acceptable or justifiable and those considered unacceptable or unjustifiable.MethodsWe conducted an experimental study to examine the impact of different motivations commonly perceived as “good and acceptable” (i.e., health risks or rape) and “bad and unacceptable” (i.e., lack of desire to have a child or incompatibility between women’s lives and their careers) on the stigmatization of women who choose to abort (i.e., moral outrage and attribution of humanness) and the perceived severity of hostile behaviors against them.ResultsFindings show that participants experienced more moral outrage towards the woman when she chose to abort for “bad and unacceptable” reasons (vs. “good and acceptable”), attributed her less humanness, and perceived hostile behaviors toward her as less severe. In addition, we found that “bad and unacceptable” reasons influenced participants’ perceptions of hostile behaviors through the mediation of moral outrage and the attribution of humanness to her.Conclusions and Policy ImplicationsHighlighting motivations for abortion reinforces not only the divide between “good” and “bad” abortions but also between “good” and “bad” women. The key conclusions, limitations, and directions for the future are explored in the context of combating abortion stigma and backlash, ultimately advocating for reproductive justice.