Evidence-Based Advocacy: How Do Abortion Providers Experience Stigma?
Evidence-Based Advocacy is a monthly column seeking to bridge the gap between the research and activist communities by profiling provocative new abortion research that activists may not otherwise be able to access.
Ask anyone to tell you who’s doing the most innovative research on abortion provider stigma and they’ll tell you it’s Dr. Lisa Harris and her interdisciplinary team at the University of Michigan. Together they pioneered the Provider Share Workshop, a pilot project testing the possibility that a support group for abortion providers could help reduce the negative impact of stigma. She writes about topics that others in even the most pro-choice communities shy away from the need to have open and honest conversations about second trimester abortion provision, how stigma affects abortion complications, and, recently, the need to recognize conscience as a motivating factor in abortion provision. Now, Dr. Harris and her team, which includes social worker Jane Hassinger, and public health PhDs Michelle Debbink and Lisa Martin, have gone a step further and actually mapped out how abortion providers experience abortion stigma, coining a new term: the legitimacy paradox.
Based on their interviews with abortion clinic staff who participated in the Provider Share Workshop, Dr. Harris and her team theorize that the combination of stigma and silence perpetuate a vicious cycle:
"When abortion providers do not disclose their work in everyday encounters, their silence perpetuates a stereotype that abortion work is unusual or deviant, or that legitimate, mainstream doctors do not perform abortions. This contributes to marginalization of abortion providers within medicine and the ongoing targeting of providers for harassment and violence. This reinforces the reluctance to disclose abortion work, and the cycle continues."
Evidence-Based Advocacy: Expanding Our Thinking About “Repeat” Abortions
Evidence-Based Advocacy is a bi-monthly column seeking to bridge the gap between the research and activist communities. It will profile provocative new abortion research that activists may not otherwise be able to access.
About 1.2 million abortions are performed in the United States every year, and of women seeking abortions, about half have had an abortion before. Women who have had more than one abortion are often targets of public-health interventions designed to increase women’s use of post-abortion contraception, or, to put it another way, to prevent them from having another abortion. Instead of seeing these women as “repeaters,” it’s time we viewed each abortion as a unique experience with its own set of complex circumstances.
Tracy Weitz and Katrina Kimport, sociologists with Advancing New Standards in Reproductive Health (ANSIRH), analyzed the interviews of ten women who’d had multiple abortions (full disclosure: I interned at ANSIRH this summer). Their research was part of several larger studies. The women interviewed varied in age, race, and geographic location, although most were from the Northeast or the West Coast. Together, they’d had a total of 35 abortions. Weitz and Kimport examined how these women thought about each abortion experience. Were they similar or different from each other? How did the circumstances of each abortion affect women’s emotional outcomes?
The researchers found that women talked about their abortions as separate events. Each abortion came with its own set of unique emotional and social circumstances, some more difficult or easy than others. In other words, a woman who’s had three abortions wasn’t repeating the same experience each time. Health interventions and policies that target women who have had more than one abortion should take into account that each abortion — and the circumstances of that pregnancy — may reflect a different emotional experience.
Evidenced-Based Advocacy: (Mis)-Understanding Abortion Regret
Evidenced-Based Advocacy is a new bi-monthly column that aims to bridge the gap between the research and activist communities. It will profile provocative new abortion research that activists may not otherwise be able to access.
"I Regret My Abortion:" we’ve all seen this infamous anti-choice sign, whether at a rally or outside a clinic. As pro-choice activists, our knee-jerk reaction may be to respond, whether aloud or in our own minds, with a reference to the plethora of research that suggests that relief, not regret, is the most commonly reported feeling after abortion. Yet our knee-jerk reaction may be as stigmatizing as the anti-choice sign itself. When we rely on a relief/regret dichotomy, we leave little room for the complexity inherent in women’s reproductive lives.
Both the pro-choice and pro-life movements create simplistic narratives about women’s attachment to pregnancy. The pro-choice movement claims that women who have abortions do not experience regret afterwards because they form no attachment to their pregnancy, while conversely, the anti-choice movement claims that women always experience regret after an abortion because of an instantaneous bond with the pregnancy.
The competing narratives of relief or regret alienate women who have more complicated relationships to their unwanted pregnancies. In her article "(Mis)Understanding Abortion Regret,” sociologist Katrina Kimport explores what makes some abortions more difficult emotional experiences than others (for a video abstract of her paper, see here). She argues that instead of enforcing a relief/regret binary, we need to understand the emotional circumstances in which abortion decisions occur.
To explore what makes some abortions emotionally difficult for some women, Kimport draws on in-depth interviews with 21 women recruited through two separate secular post-abortion support talklines. She postulates that emotional difficulty related to abortion has at least three factors.