Abortion is highly stigmatized in the United States and elsewhere. As a result, many women who seek or undergo abortion keep their decision a secret. In many regions of the world, stigma is a recognized contributor to maternal morbidity and mortality from unsafe abortion, even when abortion is legal. Women may self-induce abortion in ways that are dangerous, or seek unsafe clandestine abortion from inadequately trained health care providers out of fear that their sexual activity, pregnancy, or abortion will be exposed if they present to a safe, licensed facility. However, unsafe abortion rarely occurs in the United States, and accordingly, stigma as a cause of unsafe abortion in the United States context has not been described. I consider the relationship of stigma to two serious abortion complications experienced by U.S. patients. Both patients wished to keep their abortion decision a secret from family and friends, and in both cases, their inability to disclose their abortion contributed to life-threatening complications. The experiences of these patients suggest that availability of legal abortion services in the United States may not be enough to keep all women safe. The cases also challenge the rhetoric that “abortion hurts women,” suggesting instead that abortion stigma hurts women.
Abortion stigma is pervasive, and, as a result, many women do not disclose their abortion plans; this silence can lead to life-threatening complications.
Program in Sexual Rights and Reproductive Justice, Department of Obstetrics and Gynecology, Department of Women's Studies, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan.
Corresponding author: Lisa H. Harris, MD, PhD, Department of Obstetrics and Gynecology, University of Michigan, L4000 Women's Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109; e-mail: firstname.lastname@example.org.
Supported by the Greenwall Foundation.
Financial Disclosure The author did not report any potential conflicts of interest.