Enacted Abortion Stigma in the United States

Keywords: United States, abortion, stigma, contact hypothesis

Sarah K. Cowan

Assistant Professor

New York University

sarahkcowan@nyu.edu

1

Abstract

The nascent research on abortion stigma has not yet documented experienced stigma

instead focusing on anticipated or internalized stigma. Knowing how people react to

hearing news of an abortion is critically important now as abortion-rights advocates

encourage abortion story-telling as a tool to change American public opinion.

Comparisons between reactions to abortion and miscarriage disclosures were made using

the American Miscarriage and Abortion Communication Survey, a survey representative

of Americans. The comparison between miscarriage and abortion highlights the

experience of disclosing an abortion rather than the pregnancy or sex that preceded the

termination. T-tests compared the reactions to disclosing a miscarriage and an abortion.

Multivariable logistic regression analyses revealed predictors of receiving negative

reactions. While news of either a miscarriage or an abortion is often received with

compassionate responses, both are met with stigmatizing reactions. Unsurprisingly,

abortion disclosures received more stigmatizing responses than miscarriage disclosures

(24 percent compared to 11 percent.) Even when abortion was disclosed selectively to

avoid stigma, twenty-two percent of women disclosing their abortion received a negative

response and thirty-six percent of men disclosing an abortion in which they intended to

parent if the pregnancy were taken to term received a negative response. Being older or

never married decreased the likelihood of ever having received a negative reaction to an

abortion disclosure while being Hispanic increased the likelihood. Americans frequently

receive negative reactions when disclosing an abortion, even though the news is told

selectively and strategically. These disclosers experience enacted stigma, which can

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negatively impact their well-being. This encounter will become more frequent if

disclosers share their stories widely.

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Introduction:

The nascent and important line of inquiry into abortion stigma in the United

States has yet to answer basic questions regarding the frequency of stigmatizing reactions

to an abortion disclosure; who is more likely to be stigmatized; who is more likely to

stigmatize and what are the particularities of those reactions. These questions are timely

given national campaigns to have women “come out” about their abortions in an attempt

to sway public opinion and ultimately reduce stigma.a Here, I address this gap in the

literature by analyzing a nationally representative survey regarding the communication of

miscarriages and abortions; it captures the experience of both women and male partners’

disclosure of the pregnancy’s terminationb. Both positive and stigmatizing experiences

are described.

A stigma is an attribute that discredits, taints or discounts.1 In conceptualizing

abortion stigma, scholars describe how abortion stigma is created and manifest through

all levels of social life – individuals, communities, institutions and the law, among

others.2,3 Abortion stigma, they claim, affects not just women who seek or have had

abortions2 but abortion providers and the supporters of women who have had abortions.3

Following work on sexual stigma,4 abortion stigma is divided into three

manifestations.5 First, internalized stigma is the abortion patient’s internalized acceptance

of abortion’s capacities to taint her character. Second, is felt stigma, also called

anticipated or perceived stigma, which captures the patient’s perception of others’

a These include efforts from established and multi-faceted organizations such as Planned Parenthood as

well as newer organizations for whom abortion story-telling is a primary tactic for social change. Some of

the newer organizations are SeaChange, The 1 in 3 Campaign and Exhale. They differ in a variety of ways,

some encouraging online disclosures, others face to face etc. and some have options which are attuned to

the potential harm of disclosing such as permitting anonymous disclosures. b Throughout the article, the term “pregnancy termination” refer both to miscarriage and abortion.

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attitudes toward abortion and how they might react to news of her own. Third, is enacted

or experienced abortion stigma or the experience of others’ actions that reveal negative

attitudes toward those involved with abortion.

The little existing empirical work on abortion stigma, however, focuses

exclusively on internalized or anticipated stigma, leaving enacted stigma, i.e. the actual

experience of negative reactions, unexamined. Major and Gramzow’s pioneering work

from a 1993 sample of abortion patients inquires about how they felt others would react

to hearing of their abortion,6 a measure of perceived stigma. Shellenberg and Tsai’s

sample of abortion patients from 2008 are asked questions only regarding internalized

and felt stigma.7 Cockrill and Nack’s analysis of interviews with 34 women demonstrated

examples of enacted stigma.5 Their analysis served as an initial basis for the development

of an abortion stigma scale.8 Yet, the large, diverse sample of women who have had

abortions on which the scale was first administered revealed very few instances of

enacted stigma. The scale creators hypothesize that may have been the result of the

insensitivity of the measure.8 It is this third type of stigma – the actual experience of

stigma from others – that I examine here.

While abortion stigma may be under-researched, the more developed research on

social support with regard to abortion is instructive as to the health consequences of

stigma. Women who receive positive support recover more quickly from the abortion,

assessed shortly after the procedure whereas those who did not receive that support, or

anticipated negative reactions to an abortion disclosure had worse outcomes.9–15

Anticipating negative reactions adversely affects the emotional well-being of abortion

patients.6,14 While negative reactions to abortion disclosure have not been studied for

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disclosers other than the patients, the general literature on negative social interactions

indicates they will result in psychological distress (for a review see Lincoln 2000,16 for a

discussion of stigma’s health consequences see Link and Phelan 2006;17 Hatzenbuehler et

al 201318 Quinn and Chaudoir 200919.)

This study contributes to the burgeoning literature on abortion stigma in multiple

ways. Most importantly, it is the first study to document experienced stigma and captures

not just the valence of the reaction but its specific content. Secondly, the initial sample is

representative of American adults generally. As such, it examines both women who have

had abortions and their male partners and draws from all parts of Americans social life.

Little research examines men’s experiences with abortion, particularly in the American

context20 and the little research that does exist, primarily considers men’s role in the

abortion decision-making process21–23 or their experiences around the time of the

procedure.24,25 This is among the first studies to consider men’s experiences with abortion

after the procedure. Thirdly, following the lead of theorists of abortion stigma,2,3 the

study examines abortion stigma as interactional, analyzing the dyad of the recipient of the

stigma and the stigmatizer. Lastly, it utilizes a comparison with miscarriage to isolate the

specific effects of disclosing an abortion as opposed to the pregnancy or sex that

necessarily preceded it.

The experience of disclosing an abortion history requires particular study now as

abortion advocates endorse “coming out” campaigns in an effort to sway public opinion

on abortion. These campaigns specifically require abortion disclosure and therefore

subject the disclosers to potentially negative reactions. This study speaks to the disclosure

experience by asking: to what extent do women who have had abortions and their

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partners receive negative reactions to their disclosures? From whom are they more likely

to receive negative reactions? Are certain socio-demographic characteristics more or less

predictive of receiving negative reactions? To what extent are the reactions specific to

abortion, that is, the termination of a viable pregnancy? These questions are answered in

a context in which disclosers tell of their experience selectively,26 and as such the results

presented here are conservative estimates of the negative experiences of disclosing

widely as the social movement campaigns promote.

Methods:

Comparing Abortion and Miscarriage

When disclosing an abortion, one is also disclosing the sex, the pregnancy and to

some extent, the reaction to the pregnancy that necessarily preceded the abortion. Each of

these could be a source of stigma and evoke a negative reaction. To isolate the reaction to

the abortion, I compare reactions to abortions and miscarriages. This comparison is

helpful because the pregnancy terminations are similar demographic events but abortion

is subject to much more stigma than miscarriage in the United States.

I begin by briefly reviewing the demographic similarities between abortion and

miscarriage. They are both events that end pregnancies and usually occur within the first

trimester. Given they occur early in a pregnancy, they are more easily concealed and

require disclosure for others’ to hear about the pregnancy termination. Further, the

abortion and miscarriage patient populations are similar with regard to diversity and size.

Miscarriages, especially first miscarriages, occur randomly as a result of fetal

chromosomal abnormalities. The risk of these abnormalities increases with maternal age

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but is understood to be mostly a random event.27,28 As a largely random event,

conditional on pregnancy, women of all subpopulations have miscarriages proportional to

their pregnancy rates. Despite popular assumptions, women of all subpopulations in the

United States also have abortions. With respect to many demographics such as religion

and education, the abortion patient population is similar to the population of women of

childbearing age though Black, Hispanic and poor women are particularly over-

represented in the patient population.29

Miscarriage and abortion are also similar in the size of the populations affected,

though miscarriage is less common. Of recognized pregnancies, approximately 13

percent end in miscarriage28,30,31 while nearly 20 percent of recognized pregnancies end

in abortion (author’s calculations from Ventura et al. 2012).32 Given available data, it is

impossible to precisely determine how many women have had miscarriages to compare it

to abortions.33,34 It is certain that fewer recognized pregnancies end in miscarriage than

abortion and likely that fewer women have miscarried than aborted. One in three

American women will have an abortion in her lifetime at current rates,35 and an estimated

1.1 million abortions were performed in the United States in 2011.36

Though demographically similar, abortion and miscarriage are quite different

socially. Abortion is subject to much greater stigma than miscarriage. Women who have

had abortions feel stigmatized in nearly every context37 and the stigma is linked to the

woman’s character.3 There may be stigma associated with miscarriage which is more

linked to subfecundity or infertility.38

American Miscarriage and Abortion Communication Survey

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The data are a nationally representative survey of American adults, the American

Miscarriage and Abortion Communication Survey (AMACS). I designed the survey to

capture how Americans discuss their own and others’ miscarriages and abortions. The

survey was administered to a sample of over 1600 in the spring of 2012 by the survey

firm GfK, called Knowledge Networks at the time. The sample is drawn from a pre-

recruited panel panel.39 Respondents are recruited into a panel of 50,000 through random-

digit dialing (RDD) and address-based sampling (ABS) methods. By joining the panel,

respondents agreed to participate periodically in online surveys and were provided

Internet access and equipment if they did not already have it. As such, this Internet

survey includes individuals who otherwise would not have participated in Internet

surveys due to lack of access.

Respondents in the panel are asked to fill out an initial profile of basic

demographic information. This study had a 64.9 percent profile completion rate. Three

thousand panel members were invited to specifically take the AMACS, of which 1,640

completed the survey, a completion rate of 54.7 percent. Knowledge Networks’s samples

closely match those of traditional RDD surveys and are representative of the United

States as a whole (see Chang and Krosnick [2009] for KN’s RDD samples; 40 see

DiSogra, Dennis, and Fahimi [2010] on ABS).41 KN samples are used extensively in

academic and government research, including the American National Election Survey

and the Time-Sharing Experiments for the Social Sciences.

The data are weighted to adjust for known sources of deviation from an equal

probability of selection design. To reduce the effects of non-coverage or non-response

bias, a post-stratification adjustment is applied using demographic distributions from the

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most recent data from the Current Population Survey for gender, age, race and ethnicity,

education, census region, and whether the respondent lives in a city. The results are also

weighted with regard to Internet access, data on which are collected at time of

recruitment. All reported results are weighted except for sample sizes which are reported

unweighted.

The AMACS asks Americans about their experience hearing about others’

pregnancy terminations as well as their own. It further captures whom they told about the

pregnancy’s end and why they told that person and from whom they kept it a secret and

why they kept the pregnancy’s end a secret from that person. The survey has separate

modules on abortion and miscarriage and is designed to make comparisons across the

different pregnancy terminations. Randomization is embedded within the survey to

ensure that overall responses will not be affected by module ordering.

The AMACS survey was piloted in a number of ways prior to the final data

collection. An initial draft was tested using cognitive interviews with 23 American adult

men and women who had and had not experienced a miscarriage or abortion. It was then

pilot tested to a sample of over 1200 using a diverse convenient sample recruited from

the Internet of respondents with U.S. IP addresses. In this pilot, respondents were asked

open-ended questions regarding others’ reactions when they disclosed a pregnancy

termination. The open-ended questions were analyzed and the most common reactions

were then included in a multiple choice question detailed below. The second draft of the

survey was then tested using cognitive interviews with another 15 respondents and

piloted to a new, large convenience sample of American adults recruited from the

Internet. After small amendments, it was administered to the national sample which is

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analyzed here. The University of California, Berkeley Institutional Review Board

approved all of these data collections.

Specific Variables

The AMACS modules examined here are those in which respondents reported on

their own experiences with miscarriage and abortion. Male respondents were asked about

“a pregnancy in which you were the father (or a pregnancy in which you intended to

parent the child).” If they answered affirmatively then they were asked how many

pregnancies were lost and then a series of specific questions about the most recent

pregnancy termination.

The survey then asks about communicating the pregnancy termination, both who

was told and who was not. This study only examines the disclosures. Respondents were

asked first if they told anyone. If they answered affirmatively they were then asked if

they told anyone in their immediate family, including a spouse or partner. They were then

given a classic name generator question in which they wrote the initials or first name of

people in their immediate family whom they told and how they were related.

Respondents who had told others’ about either a miscarriage or abortion were

asked a series of questions about each person named, including what their reaction was to

hearing about the pregnancy termination. The question read: “What was [name]’s

reaction to the news about the [miscarriage/abortion]? [Name] was…(select all that

apply)” There were eight options which were shown in random order: angry, ashamed,

concerned, judgmental, sad, supportive, surprised and sympathetic. Respondents also had

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an “other” option, which was followed by a textbox. The options were chosen because

they were frequently offered to open-ended questions administered during the pilot.

When respondents finished with answering questions about immediate family,

they then answered questions about communicating with their close friends. After those

questions, they were asked about anyone else; more details on the survey have been

described elsewhere.26

Abortion is under-reported in surveys,42 including this one, (as discussed below in

limitations). That the survey was administered by computer helps alleviate under-

reporting43 (for an abortion example see Peytchev et al 2010).44 The majority of the

respondent’s social and demographic characteristics were obtained through questions

they answered when they initially entered the pool of respondents and were re-asked

annually after that. Having social and demographic characteristics collected largely at a

different time than the survey may also help alleviate under-reporting. Respondent’s

attitudes toward abortion were asked during AMACS administration.

Analysis

The analysis begins with descriptive statistics and concludes with multivariable

logistic regression analyses, all conducted in Stata 14. Descriptive statistics, t-tests and

logistic regression analyses are employed. Some respondents appear in the data twice

because they report on disclosing both an abortion a miscarriage. Thus, the regression

analyses reported at the end of the results section include standard errors that account for

clustering at the level of the individual respondent.

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Given the harmful effects of receiving negative reactions and that they are likely

to increase in frequency if Americans disclose their abortion histories more widely, the

article focuses specifically on negative reactions. The reactions of angry, ashamed and

judgmental are combined to indicate the respondent received a negative reaction. I

examine the reactions separately only in the descriptive analyses given the small sample

size for any one of the reactions.

Results

The AMACS respondents are representative of the American-resident adult

population. This analysis specifically examines the respondents who indicated that they

or their partner experienced a pregnancy termination. This sub-sample’s characteristics

are reported in Table 1. Two-hundred and eighty people have experienced a miscarriage

and 179 an abortion. Those who experienced a pregnancy termination are diverse with

regard to all relevant socio-economic and demographic characteristics: gender, race, age,

marital status and income.c They are also diverse with regard to their attitude on abortion,

though those who have experience with miscarriage skew toward believing abortion is

morally wrong while those who have experience with abortion skew toward believing

abortion is morally acceptable. The distributions are similar with regard to abortion

legality.d

[insert Table 1 about here]

c These characteristics were not assessed at the time of the pregnancy termination or disclosure. Some

characteristics may have changed since those events. Most miscarriages and abortions occurred more than

five years prior to the survey. This is discussed more in the strengths and weaknesses section of the

discussion. d Note that not all of these individuals went on to tell others’ about the pregnancy termination and therefore

evoke a reaction. Approximately three-quarters of miscarriages were disclosed and two-thirds of abortions.

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Listeners often reacted positively when they heard about either a miscarriage or

an abortion; supportive and sympathetic were the most common responses, as shown in

Figure 1. About half of abortion disclosures received supportive responses whereas more

than sixty percent of miscarriages received supportive responses (p<.05). Negative

responses (anger, shame and judgment) were the least common but were still prevalent,

particularly for abortion disclosures. Twelve percent of listeners were angered by an

abortion disclosure and two percent for miscarriage (p<.001). Nine percent of abortion

disclosures were met with judgment whereas two percent of miscarriages were (p<.01).

[insert Figure 1 about here]

A quarter of Americans in this sample disclosing an abortion received a negative

reaction and a tenth disclosing a miscarriage received a negative reaction. Disclosers who

are women, black, young, co-habiting or poor disproportionately received negative

reactions to disclosing a miscarriage. Disclosers who are men, Hispanic, young or

divorced/separated/widowed disproportionately received negative reactions to an

abortion as can be seen in Table 2, which reports descriptive statistics on individuals

receiving a negative reaction to a pregnancy termination disclosure.

[insert Table 2 about here]

When Americans in this sample disclosed a pregnancy termination – either a

miscarriage or an abortion – and received a negative reaction, it was most likely from a

close member of their family. For abortion, they were least likely to receive a negative

reaction from a close friend and for miscarriage from someone who was neither a close

family member nor close friend. This is reported in Figure 2. None of the differences are

statistically significant. There were few differences in who had which type of negative

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reaction – feeling angry, ashamed or judgmental – by their relationship to the discloser

(results not shown.) The notable exception was feeling ashamed, however. Close family

members were more likely to feel ashamed than close friends (p<.1).

[Insert Figure 2 about here]

When controlling for other variables, we see that whether the discloser is

revealing an abortion or a miscarriage is the strongest predictor of having received a

negative reaction (standardized coefficient of 2.07). Disclosing an abortion has over 4

times greater odds of receiving a negative reaction than disclosing a miscarriage (p<.01).

The predicted probability of receiving a negative reaction to disclosing a miscarriage is

.06 whereas for abortion it is .22, holding other values at their mean.

In addition, certain disclosers are more likely to receive a negative reaction.

Hispanic disclosers and the youngest disclosers are more likely than white or older

disclosers to receive a negative reaction; disclosers who have never been married are less

likely than people who are married, divorced/widowed/separated or living with a partner

to receive a negative reaction. Though there is one income covariate which is predictive

of receiving a negative reaction, there is no consistent story regarding income. While

women are more likely to receive a negative reaction than men, this finding is just under

the threshold for significance (p<.1). These results are reported in Table 3.e

[Insert Table 3 about here]

e The unit of analysis in Table 3 is pregnancy termination rather than respondents because 23 people who

had experiences both with miscarriage and abortion disclosed both terminations to others. The sample size

for this analysis is 289 while there were a total of 459 abortions and miscarriages in the sample. The

difference is primarily due to people not disclosing their pregnancy termination and therefore not being at

risk for receiving a negative reaction; this accounts for 133 pregnancy terminations. The remaining 37 are

pregnancy terminations that are missing values on one of the variables included in the analysis.

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These results raise the question of whether certain listeners more likely to react

negatively than others. Perhaps, for instance, close family react negatively more often

than close friends. To test whether the likelihood of receiving a negative reaction differs

by relationship requires an analysis of the dyad of discloser and listener. This analysis

reveals that the likelihood of receiving a negative reaction does not differ by the

relationship between the discloser and the listener. For parsimony’s sake, the results are

not shown.

Discussion

While disclosing a pregnancy termination primarily evoked positive reactions

such as support and sympathy, a substantial minority of disclosures received negative

reactions. Unsurprisingly given the widespread perception of stigma regarding

abortion,7,37,45 disclosing an abortion resulted in more negative reactions than disclosing a

miscarriage. Miscarriage disclosures still did result in negative reactions, at a rate about

one in ten. A quarter of Americans who told someone else about their, or their partner’s

abortion, received a negative reaction including anger, shame and/or judgment.

By and large, contact between people who are opposed to abortion rights and

women who have had abortions is limited.26 That is because to avoid stigma and negative

reactions, people disclose their own and others’ abortions selectively.6,26,46 They

specifically aim to disclose to those who will be supportive and avoid those who will not

be.

Given that the news was disclosed selectively to people who are intimate and who

would react positively,26 the rates of negative reactions reported here are lower-bound

estimates for the rates of receiving a negative reaction. That is, were people to share the

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news of the pregnancy termination more widely, and particularly in an attempt to change

public opinion on abortion, stigmatizing reactions would be more frequent.

Some particular disclosers were more vulnerable to receiving negative reactions,

though disclosers of every demographic sub-group experienced negative reactions to

sharing a miscarriage or an abortion.f Hispanic disclosers were particularly likely to

receive a negative reaction to sharing an abortion history. Though no prior work gives

insight into enacted stigma for Hispanic disclosers, Hispanic women (particularly those

who are foreign-born) experience social pressure to see all pregnancies, even unwanted

ones, as joyful events for which they should be thankful.47 In addition, Hispanic abortion

patients have higher rates of perceived and internalized stigma than other race/ethnic

groups. Hispanic women are more likely than other race/ethnic groups to believe others,

particularly their friends and family, would think less of them if they knew about the

abortion and are more likely to feel secrecy is required. They are also more likely to care

about others’ responses to the news of the abortion,7 though another study with a smaller

sample showed Hispanics were no different than other race/ethnic subgroups with regard

to perceived and internalized stigma.45

While this study showed that disclosers who were never married were less likely

to receive a negative reaction to their news than people who were married, other work

showed no relationship between marital status and perceived stigma.48 Americans who

held the entire range of attitudes toward abortion also experienced negative reactions

when disclosing a pregnancy termination. Men are not invulnerable to receiving negative

reactions to an abortion disclosure; here they were equally likely as women.

f Except no one who had never been married and disclosed a miscarriage received a negative reaction.

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Disclosing to a close family member is the most vulnerable relationship in which

to disclose, though this finding did not hold in the multivariate analysis. This is consistent

with Foster et al,49 which finds that for women seeking an abortion at one clinic, friends

were significantly more supportive than the patient’s mother for women over age 20.

There are two potential reasons why family members are more likely to react negatively.

First, close family are the people a woman who has had a pregnancy termination or a man

whose partner has may feel most obligated to tell26 and this may be a result of notification

norms.50 As such, selective disclosure may be not as relevant, that is, the obligation to tell

results in disclosures to people who otherwise would not have heard. This reason

suggests that there is nothing unique in the underlying relationship between family

members that would evoke a negative reaction, just in the selectivity of to whom to

disclose. The second explanation, in contrast, suggests the relationship of being close

family is unique and underlies the higher rates of negative reaction. Close family may

feel they are implicated in the pregnancy termination, that it speaks to their own

character, as expressed in shame.51 This would be particularly relevant for abortion.

Strengths and Weaknesses

Most importantly among the study’s strengths is that the survey instrument was

sensitive enough to document instances of enacted abortion stigma, when listeners

reacted with judgment, anger or shame. Additionally, the sample allows for considering

how the characteristics of disclosers and their relationship with the listener predict

receiving a negative reaction. The study also includes men involved in the pregnancy, a

role that is often over-looked when discussing the social experiences after an abortion.

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Lastly, the survey design allows for multiple comparisons -- across pregnancy

terminations, across people to whom the pregnancy was disclosed and between abortion

and miscarriage disclosures.

The study also has some weaknesses. The study lacks temporal data on when the

disclosures occurred. Some of the mutable personal characteristics predictive of receiving

a negative reaction, such as age and marital status, may have changed between the

pregnancy termination and the disclosure. I partially attended to this concern by

examining the subset of pregnancy terminations that occurred most recently to the survey

administration but the samples were too small to test most of the findings here. Of those

findings where the sample size was large enough, the results were consistent with those

presented here.

Like other surveys on abortion, this survey suffers from under-reporting of

abortion experiences. It is likely that individuals who experience or anticipate the worst

reactions to disclosing an abortion are the least likely to disclose their abortion within a

survey. Further, while I am examining negative reactions to disclosing an abortion, it is

within a context in which abortion is already selectively disclosed.26 Both of these

limitations suggest the results here are conservative estimates of how frequent negative

reactions are.

Future Research

This contribution to the nascent literature on abortion stigma is the first to

document experienced stigma; there are a number of avenues to explore in future

research. Taking the broadest view, abortion stigma affects not only those proximate to

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the abortion – the patient, her partner, her medical team and her supporters3 – but also the

structure of healthcare provision and women and their partners who are facing unintended

or unwanted pregnancies. Despite these wide-ranging consequences, there is only a

handful of articles addressing abortion stigma; this arena warrants continued theorizing

and empirical investigation.

The women who have abortions are diverse and the reasons why they do are

myriad.29,52 Americans consider some of those women and some of those reasons, more

acceptable than others (Author’s calculations of the General Social Survey.)53,54

Presumably, stigma directed toward a specific abortion also varies by the characteristics

of abortion patients and their circumstances. Some prior research considers the

characteristics of the patient,8,48 as does this study. But this work reveals inconsistent

findings with regard to basic demographic characteristics, some of which are relevant to

public opinion, such as marital status. Future work should also consider how abortion

stigma varies by the reasons for seeking an abortion, particularly since our current

insights on the relationship between attitudes and reasons for seeking an abortion are

based on survey data regarding hypothetical women, a scenario quite different from an

interpersonal disclosure.

This study disentangles the stigma of an abortion from the stigma of unintended

pregnancy and the stigma of sex through a comparison with miscarriage. These stigmas

can be intertwined and their relationships can differ depending on the characteristics of

the woman or couple. The three (potential) stigmas and how they interact should be

interrogated in future work.

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Perhaps most importantly, future research should determine whether contact

between women who have had abortions and people who have not can causally affect

public opinion. Abortion rights activists across the United States are promoting abortion

story-telling or “coming out” about one’s abortion as a means by which to sway public

opinion. Contact’s effectiveness to change opinion and in what direction, however,

remains an open question, for abortion in particular. Despite strong correlational evidence

which shows large differences in attitudes by contact across a wide range of topics,55 the

causal effect of contact has not yet been adequately tested.56 We have a paucity of either

correlational or causal research on contact and abortion specifically. Only one small

study has examined contact and abortion;57 it suggested contact will positively affect

attitudes. Here, this study indicates that even when disclosing selectively, a quarter of

abortion disclosers received a negative reaction. For these campaigns to be effective,

people with abortion histories will have to disclose broadly and likely will receive even

more negative reactions which are harmful generally and in the specific case of

abortion.14 Receiving this stigma is a high price to pay especially if contact does not

change attitudes or does not change them positively, a question to which we do not yet

have an answer.

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Table 1: Sample Characteristics (weighted %; unweighted N)

Has or Partner Has Had a

Miscarriage

Has or Partner

Has Had an

Abortion

Total Sample 16.58% 11.54%

280 179

Among those Who Have Had a Miscarriage or

Abortion

Gender

Female 62.86% 67.96%

163 111

Male 37.14% 32.04%

117 68

Race/Ethnicity

White, Non-Hispanic 73.27% 55.87%

211 114

Black, Non-Hispanic 14.48% 20.37%

31 29

Other, Non-Hispanic 2.17% 9.04%

10 18

Hispanic 10.09% 14.73%

28 18

Age

18-29 15.37% 10.50%

28 16

30-44 31.10% 21.08%

84 41

45-59 27.48% 48.54%

87 79

60+ 26.05% 19.88%

81 43

Marital Status

Married 60.61% 42.03%

184 90

Divorced/Separated/Widow

ed 24.19% 26.52%

61 43

Never Married 8.62% 16.76%

18 23

Living with Partner 6.58% 14.69%

17 23

Income

Less than $20k 13.91% 9.81%

38 18

22

$20k to $39,999 24.53% 22.83%

51 34

$40k to $74,999 30.25% 30.76%

82 51

$75k to $99,999 12.74% 10.77%

38 18

$100k+ 18.58% 25.84%

71 58

Attitude on Abortion Morality

Morally acceptable, feels

strongly 9.64% 24.57%

36 52

Morally acceptable, does

not feel strongly 10.10% 19.19%

27 30

Morally wrong, does not

feel strongly 7.23% 6.02%

21 13

Morally wrong, feels

strongly 33.26% 7.97%

94 14

Depends on the situation 37.59% 35.55%

89 61

Not a moral issue 2.18% 6.69%

9 9

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Table 2: Percent of Americans Disclosing an Abortion or Miscarriage Who Ever Received a Negative

Reaction by Select Respondent Characteristics

Miscarriage Abortion

Total Sample 11.11 24.19

Gender

Male 6.42 36.33

Female 12.96 22.20

Race/Ethnicity

White, Non-Hispanic 10.11 19.02

Black, Non-Hispanic 19.73 9.18

Other, Non-Hispanic 17.65 15.37

Hispanic 6.87 57.92

Age

18-29 20.44 59.27

30-44 11.39 25.05

45-59 8.40 20.99

60+ 6.79 12.98

Marital Status

Married 9.95 29.88

Divorced/Separated/Widowed 9.94 34.76

Never Married 0.00 2.80

Living with Partner 32.04 18.00

Income

Less than $20k 23.84 17.44

$20k to $39,999 5.46 22.88

$40k to $74,999 15.28 26.43

$75k to $99,999 14.74 16.54

$100k+ 2.97 28.94

Attitude on Abortion Morality

Morally acceptable, feels strongly 3.06 28.74

Morally acceptable, does not feel strongly 1.83 23.11

Morally wrong, does not feel strongly 16.44 13.19

Morally wrong, feels strongly 14.06 16.14

Depends on the situation 13.35 23.10

Not a moral issue 12.78 31.03

24

Table 3: Logistic Regression Analyses Predicting Receiving A Negative Reaction to Disclosing a

Miscarriage or an Abortion

Odds-Ratio

Race (ref White, non-Hispanic)

Black, non-Hispanic 1.44

(0.84)

Other, non-Hispanic 1.11

(1.02)

Hispanic 4.38*

(2.58)

Female 2.33+

(1.09)

Age (ref under 30)

30-44 0.22*

(0.13)

45-59 0.24*

(0.15)

60+ 0.08***

(0.06)

Marital Status (ref Married)

Divorced/Separated/Widowed 1.10

(0.54)

Never Married 0.03***

(0.03)

Living with a Partner 0.42

(0.33)

Income (ref under $20k)

$20k-$39,999 0.22*

(0.16)

$40k-$74,999 0.53

(0.37)

$75k-$99,999 0.37

(0.33)

$100k+ 0.35

(0.24)

Abortion attitude (ref morally acceptable, feel strongly)

Morally acceptable, do not feel strongly 0.48

(0.42)

Morally wrong, do not feel strongly 1.31

(1.26)

Morally wrong, feel strongly 1.35

(0.89)

Depends on the situation 0.86

(0.52)

Not a moral issue 1.07

(0.91)

Abortion (ref: Miscarriage) 4.48**

(2.25)

Constant 0.21

(0.26)

Observations 289

*** p<0.001, ** p<0.01, * p<0.05, + p<0.1

25

Figure 1: Frequency of Reactions to Miscarriage and Abortion Disclosures

26

Figure 2: Frequency of Disclosers Receiving Negative Reactions by Relationship to

Listener

Note: No one who reported a miscarriage disclosed to anyone in the “other” category.

27

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