title: Abortion Stigma Among Low-Income Women Obtaining Abortions in Western Pennsylvania: A Qualitative Assessment.
abstract: Abortion stigma may cause psychological distress in women who are considering having an abortion or have had one. This phenomenon has been relatively underexplored in low-income women, who may already be at an increased risk for poor abortion-related outcomes because of difficulties accessing timely and safe abortion services.
  
  
  
  A qualitative study conducted between 2010 and 2013 used semistructured interviews to explore pregnancy intentions among low-income women recruited from six reproductive health clinics in Western Pennsylvania. Transcripts from interviews with 19 participants who were planning to terminate a pregnancy or had had an abortion in the last two weeks were examined through content analysis to identify the range of attitudes they encountered that could contribute to or reflect abortion stigma, the sources of these attitudes and women's responses to them.
  
  
  
  Women commonly reported that partners, family members and they themselves held antiabortion attitudes. Such attitudes communicated that abortion is morally reprehensible, a rejection of motherhood, rare and thus potentially deviant, detrimental to future fertility and an irresponsible choice. Women reacted to external and internal negative attitudes by distinguishing themselves from other women who obtain abortions, experiencing negative emotions, and concealing or delaying their abortions.
  
  
  
  Women's reactions to antiabortion attitudes may perpetuate abortion stigma. Further research is needed to inform interventions to address abortion stigma and improve women's abortion experiences.
authors.affiliation: Resident in internal medicine, University of Colorado, Aurora.
authors.forename: Amanda
authors.initials: A
authors.lastname: Gelman
authors.affiliation: Postdoctoral fellow of women's health, VA Pittsburgh Healthcare System.
authors.forename: Elian A
authors.initials: EA
authors.lastname: Rosenfeld
authors.affiliation: Research coordinator, Center for Research on Health Care, Department of General Internal Medicine, University of Pittsburgh School of Medicine.
authors.forename: Cara
authors.initials: C
authors.lastname: Nikolajski
authors.affiliation: Assistant professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco.
authors.forename: Lori R
authors.initials: LR
authors.lastname: Freedman
authors.affiliation: Assistant professor, Department of Family Science, School of Public Health, University of Maryland, College Park.
authors.forename: Julia R
authors.initials: JR
authors.lastname: Steinberg
authors.affiliation: Associate professor of medicine and clinical and translational science, University of Pittsburgh School of Medicine.
authors.forename: Sonya
authors.initials: S
authors.lastname: Borrero
mesh_terms: D000023:Abortion Applicants / Q000523:psychology*; D000028:Abortion, Induced / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008875:Middle Aged; D010414:Pennsylvania; D011203:Poverty; D011247:Pregnancy; D036301:Qualitative Research; D057545:Social Stigma; D055815:Young Adult