218139 Abortion provision, occupational stigma, and abortion access

Monday, November 8, 2010 : 12:50 PM - 1:10 PM

Jennifer O'Donnell, BA , Abortion Access Project, Cambridge, MA
Lori Freedman, PhD , Bixby Center for Reproductive Health Research and Policy, University of California, San Francisco, Oakland, CA
Tracy Weitz, PhD, MPA , Director, Advancing New Standards in Reproductive Health (ANSIRH), University of California San Francisco, San Francisco, CA
Introduction: Stigma currently permeates abortion in the United States, attributed to both the experience of those seeking this service and those providing it. For healthcare providers, occupational stigma creates an identified but intangible disincentive to offer a common medical procedure.

Methods: This study conducted 14 in-depth interviews with participants of the Washington State Association of Abortion Providers, a network of clinical, administrative, and advocacy professionals working in the field of abortion care. Interviews were recorded, transcribed verbatim, and coded/analyzed with Nvivo software.

Results: Social disapproval of abortion work and stereotypes of those performing the work are dominant themes in the interviews. Varied approaches to disclosure are used to manage individual exposure to social disapproval and stereotypes. Even mitigated by disclosure, anticipated stigmatization and stereotyping is related to an internalized isolation. Strategies for management of stigma related to abortion work reveal resilience and adaptation. When healthcare providers commit to abortion work, they adapt their work along a continuum of covert to overt practice. This may include doing their abortion work outside their primary place of employment, providing abortion within a broad spectrum of services, or working primarily in abortion.

Implications: The experience of stigma is multi-faceted, negotiated, and mitigated by sources of support and individual strategies. A nuanced understanding of stigma enhances the reproductive healthcare community's ability to support providers currently offering abortion services and may be especially useful in efforts to recruit new providers, a key step in ensuring abortion access.

Learning Areas:
Other professions or practice related to public health
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
1)Understand how healthcare providers in abortion care experience varied levels of occupational stigma, including social disapproval and stereotypes. 2)Demonstrate how strategies for management of stigma related to abortion work reveal resilience and adaptation. 3)Discuss how of addressing stigma is necessary to support providers currently offering abortion services which may be especially useful in efforts to recruit new providers.

Keywords: Abortion, Providers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Deputy Director at the Abortion Access Project, an organization that works with healthcare provider communities to address gaps in abortion access. I am a master's degree candidate at the Harvard School of Public Health's Society, Human Development, and Health department.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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