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Stigma and abortion complications: stories from three continents.

Authors
  • Seewald, Meghan1
  • Martin, Lisa A2
  • Echeverri, Lina3
  • Njunguru, Jesse4
  • Hassinger, Jane A5
  • Harris, Lisa H6
  • 1 Project Manager, University of Michigan, 1500 E. Medical Center Dr. L4000 University Hospital South, Ann Arbor, MI 48109, USA. Correspondence: [email protected]
  • 2 Associate Professor, University of Michigan Dearborn, Departments of Health Policy Studies and Women's and Gender Studies, Dearborn, MI, USA.
  • 3 Senior Program Learning Officer, Planned Parenthood Global, Miami, FL, USA.
  • 4 Sexual and Reproductive Health and Rights Independent Consultant, Nairobi, Kenya. , (Kenya)
  • 5 Research Program Lead, University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, MI, USA.
  • 6 Professor, University of Michigan, Department of Obstetrics and Gynecology, Department of Women's Studies, Ann Arbor, MI, USA.
Type
Published Article
Journal
Sexual and reproductive health matters
Publication Date
Nov 01, 2019
Volume
27
Issue
3
Pages
1688917–1688917
Identifiers
DOI: 10.1080/26410397.2019.1688917
PMID: 31823692
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Complications from abortion, while rare, are to be expected, as with any medical procedure. While the vast majority of serious abortion complications occur in parts of the world where abortion is legally restricted, legal access to abortion is not a guarantee of safety, particularly in regions where abortion is highly stigmatised. Women who seek abortion and caregivers who help them are universally negatively "marked" by their association with abortion. While attention to abortion stigma as a sociological phenomenon is growing, the clinical implications of abortion stigma - particularly its impact on abortion complications - have received less consideration. Here, we explore the intersections of abortion stigma and clinical complications, in three regions of the world with different legal climates. Using narratives shared by abortion caregivers, we conducted thematic analysis to explore the ways in which stigma contributes, both directly and indirectly, to abortion complications, makes them more difficult to treat, and impacts the ways in which they are resolved. In each narrative, stigma played a key role in the origin, management and outcome of the complication. We present a conceptual framework for understanding the many ways in which stigma contributes to complications, and the ways in which stigma and complications reinforce one another. We present a range of strategies to manage stigma which may prove effective in reducing abortion complications.

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