Abortion stigma in a pro-choice world: A mixed methods study of abortion stigma in Australia

Author: Kari Vallury

Vallury, Kari, 2023 Abortion stigma in a pro-choice world: A mixed methods study of abortion stigma in Australia, Flinders University, College of Humanities, Arts and Social Sciences

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Stigma is a fundamental driver of health inequities. International evidence shows that abortion stigma is pervasive and has a range of health and social impacts. However, in Australia there is a dearth of abortion stigma research to inform stigma prevention and management efforts. To address this critical research gap, this doctoral thesis presents the first Australian – and largest global - study of the extent, predictors, drivers, and experiences of abortion stigma.

This sequential mixed methods research commenced with a comprehensive critical review of literature pertaining to abortion stigma and stigma theory. This informed the development, validation, and implementation of a cross-sectional national survey (tool), named The Australian Abortion Stigma Survey (TAASS), to measure anticipated and perceived abortion stigma among the Australian community. The survey went viral on social media, garnering 57,999 valid responses. TAASS found that most participants have abortion-supportive beliefs and perceive other Australians to be similarly pro-choice. However, most participants also anticipate abortion seekers and providers are likely to experience stigma and discrimination. Abortion-related attitudes and knowledge, as well as age, were found to be primary predictors of abortion stigma.

The survey was followed by a qualitative interview study to explore why young people are most likely to anticipate social consequences associated with abortion, as identified by the survey. Twenty young people, who had and had not experienced abortions, participated in semi-structured interviews. Thematic analysis identified that exposure to American media content, a lack of education about abortion in educational settings, and awkwardness around abortion in the media teach young Australians that abortion is contested and socially risky. While young people commonly resist and reject negative abortion narratives, and despite differences according to gender, religion, and class, abortion related stigma and discrimination are seen to be inevitable.

Building on stigma and abortion stigma research and theory, this thesis makes original theoretical and empirical contributions to knowledge. It provides the first comprehensive Australian dataset regarding perceived and anticipated abortion stigma and identifies the population groups most impacted. It proposes a more nuanced conceptualisation of anticipated and perceived abortion stigma than has been offered to date. Finally, this research informs a conceptualisation of abortion stigma as a social process that is primarily enacted and maintained via socio-political structures, systems, norms, and narratives. It offers an agenda for future abortion stigma research in Australia that focuses on understanding and addressing the socio-political, rather than individual and interpersonal, elements of abortion stigma. It is hoped the findings of this research will support the establishment of evidence-based policies and interventions to address abortion stigma. Addressing abortion stigma is likely to support the Australian Government’s commitment to achieve universal access to all reproductive health services, including abortion care, by 2030.

Keywords: Abortion stigma, health stigma, reproductive health, reproductive rights, women's health, abortion

Subject: Women's Studies thesis

Thesis type: Doctor of Philosophy
Completed: 2023
School: College of Humanities, Arts and Social Sciences
Supervisor: Barbara Baird