The stigma surrounding abortion plays a critical role in the social, medical, and legal marginalization of abortion care around the world. Stigma shames and silences women seeking abortions and providers, and is a major contributor to unsafe and often lethal conditions for women. Though stigma is pervasive and threatens women, it is only just beginning to be well understood.
Abortion stigma is as complex as abortion itself. It’s intertwined with issues around gender stereotypes, sexuality, power, and even other forms of stigma. All these are linked to other reproductive health issues. Eradicating it requires careful study and interventions based on evidence.
Since 2009, we’ve been learning more about abortion stigma at Ipas. Our work began with a conceptual framework and progressed to incorporation of stigma into community assessments and focus group interviews to understand what abortion stigma is, how it is created and perpetuated, and how stigma affects women’s access to safe abortion care.
In 2013, Ipas developed a scale to measure abortion stigma at the individual and community levels, the Stigmatizing Attitudes, Beliefs and Actions Scale, which we are using in Kenya, Mexico and Uganda to inform the development of interventions to mitigate stigma. We are also examining stigma in health-care facilities in Mexico and Uganda. And we are looking at the use of other strategies to raise awareness and reduce stigma:
- We’re using community interventions, such as community meetings in Bangladesh, posters and Queen Mother messages in Ghana, peer outreach and radio spots in Uganda, and video sharing in Mexico;
- In Kenya and Uganda, we’re working to increase the capacity of community organizations to combat abortion stigma;
- In Kenya, Mexico and Uganda, we’re adding stigma information and considerations to provider training.
In 2013, Ipas also co-convened 19 experts from 11 countries to set a course for future directions. Following that, we launched Inroads, a global community of practice and network to share strategies to understand and reduce abortion stigma across the globe. Ipas is the host organization for inroads and provides operational support and guidance to the network staff. Individual Ipas staff are also active participants in inroads activities. Through hosting inroads, Ipas gains a deep connection to theories, practices, questions, and problems generated and shared by diverse inroads members. The community of practice model supported by inroads has allowed Ipas pilot and refine tools to combat stigma with other inroads members around the globe.
inroads Global Member Gathering Bangkok 2016.
Photo by Emma Campbell.