How Many Abortion Complications Are Caused by Stigma, Secrecy and Silence?

August 14, 2013

Although close to one-third of all U.S. women will have an abortion by age 45, there is often little discussion of the topic because of the stigma involved.

In a commentary published in the journal Obstetrics & Gynecology, Dr. Lisa H. Harris describes the cases of two women who had access to safe, legal abortion but who completed their abortions in unsafe conditions because “each woman needed her abortion plan to remain a secret.”

In both cases, the women were undergoing cervical dilation prior to planned surgical abortions and failed to complete the procedures at the clinic. The first woman feared loss of housing and a child custody battle if her family found out about the abortion, so pretended to have miscarried. She later ended up in the ICU.

The second woman, after having a complication, could not tell anyone about her situation and had no transportation back to the clinic. She ended up going to the hospital by ambulance.

While abortion is generally very safe in the United States, Harris writes that if political wrangling leads to increased stigma (alongside more restricted access), complications may increase:

This leads me to ask, how many serious abortion complications are caused by stigma, and the secrecy and silence it generates? Because overall rates of serious complications or death from abortion in the United States are extremely low (the abortion mortality rate is 0.7 per 100,000 abortions), abortion stigma may not currently pose an important public health threat. However, abortion is becoming increasingly contested in U.S. politics and discourse, and social scientists note its increasing stigmatization. Insofar as abortion stigma leads to compulsory secrecy for many patients, which in turn may lead to disruptions of care and lapses in treatment, we might expect rates of some serious complications to increase.

The 1 in 3 Campaign is currently working to fight abortion stigma, encouraging people to share their stories of abortion and challenge shaming. The campaign website features activism resources, including a campus toolkit, and other information about abortion rights and policy.

Secular Women is also running the #ShameLESS campaign, and is posting stories on the AbortTheocracy website.

Related: Carol Joffe, a professor at the Bixby Center for Global Reproductive Health, explains how Kansas is taking the stigmatization of abortion providers to a whole new level.

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