What is reproductive stigma?

From a young age, we learn norms around sexuality, pregnancy and parenting: “First comes love, then comes marriage, then comes the baby in the baby carriage.” The unspoken rules and expectations we learn about family, sexuality, and reproduction are carried with us our whole lives. Many of us don't even think about these rules--until we break them in some way and experience reproductive stigma. 

Reproductive stigma is the labeling, judgment, discrimination or poor treatment that people face when their reproductive experiences fall outside of the expected norm. For example, people report stigma associated with abortion, infertility, pregnancy loss, adoption, and becoming a parent at a young age. Reproductive stigma can look like gossip among friends, disapproval from family members, expectations of judgment, feeling isolated and alone, or feeling the need to hide or keep your experience secret. Even more troubling, stigma can manifest in policies that make it difficult or impossible for people to access social services, healthcare, or education. Structural and individual level stigma around reproductive experiences combine with other systems of oppression like racism, ableism, and classism, exacerbating inequality, political powerlessness, and poor health outcomes.

There is a huge amount of literature on stigma that is challenging to summarize. We provide some specific details and definitions about abortion stigma and the stigma young parents face. However, there are numerous other types of reproductive stigma that are undertheorized and/or were not our area of expertise including stigma around infertility, adoption, single-parenting, LGBTQ parenting and many more. For more information and general definitions about stigma, we recommend looking at the Wikipedia page on stigma and checking out the resources at the bottom of this page.

In 1963

In 1963, American sociologist Erving Goffman described stigma as a mark or “attribute that is deeply discrediting” and that “reduces an individual from a whole and usual person to a tainted, discounted one.” Since Goffman’s groundbreaking book on stigma, researchers and practitioners have applied his concepts to understand the experiences of lesbian, gay, bisexual and transgender individuals, the mentally ill, people living with HIV and AIDS, sex workers, and other marginalized groups.

Read Article
In 2001

In 2001, Link and Phelan expanded our understanding of stigma by conceptualizing stigma as a social process in which individuals are (1) labeled as different, (2) stereotyped or associated with negative attributes, (3) conceived of as an “other,” and then (4) subjected to status loss and discrimination.

Read Article
In 2009

In 2009,  Kumar, Hessini and Mitchell expanded on these models of stigma by applying them to the specific case of abortion.

Read Article
The mark of reproductive stigma

The mark of reproductive stigma can taint anyone who is associated with stigmatized reproductive experiences, including people seeking abortions, parents who transition while parenting, young parents, people who are adopted, and individuals working in abortion care or advocacy.

Read More
In 1963

In 1963, American sociologist Erving Goffman described stigma as a mark or “attribute that is deeply discrediting” and that “reduces an individual from a whole and usual person to a tainted, discounted one.” Since Goffman’s groundbreaking book on stigma, researchers and practitioners have applied his concepts to understand the experiences of lesbian, gay, bisexual and transgender individuals, the mentally ill, people living with HIV and AIDS, sex workers, and other marginalized groups.

Read Article
In 2001

In 2001, Link and Phelan expanded our understanding of stigma by conceptualizing stigma as a social process in which individuals are (1) labeled as different, (2) stereotyped or associated with negative attributes, (3) conceived of as an “other,” and then (4) subjected to status loss and discrimination.

Read Article
In 2009

In 2009,  Kumar, Hessini and Mitchell expanded on these models of stigma by applying them to the specific case of abortion.

Read Article

What is abortion stigma?

In our 2013 report, “Addressing Abortion Stigma Through Service Delivery,” we defined abortion stigma as: 

“...a shared understanding that abortion is morally wrong and/or socially unacceptable. The stigma of abortion manifests within multiple levels, including media, law and policy, institutions, communities, relationships, and individuals. Abortion stigma is experienced through: a) negative attitudes, affect, and behaviors related to abortion, and b) inferior status experienced by people who seek abortions or who have abortions, abortion providers, and others involved in abortion care. Abortion stigma leads to the social, medical, and legal marginalization of abortion care around the world and is a barrier to access to high quality, safe abortion care." 

The stigma surrounding abortion stems from the transgression of cultural and social norms that are typically expected of women. Kumar, Hessini and Mitchell describe these norms as: “female sexuality solely for procreation, the inevitability of motherhood and instinctual nurturance of the vulnerable.” Queer, transgender and nonbinary people can also have abortions and for these individuals abortion stigma will likely intersect with notions of feminity and masculinity as well as transphobia and heteronormativity in the culture.

Abortion care providers and advocates can also experience stigma through their work. This experience can be partly explained by Everett Hughes’s concept of “dirty work.” Dirty work describes work that is socially necessary but can be seen as “dirty” because it is “tainted by physically disgusting, socially degrading, or morally dubious elements.” 

We provide links to multiple articles conceptualizing and measuring abortion stigma in the further reading section on this page. We also recommend looking at the resources provided by the International Network for the Reduction of Abortion Discrimination and Stigma (inroads).

What is abortion stigma?
Watch on Youtube
A conceptual model of abortion stigma
View Model

What is Young Parent stigma?

Young parent stigma is the shared belief that young parents --expectant or parenting people under the age of 25-- are inferior and unworthy of trust, support, or resources.  

Young parent stigma not only discredits a young parent’s right to make their own sexual and reproductive choices, it impedes their family’s access to resources and support. This stigma impacts mental health, physical health, academic achievement. Stigma for young parents might contribute to poverty as it is linked to discrimination in housing, education and employment. It also impacts a young parent’s self-representation and self-esteem.*

*This definition was developed through a partnership between the Sea Change Program and #NoTeenShame.

The Nuances of Stigma

...It’s multi-layered

Stigma is all around us. This diagram shows how everything from media to communities can either foster or combat stigma.

Here are examples of how abortion stigma manifests at different levels:

  • Mass media and communications- Mass media often frames abortion as controversial and taboo, and perpetuates stereotypes of people who have abortions as selfish, immoral, young, and childless.
  • Law and policy- State, federal, and global policies can create discriminatory practices that prevent access to safe abortion care.
  • Institutions- Institutions or institutional actors can employ practices that marginalize abortion. These practices may lead to poor quality care.
  • Communities- Community members can create and perpetuate social norms, hold prejudicial attitudes, and engage in negative behaviors toward individuals who use or provide abortion services.
  • Individuals- Individuals can experience stigma in the form of shame and guilt, worries about judgment from others, and experiences of discrimination or poor treatment. There are a few key points to note about this model:

All of these levels are important: we can’t bust stigma by just addressing one level! It’s important to remember:

  • All of the levels are working at all times. They influence one another and are a dynamic, ever-changing system;
  • All levels are made up of individual people. For example, we don’t influence “the media,” we influence journalists, editors, media owners, advertisers, and other media decision-makers;
  • System-wide changes are necessary. Stigma is a systemic problem, and can only be addressed systematically.

Stigma Operates At Multiple Levels of Culture

Reproductive stigmas can operate a many different levels of culture. This ecological model shows how abortion stigma can manifest at these different levels.

Here are examples of how abortion stigma manifests at different levels:

  • Mass media and communications - Mass media often frames abortion as controversial and taboo, and perpetuates stereotypes of people who have abortions as selfish, immoral, young, and childless.
  • Law and policy - State, federal, and global policies can create discriminatory practices that prevent access to safe abortion care.
  • Institutions - Institutions or institutional actors can employ practices that marginalize abortion. These practices may lead to poor quality care.
  • Communities - Community members can create and perpetuate social norms, hold prejudicial attitudes, and engage in negative behaviors toward individuals who use or provide abortion services.
  • Individuals - Individuals can experience stigma in the form of shame and guilt, worries about judgment from others, and experiences of discrimination or poor treatment.

There are a few key points to note about this model:

  • All of these levels are important. We can’t bust stigma by just addressing one level! All of the levels are working at all times. They influence one another and are a dynamic, ever-changing system.All levels are made up of individual people. For example, we don’t influence “the media,” we influence journalists, editors, media owners, advertisers, and other media decision-makers.
  • System-wide changes are necessary. Stigma is a systemic problem, and can only be addressed systemically.

Stigma is Multi-Dimensional

Stigma manifests differently for different people, depending on who they are and what the stigma is. Reproductive stigmas may affect people differently based on various dimensions of the stigma:

  • Visibility: The degree to which the stigma is readily apparent or known to others.
  • Course: The degree to which the stigma endures with time, whether it is episodic or continuing.
  • Salience: The degree to which the stigma is a core part of a person’s identity.
  • Aesthetic: The degree to which the stigma marks personal appearance.
  • Peril: The degree to which the stigmatized person is seen as a threat to others.
  • Responsibility: Whether the stigma was acquired through birth, accident, or personal decisions.

Stigma is Intersectional  

People experience stigma differently based on multiple intersecting and interacting identities like race, gender, class, reproductive history, and ability. Abortion stigma intersects with other forms of oppression, therefore the experience of stigma can be complicated or exacerbated depending on social identity. For example, women who are judged to be obese have described experiencing negative responses from health care providers and sometimes delays or barriers to abortion care because of their weight. Black, Latina, and Native American women have described pressure and coercion in birth control counseling at the time of an abortion, because of attitudes and beliefs around their race/ethnicity. Abortion providers of color have been called “race traitors” because they enable people of their own race to access abortion care.  

Stigma is Experienced and Managed

Stigma can manifest as:

  • Internalized stigma, or negative feelings toward oneself
  • Felt stigma, or perceptions of negative attitudes and concerns about stigmatizing behavior from others
  • Enacted stigma, or actual discriminatory behaviors or negative interactions.

When people expect or perceive stigma, they will often engage in stigma management such as:

  • Keeping the stigma a secret
  • Providing justifications and excuses
  • Avoiding conversations or contexts where the stigma could be revealed
  • Seeking support from others with the same stigma
  • Trying to reframe or shift attitudes about the stigma

What is Culture Change?

Often, when advocates and researchers discuss addressing stigma, they use the term “culture change.” This is because the roots of stigma are deeply embedded in cultural norms, values and beliefs, and we usually need to change culture to eliminate stigma But even the word culture itself has multiple definitions. So what constitutes culture change?

Culture can be defined as:

  1. The beliefs, values, and customs that a group shares.
  2. A group of people that has shared beliefs, values, and customs.
  3. The creative activities (like art, community-building, or literature) that members of a cultural group produce.

Therefore, we and our colleagues in the Culture Change Strategy group think of culture change work as leveraging culture (3) to shift culture (1) within a culture (2).

Or in other words: Culture Change is leveraging creative activities to shift the beliefs, values and customs in our culture that lead to reproductive stigma.

Further reading

What Do You Want to Do Next?

strategy

See the Big Picture
Learn More

design

Turn Empathy into Action
Learn More

research

Add Light, Eliminate Shadows
Learn More

evaluation

Measure Impact
Learn More
Strategy
See the Big Picture
Design
Turn Empathy into Action
Research
Add Light, Eliminate Shadows
Evaluation
Measure Impact

strategy

See the Big Picture
Learn More

Design

Create Solutions
Learn More

research

Answer The Big Questions
Learn More

evaluation

Measure Your Impact
Learn More

trainings

Text About Trainings
Learn More

Basic Concepts

Visions for Change

Planning Tools

Strategies

Project Design

Evaluation

Working Together

Case Studies

Quick Links:
What is Reproductive Stigma?What is Abortion Stigma?What is Young Parent Stigma?The Nuances of StigmaWhat Is Culture Change?Further Reading