kate cockrill, mph research interns: poonam pai, steph herold and becky michelson abortion stigma...
TRANSCRIPT
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Kate Cockrill, MPH
Research Interns: Poonam Pai, Steph Herold and Becky Michelson
Abortion Stigma Webinar SeriesMarch 12, 2013
Abortion Stigma: Strategies for Contact and Connection
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A Road Map30 minutes Theory Design Application
15 minutes Questions
10 minutes An example
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Stigma and Prejudice
No stigma
Negative attitudes
Inferior status
Stigma
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What is Abortion Stigma?
Inferior status experienced
by women who have had
abortions, abortion providers,
and others involved in abortion
Prejudicial attitudes toward
women who have had abortions,
abortion providers and others
who are involved in abortion
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Abortion Stigma is Harmful
Negatively affects women’s mental and emotional
health 1
Negatively affects relationships 1
Silences women’s real experiences 2
Contributes to social conflict, ideological
entrenchment and political polarization 3
Stymies efforts to improve public health 3
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Contact Theory
Under appropriate conditions interpersonal
contact is one of the most effective ways to
reduce stigma and prejudice between
majority and minority group members.
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The Optimal Conditions for Contact
Equal status
Common goals
Intergroup cooperation
Support of authorities,
law or customs
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Some Examples
Gay student and heterosexual students at a US college4
Muslims and Non-Muslims neighbors in the Netherlands5
Racial attitudes toward between Black and white teammates on sports teams.6
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Evidence about Contact Theory
80 years of evidence
Meta-analytic study of 515 studies 7
Across multiple stigmas, contact reduces prejudice
Greatest reductions were found around LGBT stigma
Reductions in prejudice are generalizable
*Pettigrew and Tropp. 2011. Meta-Analytic Test of Intergroup Contact Theory. Interpersonal Relationships and Group Processes.
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ContactRequires Some People to Talk and Others to Demonstrate a
Willingness Listen
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The Experience of Abortion Stigma
Worries about judgment
“I’m afraid I will lose an important relationship.”
“My abortion discredits me.”
Isolation
“I can’t talk with the people I’m closest to about my abortion.”
Self-judgment
“I feel like a bad person”
“I’m such a mess.”
Community condemnation
“Most of my community thinks abortion is murder.”
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Common Responses to Stigma
Excusing and justifying
Transferring the blame
Secrecy, passing & covering
Selectively disclosing and supporting
others
Condemning the condemners
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How Women Manage Stigma
Excusing and justifying
Transferring the blame
Secrecy, passing & covering
Selectively disclosing and supporting
others
Condemning the condemners
DO NOT disrupt stigmatizing attitudes
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How Women Manage Stigma
Excusing and justifying
Transferring the blame
Secrecy, passing & covering
Selectively disclosing and supporting
others
Condemning the condemners
Increase cultural silence and secrecy
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How Women Manage Stigma
Excusing and justifying
Transferring the blame
Secrecy, passing & covering
Selectively disclosing and supporting
others
Condemning the condemners
Increases polarization and perception of “difference” between group
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Different Levels of Prejudice
Total prejudice
AversionConcealed prejudice
Not at all prejudiced
Ambivalence Context-specific
compassion
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What are the conditions?
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Revisiting the Optimal Conditions for Contact
Equal status
Common goals
Intergroup cooperation
Support of authorities,
law or customs
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The Reading Women’s Lives Study
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Reading Women’s Lives
Mixed methods
Group observation
Surveys
Interviews
Pre- and post-Book Club evaluation
Connected observation data with survey and interview data
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Reading Women’s Lives: 14 Book Clubs Enrolled
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Reading Women’s Lives
121 participants
14 book clubs enrolled and observed
Age range: 23-76 years old women (median age 47) , 7 men (50’s and 60’s)
Race/ethnicity: 92 White, 12 Asian, 8 African American women, 2 Middle Eastern
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Religious Background
Not religious
Protestant
Catholic
Jewish
Hindu
Buddhist
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Pregnancy Experiences from Survey
Women reporting (#)
Percentageof total
Pregnancies 81 75%Births 73 68%Miscarriages/still births 32 30%Abortions 19 18%Adoptive mothers 2 2%Birth mothers 1 1%
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77% of Book Clubs Contained an Abortion Experience
5
11
3
2 1 01
1
03
1
Number of women reporting
abortions on confidential
survey
0
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15 out of 19 (79%) Women shared their abortion with their Book Club
1
1
1
5 1
1
3
1
1
5
Number of women who disclosed/
Confidential disclosure
Confidential survey
disclosure only
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Abortion Disclosure
“I really identified with so many of those stories … they triggered a lot of memories. At one point I
started crying and I don’t even remember which story — I think it was the story about the miscarriage … I’ve had five miscarriages. And I’ll put it out there, I had an abortion when I was 22. So, there were two or
three little touchstones for me … so many moments when I thought, “Oh, my god, that’s me.”
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The Importance of Visibility
“I’m a really private person; I don’t really share a lot with anyone. But this sort of showed me the benefit of putting yourself out there because you don’t know who you would end up connecting with or what similar experience you might share with someone that least expects it. And so it made me be more cautious of how I look at people and what I assume about people and what their experiences are.”
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“We have all told our stories to each other … it feels
really good. It builds relationships, it makes you
understand each other more, it makes you feel
more connected.”
—A participant who had previously had an abortion
“This was different than other experiences I have had talking
about abortion … because there was someone there who had had
one … Abortion is not black/white. You can’t just
dismiss someone who has had one.”
—A participant who identified as “pro-life”
Sharing and Listening
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Contact Theory: Feeling Thermometer
0 50 100
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Contact Theory: Feeling Thermometer
0 50 100
Women in General91
A Mother92
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Average Pre-Test Scores
Stigma
Pregnant Smoker23
Three Abortions48
Inconsistent Birth Control41 Pregnant Teen
66
One Abortion75
Women in General91
A mother92
0 100
Abortion Fetal Anomaly74
Reduced Pregnancy59
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Average Pre-Test Scores
Room for Change
Pregnant smoker23
Three Abortions48
Inconsistent Birth Control41 Pregnant Teen
66
One Abortion75
Women in General91
A mother92
Abortion Fetal Anomaly74
Reduced Pregnancy59
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Did Scores Increase Post-Intervention?
DescriptionIncrease in Score Post-
Intervention*Inconsistent Birth Control 0One Abortion 3Pregnant Smoker 4Pregnant Teen 4Abortion for Abnormal Fetus 5Reduced Triplet Pregnancy 5Three Abortions 12
Yes
* All values statistically significant at p<0.05
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Biggest Difference AmongMost Prejudiced
Description
AverageIncrease in
Score*
Average Increase
Among Most Prejudiced*
% of people scoring
under 50Inconsistent Birth Control 0 8 45%One Abortion 3 27 7%Pregnant Smoker 4 8 73%Pregnant Teen 4 18 11%Abortion for Abnormal Fetus 5 29 11%Reduced Triplet Pregnancy 5 22 45%Three Abortions 12 22 55%
* All values statistically significant at p<0.05
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Limitations and Caveats
Sample lacks diversity
No control group
Book lacks diversity
Stigma still exists
Doesn’t work for everyone
A lot of data left unexplored
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Questions?
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A Final Example
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A Lot of Experience
I have two children and several
miscarriages.Miscarriage and IVF. No kids.
Two stepsons, two biological daughters and a son who I
gave up for adoption when I was in high school.
…And I have two sons
A son. Never got pregnant again.
Two children; a son and his wife just went through IVF
I have had three pregnancies: three daughters.
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An Abortion Disclosure
I have two children, I’ve been through infertility treatment, I have also been a single parent...but I’ve also had an abortion.
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Reciprocal Disclosures
I’ve had three abortions. I’ve had two.
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What happened next…
A
B C
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A Sea Change
Connection
Visibility
Transformation
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Acknowledgements
Funder:The William and Flora Hewlett Foundation
Editors of Choice:Karen Bender & Nina de Gramont
All the Essayists in Choice
Research Interns:Poonam PaiSteph HeroldBecky Michelson
All the study participants
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Let’s Connect
Kate CockrillDirector
Sea Change ProgramANSIRH
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References
1. Major, B., and R. H. Gramzow. 1999. Abortion as stigma: cognitive and emotional implications of concealment. Journal of Personality and Social Psychology 77 (4):735-45.
2. Ellison, M. A. 2003. Authoritative knowledge and single women's unintentional pregnancies, abortions, adoption, and single motherhood: Social stigma and structural violence. Medical Anthropology Quarterly 17 (3):322-47.
3. Joffe, Carole. 2010. Dispatches from the abortion wars: The costs of fanaticism to doctors, patients, and the rest of us. Boston: Beacon Press.
4. Herek, G. M. (1987) The instrumentality of attitudes: Toward a neofunctional theory. Journal of Social Issues, 42, 99–114.
5. Savelkoul, Scheepers, P., Tolsma, J., Hagendoorn, L. (2011) "Anti-Muslim Attitudes in The Netherlands…" European Sociological Review, 27, 6, 741-758.
6. Brown, K.T, Brown, T.N., Jackson, J.S., et al. (2003). Teammates on and off the field? …. Journal of Applied Social Psychology, 33, 1379-1403
7. Pettigrew and Tropp. 2011. Meta-Analytic Test of Intergroup Contact Theory. Interpersonal Relationships and Group Processes.