The Public Health Facts for Choice, Voice, and Safe Legal Abortion : Shutting Down Abortion Stigma in San Francisco
Banners stating that “Abortion Hurts Women” are now displayed on public sites on Market Street, in San Francisco’s lowest-income communities, which experience the highest rates of low-weight births, and emergency room visits for pregnancy. (1) Sign here to demand public health messages that tell the truth:
Access to abortion is an issue that is relevant to young people.
Almost 615,000 U.S. women aged 15–19 (or 6%) become pregnant each year, according to the Guttmacher Institute.
- In 2010, 60% of pregnancies among 15-19 year olds ended in birth, 26% in abortion, and the rest in miscarriage.
- Black and Hispanic women have the highest teen pregnancy rates (100 and 84 per 1,000 women aged 15–19, respectively); whites have the lowest rate (38 per 1,000).
Women aged 15-19 had 157,490 abortions in 2010. About 5% of all abortions are obtained by minors. The reasons that teens most frequently give for having an abortion include concerns about changes in their lives due to having a baby, ability to afford a baby now, and not feeling mature enough to raise a child (2).
The pregnancy rate among young women has declined steadily, from 117 pregnancies per 1,000 women aged 15-19 in 1990 to 57 per 1,000 in 2010. The decline between 1995 and 2002 was mostly due to dramatic improvements in contraceptive use, with only 14% of the decline attributable to decreased sexual activity. The pregnancy rate among black teens decreased 56% between 1990 and 2010, more than the overall teen pregnancy rate (51%). Teenage women have increased their use of a single method of contraception or multiple methods simultaneously, and decreased nonuse of contraception (3). This suggests that avoiding having children during teenage years is important to young women.
Abortion is safe. Access to legal abortion services is essential.
Abortion is one of the safest medical procedures in the United States. The risk of death is 12 times higher for carrying a pregnancy to term, compared with abortion. (4)
Many women routinely lost their lives from illegal abortions before the landmark Supreme Court Case, Roe v. Wade, legalized abortion in 1973. Today, deaths from abortion have all but disappeared.
Women and girls have the right to decide whether and when to have children. Public policies and services must support that right. Access to legal and affordable family planning health care services has been integral to expanding opportunities for success and satisfaction by women and girls in the emotional, economic, educational and professional spheres, as well as for the men and children in their lives and for communities as a whole.
Denied abortion care perpetuates poverty, and women with incomes below 200% of the federal poverty level are already five times more likely to have unintended pregnancies.
Barriers to Access to Abortions: Funding Cuts, Legal Restrictions. Stigma
Low Income Women Are Unfairly Impacted By Funding Restrictions (5)
Shortly after the Supreme Court’s Roe v. Wade decision in 1973 legalizing abortion in every state, Congress enacted the Hyde Amendment to an appropriations bill. It bars the use of federal funds to pay for abortions except in cases of rape, incest, and a threat to the mother’s life. The Hyde Amendment has been renewed each year since 1976. Young women are disproportionately impacted by funding bans because they are less likely to have a steady source of income and more likely to be uninsured than women of all ages. The cost of an abortion ranges from $350 to $1000. (California exercises its state authority to pay for abortions through MediCal.)
Funding restrictions force one in four women to carry unwanted pregnancies to term, with the proportion higher among younger women. (6)
Teens Face Additional Barriers To Access, Including Lack of Accurate Information
The majority of states – thirty-nine as of January 2014 – currently enforce laws that require a young woman to notify or obtain consent from one or both parents before she can receive abortion care. These laws endanger young women’s health and safety, while having no clear impact on birth rates or abortion rates.
Most young women do consult their parents before seeking abortion care, but those who do not may face dangerous circumstances at home. 50% of pregnant teens have experienced violence; 30% of teens who do not tell their parents about their abortions feared violence or being forced to leave home.
Parental involvement laws often delay young women’s abortion care, leading to riskier, later-term abortion procedures.
Websites that teens turn to for sexual health information often have inaccurate information. For example, of 177 sexual health Web sites examined in a recent study, 46% of those addressing contraception and 35% of those addressing abortion contained inaccurate information. (6)
Anti-Abortion Forces Have Found Stigma is a Powerful Tool
Cultural factors impact women’s ability to access abortion and lead to an atmosphere of silence and stigma around abortion. The anti-abortion movement increasingly seeks both to erect overt barriers to abortion and to change cultural values, beliefs, and norms about abortion so that women will seek abortion less frequently regardless of its legal status. From photographing women entering clinics to distributing flyers to the neighbors of providers, the anti-abortion movement foments abortion stigma as a deliberate tactic, not just as a byproduct of its legislative initiatives. Many clinics are regularly visited by protestors; politicians and other public figures routinely condemn abortion as murder. Some religions forbid abortion. Set off from other medical practices and beset by picketers, the institutional arrangements of abortion provision may validate abortion stigma. Women may internalize abortion stigma so deeply that they feel judged even by those who support their decisions. Abortion stigma may cause women to feel less empowered to ask questions about the procedure and its health consequences. Eroding public support for the idea of abortion is seen as an underpinning of future institutional limits. (Joffe, 2009)
The result is fear of being judged and secrecy around abortion. (7) One study found that women ages 19-24 experienced more stigma and had more worries about being judged than women in other age groups
Opponents of abortion in the U.S. have championed a new argument, that ‘abortion hurts women.’ This argument positions women as victims of a profiteering abortion industry and objects of pity, reduces providers to cruel and callous manipulators and women to ‘damaged goods.’
Although definitively refuted by substantial scientific studies, alleged links between abortion, breast cancer, and impaired fertility have been used to frame a “women-centered” anti-abortion strategy. In contrast with other examples, in which abortion reveals or symbolizes flaws in women’s character, here women become flawed because of the experience of having an abortion, and the abortion provider is further tainted, now harming both fetus and woman.
Seven states have integrated groundless claims about the psychological effects of abortion (such as so-called post-abortion syndrome) into regulations. These institutional practices deny the normalcy of abortion as a technique and as medical care and reinforce stigmatizing ideas that abortion is unhealthy.
(1) San Francisco Department of Public Health, Health Care Services Master Plan. 2012.
(2) “American Teens’ Sexual and Reproductive Health.” Guttmacher Institute. May 2014. New York, NY. http://www.guttmacher.org/pubs/FB-ATSRH.pdf
(3) “Facts on American Teens’ Sources of Information About Sex.” Guttmacher Institute. Feb 2012. New York, NY. http://www.guttmacher.org/pubs/FB-Teen-Sex-Ed.pdf
(4) Women’s Health STATS & FACTS 2011. American Congress of Obstetricians and Gynecologists. p. 2. https://www.acog.org/~/media/NewsRoom/MediaKit.pdf
(5) NARAL Pro-Choice America: Discriminatory Bans on Abortion Funding Threaten Women’s Health http://www.prochoiceamerica.org/media/fact-sheets/abortion-funding-restrictions.pdf
(6) “Abortion and Young People in the United States.” Advocates for Youth. Accessed at: http://www.advocatesforyouth.org/publications/publications-a-z/2296-abortion-and-young-people-in-the-united-states.
(7) Norris, Alison, et. al. “Abortion Stigma: A Reconceptualization of Constituents, Causes, and Consequences.” Women’s Health Issues. May-June 2011. Volume 21, Issue 3, Supplement, pp. S49–S54. Accessed at http://www.guttmacher.org/pubs/journals/Abortion-Stigma.pdf.