Dynamics of stigma in abortion work: Findings from a pilot study of the Providers Share Workshop

Abortion is highly stigmatized in the United States. The consequences of stigma for abortion providers are not well understood, nor are there published accounts of tools to assess or alleviate its burdens. We designed The Providers Share Workshop to address this gap. Providers Share is a six-session workshop in which abortion providers meet to discuss their experiences, guided by an experienced facilitator. Seventeen workers at one US abortion clinic participated in a pilot workshop. Sessions were recorded and transcribed, and an iterative process was used to identify major themes. Participants highlighted stigma, located in cultural discourse, law, politics, communities, institutions (including the abortion clinic itself), and relationships with family, friends and patients. All faced decisions about disclosure of abortion work. Some chose silence, fearing judgment and violence, while others chose disclosure to maintain psychological consistency and be a resource to others. Either approach led to painful interpersonal disconnections. Speaking in the safe space of the Workshop fostered interpersonal connections, and appeared to serve as an effective stigma management tool. Participants reflected favorably upon the experience. We conclude that the Providers Share Workshop may alleviate some of the burdens of abortion stigma, and may be an important intervention in abortion human resources. We present a conceptual model of the dynamics of stigma in abortion work.

► Abortion workers experience stigma in sites ranging from cultural discourse to relationships with family/friends or patients.
► In response to stigmatized work identity, some providers remain silent about their work, while others choose to disclose it.
► Silence and disclosure are continually re-negotiated; however, both strategies bring painful interpersonal disconnections.
► Providers Share Workshop may reduce the burden of stigma for abortion workers by restoring interpersonal connections.
► Abortion provider narratives may help promote more nuanced and revitalized pro-choice discourse.