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Commentary: Imagine a World Without Abortion Stigma a
Kate Cockrill MPH a
Sea Change Program, Oakland, California, USA Accepted author version posted online: 25 Jul 2014.Published online: 25 Sep 2014.
Click for updates To cite this article: Kate Cockrill MPH (2014) Commentary: Imagine a World Without Abortion Stigma, Women & Health, 54:7, 662-665, DOI: 10.1080/03630242.2014.919986 To link to this article: http://dx.doi.org/10.1080/03630242.2014.919986
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
Women & Health, 54:662–665, 2014 Copyright © Taylor & Francis Group, LLC ISSN: 0363-0242 print/1541-0331 online DOI: 10.1080/03630242.2014.919986
Downloaded by [University of Colorado at Boulder Libraries] at 19:42 30 December 2014
Commentary: Imagine a World Without Abortion Stigma KATE COCKRILL, MPH Sea Change Program, Oakland, California, USA
This commentary explores what a world without abortion stigma might look like at the individual, community and institutional level. The article further articulates the need for interdisciplinary collaboration for developing a vision, research agenda, and intervention strategy for change. KEYWORDS
abortion, stigma, culture, women, health
Imagine a world without abortion stigma. What does it look like? Early on, gay rights activists identified “pride” as the opposite of sexual stigma. Fat activists and health experts have argued for “fat positivity” and “health at every size” to combat stigma and bias for those who are overweight. Are these terms “positivity,” “pride,” and “neutrality” relevant to a world without abortion stigma? If not, what terms are? Some recognizable slogans in the abortion rights movement express possible visions, such as “abortion, on demand, without apology” or “abortion should be safe, legal, and rare.” However, many feel that the phrase “abortion, on demand, without apology” is too strident and leaves little room for complexity, while “abortion should be safe, legal, and rare,” comes across as both apologetic and judgmental. Recently, Planned Parenthood Federation of America, a visible abortion service provider and advocacy group, has publicly distanced themselves from the term “pro-choice” and started a campaign called “not in her shoes.” This campaign asks us to visualize both women who have abortions and their circumstances and is a big step in moving forward a culture of non-judgment around abortion decisions. But is tolerance the best we can do?
Received February 19, 2014; accepted February 20, 2014. Address correspondence to Kate Cockrill, MPH, Sea Change Program (a project of the Tides Center), 436 14th Street, 5th Floor, Oakland, CA 94612. E-mail: kate@seachange program.org
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Imagine a World Without Abortion Stigma
663
In developing a vision for what a world without abortion stigma could be, it is useful to consider what is known about abortion stigma. Abortion stigma is a latent variable. In other words, it cannot be directly observed but is inferred through the presence of other observable factors. For example, abortion stigma can be observed at the individual level by measuring worries about the judgment by others, isolation, self-judgment (such as shame), and perceptions of community condemnation (Cockrill et al., 2013). Abortion stigma can be measured in law and policy by the presence of laws that discriminate against abortion providers, intentionally shame women who seek abortions, or criminalize or create barriers to abortion access (Kumar, Hessini, & Mitchell, 2009). Finally, abortion stigma might be measured in our culture through observations of stereotypes in media representations, the polarization of our electorate, and abortion’s absence from normal reproductive discourse (including sexuality education). The “opposite of stigma” is likely to be another latent variable, only observable through the presence of other factors. But what might those factors be? Below are a few ideas. 1. Connection. Brene Brown, a professor of social work who has conducted research on shame and disconnection in US culture, described connection as “the energy that exists between people when they feel seen, heard, and valued; when they can give and receive without judgment; and when they derive sustenance and strength from the relationship”(Brown, 2010). Though connection described as energy may not be directly observable, elements of Brown’s description are: social support, validation, and the ability to share freely one’s experience. We can imagine a world in which abortion stigma and shame do not taint the relationships of people with abortion experiences or abortion providers. People might talk regularly about their abortion experiences with co-workers, friends, and family members in the way they share their birth stories, adoption stories, and experiences with infertility and/or pregnancy loss. Abortion providers would freely discuss their work without fear of reproach or discomfort from family, friends, and/or society at large. 2. Visibility. We can also imagine a world in which media, online networks, and in-person community interaction raise the visibility of abortion experience. We can envision a media that depolarizes, normalizes, and debunks stereotypes about abortion. Diverse stories featuring experiences with abortion would appear on regularly scripted and reality television, representing the complexity of abortion in reproduction and family life. Networks would not fear reprisals related to abortion coverage, such as boycotts or sponsor cancellations. On the whole, the media pieces about abortion would be educational and relationship-oriented rather than sensational. Imagine a Cosmopolitan feature story: “10 things you can do to care for yourself after an abortion” or a character on The New Girl
Downloaded by [University of Colorado at Boulder Libraries] at 19:42 30 December 2014
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K. Cockrill
who has an abortion and is surrounded by supportive friends. We can imagine a world in which multiple online networks connect women and men with abortion experience across counties, states, and nations to share stories and offer support. These networks would reduce the fear of harassment that women, men, and abortion providers feel and reward risk-taking behaviors that give visibility to a personal experience. Finally, in-person interactions in book clubs, sororities, and religious communities would include conversations about abortion, allowing people without experience in abortion to hear the stories of their friends and neighbors. 3. Integration. We will know that abortion is destigmatized when abortion care is fully integrated into the health care systems globally. This integration would include the presence of strong referral networks that enable women to make health decisions, the inclusion of abortion services into broader reproductive health care, and implementation of laws that reduce emotional harm and facilitate positive health outcomes for women. In a world without abortion stigma, the distinction between health care providers and “abortion providers” would have clinical but not social relevance. Pregnancy centers and health hotlines would provide patientcentered, unbiased referrals to abortion care, prenatal care, and social services for adoption and parenting. The regulatory framework around pregnancy would be based on the principles of reproductive justice: supporting the right to make pregnancy decisions and enabling people and their families to have the care and support to realize those decisions. 4. Peace. The social/political conflict over abortion is highly visible and present in most cultures and regions of the world. Is it hopeless to envision a world without stigma when such entrenched religious, social, and political conflicts exist around abortion? The negative patterns of social conflict—such speaking only with certainty, refusing to engage with “the enemy,” using demonizing language, and framing abortion in us versus them terms—produce many of the same results as stigma. Therefore, a world without abortion stigma is one in which we neither ignore nor give authority to conflicting beliefs about abortion. Instead, we must build our capacity to accept conflict over abortion as normal and engage in conflict constructively and productively. When we treat our differences—and one another—with a degree of wonder, respect, and humility, we reduce stigma. Mapping a shared vision for a world free of abortion stigma requires a diverse set of cartographers. A shared vision might draw on the insights of social scientists, theologians, practitioners of conflict transformation, artists, advocates for health, rights and justice, and community members who are affected by abortion stigma. Reducing stigma requires a set of visionaries who are willing to engage in the possibilities and the pain involved in social change and to work together to chart a course for a stigma-free future.
Imagine a World Without Abortion Stigma
665
REFERENCES
Downloaded by [University of Colorado at Boulder Libraries] at 19:42 30 December 2014
Brown, B. 2010. The gifts of imperfection. Center City: Hazelden. Cockrill, K., U. Upadhyay, J. Turan, and D. Foster. 2013. The stigma of having an abortion: Development of a scale and characteristics of women experiencing abortion stigma. Perspect Sexual Reprod Health 45(2):79–88. doi:10.1363/4507913 Kumar, A., L. Hessini, and E. M. Mitchell. 2009. Conceptualising abortion stigma. Culture, Health & Sexuality 11(6):625–39.
Women & Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wwah20
Commentary: Imagine a World Without Abortion Stigma a
Kate Cockrill MPH a
Sea Change Program, Oakland, California, USA Accepted author version posted online: 25 Jul 2014.Published online: 25 Sep 2014.
Click for updates To cite this article: Kate Cockrill MPH (2014) Commentary: Imagine a World Without Abortion Stigma, Women & Health, 54:7, 662-665, DOI: 10.1080/03630242.2014.919986 To link to this article: http://dx.doi.org/10.1080/03630242.2014.919986
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
Women & Health, 54:662–665, 2014 Copyright © Taylor & Francis Group, LLC ISSN: 0363-0242 print/1541-0331 online DOI: 10.1080/03630242.2014.919986
Downloaded by [University of Colorado at Boulder Libraries] at 19:42 30 December 2014
Commentary: Imagine a World Without Abortion Stigma KATE COCKRILL, MPH Sea Change Program, Oakland, California, USA
This commentary explores what a world without abortion stigma might look like at the individual, community and institutional level. The article further articulates the need for interdisciplinary collaboration for developing a vision, research agenda, and intervention strategy for change. KEYWORDS
abortion, stigma, culture, women, health
Imagine a world without abortion stigma. What does it look like? Early on, gay rights activists identified “pride” as the opposite of sexual stigma. Fat activists and health experts have argued for “fat positivity” and “health at every size” to combat stigma and bias for those who are overweight. Are these terms “positivity,” “pride,” and “neutrality” relevant to a world without abortion stigma? If not, what terms are? Some recognizable slogans in the abortion rights movement express possible visions, such as “abortion, on demand, without apology” or “abortion should be safe, legal, and rare.” However, many feel that the phrase “abortion, on demand, without apology” is too strident and leaves little room for complexity, while “abortion should be safe, legal, and rare,” comes across as both apologetic and judgmental. Recently, Planned Parenthood Federation of America, a visible abortion service provider and advocacy group, has publicly distanced themselves from the term “pro-choice” and started a campaign called “not in her shoes.” This campaign asks us to visualize both women who have abortions and their circumstances and is a big step in moving forward a culture of non-judgment around abortion decisions. But is tolerance the best we can do?
Received February 19, 2014; accepted February 20, 2014. Address correspondence to Kate Cockrill, MPH, Sea Change Program (a project of the Tides Center), 436 14th Street, 5th Floor, Oakland, CA 94612. E-mail: kate@seachange program.org
662
Downloaded by [University of Colorado at Boulder Libraries] at 19:42 30 December 2014
Imagine a World Without Abortion Stigma
663
In developing a vision for what a world without abortion stigma could be, it is useful to consider what is known about abortion stigma. Abortion stigma is a latent variable. In other words, it cannot be directly observed but is inferred through the presence of other observable factors. For example, abortion stigma can be observed at the individual level by measuring worries about the judgment by others, isolation, self-judgment (such as shame), and perceptions of community condemnation (Cockrill et al., 2013). Abortion stigma can be measured in law and policy by the presence of laws that discriminate against abortion providers, intentionally shame women who seek abortions, or criminalize or create barriers to abortion access (Kumar, Hessini, & Mitchell, 2009). Finally, abortion stigma might be measured in our culture through observations of stereotypes in media representations, the polarization of our electorate, and abortion’s absence from normal reproductive discourse (including sexuality education). The “opposite of stigma” is likely to be another latent variable, only observable through the presence of other factors. But what might those factors be? Below are a few ideas. 1. Connection. Brene Brown, a professor of social work who has conducted research on shame and disconnection in US culture, described connection as “the energy that exists between people when they feel seen, heard, and valued; when they can give and receive without judgment; and when they derive sustenance and strength from the relationship”(Brown, 2010). Though connection described as energy may not be directly observable, elements of Brown’s description are: social support, validation, and the ability to share freely one’s experience. We can imagine a world in which abortion stigma and shame do not taint the relationships of people with abortion experiences or abortion providers. People might talk regularly about their abortion experiences with co-workers, friends, and family members in the way they share their birth stories, adoption stories, and experiences with infertility and/or pregnancy loss. Abortion providers would freely discuss their work without fear of reproach or discomfort from family, friends, and/or society at large. 2. Visibility. We can also imagine a world in which media, online networks, and in-person community interaction raise the visibility of abortion experience. We can envision a media that depolarizes, normalizes, and debunks stereotypes about abortion. Diverse stories featuring experiences with abortion would appear on regularly scripted and reality television, representing the complexity of abortion in reproduction and family life. Networks would not fear reprisals related to abortion coverage, such as boycotts or sponsor cancellations. On the whole, the media pieces about abortion would be educational and relationship-oriented rather than sensational. Imagine a Cosmopolitan feature story: “10 things you can do to care for yourself after an abortion” or a character on The New Girl
Downloaded by [University of Colorado at Boulder Libraries] at 19:42 30 December 2014
664
K. Cockrill
who has an abortion and is surrounded by supportive friends. We can imagine a world in which multiple online networks connect women and men with abortion experience across counties, states, and nations to share stories and offer support. These networks would reduce the fear of harassment that women, men, and abortion providers feel and reward risk-taking behaviors that give visibility to a personal experience. Finally, in-person interactions in book clubs, sororities, and religious communities would include conversations about abortion, allowing people without experience in abortion to hear the stories of their friends and neighbors. 3. Integration. We will know that abortion is destigmatized when abortion care is fully integrated into the health care systems globally. This integration would include the presence of strong referral networks that enable women to make health decisions, the inclusion of abortion services into broader reproductive health care, and implementation of laws that reduce emotional harm and facilitate positive health outcomes for women. In a world without abortion stigma, the distinction between health care providers and “abortion providers” would have clinical but not social relevance. Pregnancy centers and health hotlines would provide patientcentered, unbiased referrals to abortion care, prenatal care, and social services for adoption and parenting. The regulatory framework around pregnancy would be based on the principles of reproductive justice: supporting the right to make pregnancy decisions and enabling people and their families to have the care and support to realize those decisions. 4. Peace. The social/political conflict over abortion is highly visible and present in most cultures and regions of the world. Is it hopeless to envision a world without stigma when such entrenched religious, social, and political conflicts exist around abortion? The negative patterns of social conflict—such speaking only with certainty, refusing to engage with “the enemy,” using demonizing language, and framing abortion in us versus them terms—produce many of the same results as stigma. Therefore, a world without abortion stigma is one in which we neither ignore nor give authority to conflicting beliefs about abortion. Instead, we must build our capacity to accept conflict over abortion as normal and engage in conflict constructively and productively. When we treat our differences—and one another—with a degree of wonder, respect, and humility, we reduce stigma. Mapping a shared vision for a world free of abortion stigma requires a diverse set of cartographers. A shared vision might draw on the insights of social scientists, theologians, practitioners of conflict transformation, artists, advocates for health, rights and justice, and community members who are affected by abortion stigma. Reducing stigma requires a set of visionaries who are willing to engage in the possibilities and the pain involved in social change and to work together to chart a course for a stigma-free future.
Imagine a World Without Abortion Stigma
665
REFERENCES
Downloaded by [University of Colorado at Boulder Libraries] at 19:42 30 December 2014
Brown, B. 2010. The gifts of imperfection. Center City: Hazelden. Cockrill, K., U. Upadhyay, J. Turan, and D. Foster. 2013. The stigma of having an abortion: Development of a scale and characteristics of women experiencing abortion stigma. Perspect Sexual Reprod Health 45(2):79–88. doi:10.1363/4507913 Kumar, A., L. Hessini, and E. M. Mitchell. 2009. Conceptualising abortion stigma. Culture, Health & Sexuality 11(6):625–39.
