Can Storytelling Help Destroy Abortion Stigma?

Last year was dubbed “the year of the abortion story.” Though these narratives have changed some hearts and minds, dismantling abortion stigma won’t happen overnight. And it certainly won’t ensure reproductive freedom for all.
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Last year was dubbed “the year of the abortion story.” Though these narratives have changed some hearts and minds, dismantling abortion stigma won’t happen overnight. And it certainly won’t ensure reproductive freedom for all.
(Photo: jennfarr/Flickr)

(Photo: jennfarr/Flickr)

One of the first pieces I ever wrote on the Internet was about my abortion—or rather, my experience talking about it. The procedure itself was unremarkable—emotionally and logistically as easy as they come—but I was surprised to experience the silence surrounding the choice first-hand, to feel the reach of the long tentacles of stigma even in my pro-choice bubble. “No matter how many legal battles are won,” I concluded with a young blogger’s certainty, “until we can talk about our experiences with abortion, it will remain stigmatized, inaccessible to many women, and constantly under threat.”

In the more than five years since I wrote that post, we have certainly been talking more. We’ve blogged, hashtagged, live-tweeted, filmed, and uploaded our abortion stories. Last year alone, multiple state legislators, hip-hop star Nicki Minaj, and dozens of ordinary women spoke out about their experiences ending a pregnancy—everywhere from the Guardian to Glamour. The 1 in 3 Campaign held the first-ever online abortion speak-out, an eight-hour affair in which more than 100 people participated. And as 2014 came to a close, the “pro-voice” organization Exhale hailed it as “the year of the abortion story.”

I was surprised to experience the silence surrounding the choice first-hand, to feel the reach of the long tentacles of stigma even in my pro-choice bubble. 

While people have many different reasons for sharing their abortion experiences—publicly and privately—much of the online storytelling in recent years has been motivated by a hope that it will both help de-stigmatize what is a very common procedure and, ultimately, lead to more widespread support for abortion rights. It’s a hope that got a small boost just last week when Representative Tim Ryan announced that, after 14 years in office as an anti-choice Democrat, his thinking has changed. “I have sat with women from Ohio and across the nation and heard them talk about their varying experiences: abusive relationships, financial hardship, health scares, rape and incest,” he wrote in an op-ed in the Akron Beacon Journal. “These women gave me a better understanding of how complex and difficult certain situations can become.”

Meanwhile, a parallel interest in abortion stigma has taken off in the social science realm. Though it is still an under-theorized and under-studied topic, the emerging research provides reason for optimism about the recent increase in public abortion storytelling. But experts also warn that abortion stigma—the shared cultural understanding that the procedure is socially unacceptable—is a tricky nut to crack; dismantling it will likely require a long-term, multi-pronged effort. And, even then, ending stigma probably won’t fix everything that keeps abortion “inaccessible to many women, and constantly under threat.”

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Though the research is still in its infancy, you don’t need many studies to grasp one of abortion stigma’s most vexing characteristics for those hoping to dismantle it: It’s stubbornly self-perpetuating. In the most simplistic telling of this dynamic, stigma breeds silence, which breeds more stigma. 

The reality is slightly more complicated but no less challenging: Most people don’t keep their abortions completely secret from family and friends, but they do tend to avoid telling those they suspect will be judgmental. For individuals, this is an understandable response to stigma—and often seems to be a good strategy for dealing with it. A 1990 study found that while social support is generally helpful after having an abortion, sharing the story can also be a major risk. When women told loved ones who were even just a tiny bit unsupportive of their choice, it negatively affected them even more than not telling anyone at all. 

"Selective disclosure" is what enables nearly 40 percent of the public to claim they don’t know anyone who has had an abortion, even though one third of American women have had one by age 45. 

On the community level, though, “selective disclosure” is what enables nearly 40 percent of the public to claim they don’t know anyone who has had an abortion, even though one third of American women have had one by age 45. As a 2013 paper put it: “The collective social silence around abortion is, in part, an unintended consequence of successful individual stigma management.”

An enduring perception gap between pro-choice and anti-choice Americans is another unintended consequence, as a recent New York University study demonstrated. Those who believe abortion should be illegal were 21 percent less likely than pro-choice Americans to have heard—either first- or second-hand—that someone they knew had had one. This is a discrepancy that’s unlikely to be due to any difference in the actual prevalence of the procedure within these social networks. Theoretically, the causal arrow could point in either direction—that is, perhaps people learned that their friend, aunt, or colleague had an abortion and consequently became more pro-choice. But given that Americans’ opinions on abortion rights very rarely change over time, the study concludes that it’s probably the reverse: Our pre-existing views determine the secrets we’re told, enabling those who oppose abortion to hold onto the “self-fulfilling illusion” that the “one in three” aren’t women they know. This dynamic, the study concludes, may help explain “the relative stability in public opinion on abortion over the past 30 years.”

If the NYU study underscores how the status quo tends toward stasis, it also shows why pro-choice advocates are so interested in the potential power of abortion storytelling. What would happen if, somehow, the illusion were shattered? “If it is the case that some people who are opposed to abortion rights would be swayed to become more supportive of abortion rights if they heard that their mother, their sister, their cousin, or their fellow parishioner had had an abortion—there’s this potential for opinion change that’s not happening right now,” the study’s author, Sarah K. Cowan, explained to ThinkProgress.

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At this point, that’s still an “if.” But there’s certainly a sound theoretical basis in the research for believing it might. “Contact theory,” developed by psychologist Gordon Allport back in the 1950s, posits that direct personal contact with a stigmatized minority can reduce prejudice over time—particularly under certain optimal circumstances. Initially applied to combat racial or ethnic animosity, it’s since proven successful across a wide range of groups. Though it’s difficult to account for the natural selection bias on a societal level, some see evidence of contact theory-in-action lurking behind the relatively rapid transformation in homophobic attitudes over the past few decades. Polling shows that support for gay rights and the proportion of Americans who say they know an LGBTQ person has risen in tandem, and a third of those who have changed their mind on same-sex marriage specifically credit the fact that they know someone who’s gay. In small-scale interventions, contact theory has also been employed to reduce the stigma around other health experiences, in particular HIV/AIDS and mental illnesses.

“Contact theory,” developed by psychologist Gordon Allport back in the 1950s, posits that direct personal contact with a stigmatized minority can reduce prejudice over time.

The pioneers working in the emerging field of abortion stigma research are attempting to draw lessons from these other realms, while keeping in mind that they likely can’t be directly applied to abortion stigma. “That literature is extremely rich and helpful, but we have to be cognizant of the real differences between the issues,” says Anu Kumar, executive vice president for the international reproductive health and rights organization Ipas. She recently penned a provocative article on RH Reality Check suggesting that the pro-choice movement may be putting too much stock in storytelling as an abortion stigma mitigation strategy. “At Ipas we’re working on other strategies right now, but I’m really interested in learning from the data others are gathering,” she says.

Others have begun the work of testing it. The organization Sea Change, founded in 2014 to transform the culture of stigma around abortion, has put contact theory at the center of its “theory of change.” “We can’t copy-and-paste from other movements,” agrees Steph Herold, Sea Change’s deputy director. “But there’s so much to learn from other fields. We want to adapt it in the most intentional, targeted, evidence-based ways for creating the long-term change we want to see.”

The data is starting to trickle in. Sea Change did a small pilot study in 2012 (which will be described in a forthcoming academic paper) in which more than a dozen book clubs across the country discussed an anthology of non-fiction pregnancy stories. In most groups, at least one participant who’d had an abortion shared her own story, often for the first time, as part of the discussion. Surveys before and after the meetings revealed a shift in support for abortion—with the greatest change among those who’d previously held the most negative attitudes. And late last year, preliminary results from an intriguing University of California-Los Angeles study found that in-person conversations with a political canvasser were able to increase support for legal abortion by 10 percent. Mirroring the researchers’ previous results using LGBTQ canvassers to change minds on same-sex marriage, the canvassers who disclosed their own abortion experiences achieved the most lasting impact on voters’ views.

Still, there are some key limitations in using storytelling as a strategy for reducing abortion stigma population-wide. For one thing, the research on contact theory shows that personal storytelling is most potentially transformative. The disclosure of a stigmatizing experience is especially likely to reduce prejudice when it takes place face-to-face and within a pre-existing and close relationship between individuals of equal status. It also helps if the storyteller and listener come from the same culture and share a similar background. Part of what helps change attitudes, Herold explains, is realizing “that this person that’s exactly like them has had this experience.” A blog post or YouTube video by a stranger on the Internet? As much as I like to flatter myself by thinking that I’ve changed a few anti-choice minds, that’s likely far less powerful.

Of course, in an age in which our “IRL” and online lives are intertwined, telling your abortion story “publicly” on the Internet usually involves outing yourself to personal friends and family on Facebook too. Still, the fact is your story is far more likely to change the mind of, say, your pro-life cousin than it is to transform strangers who stumbled across it in an article in Cosmo. This points to a real scalability problem. The UCLA study is particularly encouraging because it suggests that people’s views can change even after hearing the abortion story of a stranger who just showed up unexpectedly at their front door. Even so, if we’re relying on an army of canvassers going door to door, Kumar says, “it’s going to be incredibly challenging to reach the 300 million plus Americans out there.”

That’s why it would be nice if public storytelling could be a meaningful replacement for more intimate, one-on-one disclosures. And just because it might not be doesn’t mean it’s not valuable for other reasons. Most obviously, storytelling can play a helpful role in pro-choice advocacy by putting a real human face to the consequences of anti-choice laws. As writer Monica Heisey recently put it in a Gawker piece on her own abortion: “It is easier to give away the reproductive rights of an abstract idea.”

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It’s also clear that public storytelling has been critical in treating some of the side effects of stigma. Since frank discussion of the procedure itself is rare and misinformation runs rampant, some online stories in recent years have simply helped de-mystify it. Emily Letts, who filmed herself having a surgical abortion, and Angie Jackson, who filmed herself having a medical one, both explained that they wanted to show that the procedures are not that scary. A recent survey of public abortion storytellers conducted by Sea Change found that 41 percent decided to share their story in order to reveal a new narrative about the choice. By claiming the right to feel good about their abortion experiences, some have challenged the way stigma puts pressure on people to, in Letts’ words, “feel guilty for not feeling guilty.” Others have carved out space to talk about them with a nuance and an emotional complexity that the polarized political debate shuts out.

When reproductive justice activist Renee Bracey Sherman began telling her abortion story publicly, the responses she received revealed just how important visibility itself can be. “I can’t tell you how many times I’ve heard from people who say, ‘I thought I was the only one until I saw your story on the Internet,’” she says. “I get messages from people saying, ‘I’m having an abortion this weekend and I was Googling online and I found your story, and it’s making me feel like I can do this.’ Or saying, ‘Can you tell me I’m a good person?’” And though curbing the shame and isolation felt by many of the one million-plus women who have an abortion in the United States each year is a service in and of itself, this increased visibility in the public sphere can also have a trickle-down effect—empowering others to disclose their abortions, too, even just to a few close friends.

“There’s this tendency to say, ‘Tell your story and reduce abortion stigma,’ as if you’re not supportive of reproductive rights if you don’t tell your story.”

But this brings up another inherent tension that can sometimes seem like an intractable chicken-and-egg dilemma: More stories may help change the culture but until the culture changes, telling your story can carry real risks. Calling for individuals to disclose their abortions to the very people in their lives who are most likely to condemn them for it is not just unrealistic but ethically problematic. Most pro-choice advocates are careful not to do that, instead applauding those who choose to speak out, while emphasizing that no one should feel obligated to, in any context, if they’re not comfortable.

But Kumar worries that the focus on storytelling puts too much of the implicit burden on individuals. “There’s this tendency to say, ‘Tell your story and reduce abortion stigma,’ as if you’re not supportive of reproductive rights if you don’t tell your story,” she explains. “Yes, we should be able to talk about it. But we should also not have to talk about it.” As feminist writer Jessica Valenti wrote after Wendy Davis disclosed her abortions in her memoir, “It’s shameful that we have to lay bare our reproductive lives just so others can–maybe, if we’re lucky–view us as full people.” (That’s one reason I’ve been excited by the potential of fictional abortion stories, like the recent rom-com Obvious Child, to provide some of the same opportunities for identification and empathy that non-fictional ones can, without subjecting a real person to judgment.)

In recognition of this, Sea Change has put much thought into what conditions must be present to ensure that sharing an abortion story is a positive experience for the teller, not just potentially mind-opening for the listener. Its theory of change emphasizes the importance of cultivating protected spaces—say, an online forum, listserv, or in-person support group—for people who’ve had abortions to connect with each other so that they have a support network before they share their stories more broadly in the media, the policy realm, or their communities. “It’s not really responsible to push people out into the open without any support at all,” Herold explains. They’re also working on developing concrete guidance for the “two in three”—people who know someone who has had an abortion—and for organizations that want to support public storytellers. “Everyone has a role in reducing abortion stigma,” she says. 

Bracey Sherman, too, has been thinking about how to shift the pressure off of storytellers and onto those doing the stigmatizing. She argues that the climate that makes talking about your abortion so hard can be shifted, to some extent, without a wholesale change in anti-choice views. “There are people who are totally supportive of abortion rights and when someone tells them their abortion story, they just freeze up and don’t know what to say,” she explains. “That’s not an issue around abortion itself—it’s an issue of being comfortable with someone else’s vulnerability.”

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But if, as Herold says, “everyone has a role in reducing abortion stigma,” it’s also important to remember that everything plays a role in reinforcing it. “It’s not just the individual level that is in operation when a woman feels stigma. It is also the level of mass media and culture and the institutional level and the political level—and these are all linked,” Kumar says. Even if interpersonal stigma is significantly reduced by storytelling, “it’s not going to be sufficient because the political structures are still going to remain in place.”

In fact, abortion stigma may be as much a consequence as it is cause of the restrictions put on the procedure, Kumar argues. And in the U.S., those restrictions are as rooted in structural inequalities across gender, race, class, and age as they are in the social disapproval of abortion, per se. These inequalities affect how we experience the stigma around the choice. For example, writer Tasha Fierce noted recently, “For White women in American society, the shame of having an abortion is mainly centered on their individual behavior. For Black women, our behavior reflects on Black folks as a whole.” And they also determine which of us face actual discrimination. After all, while everyone who gets an abortion—even a white, middle-class 20-something living in Brooklyn like me—may feel stigma, only some of us come up against real barriers to exercising our reproductive rights.

In fact, abortion stigma may be as much a consequence as it is cause of the restrictions put on the procedure, Kumar argues. And in the U.S., those restrictions are as rooted in structural inequalities across gender, race, class, and age as they are in the social disapproval of abortion, per se.

Some policies, like the Hyde Amendment that prohibits abortion coverage under Medicaid or the parental consent laws that force teens to beg for permission to end their pregnancies from a judge, are blatantly discriminatory. And as clinics are forced to close and more than half of American women now live in areas of the country that are “hostile” to abortion rights, it is inevitably the most privileged who have the time, money, and resources needed to clear the logistical hurdles. “For the women I work with it is not enough to talk about removing stigma and judgment,” Monica Simpson, executive director of the reproductive justice organization SisterSong, told RH Reality Check recently. “Folks still won’t have access because of economic instability. They still won’t have the ability to get the same treatment because of the color of their skin.”

Here, too, though, storytelling can be powerful. “Stories can illustrate those structural problems in digestible ways that people can understand that don’t sound like talking points or policy wonks,” Herold says. But, as Bracey Sherman argued recently, that requires us to listen beyond the conventional facts of the abortion itself. “When storytellers share their whole story, then, they’re able to tell us the role low wages, jobs without health insurance, racism, gender discrimination, and lack of access to food and child care may have played in their abortion experience,” she wrote.

Actually hearing—and, just as importantly, responding to—the “whole story” often calls for empathy across not just one but many of the axes that divide us. It demands a shift far deeper than the one that contact theory promises: a realization that not only do people “exactly like you” have abortions but also that people very unlike you do too—and they are no less deserving of the freedom to do so with safety and dignity. And, finally, it requires shattering another deeply held American illusion: that such freedom is currently extended to us all.

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