Exploring stigma and social norms in women’s abortion experiences and their expectations of care
Outcomes: Gender‑Based Violence, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Abortion stigma is deeply intertwined with social norms around female sexuality, marriage, and motherhood. In both Kenya and India, community disapproval and cultural taboos contribute to secrecy, fear, and delayed care-seeking. Interventions must address these norms by promoting respectful, youth-friendly, and rights-based services. Ensuring privacy, providing accurate information, and challenging harmful expectations are essential to reducing stigma and expanding safe abortion access.
Objectives This qualitative study aimed to understand how stigma and social norms shape women’s abortion experiences and their expectations of care in Kenya and India. The research explored the role of social expectations, fears, secrecy, and perceived judgement on women’s attitudes toward abortion and their interactions with healthcare providers.
Methods Researchers conducted 34 in-depth interviews and two focus group discussions with 45 women aged 18–46 who had obtained abortions at clinics or private providers in Kenya and India. Participants were recruited inpartnership with Family Health Options Kenya(FHOK) in Thika and Eldoret in Kenya and with Family Planning Association of India (FPAI) in the Thane district of Maharashtra state in India. Thematic analysis of transcripts was guided by the individual-level abortion stigma framework and the theory of normative conduct. Data were coded and analyzed using a combined approach to highlight common experiences across both countries.
Results Participants in both countries reported limited knowledge about abortion before seeking care, and most feared negative health outcomes or being judged. Many expressed internalized stigma, associating abortion with immorality or sin, and worried about confidentiality. Fears were compounded by community disapproval, religious beliefs, and concerns about sanctions, especially for young or unmarried women. Despite these concerns, most women had better-than-expected experiences, particularly at non-profit clinics where they were treated respectfully. However, they continued to fear being judged by peers or providers, and often kept their abortion secret. Women in Kenya emphasized judgment based on age, while Indian participants highlighted marital status as a key factor in how they believed they would be treated.
Conclusions Stigma and social norms significantly influence how women perceive and experience abortion care. Fear of community judgement, low expectations of providers, and misinformation create barriers to timely and safe services. Although participants in this study ultimately accessed care, many encountered psychological and social hurdles that could deter others. Improving services requires acknowledging these challenges, especially for vulnerable groups like younger or unmarried women.
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