Key Social Norms Take-aways Social norms associating abortion with immorality and female promiscuity continue to impose strong stigma on young women. However, rather than being solely constrained by these norms, many women actively resist them, demonstrating self-reliance and confidence. Programs aiming to reduce stigma must focus not only on shifting harmful norms but also on amplifying and supporting women’s existing agency and resilience.

Objectives This study explored how abortion stigma influences young Kenyan women’s experiences in seeking abortion and post-abortion care (PAC) services and how these women navigate stigma through expressions of agency. The goal was to understand how stigma affects their decision-making and access to care in a context where abortion remains highly stigmatized despite legal changes.

Methods Researchers conducted 15 semi-structured in-depth interviews with women aged 18–24 who had recently sought abortion or PAC services at four Marie Stopes Kenya clinics in Nairobi. Participants were recruited on the day of their procedure to maximize recall accuracy. Data were analyzed using grounded theory methods with open coding and thematic analysis, focusing on barriers to care, beliefs about abortion, perceived stigma, and expressions of agency.

Results Participants reported experiencing intense social stigma from religious, cultural, and community sources, leading to feelings of isolation and fear of judgment. Common barriers to care included fear of gossip, judgment from family or community, and internalized moral beliefs against abortion. Nevertheless, many women responded to stigma by asserting their autonomy, prioritizing their own wellbeing, and expressing resilience. Women minimized the importance of external opinions and emphasized that abortion was a private decision. Trust in the confidential and respectful environment at Marie Stopes clinics was critical to overcoming fears of judgment. Participants demonstrated positive coping and decisional confidence, countering assumptions that stigma inevitably leads to negative psychological outcomes.

Conclusions While abortion stigma remains a significant barrier, young Kenyan women showed a strong sense of agency by prioritizing their own health and futures over societal judgment. Findings suggest that even within highly stigmatizing environments, women can and do exercise resilience and empowerment. Interventions should support this agency by creating confidential, stigma-free service environments and reinforcing positive coping strategies.