Stigmatisation in Connection with Abortion: Internalised, Anticipated, and Experienced Dimensions among Women in Germany – A Cross-Sectional Analysis of the ELSA Study

Background: The legal restrictions and moral constraints associated with abortion expedite various forms of stigmatisation. Stigmatisation is potentially associated with considerable psychosocial stress and can impede access to appropriate care. Existing research indicates that social norms – especially expectations around motherhood and “responsible” reproduction – are central drivers of such stigmatisation processes. Objective: The objective of the present study was to quantify the extent of internalised, anticipated, and experienced stigmatisation among women in Germany who have had an abortion, to analyse the relationship between the three forms, and to identify possible influencing factors. Methods: The data was gathered through a survey of 608 women who had aborted an unwanted pregnancy, conducted in the scope of the ELSA study Internalised, anticipated, and experienced stigmatisation was recorded using standardised items. Statistical analysis was conducted using means, indices, and correlational analysis; the potential influence of sociodemographic characteristics was investigated. Findings: 83.5% of respondents reported internalised stigmatisation in the form of feelings of shame and guilt, while 78% reported anticipated stigmatisation. Experienced stigmatisation, in the form of disappointment and condemnation, was rarer. Statistical analysis revealed significant correlations between the three forms of stigmatisation, in particular between internalised and anticipated stigmatisation (p=0.387). Conclusion: Internalised and anticipated stigmatisation are found to be the most prevalent forms, while experienced stigmatisation is rarer. The clear correlation between internalised and anticipated stigmatisation suggests mutual reinforcement processes. Given that sociodemographic characteristics play no role in those two forms, stigmatisation appears to be a universal phenomenon.