Published Work: Abortion

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Enacted Abortion Stigma in the United States

Cowan, Sarah K

Published in Social Science and Medicine 177:259-268 (2017)
Rationale: Abortion is a common medical procedure at the center of political debate. Yet, abortion stigma at the individual level is under-researched; the nascent research on abortion stigma has not yet documented experienced (enacted) stigma instead capturing anticipated or internalized stigma.
Objective: This study documents how women and men who disclosed abortions perceived others’ reactions and determinants of those perceptions.
Method: The study uses the American Miscarriage and Abortion Communication Survey, a survey representative of American-resident adults. Data from the sub-sample who had personal experience with abortion were analyzed (total sample, N = 1640; abortion disclosure sub-sample, n = 179). The survey captured each disclosure of the most recent abortion. Respondents had eight possible choices for articulating how the listener reacted. Cluster analyses grouped these reactions. Multinomial logistic regression identified predictors of the perceived reactions. Ordinal logistic regression revealed which disclosers perceived exclusively negative reactions, exclusively positive reactions, and a mix of negative and positive reactions.
Results: Each disclosure fell into one of three clusters: negative reaction, supportive reaction or sympathetic reaction. The majority of abortion disclosures received largely positive reactions (32.6% were characterized as supportive and 40.6% were characterized as sympathetic). A substantial minority of disclosures received a negative reaction (26.8%). The perceived valence of the reaction is predicted, in part, by to whom the disclosure was made and why. Across all their disclosures, most people disclosing an abortion history perceived only positive reactions (58.3%). A substantial minority of people perceived either exclusively negative reactions (7.6%) or a mix of negative and positive reactions (34.1%). Ordinal logistic regression (with people as the unit of analysis) showed perceived reactions are predicted by the number of disclosures made and the revealer’s race and income.
Conclusion: Whereas most people disclosing an abortion received support or sympathy, a substantial minority received stigmatizing reactions, which plausibly negatively impact on health.

This research was covered in Glamour.

Category: Abortion, Stigma

Alternative Estimates of Lifetime Prevalence Of Abortion from Indirect Survey Questioning Methods

Cowan, Sarah K., Lawrence Wu, Susanna Makela*, Paula England

Published in Perspectives on Sexual and Reproductive Health48: 229–234 (2016)
Abortion is a frequent medical procedure undergone by diverse women in the United States with profound demographic and political implications yet we do not know how many American women alive today have had abortions. We do not know this basic fact because women under-report their abortion histories in surveys. There are a number of well-established techniques to elicit more accurate survey responses to sensitive items. In this comment, we propose that lifetime prevalence estimates for abortion in the United States could be improved through use of these techniques, in particular the double list experiment. We report on a pilot double list experiment we conducted which shows promising results. We also provide unique formulae for determining the appropriate sample sizes needed to detect that the double list experiment has improved accuracy of estimates over those obtained from asking women directly whether they have had an abortion.

Category: Abortion, Measurement

Secrets and Misperceptions: The Creation of Self-Fulfilling Illusions

Cowan, Sarah K.

Published in Sociological Science 1: 466-492 (2014)
This study examines who hears what secrets, comparing two similar secrets — one which is highly stigmatized and one which is less so. Using a unique survey representative of American adults and intake forms from a medical clinic, I document marked differences in who hears these secrets. People who are sympathetic to the stigmatizing secret are more likely to hear of it than those who may react negatively. This is a consequence not just of people selectively disclosing their own secrets but selectively sharing others’ as well. As a result, people in the same social network will be exposed to and influenced by different information about those they know and hence experience that network differently. When people effectively exist in networks tailored by others to not offend then the information they hear tends to be that of which they already approve. Were they to hear secrets they disapprove of then their attitudes might change but they are less likely to hear those secrets. As such, the patterns of secret-hearing contribute to a stasis in public opinion.

This research has been covered by The New York Times, Salon, National Public Radio, RH Reality Check , Daily Kos (twice — see the more recent one here), LifeSite, Minnesota Post, The New Republic, The Daily Beast, Huffington Post, PSMag and ThinkProgress among other news sources.

This research won the Robert K. Merton Prize for Analytical Sociology from the International Network of Analytical Sociologists, and the Honorable Mention for Best Paper from the Communication, Information Technologies and Media section of the American Sociological Association.

Category: Abortion, Secrets, Social Networks

Cohort Abortion Measures for the United States

Cowan, Sarah K.

Published in Population and Development Review 39(2):289–307 (2013)
Demographers interested in abortion in the United States have thus far focused on cross-sectional and synthetic cohort measures, due to data availability. We now have cohorts that have completed their entire reproductive years after the Roe v. Wade decision legalizing abortion nationwide. For women who are in the midst of their childbearing years at the conclusion of data collection, I apply the Lee-Carter forecasting technique – its first application in abortion research – to complete their age-specific abortion rates. Using true cohort measures reveals markedly different abortion experiences by cohort. I find stasis in the distribution of abortion by abortion order and the racial composition of abortion incidences. In addition to the substantive findings, cohort measures shift the focus of quantitative abortion research from incidence rates to women’s lives over their reproductive years.

Category: Abortion, Measurement