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Reproductive Health
Published in: Reproductive Health 1/2018

Open Access 01-12-2018 | Research

“It’s something that marks you”: Abortion stigma after decriminalization in Uruguay

Authors: Roosbelinda Cárdenas, Ana Labandera, Sarah E. Baum, Fernanda Chiribao, Ivana Leus, Silvia Avondet, Jennifer Friedman

Published in: Reproductive Health | Issue 1/2018

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Abstract

Background

Abortion stigma is experienced by women seeking abortion services and by abortion providers in a range of legal contexts, including Uruguay, where abortion was decriminalized up to 12 weeks gestation in 2012. This paper analyzes opinions and attitudes of both abortion clients and health professionals approximately two years following decriminalization and assesses how abortion stigma manifests among these individuals and in institutions that provide care.

Methods

In 2014, we conducted twenty in-depth, semi-structured interviews with abortion clients (n = 10) and health care professionals (n = 10) in public and private facilities across Uruguay’s health system. Interviews were recorded, transcribed, and then coded for thematic analysis.

Results

We find that both clients and health professionals express widespread satisfaction with the implementation of the new law. However, there exist critical points in the service where stigmatizing ideas and attitudes continue to be reproduced, such as the required five-day waiting period and in interactions with hospital staff who do not support access to the service. We also document the prevalence of stigmatizing ideas around abortion that continue to circulate outside the clinical setting.

Conclusion

Despite the benefits of decriminalization, abortion clients and health professionals still experience abortion stigma.
Footnotes
1
Hereon after, we will refer to abortion providers as health professionals who participate in abortion services, or simply as health professionals. We do this in order to highlight the broad spectrum of work that these professionals are involved in, rather than pigeonholing their work as simply abortion provision.
 
2
IVE is the acronym for Interrupción Voluntaria del Embarazo (Voluntary Interruption of Pregnancy), which has become a term in its own right in Uruguay, and is often used instead of the word abortion. Accordingly, IVE1, IVE 2, IVE3 and IVE 4 are used to refer to each of the four mandatory clinical visits established by the clinical guides. In this piece, we primarily use the word abortion but have opted to keep IVE when its meaning is not fully captured by the term abortion. In addition, we have used Visit 1, 2, 3, and 4 to substitute for the IVE terminology described above.
 
3
Note that in August 2015, a ruling by the Court of Administrative Disputes overturned 7 of the 11 articles in the decree, which were challenged by a group of gynecologists arguing that it restricted their right to conscientious objection. As a result of this ruling, the scope of objection was expanded to include not only gynecologists who prescribe the drug, but also other health providers (e.g., sonographers and nurses) who are involved in preparatory procedures and consultations prior to the termination where information and counseling are provided (Visits 1 and 2).
 
4
It bears to note that in Uruguay abortion outside the health system continues to be penalized.
 
5
Within the hospital, recruitment and analysis was done in partnership with Iniciativas Sanitarias, a leading coalition of sexual and reproductive health professionals whose work advances sexual and reproductive health and rights as a basic human right for women and men in Uruguay.
 
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Metadata
Title
“It’s something that marks you”: Abortion stigma after decriminalization in Uruguay
Authors
Roosbelinda Cárdenas
Ana Labandera
Sarah E. Baum
Fernanda Chiribao
Ivana Leus
Silvia Avondet
Jennifer Friedman
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2018
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-018-0597-1

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