Unintended Pregnancy and Stigma in Alabama

Young women in the southern U.S. have disproportionately high rates of unintended pregnancy, yet little is known about this population’s attitudes toward the issue. An article in Perspectives in 2016 was a step in addressing this research gap. The qualitative study’s main takeaway? Social norms and stigma play a major role in the reproductive decisions of some Southern women who have unintended pregnancies.

Smith and colleagues conducted six focus groups and 12 interviews with low-income women aged 19–24 in Alabama and found that the stigma began with the pregnancy itself—and spilled over to affect pregnancy-related decisions. Participants in the study said their close contacts, and their broader communities, blamed women for unintended pregnancies; some families even shunned women for getting pregnant. These families “won’t even care what [their children] do after they get pregnant,” said one participant.

Participants said parenting is viewed as a much more acceptable option than either abortion or adoption following an unintended pregnancy. Abortion carries a heavy stigma in Alabama, where the climate related to this reproductive choice is particularly hostile; participants said they knew of women who had kept their abortion secret, because, as one woman put it, “they know it’s wrong.” Formal adoption rarely occurred in the participants’ communities—placing a child with a relative or in foster care was more common.

The authors concluded by recommending that health professionals try to counteract the stigma surrounding unintended pregnancies in their interactions with clients. This type of provider behavior, the authors hoped, would help women with unintended pregnancies reduce their stress levels and feel more comfortable with their options.

Cover illustrations of Margaret Sanger © Matthew and Eve Levine