Objectives: We explored the role that reproductive stigmas play in decision-making when faced with an unintended pregnancy among young low-income women in Birmingham, Alabama. Methods: We conducted six focus groups with low-income women aged 19-24 attending health department clinics and a community college (n=34). Using the focus group findings and our existing abortion stigma survey items, we developed new items that captured other reproductive stigmas, and pre-tested them in 12 cognitive interviews. Finally, we conducted a self-administered iPad survey with 184 women aged 19-24 recruited from health department clinics. Results: Participants reported that women faced with unintended pregnancies are expected to bear and raise their child, regardless of personal circumstances. Though all young women with an unintended pregnancy were seen as stigmatized to some degree, those who choose to have and raise their child received more positive social labels. Participants reported that adoption and abortion were perceived as less common and generally unacceptable alternatives, and that women who chose these alternatives often did not disclose their pregnancy and related decision. The quantitative data confirmed that young women who choose abortion and adoption are more frequently associated with negative labels (irresponsible, selfish, cold/heartless) and less frequently associated with positive labels (mature, strong), than those who give birth and raise the baby. Conclusions: Stigmatizing attitudes related to pregnancy and reproductive decisions impact individual women’s health decision