Measurement of individual-level abortion stigma resulting from Pennsylvania state-mandated abortion consent language: A pilot randomized controlled trial
Awarded 2015
Small Research Grants
Elizabeth Gurney, MD, MPH
University of Pennsylvania

Objective: To investigate the effect of state-mandated abortion counseling requirements intended to dissuade women from having abortions on patients’ individual-level abortion stigma. Methods: We randomized women presenting for abortion to complete a demographic survey and the validated Individual Level Abortion Stigma (ILAS) scale either before (unexposed) or after (exposed) hearing the mandatory Pennsylvania Abortion Control Act counseling via a standardized video. A sample size of 46 (23 per group) allowed us to detect a one standard deviation difference in mean ILAS score between the groups. The ILAS scale ranges from 0-3.5, with higher scores indicating greater stigma. Results: From November 2015 to April 2016, 46 participants completed the study. All baseline characteristics were balanced except that the unexposed group had a greater proportion of low-income participants. The mean ILAS score among all participants was 1.02 +/- 0.60. ILAS scores were significantly higher among the unexposed group (median 1.25, interquartile range [IQR] 0.7,1.9) compared to the exposed group (median 0.75, IQR 0.5,1.05; p=0.016). However, when controlling for participant income category, the effect of the state-mandated counseling on stigma scores was no longer present (p=0.068). Conclusion: In this randomized trial, stigma scores were higher among women who had not heard the state-mandated abortion counseling when compared with stigma scores for those who had heard the script, but this effect was confounded by participants’ income category. State-mandated counseling processes intended to dissuade women from having abortions may not increase perceived stigma; however, the effect of socioeconomic status on abortion stigma deserves further study.