This article is part of a larger HuffPost US series titled The End Of Roe. Head Head here to read more.
A bombshell Supreme Court draft opinion leaked in May confirmed long-standing fears that the court’s conservative majority could strike down Roe v. Wade, the 1973 ruling that made abortion a constitutional right in the US.
If the landmark decision is overturned, it would allow states to dramatically restrict – or even ban – abortion for millions of Americans.
The court’s official ruling is expected to come within the next month. With Roe v. Wade hanging in the balance, it’s critical that we do what we can to destigmatise abortion and protect the right to have one.
To that end, we asked doctors and advocates to reveal the ways we may be perpetuating abortion stigma without even realising it.
1. Not saying the word “abortion” and using euphemisms instead
When you use euphemistic language like “reproductive rights” or “the right the choose” to avoid saying “abortion,” it makes it seem like it’s a bad or dirty word.
Similarly, saying things like “no one is pro-abortion” is inaccurate and can be damaging. In fact, “many abortion providers and advocates will proudly say we are pro-abortion,” Shireen Whitaker, culture and equity manager at Planned Parenthood Affiliates of California, told HuffPost.
“That’s because we believe that not only is abortion a safe and common medical procedure, but that abortions help individuals, families and communities thrive,” she said. “When people are able to obtain the abortions they need, they are determining their own destiny and wellbeing, and doing what’s best for their families.”
Tiptoeing around the word as if it’s shameful does a disservice to the cause.
“At the very least, if we are going to fight for our right to have an abortion, we must be comfortable with saying the word,” Whitaker said.
“If we are going to fight for our right to have an abortion, we must be comfortable with saying the word.”
- Shireen Whitaker of Planned Parenthood Affiliates of California
And it’s not just a problem on an individual level. When large institutions with a lot of power and influence, like health care systems and universities, stay silent on abortion, it further contributes to stigma surrounding the issue, Northwestern Medicine obstetrician-gynaecologist Dr. Melissa Simon told HuffPost.
These leaders, systems and institutions should state and continually voice their support of abortion rights and commitment to providing that care for their patients, said Simon, who is also a health equity researcher and advocate.
Otherwise, they’re supporting nothing – “or worse, supporting those who are anti-choice,” she said.
2. Using the phrase “late-term abortion”
“Late-term abortion” generally refers to abortions that occur at or after 21 weeks of gestation – but know that it is not a clinical term. In fact, medical professionals avoid using this language, as it can be stigmatising and misleading.
Obstetrician-gynaecologist and abortion care provider Dr. Jenn Conti told The Washington Post that the “late-term” phrasing is “intentionally vague” and contributes to confusion about when these abortions are actually performed. While most later abortions occur toward the end of the second trimester, anti-abortion politicians and activists often describe absurd hypothetical situations that would have you believe doctors are performing them much later – like when a woman is about to give birth. (Which, for the record, is “not how medical care works,” Conti said.)
The word “late” also implies that there’s some type of cutoff – “a specific point in time when it is acceptable to get an abortion,” said Ushma Upadhyay, associate professor of obstetrics, gynaecology and reproductive sciences at the University of California, San Francisco. “It suggests there are ‘on-time abortions’ and after that point you are ‘late,’” she told HuffPost.
Abortions performed at or after 21 weeks are relatively rare, making up less than 1% of all procedures in the US, according to 2019 data from the US Centers for Disease Control and Prevention.
To reduce stigma, it’s better to use language like “later abortions” or “abortions later in pregnancy,” which implies that “time is a continuum and it is just later relative to other points in pregnancy,” said Upadhyay.
3. Using coat hanger imagery or terms like “back-alley”
Today, abortions are very safe, uncomplicated procedures. In pre-Roe v. Wade America, however, abortions were illegal in most situations and much more risky ≠ even deadly. Women desperate to end their pregnancies had few options: some found unqualified people to perform the abortion, often under dangerous circumstances. Others tried to induce abortion themselves using coat hangers, knitting needles, bleach or by throwing themselves down the stairs.
Using hanger imagery or terms like “back-alley” abortion today conjures up “the horrific and extreme measures” people were forced to take before abortion was a constitutional right, Whitaker said.
“Continuing to use these symbols may incorrectly give people the idea that dangerous methods are their only options and stigmatises self-managed medication abortion,” she added.
Medication abortion involves the use of two oral drugs: mifepristone and misoprostol. These abortion pills, as they’re sometimes called, can be used together or misoprostol can be taken on its own (though it’s slightly less effective than the combination of the two). In 2020, medication abortion accounted for 54% of all US abortions, according to the Guttmacher Institute.
Abortion clinics and certified providers can prescribe medication abortion for use in the first 10 weeks of pregnancy. In some states, you can get abortion pills mailed to you after a telehealth visit with a provider. Other states require you to visit a clinic in person. (For more information on how to access abortion pills in your state, visit the Plan C website.)
4. Pointing out that US taxpayer money doesn’t pay for abortions
The Hyde Amendment prohibits the use of US federal funds, such as Medicaid, to cover the cost of abortion care, except in cases of rape, incest or if the pregnancy will endanger the person’s life. Some states, like California, New York, New Jersey, Oregon and others, use their own funds to cover the cost of abortions for people enrolled in publicly funded insurance programmes, but most states do not. Many states also prevent private insurance plans from covering abortion. That means that many pregnant people in the US must pay out of pocket for this type of care.
By emphasising that taxpayer money doesn’t cover abortions, you are effectively saying it’s OK that abortion care is treated differently than other health care services, Upadhyay said.
“Medicaid should cover abortion care for low-income people,” she said. “In our recent paper on costs of abortion, we find that one-quarter of Americans cannot pay for an emergency expense that is $400 or more.”
An abortion at 10 weeks gestation costs $550 on average, according to the Guttmacher Institute. Later in pregnancy, that number can be upwards of $1,000.
“The presence of restrictions on the use of insurance perpetuates economic and racial health care disparities,“ Upadhyay said. “To reduce abortion stigma, the Hyde Amendment should be repealed.”
5. Assuming that the decision to have an abortion is always difficult
It may be a hard choice to make for some women, but for others, deciding to have an abortion may not be difficult at all.
“For some people it is very clear and they don’t have to think about it. Such language may make someone feel like they are a bad person if it was an easy decision for them,” Upadhyay said, citing the landmark Turnaway Study she co-authored that found that five years after an abortion, more than 95% of patients said it was the right choice for them.
“Such language may make someone feel like they are a bad person if it was an easy decision for them.”
- Ushma Upadhyay, professor of obstetrics, gynecology & reproductive science
Plus, assuming that having an abortion was a “hard choice” suggests that terminating a pregnancy is a “moral issue requiring an ethical debate,” news analyst Janet Harris wrote for the Washington Post.
“To say that deciding to have an abortion is a ‘hard choice’ implies a debate about whether the fetus should live, thereby endowing it with a status of being,” which puts focus on the fetus rather than the pregnant person, she said.
“As a result, the question ‘What kind of future would the woman have as a result of an unwanted pregnancy?’ gets sacrificed,” Harris wrote.
As Harris pointed out, the situation may be difficult – navigating state laws, finding a clinic and paying for the abortion – but the decision itself is often straightforward.
6. Referring to abortion as just a women’s issue
Anyone who can get pregnant can have an abortion. That includes transgender men and nonbinary people who are frequently left out of the conversation. Focusing on abortion as solely a women’s issue makes it more difficult for individuals in these communities to access safe abortion care. Incorporating more inclusive language – like saying “pregnant people” instead of always saying “pregnant women” – can help.
“For people who are marginalised because of their gender identity, gender expression, or gender nonconformity, getting an abortion in an often gendered health care system can be difficult already, and femininised language like ‘women’s health care’ only makes that experience more difficult,” the Planned Parenthood Advocacy Fund of Massachusetts website reads.
Even people who do not get abortions are affected by them: cisgender men, families and larger communities, too.
Remember: abortion isn’t just “women’s health care” — it’s health care.