IPAS - Focus Groups For Exploring Stigma

Focus group guide
for exploring
abortion-related stigma
Deborah Billings, Leila Hessini and Kathryn Andersen Clark

ISBN: 1-933095-47-4
©2009 Ipas.
Produced in the United States of America.
Deborah Billings, assistant professor, Arnold School of Public Health & Women’s and Gender Studies,
University of South Carolina
Leila Hessini, director of community engagement and mobilization, Ipas
Kathryn Andersen Clark, senior research associate, Ipas
Suggested Citation: Billings, Deborah, Leila Hessini, Kathryn Andersen Clark. 2009. Focus group guide for exploring
abortion-related stigma. Chapel Hill, NC: Ipas.
Ipas is a nonprofit organization that works globally to increase women’s ability to exercise their sexual and
reproductive rights and to reduce abortion-related deaths and injuries. We seek to expand the availability,
quality and sustainability of abortion and related reproductive health services, as well as to improve the enabling
environment. Ipas believes that no woman should have to risk her life or health because she lacks safe reproductive
health choices.
Ipas
P.O. Box 5027
Chapel Hill, NC 27514 USA
customerservice@ipas.org
www.ipas.org
Graphic Design: Jamie McLendon
Printed on recycled paper
An Ipas international publication

Background to this guide
Stigma and its manifestations present key barriers to women’s access to safe, legal and affordable
abortions. Identifying social norms that stigmatize abortion and reducing abortion-related stigma are
essential to ensuring that all women are able to exercise their reproductive health rights. However, few
researchers have explored how stigma is generated in different contexts; by whom; what forms it takes;
and what its consequences are for women seeking abortions, their families and societies. Without
understanding these dynamics, designing effective interventions to reduce abortion-related stigma is
impossible.
This guide is intended to help users to better understand how stigma affects abortion-related work and
what steps can be taken to mitigate it. It builds on a conceptual model of abortion-related stigma that
discusses possible root causes of abortion-related stigma; ways in which it is perpetuated and
normalized; and ideas for measuring and mapping its impact on women’s health (Kumar, Hessini and
Mitchell (2009)). This analysis acknowledges that the ways in which stigma is created, who is
stigmatized, and for what reasons, varies over time and across contexts. Abortion-related stigma can
have a negative impact on women’s health and lives as outlined in the diagram below (Ibid, 2009).
The intended users of this guide are Ipas staff as well as key partners. By developing this tool, we hope
to engender interest among others in exploring stigma and the ways in which it is manifested. This
resource begins with an introduction followed by examples of where to look for abortion-related stigma.
It includes a set of exploratory questions that link stigma and values clarification, and focus group guides
that can be used with community members, health care professionals, pharmacists and pharmacy
workers. This manual is a work in progress and has been piloted in Nepal, Pakistan and Uruguay by Ipas
staff and partners.
1
As we are interested in investigating how stigma associated with abortion expresses itself across
different contexts, we encourage you to share your experiences using this manual and your findings
with us. The knowledge we gain from the use of this tool will help to identify and shape interventions to
help women receive the support they need when they experience unwanted and/or unhealthy
pregnancies. Your feedback, comments and recommendations are appreciated and can be sent to Leila
Hessini at hessinil@ipas.org
Introduction to Stigma
Stigma as a social concept was first developed and operationalized by the sociologist Erving Goffman
(1963). Since that time, researchers and activists in the social sciences and public health have
endeavored to better understand how people with certain conditions, traits, identities or behaviors are
“marked” or perceived as different. They also have researched the impact that such labeling has on
people’s health and overall lives. As Das (2001) notes, such conditions, traits or behaviors, “symbolically
mark the bearer [of stigma] as culturally or socially unacceptable or inferior.” Symbolic marking, then,
provides the basis for exclusion and discrimination at individual and societal levels.
In current usage, stigma often is individualized, with a focus on the externally determined attributes of
the person without recognizing how social relationships create stigma (Link and Phelan 2006). Link and
Phelan (2006) recognize the importance of social relations and propose interrelated components that
produce and sustain stigma:
1. Labeling: People identify and label human differences.
2. Stereotyping: Dominant cultural beliefs link labeled individuals to undesirable characteristics --

to negative stereotype.
3. Separation: Labeled persons are placed in distinct categories, dividing "us" from "them.
4. Discrimination: Labeled persons experience status loss, rejection, exclusion and discrimination
that lead to unequal outcomes.
Stigma and discrimination are sustained when the social, economic and political power differences
between stigmatizers and those who are stigmatized are used oppressively to divide and exclude certain
social groups. Thus, the context of power and power differentials in which stigma is created is important
to understanding its tenacity. These dimensions must be taken into account when creating
interventions aimed at deconstructing stigma and halting its reproduction.
At the individual level, those being stigmatized often feel shame, guilt and disgrace, leaving them with
little power to access resources that can change their situation. These are precisely the reactions that
individuals and institutions that stigmatize aim to invoke. At societal levels, those who are stigmatized
are effectively excluded and marginalized, often leaving them without social networks and resources
that could improve their health and well-being.
Despite such limitations, examples abound of stigmatized persons uniting to confront the groups and
social structures that perpetuate stigma and to demand resources to address their situations. One of
2
the most recent visible movements is comprised of people living with HIV/AIDS; they have challenged
people’s personal perceptions of HIV and its transmission; worked to change discriminatory laws and
policies; and advocated for new policies that guarantee resources for research, treatment and support.
Where to look for abortion-related stigma
Examining abortion-related stigma means exploring its intimate ties to issues of morality, sexuality,
gender, motherhood and innocence in societies throughout the world. When sexual and cultural norms
are violated, this may be seen as a danger to the moral universe, which has been socially created and
held together by rules, regulations and the threat of stigma and exclusion. For example, women who
have abortions may be seen as sexually promiscuous or sinful, that is, of having violated sexual and
religious norms in some societies. Once these labels are placed on women, they can be stereotyped,
separated from “morally upright” women and then blamed for their own exclusion.
Abortion-related stigma is so strong that, in some societies, 19th-century laws have been kept on the
books and abortion has been legally restricted for all indications, including rape or when the pregnancy
presents a risk to the life of the woman. However, legality of abortion is not the only indicator of
whether abortion-related stigma exists. In countries such as the United States and South Africa, where
abortion is legal, abortion-related stigma is evident. Anti-choice movements in both countries work to
portray women who have abortions and the health-care providers who assist them as “sinful” and as
“murderers.” The powerful images that they use, especially of fetuses, serve to strengthen those labels.
But such movements do not have the same presence in other countries where abortion is also legal,
such as Tunisia and Vietnam.
However, maintaining a pregnancy can also be stigmatizing for certain women in different societies.
Young, unmarried women and women living with HIV/AIDS who continue with their pregnancies often
are stigmatized and face discrimination from multiple sectors in society, including health-care providers
who may be judgmental or even refuse to provide prenatal, labor and delivery, or postnatal services.
The words, phrases and images used to portray women who maintain socially unacceptable pregnancies
also are important since they label women in ways that are used to justify exclusion and violence.
Abortion-related stigma is generated and experienced at both personal and societal levels. While its
forms and consequences may have commonalities across different contexts, it is always important to
consider the local causes and consequences of abortion-related stigma so that locally appropriate ways
to mitigate it can be developed. Kumar and colleagues (2009) emphasize that the following categories
need to be examined to fully understand abortion-related stigma: personal interactions; families and
communities; popular and medical discourses; government and political structures; and social
institutions, such as education and religion.
How does work on stigma link to values clarification and attitude transformation (VCAT) work?
The values that people hold and guide what they think is important are closely linked to stigma. Ipas’s
VCAT manual, Abortion Attitude Transformation: A Values Clarification Toolkit for Global Audiences
(Turner and Chapman 2008), provides an overview of definitions of “values,” including:
Values are concepts or beliefs about desirable end states or behaviors that transcend specific
situations, guide selection or evaluation of behavior and events and are ordered by relative
importance (Schwartz et al. 1987).
3
Values are enduring beliefs that a specific mode of conduct is personally or socially preferable to
an opposite or converse mode of conduct (Rokeach 1973).
These two statements illustrate how important values are to the process of creating or reducing stigma.
Values are deeply held and can be difficult to change; they guide and help to evaluate behavior. Acting
in ways that are contrary to the values held by society members can result in labeling, stereotyping,
separation (“them” from “us”), and ultimately exclusion and discrimination. On the other hand, values
held by providers could allow them to choose behaviors that are not socially sanctioned because these
values are at a higher level or related to an ethical code that is key to their professional.
Exploratory questions
If creating stigma, defining ‘us’ vs ‘them’ is a basic cultural process, then what is to be gained from
understanding the origins of stigma? Investigating the sources and channels of stigma is essential to
understanding how the cycle of stigma is perpetuated at the individual and institutional levels and how
stigma works along a continuum of labelling, stereotyping, separation, to discrimination. How these
dynamics actually take shape in different contexts and under various situations are important questions
to ask when developing interventions to mitigate abortion-related stigma.
Has abortion-related stigma always existed? How does it differ across time and location? Does it differ
in settings where abortion laws are liberal versus where abortion laws are more restrictive? What forms
does stigma take for different situations or reasons for which women have abortions? For example, are
women who abort after becoming pregnant from rape stigmatized in the same ways that are women
who abort because of fetal malformation or because they want to continue with their education? What
is the impact of public programs, such as publicly-funded abortion services, on abortion-related stigma?
Are some women more “deserving” of support and attention than others, according to social actors?1
Work on stigma and abortion must have a multipronged approach that focuses on different levels and
actors:
1. Who are the individuals/ what are the social institutions that create abortion-related stigma?
a. Why do they stigmatize?
b. What mechanism do they use to stigmatize (e.g. laws and policies)?
2. How is stigma experienced by:
a. Women who have abortions and their partner, families and/or social networks?
1
Das (2001) notes that “*t+he first decade of the twentieth century was a period of intense concern with sexually transmitted
diseases and the appearance of the social hygiene movement in North America. It is interesting to observe that not only in
popular discourse but also in the biomedical system, a distinction was made between ’venereal insontium,’ i.e., the venereal
disease of the innocent versus the venereal disease of those who were held guilty because of sexual misconduct. Allen Brandt
(1988) argues that this distinction had the effect of dividing victims into those who were deserving of medical support and
sympathy and others who were not, because they were guilty of sexually promiscuous behavior.”
4
b. Abortion-service providers (trained providers of medical and surgical/aspiration
abortion services, as well as untrained providers) and their colleagues?
c. Advocates for safe, legal, accessible abortion services?
3. institutions or facilities, such as clinics that provide abortion services, pharmacies that are
known sources for medical abortion drugs or centers that train on abortion care?What are the
consequences of stigmatizing?
a. How are stigmatized people excluded and marginalized? How is discrimination used
against people as a tool for excluding and marginalizing?
b. What does this mean for their lives?
c. What does it mean for larger society?
4. What efforts are being made by individuals and social institutions (including the creation of
programs and policies) to de-stigmatize abortion?
REFERENCES
Brandt, Allen M. 1988. From social history to social policy. In Aids: The Burdens of History, ed. Elizabeth
Fee and Daniel M Fox. Berkeley: University of California Press.
Das, Veena. 2001. Stigma, contagion, defect: Issues in the anthropology of public health. Paper
presented at the National Institutes of Health “Stigma and Global Health Conference: Developing a
Research Agenda” conference, September 5, 2001, Bethesda, Maryland.
http://www.stigmaconference.nih.gov/FinalDasPaper.htm.
Goffman, Erving. 1963 Stigma: Notes on the management of spoilt identity. Englewood Cliffs, N.J.:
Prentice Hall.
Kumar, Anu, Leila Hessini, and Ellen Mitchell. 2009. Conceptualising abortion stigma. Culture, Health &
Sexuality; 11; 625-639.
Link, Bruce and Jo Phelan. 2006. On stigma and its public health implications. The Lancet, 367: 528-9.
Rokeach, Milton. 1973. The nature of human values. New York: Free Press.
Schwartz, Shalom and Wolfgang Bilsky. 1987. Toward a universal psychological structure of human
values. Journal of Personality and Social Psychology, 53: 550-562.
Turner, Katherine and Kimberly Chapman Page. 2008. Abortion attitude transformation: A values
clarification toolkit for global audiences. Chapel Hill: Ipas.
http://www.ipas.org/Publications/Abortion_attitude_transformation_A_values_clarification_toolkit_for
_global_audiences.aspx?ht=
5
QUESTIONS ABOUT STIGMA TO INCORPORATE INTO FOCUS GROUPS
The following questions were developed by the co-authors as one way to concretely explore abortion-
related stigma in various contexts. They are currently written as draft focus group guides but could be
adapted as in-depth interview questions as well as items on a questionnaire. The questions are followed
by a matrix that helps facilitators to understand which aspects of stigma each question attempts to
measure. Please note that in the matrix some questions are repeated, meaning that they are questions
that can potentially measure more than one dimension of stigma. Instructions to the facilitators are in
italics, and focus group questions are in normal font.
Since abortion is a sensitive and stigmatized topic, it is important to ensure that people feel as
comfortable as possible talking about it. For this reason, we suggest that you never ask people for their
personal opinions but rather focus on what people in their communities feel, talk about, or do. It will
not be surprising if people begin to talk about their personal opinions and experiences, but we do not
want them to feel pressured to do so.
Note that many of the questions ask people to reflect on their own communities. If focus group
members are not from the same community, facilitators will need to modify the language to use terms
that make sense for the composition of the group.
Transition text to be used to go from other focus group questions to the questions about stigma
Thank you for the rich discussion about “X topic.” Now we’d like to focus on a different issue that will
help us understand the experiences and perspectives of people in your communities about the issue of
abortion. You don’t need to talk about your own personal experiences but can if you feel comfortable.
We’re interested in what you’ve heard and seen from people in your communities when the issue of
abortion is raised. Sometimes the issue comes up on the radio, in newspapers or from neighbors after a
woman has had an abortion. Remember that everything we talk about in this group stays in the group
and won’t be shared with other people. Can we begin?
6
Focus groups with women and men (conducted separately)
Note that throughout this focus group, it is important to probe participants about different categories of
women: married, single, already mothers, young, with support of husband, without support, etc. Think about
the categories that are most relevant in the social setting where the focus groups are taking place and use those
categories throughout the discussion.
Show a drawing of a woman (perhaps 30-35 years old). Tell the group that her name is (add name), she is 32 years
old in (add place name). Ask the group: What do you think of when you see the drawing of (name)?
Last year (name) had an abortion.
Think about the community where you live:
o Why do women experience unwanted pregnancies?
o What happens when women experience unwanted pregnancies?
o What does the word “abortion” mean to people in your community?
o What words do people use in your community to talk about abortion (probe: do they say the
word “abortion,” or are there other words or phrases, like “bringing down the period” that people
use to talk about terminating a pregnancy)?
o What would people in your community think about (name)?
What would women think? What would men think?
o What might they say about her?
 Why would they say these things?
 Who would they say them to? The woman herself? Only friends and family?
o Would people in your community accept her action and support her? Would people in your
community isolate her in any way or make her feel bad about the abortion? What would they
do? (Note: The facilitator should try to get at specific actions that community members might
take to support or isolate, discriminate or abuse her.)
 Why would they take these actions?
How do you think women feel about themselves after an abortion? What do they think about themselves after
having an abortion? Why do they think or feel this way (probe: what conditions does this depend on)?
Would the reaction to (name)’s having an abortion be any different if her pregnancy was the result of being raped?
What would be different (probe: what people say about her, who they say comments to, what actions would be
taken)?
 Why would the reactions be different?
7
 What do people in your community think about women who have been raped?
 What happens to women from your community who have been raped?
Would the reaction to (name)’s having an abortion be any different if her pregnancy presented a risk to the
(name’s) life? What would be different (what people say about her, who they say them to, what actions would be
taken)?
What is the abortion law in this (state or country)?
Are women who have an abortion in (X country) treated differently than women who have never had an abortion?
In what ways? Why?
If participants do not discuss the topic of women being imprisoned for having abortions, the facilitator should probe
with the question: Should women go to jail?
What do people say about the person (doctor, nurse, midwife, other) who helped the woman have the abortion?
Are these health-care providers viewed or thought of by community members in the same way as health-care
providers who don’t provide abortion services? Why or why not (probe: what if the abortion is safe, what if the
abortion is unsafe)?
What do you hear about abortion in newspapers or on radio or television? What is said about abortion? What is
said about women who have abortions (probe: why do they have abortions, who are the women, how are they
described)? What is said about the people who help women have abortions (probe: why do they perform
abortions, who are they, how are they described)?
Do you think that there is anything that can be done in (X community or country) so that women who have an
abortion are treated in the same way as other women? What can be done?
8
Focus groups with pharmacists, chemists or drug vendors
Show a drawing of a pharmacist (perhaps 35-40 years old). Tell the group that his/her name is (add name) and
he/she works in a local pharmacy. Ask the group:
What do you think of when you see the drawing of (name)?
Last year (name) began to sell (whatever is available in your context: misoprostol, mifepristone and misoprostol)
and to provide information to customers about abortion when they want to purchase the medication.
o What would (name)’s colleagues think of her?
community isolate her in any way or make her feel bad about the medications that she is selling?
What would they do? (Note: The facilitator should try to get at specific actions that community
members might take to support or isolate, discriminate or abuse her.)
o Would (name)’s colleagues accept her action and support her? Would her colleagues isolate her
in any way or make her feel bad about the medications that she is selling? What would they do?
(Note: The facilitator should try to get at specific actions that community members might take to
support or isolate, discriminate or abuse her.)
Are pharmacists, chemists or drug vendors who sell abortifacients viewed or thought of by community members in
the same way as pharmacists who aren’t selling the medications? Why or why not?
9
Focus groups with MA providers
Show a drawing of a physician (perhaps 35-40 years old). Tell the group that his/her name is (add name) and
she/he? works in a local hospital or clinic. Ask the group:
What do you think of when you see the drawing of (name)?
Last year (name) began to provide abortion services.
o What would (name)’s colleagues think of her?
community isolate her in any way or make her feel bad about the abortion? What would they
do? (Note: The facilitator should try to get at specific actions that community members might
take to support or isolate, discriminate or abuse her.)
o Would (name)’s colleagues accept her action and support her? Would her colleagues isolate her
in any way or make her feel bad about the abortion services she provides? What would they do?
(Note: The facilitator should try to get at specific actions that community members might take to
Are these health-care providers that offer abortion services viewed or thought of by community members in the
same way as health-care providers who don’t provide abortion services? Why or why not?
In what ways is providing MA services different from providing surgical/aspiration abortion services? (The aim here
is not to focus on the technical aspects but to bring out whether it “protects” providers (and/or women) from
stigma and repercussions in some ways.)
10
The following matrix helps community activists, workshop facilitators and local researchers to
understand which aspects of stigma each question attempts to measure. Please note that in the matrix
some questions are repeated, meaning that they are questions that can potentially assess more than
one dimension of stigma.
Focus groups with women and men in communities
Labeling What happens when women have pregnancies that aren’t

considered “socially acceptable?” (i.e. because they too
(by others, including people and media, and by young, not married, etc.)
women themselves)
What does the word “abortion” mean to people in your
community?
What would people in your community think about the

woman with an abortion?
What might they say about her?
How do you think women feel about themselves after an

abortion? What do they think about themselves after
having an abortion? Why do they think or feel this way?
What do people say about the person (doctor, nurse,

midwife, other) who helped the woman have the abortion?
Are these health-care providers viewed or thought of by
community members in the same way as health-care
providers who don’t provide abortion services? Why or why
not?
What do you hear about abortion in newspapers or on radio

or television? What is said about abortion? What is said
about women who have abortions (probe: why do they have
abortions, who are the women, how are they described)?
What is said about the people who help women have
abortions (probe: why do they perform abortions, who are
they, how are they described)?
Would the reaction to (name)’s having an abortion be any

different if her pregnancy was the result of being raped? If
the pregnancy was going to present a risk to (name)’s life?
 What would be different (what people say about

her, who they say them to, what actions would be
taken)?
11
Stereotyping What might they say about her?
What do people say about the person (doctor, nurse,

midwife, other) who helped the woman have the abortion?
not?



taken)?
Separating “us” from “them” Would people in your community accept her action and
support her? Would people in your community isolate her
in any way or make her feel bad about the abortion? What
would they do?

not?


taken)?

12
abortions, who are the women, how are they described?.
Exclusion and discrimination Would people in your community accept her action and
would they do?



taken)?
Are women who have an abortion in (X country) treated

differently than women who have never had an abortion?
In what ways? Why?
If participants do not discuss the topic of women being
imprisoned for having abortions, the facilitator should probe
with the question: Should women go to jail?
Do you think that there is anything that can be done in (X

country) so that women who have an abortion are treated
in the same way as other women? What can be done?
13
Focus groups with pharmacists
Labeling Last year, (name) began to sell (whatever is available in your

context: misoprostol, mifepristone and misoprostol) and to
provide information to customers about abortion when they
want to purchase the medication.

o What would people in your community
think about (name)?
 Why would they say these
things?
 Who would they say them to?
The woman herself? Only friends
and family?
o What would (name)’s colleagues think of
her?
things?
and family?
Are pharmacists who sell abortifacients viewed or thought

of by community members in the same way as pharmacists
who aren’t selling the medications? Why or why not?
Stereotyping Last year, (name) began to sell (whatever is available in your


think about (name)?
things?
and family?
her?
14
things?
and family?
Are pharmacists, chemists and drug sellers who sell

abortifacients viewed or thought of by community members
in the same way as those who aren’t selling the
medications? Why or why not?
Separating “us” from “them” Last year, (name) began to sell (whatever is available in your

think about (name)?
things?
and family?
her?
things?
and family?
o Would people in your community accept
her action and support her? Would
people in your community isolate her in
any way or make her feel bad about the
medications that she is selling? What
would they do? (Note: The facilitator
should try to get at specific actions that
community members might take to
support or isolate, discriminate or abuse
her.)
 Why would they take these
actions?
Would (name)’s colleagues accept her action and support

her? Would her colleagues isolate her in any way or make
her feel bad about the medications that she is selling?
What would they do? (Note: The facilitator should try to get
15
at specific actions that community members might take to

actions?
in any way or make her feel bad about the medications that
she is selling? What would they do? (Note: The facilitator
should try to get at specific actions that community
members might take to support or isolate, discriminate or
abuse her.)

actions?

her feel bad about the medications that she is selling?

actions?
16
Focus groups with MA providers
Labeling Last year, (name) began to provide abortion services.

think about (name)?
things?
and family?
her?
things?
and family?
Are these health-care providers who offer abortion services

viewed or thought of by community members in the same
way as health-care providers who don’t provide abortion
services? Why or why not?
Stereotyping Last year, (name) began to provide abortion services.

think about (name)?
things?
and family?
her?
things?
and family?
17
Are these health-care providers who offer abortion services
viewed or thought of by community members in the same
way as health-care providers who don’t provide abortion
services? Why or why not?
Separating “us” from “them” Last year, (name) began to provide abortion services.

think about (name)?
things?
and family?
her?
things?
and family?
Would people in your community accept her action and

would they do? (Note: The facilitator should try to get at
specific actions that community members might take to

actions?

her feel bad about the abortion services she provides?
Why would they take these actions?
18
would they do? (Note: The facilitator should try to get at
specific actions that community members might take to

actions?

her feel bad about the abortion services she provides?

actions?
19
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Focus group guide

Deborah Billings, Leila Hessini and Kathryn Andersen Clark

Graphic Design: Jamie McLendon

Printed on recycled paper

An Ipas international publication

1. Labeling: People identify and label human differences.

2. Stereotyping: Dominant cultural beliefs link labeled individuals to undesirable characteristics --

Where to look for abortion-related stigma

a. Why do they stigmatize?

b. What mechanism do they use to stigmatize (e.g. laws and policies)?

2. How is stigma experienced by:

c. Advocates for safe, legal, accessible abortion services?

b. What does this mean for their lives?

c. What does it mean for larger society?

Last year (name) had an abortion.

Think about the community where you live:

o Why do women experience unwanted pregnancies?

o What happens when women experience unwanted pregnancies?

o What does the word “abortion” mean to people in your community?

o What would people in your community think about (name)?

What would women think? What would men think?

o What might they say about her?

 Why would they say these things?

 Why would they take these actions?

 Why would the reactions be different?

 Why would the reactions be different?

What is the abortion law in this (state or country)?

What do you think of when you see the drawing of (name)?

Think about the community where you live:

o What would people in your community think about (name)?

o What might they say about her?

 Why would they say these things?

o What would (name)’s colleagues think of her?

o What might they say about her?

 Why would they say these things?

 Why would they take these actions?

 Why would they take these actions?

What do you think of when you see the drawing of (name)?

Last year (name) began to provide abortion services.

Think about the community where you live:

o What would people in your community think about (name)?

o What might they say about her?

 Why would they say these things?

o What would (name)’s colleagues think of her?

o What might they say about her?

 Why would they say these things?

 Why would they take these actions?

 Why would they take these actions?

Focus groups with women and men in communities

Labeling What happens when women have pregnancies that aren’t

What would people in your community think about the

What might they say about her?

How do you think women feel about themselves after an

What do people say about the person (doctor, nurse,

What do you hear about abortion in newspapers or on radio

Would the reaction to (name)’s having an abortion be any

 What would be different (what people say about

What do people say about the person (doctor, nurse,

What do you hear about abortion in newspapers or on radio

Would the reaction to (name)’s having an abortion be any

 What would be different (what people say about

Are these health-care providers viewed or thought of by