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State-Level Variation in Abortion Stigma and Women and Men’s Abortion Underreporting in the USA

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  • Isaac Maddow-Zimet

    (Guttmacher Institute)

  • Laura D. Lindberg

    (Guttmacher Institute)

  • Kate Castle

    (University of Michigan)

Abstract

Abortion is highly stigmatized in most settings and severely underreported in demographic surveys. In the USA, variation in the context of abortion between states may influence respondents’ exposure to abortion stigma and create geographic variation in their likelihood of disclosing abortion in surveys. We used restricted geographic data from the 2006–2010 and 2011–2015 National Survey of Family Growth (NSFG) to investigate the association between abortion reporting in the USA and state-level structural factors that may influence respondents’ experience of abortion stigma. At the aggregate level, we compared the weighted number of abortions women reported in the NSFG to abortion counts derived from abortion provider censuses and test for variation in underreporting by state-level structural measures. At the individual level, we tested if state-level structural factors were associated with less reporting of abortion in the face-to-face (FTF) survey mode than the more confidential audio computer-assisted self-interviewing mode (ACASI) of the NSFG. We found that at the aggregate level, there were no differences in reporting by the state-level measures. At the individual level, about 40% of women and men who reported an abortion in their ACASI did not fully report in the FTF interview; however, there were few differences by any state-level factors. This study documents that abortion stigma plagues the quality of reporting in the USA for both women and men, regardless of which state they live in. Survey improvements to reduce abortion underreporting are needed.

Suggested Citation

  • Isaac Maddow-Zimet & Laura D. Lindberg & Kate Castle, 2021. "State-Level Variation in Abortion Stigma and Women and Men’s Abortion Underreporting in the USA," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 40(6), pages 1149-1161, December.
    • Handle: RePEc:kap:poprpr:v:40:y:2021:i:6:d:10.1007_s11113-021-09657-4
    DOI: 10.1007/s11113-021-09657-4
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    References listed on IDEAS

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    1. Katherine I. Tierney, 2019. "Abortion Underreporting in Add Health: Findings and Implications," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 38(3), pages 417-428, June.
    2. Cowan, Sarah K., 2017. "Enacted abortion stigma in the United States," Social Science & Medicine, Elsevier, vol. 177(C), pages 259-268.
    3. Vidhura Tennekoon, 2017. "Counting unreported abortions: A binomial-thinned zero-inflated Poisson model," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 36(2), pages 41-72.
    4. Laura Lindberg & Kathryn Kost & Isaac Maddow-Zimet & Sheila Desai & Mia Zolna, 2020. "Abortion Reporting in the United States: An Assessment of Three National Fertility Surveys," Demography, Springer;Population Association of America (PAA), vol. 57(3), pages 899-925, June.
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    Cited by:

    1. Heide M. Jackson & Michael S. Rendall, 2025. "Addressing Abortion Underreporting in Surveys with the List Experiment: Lifetime and Five-Year Abortion Incidence with Multivariate Estimation of Socio-Demographic Associations in Two U.S. States," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 44(1), pages 1-28, February.
    2. VandeVusse, Alicia J. & Mueller, Jennifer & Kirstein, Marielle & Strong, Joe & Lindberg, Laura D., 2023. "“Technically an abortion”: Understanding perceptions and definitions of abortion in the United States," Social Science & Medicine, Elsevier, vol. 335(C).

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