The Relationship between Body Appreciation, Weight Loss Behaviors, and Abortion Stigma

Background and Purpose: This is the first known study to explore associations between women’s body image and their experiences and attitudes regarding abortion. Research has found that there is stigma surrounding abortion in the United States, which discredits individuals with a history of abortion (Norris et al., 2011). Previous studies have suggested that there may be a relationship between individuals’ body image and their attitudes about reproductive processes. One such study found that women who exhibit appreciation for their bodies have fewer negative feelings about menstruation (Chrisler, Marván, Gorman, & Rossini, 2015). The current study predicted that women with higher levels of body appreciation and who engage in fewer weight loss behaviors would have lower levels of abortion stigma endorsement.

Methods: A cross-sectional survey was administered electronically to participants seeking health care services at various family planning clinics in the Midwest. The Body Appreciation Scale 2 (BAS-2; Tylka & Wood-Barcalow, 2015) and the Stigmatizing Attitudes, Beliefs and Actions Scale (SABAS; Shellenberg, Levandowski, & Hessini, 2014) were used to assess participants’ body appreciation and abortion stigma, respectively. Weight loss behaviors were also assessed to determine how many of these types of behaviors the participants engaged in, ranging from zero to three behaviors. A total of 125 participants initiated the survey.  However, for the purposes of this study, only 97 responses from individuals who identified as female and were over 18 years of age were analyzed. All 97 participants completed the BAS-2, but only 23 participants  answered the SABAS. The missing data were handled by excluding the missing cases as no significant demographic differences were found between those who completed the SABAS and those who did not.

Results: A multiple regression was conducted to determine which independent variables (body appreciation and weight loss behaviors) were the predictors of abortion stigma. Regression results indicate that body appreciation and weight loss behaviors significantly predicted abortion stigma [R2 = .348, R2adj =.279, F(2, 21) = 5.07, p = .017]. The study model accounted for 34.8% of variance in abortion stigma. The mean age of the 23 participants was 29.87 [range 20 to 57] and the sample was 78.3% White, 13.0% Black, 4.3% Asian, and 4.3% other.

Conclusions and Implications: The findings will be useful to healthcare providers and reproductive rights advocates as they work to decrease stigma surrounding abortion and increase access to the full range of reproductive healthcare. Approximately one in four American women will have an abortion by the age of 45 (Jones & Jerman, 2017), but many people do not speak of the experience. Silence can lead to stigma; Unrealistic body image expectations and stigma can result in shame and even lead to gender based violence. Abortion stigma often contributes to similar harmful outcomes, including the intimidation and social ostracization of women who choose to utilize abortion services. This study examines the intersection between two different but interrelated types of stigma and how experiencing stigma in one area can make one prone to perpetuating it in another domain.