Abstract
In recent years, stigma has become a central focus within research concerning women’s experiences of abortion (Hoggart, 2015; Purcell, 2015). Drawing on Goffman’s (1963) analysis of the social construction of stigma, Kumar, Hessini and Mitchell (2009) define abortion stigma “as a negative attribute ascribed to women who seek to terminate a pregnancy that marks them, internally or externally, as inferior to ideals of womanhood” (p. 628). In connecting abortion stigma to gender norms, they emphasise that understandings of abortion are locally specific and open to deconstruction. Their analysis considers how abortion stigma is perpetuated, one route being through “framing discourses.” However, as Purcell (2015) highlights, although available discourses have clear implications for women who end their pregnancies, few studies have analysed the language that women
In this paper, I begin to address this issue, drawing on insights from discursive psychology (for example, Edley, 2001; Potter & Wetherell, 1987) to explore how women in England talk about having had an abortion during research interviews. In contrast to psychological approaches that treat language as a means to access a speaker’s “internal” identity, discursive psychology explores how identities are
Some subject positions are harder to claim than others because “departures from ‘what everybody knows to be appropriate’ require explanation and create ‘trouble’ in […] interaction” (Wetherell & Edley, 1998, p. 161). By exploring various forms of “trouble” that speakers encounter, discursive psychological research highlights the social norms that render particular identities problematic
In the analysis that follows, I explore the discursive work through which women successfully navigate the “trouble” they encounter when describing themselves as someone who has had an abortion. In doing so, I critically explore the discursive resources available for meaning-making within a particular context of talk about abortion. I also contrast a discourse analytic approach to women’s accounts of abortion with the very different approach taken by the growing body of literature that explores women’s experiences of abortion stigma. By juxtaposing these approaches, I seek to provoke reflection about the implications of the discursive frameworks through which women’s accounts of abortion are solicited and explored.
Accounts of stigma
Several studies have used interview and survey data to explore how stigma features in women’s experiences of abortion (Astbury-Ward, Parry, & Carnwell, 2012; Cockrill & Nack, 2013; Cockrill, Upadhyay, Turan, & Greene Foster, 2013; Hoggart, 2017; Major & Gramzow, 1999; Shellenberg et al., 2011; Shellenberg & Tsui, 2012). For example, Cockrill and Nack (2013) identify three “manifestations” of abortion stigma in women’s interview accounts of their experiences of abortion in the United States. “Internalised stigma results from a woman’s acceptance of negative cultural valuations of abortion” (Cockrill & Nack, 2013, p. 974). “Felt stigma” is a woman’s anticipation of “unsupportive reactions to disclosing an unplanned pregnancy, an abortion decision, or an abortion history” (Cockrill & Nack, 2013, p. 980). “Enacted stigma” is “a woman’s experiences of clear or subtle actions that reveal prejudice against those involved in abortion” (Cockrill & Nack, 2013, p. 974). Cockrill and Nack illustrate strategies women use to individually “manage” such stigma, for example, through non-disclosure, through constructing their reasons for abortion as “exceptional,” or through condemnation of anti-abortion perspectives. They argue such strategies often perpetuate abortion stigma by making abortion invisible, or by suggesting that it requires exceptional grounds. Drawing on these qualitative findings, Cockrill et al. (2013) develop a scale to quantitatively measure the extent of individual-level abortion stigma.
Such research provides a valuable means of representing the impact of the stigmatisation of abortion on women’s lives. For example, in a study conducted in England and Wales, Astbury-Ward et al. (2012) argue that “women’s perceptions of abortion as a deeply discreditable and personally stigmatising event” (p. 3144) prevent them from seeking crucial social support. However, it is important to reflect on the understandings of language, identity and stigma which this body of research works with and reproduces. Language is approached as a “transparent medium” (Wetherell, 2001, p. 16) through which aspects of identity, conceived of as internal to individuals (e.g. attitudes, experiences, values, and perceptions), can be accessed by researchers as opposed to an ongoing social practice through which identities are
Writing in relation to other forms of stigma, Parker and Aggleton (2003) and Farrugia (2009) draw attention to the consequences of these kinds of conceptual formulation. Treating stigma as a “kind of thing” (Parker & Aggleton, 2003, p. 14) that can be measured through individual accounts of experience risks obscuring the
Abortion in public discourse in Great Britain
In England and Wales, abortion is a criminal offence under the Offences Against the Person Act 1861, unless two doctors agree that it is necessary on one of several grounds that concern risks to the pregnant woman’s (mental or physical) health, or the future health of her foetus. These grounds were introduced through the Abortion Act 1967, a piece of legislation that has enabled abortion to “become entrenched as a normal part of routine healthcare” (Sheldon, 2016, p. 344) in Great Britain. 1
Although it has facilitated liberal abortion provision, the Abortion Act constructs abortion as a “deviant” practice which requires regulation and positions women as incapable of reproductive decision-making (Boyle, 1997; Fyfe, 1991; Jackson, 2001; Lee, 2003, 2004; Sheldon, 1997, 2016). Negative framings of abortion are also generated by an entrenched anti-abortion lobby that depicts foetuses as individual persons (Franklin, 1991) and women who have abortions as the unwitting victims of a procedure which inevitably leaves them physically and psychologically damaged (Amery, 2014; Hoggart, 2015; Hopkins, Reicher, & Saleem, 1996). These framings dominate the British print media, which constructs abortion as a moral “controversy” and portrays the transgression of the feminine norm of maternity as a risky decision, associated with regret and suffering (Purcell, Hilton, & McDaid, 2014).
Women’s experiences with abortion in Great Britain
Qualitative research concerning women’s experiences with abortion in Great Britain has focussed primarily on processes of abortion decision-making and of using healthcare services. A consistent finding is that women reach decisions about their pregnancies based on the specific relational contexts of their own lives (Hoggart, 2012; Lattimer, 1998; Lee, 2004; Lee, Clements, Inghan, & Stone, 2004; Purcell, Cameron, et al., 2014). In contrast with the law’s medicalised construction of abortion decision-making, this typically takes place
Methods
Ethical approval for this study was obtained from an NHS Research Ethics Committee and from the University of York’s Economics, Law, Management, Politics and Sociology Ethics Committee. Study information was made available to women attending abortion clinics and, when recruitment in this context proved difficult, I also placed advertisements in non-clinical settings such as newspapers and social media. Regardless of the site of initial contact, the recruitment process was effectively the same. In both cases, women were provided with information about the study that explained how to contact me if they were interested in taking part. Seventeen women were recruited through the clinic route, and 11 through the non-clinic route. A gift of £20 was offered to thank women for their time. All participants provided informed consent.
The majority of participants had, or were pursuing, an undergraduate degree or professional qualification (n = 21). Using British census categories, most of the participants identified as “White British/Other White background” (n = 25). Two participants identified as “Black/Black British–Caribbean,” and one identified as having a specific “Mixed background.” With the exception of one participant, who had an abortion while living overseas, their experiences of abortion all took place in England. At the time of interview, nine women had children and 19 did not. The length of time since abortion varied considerably, from approximately three weeks to 37 years (with a mode of three to four weeks since first experience of abortion). This meant participants had very different opportunities to formulate narratives concerning their experiences. However, length of time post-abortion did not seem to be associated with differences in women’s discursive work.
Women’s age at the time of their (first experience of) abortion ranged from approximately 14–36 years, and this variable did appear to shape participants’ positioning of themselves during interviews. Resonating with studies which highlight parental involvement in teenage women’s pregnancy outcomes (Hoggart, 2012; Lee, 2004), women’s descriptions of ending a pregnancy under the age of 18 (n = 3) were distinguished by depictions of abortion as a decision that had been made by others. These accounts were so different from the rest of the data corpus that they are not explored in the analysis that follows, which focuses on how women negotiated the meaning of having decided to end a pregnancy.
Interviews took place by phone (n = 12) or face-to-face (n = 16). In recognition of the researcher’s role in making particular subject positions available to participants (Taylor, 2001), I tried to produce a supportive research encounter that did not replicate the “troubling” of abortion. Recruitment materials highlighted the absence of women’s voices from discussion of abortion and described study participation as a way to address this problem by building research knowledge about “the issues important to women.” In interviews, I tried to avoid suggesting that abortion needed to be justified by asking women to tell me about their experiences rather than asking “why” they had decided on abortion. I began with a very open-ended question (Can you tell me a bit about what happened when you first thought you might be pregnant?) to give women the opportunity to shape the focus of the conversation. I also used a topic guide to explore some pre-defined issues with all participants if they did not arise spontaneously (for example, aspects of the abortion care pathway, or views about media coverage of abortion). Throughout the analysis that follows, I foreground my role in the production of data by indicating when a question directly preceded a participant’s stretch of talk and by reflecting on my framing of the research.
Interviews were recorded and professionally transcribed verbatim. Owing to a recording device failure, one interview could not be included in the data corpus, but nonetheless informed the analysis. All participants’ identities have been anonymised using an interview number. As I have described elsewhere (Beynon-Jones, 2015), the use of numbers rather than pseudonyms represents a (far from ideal) solution to concerns that some women expressed about the concealment of their identities.
My analysis of the data was supported by the qualitative data management software NVivo 10. I explored the different forms of interactional trouble which women encountered and coded the transcripts in terms of thematic patterns in the discursive work via which they navigated this. Below, I present three examples of this discursive work and explain how it enables women to take up, or reject, particular subject positions in specific moments of talk concerning abortion. I also highlight how the positions available to women are limited by available “interpretative repertoires” (routinised ways of speaking) about abortion.
As discourse analysis is itself a form of social action, its proponents do not typically seek to make truth claims. Nonetheless, there are criteria against which the legitimacy of a discourse analysis can be assessed. In analysing my data, I was particularly concerned with “participants’ orientation” (Potter & Wetherell, 1987, p. 170), i.e. whether the forms of discursive labour that I identified seemed significant for women themselves, and “fruitfulness” (Potter & Wetherell, 1987, p. 171), i.e. whether the discursive patterns identified provided new analytic insights.
Analysis
Asserting certainty
In this section, I illustrate a key form of discursive labour in which women engaged, namely, the strategies via which they positioned themselves as “certain” that their decisions to end their pregnancies were correct. The articulation of abortion as the only possible and legitimate outcome of a particular pregnancy was central to most women’s accounts. However, what was notable about these accounts was that assertions of “certainty” were often constructed through the refutation of alternative, “troubled,” subject positions:
Another way in which certainty is asserted in these accounts is through explanatory work around abortion decision-making. Such work would be anticipated by other studies that note the prevalence of justifications in women’s accounts of abortion (for example, Cockrill & Nack, 2013; Lattimer, 1998). However, an interesting feature of the explanations provided by participants in this study is that the desire not to have children, to pursue a career or to gain an education are depicted as legitimate goals which – far from requiring explanation or apology – are deployed as straightforward, untroubled, evidence of “certainty” about abortion. This resonates with Hoggart’s (2012) finding that, in spite of a UK policy discourse which constructs teenage pregnancy and abortion as problematic, teenage women are able to describe having an abortion as socially legitimate. In this study it was notable that participants across a wide range of ages at the time of abortion (18–36 years) constructed the pursuit of education, career, relationship or other life aspirations as valuable and, indeed, more legitimate alternatives to continuing with a particular pregnancy. Such accounts were provided by women with, and without, children.
Not all participants described abortion decision-making as non-dilemmatic. One participant, for example, spent nearly three hours discussing the difficult process of deciding to end her pregnancy following her partner’s decision not to support it. Nonetheless, while her account of the decision-making e
Women who did not have children, such as the participant speaking in the previous extract, typically (although not exclusively – see Extract 1) emphasised their plans to pursue maternity
Emphasising individual agency
Another key form of discursive work via which women untroubled the meaning of having decided to have an abortion was to critique others’ negative judgements. In analysing women’s strategies of stigma management in relation to abortion, Cockrill and Nack (2013) argue that: Through
In this study, a cross-cutting feature of such accounts was participants’ deployments of a repertoire of “liberalism”:
Women developed related critiques concerning their experiences of navigating anti-abortion protests outside of clinics: Participant: I just kind of like doing it I guess. I think it helps. And it’s like really annoying when those people stand outside the clinic all the time. At the [
Critiquing particular expressions of opposition to abortion as oppressive encroachments into private choices and experiences enabled participants to depict their individual agency as morally important. It also allowed them to construct the problems they encountered as resolvable and to position themselves as potential agents in the process of addressing “ignorant” or “abusive” behaviour, by correcting misrepresentations of abortion. This positioning was, arguably, facilitated by the study’s explicit framing as a means of “giving voice” to women through building research knowledge about marginalised perspectives.
Nonetheless, liberalism also “dissolves entire areas of socio-political conflict into interpersonal problems” (Kitzinger, 1987, p. 196). Constructions of stigmatisation as the product of individually problematic behaviours (e.g. ignorance or abusiveness) render invisible – and make it harder to confront – the gendered social relations which construct abortion as a stigmatised course of action (this argument is outlined by Parker & Aggleton (2003) in the context of HIV/AIDS). Although the promotion of tolerance through education is widely advocated as a solution to multiple forms of stigmatisation, “tolerance and intolerance are […] very much the same thing – neither position requires those in power to give up power, rather these concepts reinforce power differentials by denoting who does and does not have the power to be tolerant” (Clarke, 2005, p. 4). Notably, in the extracts considered above, women position themselves as
Explaining silence
While women regularly took up the position offered by the study’s framing, of voicing a missing perspective that should be central to discussion of abortion, many (although not all) constructed speaking
Central to the way in which women described talking about having an abortion was the notion that there is a taken-for-granted etiquette concerning the circumstances in which this is “appropriate,” or “reasonable”: Participant: Yeah, I’ve talked about it with probably three of my closest friends but not - maybe four even – but not, not flippantly. But I have shared my experiences with friends, yeah. Siân: Yeah, ok. So when you say not flippantly do you mean sort of it’s something that you’d have a more of an in-depth conversation about as opposed to something you would mention in passing kind of thing? Participant: Yeah. No, “Oh yeah, I had one of those,” [
Rules surrounding speech about abortion re-occurred in many of the interviews: Participant: I think I told maybe sort of friends-wise only maybe one or two people. And if it comes up in conversation normally I just kind of say that we lost the baby. But then that kind of - I feel a bit ashamed to lie about it but I’m not lying it’s just, it’s such a big conversation to have and to try and explain that I just tend to say that we just lost the baby. But I think my gut instinct is that I would just say but it’s just that it’s such a big conversation. And then like we said, it’s the timing. If your friend is pregnant it’s not a conversation that you’re going to enter into. (Interview 5)
Conclusion
Drawing on insights provided by critical approaches to the conceptualisation of stigma in other fields of healthcare (Farrugia, 2009; Parker & Aggleton, 2003), this paper has highlighted the significance of the conceptual frameworks through which women’s accounts of abortion are explored. Treating such accounts as a “transparent medium” (Wetherell, 2001, p. 16) through which to access the “reality” of individual experiences of abortion stigma, I have suggested, risks reifying stigma as an a-social “kind of thing” (Parker & Aggleton, 2003, p. 14) and positioning women who have abortions as possessors of a “spoiled” identity. In contrast, discursive psychology treats identity construction as an unfolding social process, through which speakers position and re-position themselves in relation to particular contexts of talk.
In applying this approach to the analysis of women’s interview accounts of abortion in England, I have highlighted how the social contexts of talk about abortion shape women’s navigations of untroubled (i.e. non-stigmatised) identities. I have explored three examples of the discursive work in which women engage when talking about having decided to have an abortion. A central finding is the discursive labour in which women have to engage in order to negotiate an anti-abortion repertoire of (inevitable) regret and position themselves as “certain” about their decisions to end their pregnancies. Participants’ accounts illustrate that women
In a country in which abortion is not a legal “choice” for women, it is striking that another key form of discursive work in which participants engaged was to emphasise the importance of non-interference with personal reproductive choices. Drawing on a repertoire of “liberalism,” women constructed abortion as a private decision and positioned others’ problematisations of abortion as individual failures of tolerance. While women’s capacity to prioritise their individual agency and autonomy is significant, I have suggested that it is important to reflect critically on the liberal repertoire through which this positioning is achieved. Constituting stigmatisation as “what some individuals do to other individuals” (Parker & Aggleton, 2003, p. 16) obscures, and makes it difficult to contest, the
I have argued that key insights into the social possibilities of meaning-making about abortion are also generated by attending to women’s talk about
In comparison to conventional accounts of abortion stigma, addressing language as a form of social action both offers alternative insights into women’s accounts of abortion and underscores the significance of the discursive contexts in which these accounts are solicited. This study positioned “women’s voices” as marginalised but essential to understanding abortion, a framing which appeared to make particular positions available to participants. Women routinely asserted the legitimacy of abortion and highlighted the importance of their experiential knowledge. In terms of feminist research and abortion advocacy this illustrates the importance of attending not only to the production of spaces in which women can “voice experiences” but also the specific ways in which women are positioned through the framing of these spaces. What kinds of accounts of abortion do they make possible?
It is important to also highlight some of the silences produced through my discourse analysis of women’s stories. The relative demographic homogeneity of the sample (primarily White and/or highly educated) may have concealed social divisions in the discursive resources available for speaking about having an abortion in England. A focus on patterns that cut across women’s accounts also makes it easy to lose sight of other key differences, namely, participants’ very different emotional experiences of ending their pregnancies. Relatedly, while it offers important insights into the re-negotiable basis of identity, the analytic approach adopted in this paper arguably fails to consider what it is like to
