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Primary Submission Category: Reproductive health
Stigmatized in Emotional Distress: The Cost of Procuring a Clandestine Abortion.
Authors: Charles Katulamu,
Presenting Author: Charles Katulamu*
There is a significant public health crisis in countries that criminalize and restrict abortion, where stigma against those who seek abortions prevents women from accessing care, making them turn to unsafe abortion practices. Unsafe abortions pose several health risks, like life-threatening complications and preventable deaths. As restrictive legal frameworks persist and force women into clandestine abortions, there is an urgent need to understand the social and structural factors shaping their experiences. This study addresses this need by examining how stigma interacts with Uganda’s criminalized and restrictive legal environment and fragile health system to shape women’s abortion experiences.
Through semi-structured in-depth interviews, I conducted a retrospective investigation of the experiences of 50 women who terminated their pregnancies in Uganda. Findings demonstrate how stigma is a multi-layered force that interacts with abortion criminalization and restriction and health-system fragility to shape every stage of women’s abortion trajectories. I show that perceived stigma, including fear of arrest, moral judgment, parental backlash, and partner resentment, delays care-seeking and drives women into clandestine abortions. Once they seek care, women encounter experienced stigma where verbal and physical abuse, painful procedures, absent counselling, and denial of follow-up exacerbate both emotional and physical complications. Over time, these experiences deepen internalized stigma, manifesting as guilt, shame, and self-blame, and in some cases, attributing infertility or lasting health problems to the abortion itself.
I therefore argue that abortion stigma is a by-product of an interconnected web of the abortion process, legality, access, and the health system. To avoid negative health outcomes, countries should not only prioritize access to quality, comprehensive, and woman-centered abortion care but also invest in dismantling the systemic structures of stigma.