Association of abortion stigma and psychological flexibility in women who had termination of pregnancy due to fetal anomalies

INTRODUCTION:
To assess factors associated with stigmatizing behaviour and beliefs in women who had termination of pregnancy due to fetal anomalies.


METHODS:
This was a cross-sectional study of women who had pregnancy termination due to fetal anomalies and age-matched pregnant women as controls, conducted between January – December 2023, at a tertiary fetal medicine center. The participitants completed the Turkish-validated version(1) of Stigmatizing Attitudes, Beliefs and Actions Scale (SABAS)(2) and psychological flexibility scale(3, 4) upon admission. Maternal sociodemographic and obstetric history data were collected and analyzed with the questionnares.
RESULTS:
Abortion stigma was low in both groups (mean scores 30 vs. 31, out of the maximum score of 90, p=0.65). Psychological flexibility was higher among the control group (132 vs. 109, p<0.001). Higher education and higher economic status were inversely related to abortion stigma (26±7 vs. 33±9, p=0.0014 and 26±7 vs. 31±10, p=0.05, respectively). Women who had at least one child had more stigma towards pregnancy termination compared to women who do not have any children (32±9 vs. 27±8, p=0.02). Timing of termination of pregnancy (first vs. second trimester), maternal age, presence or absence of aneuploidy screening test, time from diagnosis to termination were not factors associated with abortion stigma.
DISCUSSION AND CONCLUSION:
We have shown that abortion stigma is low among women who had to terminate their pregnancy. Stigmatizing beliefs and behaviours are positively associated with having at least one child, and negatively associated with higher education and higher economic status.