Wollum Alexandra, Makleff Shelly, Baum Sarah E
Ibis Reproductive Health, Oakland, CA, United States.
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Front Glob Womens Health. 2021 Jun 10;2:678101. doi: 10.3389/fgwh.2021.678101. eCollection 2021.
The Individual-Level Abortion Stigma (ILAS) scale is a tool to measure multiple dimensions of stigma among people who have abortions. Despite use of the scale globally, little is known about participant experiences completing the scale. We assessed reactions to and experiences with the scale among women who obtained abortions in Mexico, exploring how the items made them feel about themselves and their abortion. We conducted 10 in-depth interviews with women approximately 6 months after their abortion. We explored experiences answering the ILAS overall as well as each sub-scale (self-judgement; worries about judgement; isolation; community condemnation). We used thematic analysis to examine overall experiences with the ILAS and framework analysis to summarize responses by sub-scale. Many respondents reported positive experiences responding to the scale or said it served a therapeutic purpose. Other participants said the scale caused strong or mixed emotions or generated doubts. Women generally described mixed and negative reactions to the "worries about judgement" and "community condemnation" sub-scales, and more neutral or positive reactions to the "isolation" and "self judgement" sub-scales. Nearly all respondents hypothesized that completing the ILAS at the time of their abortion would be more difficult than responding months after their abortion. People can experience both positive and negative effects when responding to abortion stigma scales. Use of the scales may cause discomfort and introduce concepts that further perpetuate stigma. This study highlights the importance of carefully considering when it is appropriate to implement the scale and exploring safeguards for participants.
个体层面的堕胎污名化（ILAS）量表是一种用于衡量堕胎者污名化多维度情况的工具。尽管该量表在全球范围内都有使用，但对于参与者完成该量表的体验却知之甚少。我们评估了墨西哥堕胎女性对该量表的反应和体验，探究这些条目如何影响她们对自身及堕胎行为的感受。我们在女性堕胎约6个月后对她们进行了10次深度访谈。我们探讨了她们回答ILAS量表整体以及各个子量表（自我评判；对评判的担忧；孤立感；社区谴责）的体验。我们采用主题分析法来审视对ILAS量表的整体体验，并运用框架分析法按子量表总结回答情况。许多受访者表示回答该量表的体验良好，或者说它起到了治疗作用。其他参与者则表示该量表引发了强烈或复杂的情绪，或者产生了疑虑。女性总体上对“对评判的担忧”和“社区谴责”子量表描述了复杂和负面的反应，而对“孤立感”和“自我评判”子量表则有更中性或积极的反应。几乎所有受访者都推测，在堕胎时完成ILAS量表会比在堕胎数月后回答更困难。人们在回答堕胎污名化量表时可能会经历积极和消极两种影响。使用这些量表可能会引起不适，并引入进一步使污名化持续存在的概念。本研究强调了仔细考虑何时适合实施该量表以及探索针对参与者的保障措施的重要性。
