Researchers see stress, trauma in women’s abortion stories

A UB-led research team has used public narratives, an increasingly popular form of person-centered advocacy offering a forum for sharing previously untold stories, to study the undue stress experienced by women in relation to abortion.

Storytelling is a universal characteristic of humanity, present throughout history and manifest in every culture. Stories told over time on similar themes present rich patterns that enhance understanding, encourage empathy and provide insights into a lived experience that can be unfamiliar to its audience.

The Tennessee Stories Project — a regional initiative that provides space for people with Tennessee-related experiences to find affirmation and form community through storytelling — serves as an abortion narrative platform similar to what is trending on the national level in the #YouKnowMe stories recently initiated by actress Busy Philipps.

“Many researchers are looking at epidemiological factors surrounding abortion, but from a social work practice perspective we recognized there is stress inherent in the abortion experience, especially in the Southeast. We wanted to conduct a formal qualitative analysis to examine stress in these stories,” says Gretchen Ely, associate professor in the School of Social Work, who co-led the study with Mickey Sperlich, a UB assistant professor of social work.

The study results allowed the researchers to categorize themes related to stress, which has the potential to inform intervention and policy.

“Our analysis indicates that stress was found to be present throughout the abortion narratives in four distinct categories: existing stressors prior to the abortion, stressors experienced while attempting to access an abortion, stressors experienced during abortion obtainment and stressors arising after the abortion. A better understanding of when stress is occurring can help educate social workers and other front-line providers, and inform their clinical care and practice responses, and improve policy development,” says Sperlich.

The researchers used a trauma-informed approach to design their study, published in the Journal of Social Work, a framework that recognizes trauma often exists in the lives of people who are seeking health and social services.

At its core, a trauma-informed approach asks, “What happened?” not “What’s wrong?”

“With that in mind, we looked at these 39 narratives for signs where women who experienced trauma are potentially re-triggered by the stress present in their abortion-seeking experience, not the abortion itself,” says Sperlich. “I’m cognizant that many people seeking abortion are not only dealing with an unwanted pregnancy, but may be dealing with other stressors and traumas, such as homelessness, partner violence or rape.”

Abortion is legal at the federal level, but federal funds from programs such as Medicaid can’t be used to cover abortion expenses. State laws requiring things like mandatory waiting periods further restrict access, and are common in Tennessee and throughout the Southeast. If the abortion bans proposed most recently in states like Alabama and Missouri are allowed to stand, whole swaths of the region will be without legal abortion services, creating more stress for abortion seekers.

These potential bans, existing restrictions, abortion stigma, negative interactions with protestors and personal hardships “make the process of trying to access an abortion in Tennessee and throughout the Southeast fraught and stressful,” according to the researchers.

“We have to consider these stories are from a Southeastern state, and represent people who often have a great many stressful burdens to overcome,” says Ely. “Abortion bans in places like Alabama just compound the stress and potentially exacerbate trauma, but do nothing to reduce the actual rates of abortions in the region. They would just delay legal abortion access, or force people to manage abortions illegally on their own.

“For some reason, we don’t seem to realize that these people are our community members, who, for whatever reason, don’t feel their bodies or psyches can bear a child,” Ely adds. “Because of that, they’re in a dire situation and need access to safe and legal health care in the geographic areas where they reside.”