Constructing a validated scale to measure community-level abortion stigma in Mexico

Area of Science:

• Public Health
• Social Sciences
• Reproductive Health

Background:

• Abortion stigma is a significant barrier to accessing safe abortion services.
• Stigma at the community level in Mexico remains largely unquantified.
• Measuring abortion stigma is crucial for developing targeted interventions and upholding reproductive rights.

Purpose of the Study:

• To develop and validate a scale for measuring community-level abortion stigma in Mexico.
• To examine the prevalence of abortion stigma in a nationally representative sample.
• To identify demographic and regional factors associated with abortion stigma.

Main Methods:

• Development of a comprehensive abortion stigma scale through qualitative work and cognitive testing.
• Pilot testing of a 33-item scale in a nationally representative household survey of 5600 Mexican residents.
• Factor analysis (confirmatory and exploratory) to refine the scale and regression analyses to identify associated factors.

Main Results:

• A 23-item, four-factor model of abortion stigma was established, demonstrating good internal consistency (Cronbach's alphas 0.80-0.90).
• Exploratory factor analysis revealed codependence between discrimination, guilt/shame, and religion dimensions.
• Higher stigma levels were associated with older age, lower education, and living in northern Mexico, particularly concerning discrimination and religion.

Conclusions:

• The developed scale is the first of its kind for measuring community-level abortion stigma in Mexico.
• This validated tool can be utilized in Mexico and similar settings to assess stigma prevalence, identify contributing factors, and evaluate interventions.
• The scale supports policymakers, practitioners, and advocates in addressing abortion stigma and promoting reproductive rights.