Physicians, abortion provision and the legitimacy paradox

Physicians who provide abortion care are targets of stigma, harassment and violence. As a result, many providers do not speak openly about their work. We hypothesize that stigma and silence produce a vicious cycle: when abortion providers do not disclose their work in everyday encounters, their silence perpetuates a stereotype that abortion work is unusual or deviant, or that legitimate, mainstream doctors do not perform abortions. This contributes to marginalization of abortion providers within medicine and the ongoing targeting of providers for harassment and violence. This reinforces reluctance to disclose abortion work, and the cycle continues. We call this phenomenon a legitimacy paradox. The paradox is that although many highly trained, legitimate physicians provide abortion care, abortion providers continue to be depicted as illegitimate, deviant or substandard doctors. The legitimacy paradox has adverse consequences for abortion human resources, for women's experiences of abortion care and for abortion law and policy. (c) 2013 Elsevier Inc. All rights reserved.