Defining abortion beyond the clinic: Lay perspectives of abortion from a multi-state cross-sectional survey

Abortion as a term functions within and across multiple spheres of interaction-medical, legal, public, and lay. Considerable attention has been given to medical and legal definitions regarding abortion. However, limited research exists regarding lay definitions of abortion and how they may be distinct from those in other discursive realms. This is the case even though research suggests lay conceptualizations of reproductive health topics play a central role in shaping reproductive health-related beliefs, norms, and behaviors. In an effort to begin closing this gap in knowledge, this study investigates lay definitions of abortion within the context of the contemporary U.S. reproductive health landscape, focusing on three western states with large rural populations. In a quantitative survey of 2,603 individuals, we explored people's definitions of abortion by asking them to identify if a range of reproductive scenarios qualify as abortion. Our analysis also examines how specific demographic and social factors influence those definitions. Results reveal substantial uncertainty among participants about what reproductive situations qualify as abortion, with only one prompted scenario-having a procedure to end a pregnancy after deciding not to be pregnant-consistently classified as abortion. Participants often diverge from medical definitions, sometimes classifying non-medical scenarios as abortion while not classifying medically defined abortion as such. Analysis further demonstrates that lay definitions are influenced by participants' stances on abortion legality, political ideology, personal experiences, and beliefs about pregnancy. Those who believe abortion should not be legal are more likely to classify pre-implantation scenarios as abortion, while those who believe abortion should be legal tend to classify more scenarios as abortion overall. Our findings underscore the complexity and heterogeneity of lay definitions for abortion and create infrastructure for the continued examination of what those lay definitions are and how they differ according to individual demographics, beliefs, and experiences.