Original research article Analyzing the impacts of abortion clinic structures and processes: a qualitative analysis of women's negative experience of abortion clinics Katrina Kimport ⁎ , Kate Cockrill, Tracy A. Weitz Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, University of California, San Francisco, 1330 Broadway, Ste. 1100, Oakland, CA 94612, USA Received 22 July 2010; revised 21 May 2011; accepted 27 May 2011 Abstract Background: In the United States, the social myth that abortion clinics are unsafe, lonely places is pervasive. Little research has investigated the extent to which women's negative experiences of clinic interactions and processes confirm or contest this myth. Study Design: Semistructured interviews with 41 women who received an abortion at a clinic were conducted and analyzed using qualitative analytical techniques in Atlas 5.0. Results: The processes and structures of the abortion clinic necessitated by the realities of antiabortion hostilities lead some women to react negatively to the clinic experience in ways consistent with the social myth of the abortion clinic. Staff interactions can mitigate or alleviate these experiences. Conclusions: Clinic workers and administrators should be aware that safety structures and processes may create negative experiences for some women. Policymakers should be aware of the extent to which public policies and conflict over abortion render the social myth of the clinic a reality. © 2012 Elsevier Inc. All rights reserved. Keywords: Abortion; Abortion clinic; Abortion myths; Qualitative research 1. Introduction In the American context, abortion is provided predomi- nately in freestanding clinics: over 70% of abortions occur in facilities where more than half of the care provided is abortion-related [1]. The emergence of the freestanding abortion clinic is a historical phenomenon, influenced by social factors, including the work of advocates and opponents [2–4]. In parallel, the abortion clinic has become a popular narrative frame in the political debate over abortion rights. Depictions of clinics in popular culture, such as in the movie Juno [5], cast them as lonely, depressing places devoid of compassion or human contact. Other films, such as If These Walls Could Talk [6], and ongoing media coverage of violent protests outside abortion clinics reinforce the idea that clinics are volatile and scary places. Other common characterizations of the abortion clinic are more extreme, labeling the clinic a “mill” or “factory” [7] and thereby asserting that clinics are highly efficient enterprises with a capitalist motivation and no concern for the women themselves. For example, a new documentary, Blood Money [8], professes to expose the profit Planned Parent- hood makes from abortion. Collectively, these narratives of the clinical space are emotionally intense and invite identification by the general public, especially those who have not had an abortion at a clinic but believe they understand the experience. These characterizations do not generally match the reality of the abortion clinic. Prior research documents that, overall, women are highly satisfied with the abortion care they receive in clinics [9–12]. But negative characterizations of the clinic nonetheless occupy a central place in public narratives about what abortion is. Just as narratives of illegal abortion in the 1960s introduced the rhetoric of a “back alley abortion” with its attendant connotations of victimization [13], tales of the abortion clinic in contemporary narratives of abortion can be understood as representing a social myth of abortion. While these myths may be dismissed as false or Contraception 85 (2012) 204 – 210 ⁎ Corresponding author. Tel.: +1 510 986 8929. E-mail address: kimportk@obgyn.ucsf.edu (K. Kimport). 0010-7824/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.contraception.2011.05.020