Theory of Change

Many of us who grapple with stigma or see the negative effects of stigma around us are on a culture change mission. We seek a world where people are supported in making the best reproductive decisions for themselves and their families, free of interference, judgment or fear. So how can we make that happen?

At Sea Change we have developed a four-stage model of culture change. This model is based on the work of a long line of stigma theorists as well as our observations of people and organizations that are affected by abortion stigma. It draws on our understanding of what motivates changes in behavior and attitude among both the stigmatized and the non-stigmatized.

We expect our theory of change to be a work in progress! And we invite curiosity, engagement, and re-envisioning of our model. Let us know what you think and how you are approaching the issue of stigma in your work.


Stage 1: IsolationStage 1: Isolation

Women and men who have chosen abortion, parents who have supported a child through an abortion, clinicians and clinic workers, and even pro-choice advocates may feel stigmatized by their association with abortion. Yet our experiences with abortion and the feelings associated with these experiences are often concealed. Even if we don’t agree with the stigmatizing attitudes we observe, we conceal stigmatizing experiences to avoid judgment, awkward encounters, and to protect our own reputations and the privacy of our loved ones.

Yet, concealing our experiences with abortion doesn’t protect us from some forms of stigma. We can become isolated and invisible to those around us, even those who might have a shared experience. We might observe people’s judgment about abortion and see stereotypical representations of abortion in the media. We are aware that our government withholds abortion care from some people and that governments around the world make abortion illegal altogether. In fact, many of us have been taught from a young age that abortion is wrong, sinful, and selfish, it can be hard to shake those messages even if we don’t fully believe they are true.

At Sea Change we get it: stigma hurts. Secrecy and isolation can provide protection from some forms of stigma, but other forms will persist. And what’s worse, secrecy perpetuates disconnection and invisibility. Disconnected, invisible people can’t advocate for change. We develop strategies to help people connect with and become visible to other people who understand.

Stage 2: ConnectionStage 2: Connecting in a protected space

Changing the culture means coming out of disconnection, invisibility and isolation and beginning to connect with other people who share our stigma. So how do we stick our toes in those waters? Well…

  • If you have had an abortion, you might go online and search for abortion stories or call a talkline to talk to a volunteer.
  • If you work in abortion care, you might attend a professional workshop or a conference with other people who work in abortion service provision.
  • If you are a parent of a young person who needs abortion care, you might talk to another parent or a clinician.
  • If you are an advocate, you might go on Facebook or Twitter to find others who understand your point of view.

Each of these decisions meets the same goal: connecting with and becoming visible to a community of people who might just “get it.”

At Sea Change we call these spaces “protected” because they facilitate connection among stigmatized people, while reducing the anxiety of public scrutiny or comment. We help organizations and individual develop, maintain and measure the effect of protected spaces.

Here’s what we’ve discovered: once we begin to gather and share our stigmatized experiences in private space, some important things can happen. We can form a group identity, set our own agenda, name our own struggles, and develop strategies for resistance and resilience to stigma in the culture. Connecting in private space creates the conditions that support Stage 3: Engaging with culture.

Stage 3: Engaging with cultureStage 3: Engaging with Culture

Culture change is impossible if we are only talking to people who are like us and understand our struggle. We need to identify allies, raise awareness, change hearts and minds, and dismantle the norms, institutions, and conditions that perpetuate stigma.

At Sea Change we believe that engaging with culture requires naming our culture change targets, adopting evidence-based strategies, implementing those strategies, and evaluating their impact.Targets may include community members, politicians or political parties, and health care institutions. We also might adjust our messages to target an aspect of identity that is shared among a diverse group of people such as: motherhood, nursing, or being a member of a shared race or ethnic group. We help stigmatized groups to adopt successful strategies for achieving their culture change goals such as: sharing stories, producing new evidence, or teaching people strategies to listen and engage on the issue of abortion in new ways. Finally we produce tools to measure the effectiveness of these strategies.

When we connect with other individuals and engage with culture in targeted and evidence-based ways, we can create measurable changes in attitudes, engagement, representation and policy. These successes lay the groundwork for Stage 4: Amplification.

Stage 4: AmplificationStage 4: Amplification

Our successes in Stage 3 prompt a desire to scale our efforts through thoughtful movement collaboration. By working with other groups in diverse contexts we can have a greater impact than when we are small and siloed. Collaboration can be extremely effective for drawing in resources, developing a shared agenda, and moving our vision forward. These efforts can create a sea change: a world where abortion is normal, supported, and safe.

At Sea Change we live in the final stage of culture change by focusing on sustainable, collaborative action.We help organizations and individuals to network with one another, share tools and strategies, and generate creative new ideas. We support existing culture change leaders and train new change agents. We communicate with and learn from groups and individuals who are promoting culture change around other stigmatized experiences or identities. We are allies and supporters of movements and individuals who have similar experiences and concerns.

Does this model of culture change make sense to you? Do you feel challenged? Inspired? Curious? Skeptical? Join us in creating a sea change. We would love to hear your feedback!

Frequently Asked Questions

We’ve presented this culture change model at many meetings and we have received some comments and questions. We share some of this feedback here and some of our thoughts.

Comment: “This is so obvious.”

Response: Thank you! This feeling is the hallmark of good social science. It means we’re on to something. We want this model to feel like second nature and be memorable and adoptable.

Comment: “This is great, but how do we get more people to talk about their abortions.”

Response: Great question. We think that people are more likely to share their stories when they have had an opportunity to connect in protected space. So if you would like to hear more people share their experiences with abortion, we suggest that you invest in interventions that connect people who have abortions with one another. Email us and we can talk more about organizations that use this type of intervention successfully.

Comment: “This is pretty good, but my thinking about stigma is slightly different.”

Response: Awesome. We’d love to talk with you more about that. Feel free to contact us through email or twitter, share a link to your work or send us a sketch on the back of an envelope. We’re culture change geeks and we’d love to hear from you.

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Stigma impacts us all. It creates a culture of shame in which people cannot be their whole selves. Help us grow our work and support culture change around the world.


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