Category evolution under conditions of stigma: the segregation of abortion provision into specialist clinics in the United States

Grace Augustine, Alessandro Piazza

Research output: Contribution to journalArticlepeer-review

5 Citations (SciVal)
154 Downloads (Pure)


Organizational involvement in stigmatized practices, that is, practices that attract substantial societal condemnation, is often challenging, inasmuch as it requires the successful management of stakeholder disapproval. In this regard, existing work on organizational stigma has highlighted the advantages of situating stigmatized practices within large, generalist organizations, because doing so allows for stigma dilution—that is, organizations can reduce stakeholder disapproval by increasing their relative engagement in uncontested practices, thereby straddling multiple categories in the eyes of audiences. This line of argument, however, runs counter to the empirical observation that stigmatized practices often remain overwhelmingly concentrated within smaller, specialist organizations, even though these are often not optimally positioned to cope with stigma. In this paper, therefore, we undertake an in-depth historical analysis of a revelatory case—abortion provision in the United States following the landmark Roe v. Wade U.S. Supreme Court decision—to build theory of how stigmatized categories can come to be populated predominantly by specialists. Building on primary and secondary archival materials, we identify three mechanisms that shaped category evolution and resulted in the de facto segregation of abortion into specialist organizations: the founding of freestanding facilities by values-driven providers, the exit of generalist organizations from the category, and the involuntary specialization of remaining providers, as customers no longer frequented them for other services and they soon became labeled simply as “abortion clinics.” We conclude by discussing the implications of our findings for the stigma literature and the generalizability of our theorizing to other settings.
Original languageEnglish
Pages (from-to)624-649
Number of pages26
JournalOrganization Science
Issue number2
Early online date26 Mar 2021
Publication statusPublished - 31 Mar 2022

Bibliographical note

Funding Information:
The authors contributed equally to this manuscript and are listed in alphabetical order. During the development of this manuscript, they have benefited from useful conversations with Esmé Deprez, Drew Halfmann, Carole Joffe, and Johanna Schoen. Callen Anthony, Brayden King, Daniel Hirschman, Nevena Radoynovska, Eero Vaara, and Daniel Waeger provided useful comments, as did seminar participants at the Aalto School of Business. Remaining errors are our own.

Publisher Copyright:
© 2021 INFORMS


  • Roe v. Wade
  • abortion
  • categories
  • clinics
  • generalists
  • specialists
  • stigma

ASJC Scopus subject areas

  • Strategy and Management
  • Organizational Behavior and Human Resource Management
  • Management of Technology and Innovation


Dive into the research topics of 'Category evolution under conditions of stigma: the segregation of abortion provision into specialist clinics in the United States'. Together they form a unique fingerprint.

Cite this