Reviewer ’s report  
 
Title: Reducing underreporting of stigmatized pregnancy outcomes: results from a mixed -
methods study of self -managed abortion in Texas using the list -experiment method  
 
Version: 0 Date: 08 Apr 2019  
Reviewer: Aisling  O'Do nnell 
Reviewer's report:  
Review  
Manuscript ID: PRCH -D-19-00271  
Manuscript title: Reducing underreporting of stigmatized pregnancy outcomes: results from a 
mixed methods study of self -managed abortion in Texas using the list -experiment method  
This paper presents an investigati on of the ability of a novel method, the "list experiment", to 
predict population levels of self -managed abortion; something that is difficult to measure due to 
the desire to avoid judgment. The paper also presents further evaluation of the utility of the 
method in relation to how women interpreted the method and the wording of the relevant item, to 
refine the use of this method. As a psychologist with a research interest in the stigmatisation of 
abortion, I know that prior research confirms the intentional  non-disclosure of abortion 
experiences. Given this, and given the risks associated with self -managed abortion more 
specifically, it seems clear that there would be a benefit to having an accurate way to measure its 
prevalence.  
The introduction to the pa per is brief and extremely clear. I felt the rationale for the importance 
and appropriateness of the present study was well demonstrated.  
I must point out that I do not have expertise in the particular methods and software used to 
analyse the data in the se linked studies - so other reviewers will be better placed than I to 
comment on these. However, the analyses were explained and reported clearly and appear 
appropriate to the data and to the study design(s).  
Any limitations that I might have identified  based on the issues with item wording in the list 
experiment were identified and discussed critically by the authors in their discussion. I 
particularly liked the conclusion, which made clear the potential applications of this method in 
terms of understan ding population needs and improving healthcare.  
  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
 
 
Are the conclusions drawn  adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is r ecommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
 
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financia lly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold o r are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do yo u have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the  above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests . 
 
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