Reviewer’s report
Title:  Crowdfunding Abortion: An Exploratory Thematic Analysis of Fundraising for a Stigmatized
Medical Procedure
Version: 0 Date: 09 Jul 2019
Reviewer: Kelly Folkers
Reviewer's report:
This paper is an important study showing proof of concept that stigmatized diseases, conditions, or
procedures may be less successful in raising funds on medical crowdfunding platforms based on
perceived features of worthiness. The authors chose to evaluate this topic with an interesting and apt
comparison between common themes in campaigns seeking funds to access abortion related services
with campaigns that used the choice not to terminate a pregnancy or the harms of abortion as a reason
to donate. This comparison has revealed that campaigns seeking funding for abortions - legitimate
medical procedures that allow people who become pregnant that do not want to carry a pregnancy to
term for a variety of reasons including medical, financial, or social barriers - receive on average
significantly less funding from fewer individual donors than campaigns that appeal to choosing not to
have an abortion as a reason to give. Additionally, it is notable that the latter group of campaigns
receive on average more Facebook shares than those seeking funds for abortion related services. This
result  suggests  that  individual  donor  support  of  individual  campaigns  raising  funds  to  terminate
pregnancies and/or for the costs associated with these choices is in itself highly stigmatized. This is
particularly is striking considering that the Pew Research Center has estimated that 60% of Americans
believe that abortion should remain legal. The authors put these results into context and suggest that
"certain conditions and disease may be less successful in medical crowdfunding based on perceived
features of worthiness..." The authors provide support for the hypothesis that donors are less likely to
financially support and/or publicize campaigns in which there is pervasive social stigma, particularly if
individuals do not fit socially accepted criteria for worthiness or could be perceived as being worthy of
blame for their condition. While this is likely to be true, their broad conclusion is too strong given the
lack of research on crowdfunding for other stigmatized conditions and procedures, like substance
abuse, mental health, alcoholism, and sexually transmitted diseases. It is possible that the gaps in
equitable funding between campaigns for abortion related services and those citing the choice not to
terminate a pregnancy/the harms of abortion as a reason to give are particularly vast as compared to
other stigmatized conditions, given that abortion is one of the most highly politicized partisan issues in
public discourse today. Their broad conclusion could be drawn with additional research that compares
perceived  features  of  worthiness  in  other  areas  unrelated  to  reproductive  health;  for  example,  a
thematic comparison between campaigns raising funds for alcoholic liver disease and non-alcoholic
liver disease may help elucidate this idea further and answer the question of whether this study's results
are particular to abortion.
Furthermore, the manuscript would benefit from reporting the average amount of funding requested for
each  area.  This  would  allow  for  a  more  direct  comparison  between  the  two  main  categories  of
campaigns if the percentage of the average funds raised over the average funds sought were reported.
Though there may be differences in the average amount of funds sought between the two categories, it
seems likely that campaigns raising money for abortion related services would still receive far fewer
donations and less attention on social media than those specifically appealing to the choice not to
terminate a pregnancy or to the harms of abortion. Reporting the data in this manner would strengthen
the paper's conclusions and provide additional evidence that stigmatized conditions and procedures are
substantially less successful than those without such stigma.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
Declaration of competing interests
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