Although Roe v. Wade identified abortion as a constitutional right over 40 years ago, it bears stigma—a proverbial scarlet A—in the United States. Millions participate in or benefit from it abortion, but few want to reveal that they have done so. Approximately one in five pregnancies in the US end in abortion, a statistic many are startled to learn. Why is something so common, which has been legal so long, still a source of shame and secrecy? Why is it so regularly debated by politicians, and so seldom divulged from friend to friend, or loved one to loved one? This book explores the personal stigma that prevents many from sharing their abortion experiences with friends and family in private conversation, and the structural stigma that keeps it that way. It argues persuasively why America would benefit from working to reverse such stigma, providing readers with tools that may help them model ways of doing so. Our silence around private experience with abortion has distorted our public discourse. Those who support abortion's legality focus on extraordinary cases of abortion need, and those who oppose it focus on what they perceive as extraordinary cases of 'abortion abuse.' As a result, the cases we discuss most are the ones that occur least. Focusing on extremes also contributes to the polarizing and deeply contentious tone that predominates in public discourse. So Katie Watson focuses instead on the remaining 95% of abortion cases, or what she terms 'ordinary abortion.' The book gives the reflective reader a more accurate impression of what the majority of American abortion practice really looks like. It explains why this public/private disjuncture exists, what it costs us, and what can be gained by including ordinary abortion in public debate. To say the US Constitution gives women the right to end an unplanned pregnancy is only the beginning of a conversation. Scarlet A begins with this premise of legality, explaining why abortion has been a constitutional right for nearly 45 years and arguing that it should remain one. It bypasses the quicksand of political debate for richer, more productive conversations about abortion ethics: given the right to continue or end an unplanned pregnancy, how could or should people decide whether to exercise this right? It offers a multi-disciplinary analysis in accessible, translational writing style, combining statistics, philosophy, literary theory and social science with the personal stories of patients and providers. It paints a rich, rarely seen picture of how patients and doctors currently think and act, and ultimately invites readers to draw their own conclusions.