How abortion is portrayed on TV and in movies actually matters so much

The first time a lead character on a prime time television show had an abortion was on the two part episode of Maude called “Maude’s Dilemma” in November 1972, just months before Roe v. Wade was decided. As we come up on the 45th anniversary of the legendary Supreme Court decision on January 22, it still matters how abortion is portrayed on television because, really, we haven’t come all that far. Just earlier this month, Black Mirror was criticized for an episode in which the writers completely conflated emergency contraception and a medical abortion. The show got their facts straight-up wrong and further illustrated how important education, awareness, and accurate portrayals of common and safe medical procedures really are.

ICYMI, the episode in question was called “Arkangel,” in which a mother tries to terminate her daughter’s pregnancy by slipping her what is ostensibly the abortion pill. When the 15-year-old gets sick later in the episode, vomiting and looking like death, she has some tests run. A nurse then tells her that it was “emergency contraception” that caused her illness and the end of her pregnancy. “Emergency contraception. For terminating your pregnancy. You’re not pregnant anymore,” the nurse says. On social media, viewers immediately called the episode — directed by Jodie Foster, of all people — out for misrepresenting, well, everything about abortion, medical abortions, and emergency contraception.

And the call out was for good reason, since the show obviously missed something major.

To be clear, emergency contraception and the abortion pill are two very different things.

Emergency contraception, which is often called the “morning after pill,” can be taken within 72 hours of having sex and works by preventing an egg from being released, so that it never even meets sperm and a pregnancy can’t even occur. But if a pregnancy has already been established by the time the woman takes the pill, it cannot terminate that pregnancy. Meanwhile, the abortion pill is actually a two-step process that can be taken within the first ten weeks of pregnancy, according to the New York Times (though the availability varies state to state).

When taking the abortion pill, or getting a “medical abortion,” according to Planned Parenthood,  a woman takes mifepristone, which blocks progesterone (a hormone needed for pregnancy). About 6 or 8 hours later, they’ll take a second pill, misoprostol, which causes bleeding to empty the uterus. Women will feel cramping with the second pill, and in very rare occurrences, feel nauseous after the first one, but that’s not common. So Black Mirror was all sorts of wrong, especially since both EC and medical abortions are totally safe, don’t make you feel violently ill, and one of them doesn’t even terminate a pregnancy. (Pop quiz: Only the abortion pill can do that.) 

Some fans on social media defended the “mix up,” saying that the show is science fiction and has no responsibility to portray abortion accurately. Experts, however, disagree (as should anyone who cares about abortion rights) since these misconceptions weasel their way into our collective subconscious and can theoretically affect public opinion and policy around abortion. Dr. Daniel Grossman, the director of Advancing New Standards in Reproductive Health (ANSIRH), summed it up in one tweet:

"There are so many myths and misconceptions related to sexual and reproductive health, especially among young people. The entertainment industry has a responsibility to give viewers facts and not further spread untruths that could adversely affect their health."

He added that even in a dystopian future, they could have at least been accurate and distinguished between a medical abortion and  emergency contraception. He pointed to research done by his colleague, Dr. Gretchen Sisson, who heads up the “Abortion Onscreen” project at ANSIRH, by tracking how abortions are portrayed on television. Her most recent research maps how abortions are portrayed across genres and how they differ from dramas to comedies, but her team has also collected data on other aspects of televised abortion. They collect data on the demographic of the woman getting an abortion, why the character is getting one, what barriers she encounters, and what happens afterwards.

Although an impact study is in the works, in which she’ll examine how these portrayals of abortion might affect peoples’ opinion of abortion and abortion laws, she told HelloGiggles that some inferences that can be made.

Take the common trope of a woman on TV who goes to the clinic, decided on an getting abortion, and then changes her mind in the waiting room. “So you can see how that might relate to the public opinion about how women change their mind about abortion and draw a direct parallel to things like waiting periods and mandatory counseling requirements,” Sisson told HG. 

There are a lot of things that we don’t know yet, though. For example, about a quarter of all abortions on TV happen in the past, often in different time periods in which abortions were more dangerous. Think period pieces like Call The Midwife or Atlas Grace. We know what the creators of those shows are thinking, but, Sisson asks, “When viewers see that abortion is dangerous, do they walk away from it thinking, ‘Well, it’s a good thing it’s legal now because that makes it safer’ or do they walk away from it thinking that abortion is really risky?” That’s something Sisson is endeavoring to find out. 

In any case, she says, abortion on TV rarely matches up to the reality of abortion, and there are some patterns she notices again and again. For one, most of the time it’s young, white women getting abortions on television, “actually to a greater extent than TV is white,” Sisson says. In reality, women of color also get abortions and most of them (61 percent, according to Slate) are already parents. Sisson told HG:

"What we’re seeing in pop culture is these young, white, teen girls having abortions. That’s not inaccurate. There are plenty of young, white, teenage girls every day that are getting abortions, but the overall aggregate pattern ...that's not what most people getting abortions look like. It’s a misunderstanding of who gets abortions and why. So that’s certainly problematic."

Another problem is an exaggeration of the physical and psychological adverse effects of an abortion. Sisson said, “Anytime you see an adverse effect of an abortion on TV, it’s exaggerated, whether it’s Claire Underwood being told on House of Cards that her past abortions will cause infertility (they don’t) or even women dying from illegal abortions. “ The proportion of [abortions] that take place in the past are shown to be more dangerous, but the risk of illegal abortions, is even likely exaggerated on TV, which is important to know. But even among contemporary abortions, the risks of physical and psychological adverse outcomes are exaggerated,” Sisson said. 

In recent years, we’ve definitely seen some more “accurate” portrayals of abortion, such as Paula in Crazy Ex-Girlfriend, Donna in Halt and Catch Fire, Xiomara in Jane the Virgin, Cristina Yang in Grey’s Anatomy, or Olivia Pope in Scandal. But even some of those are exaggerated. While Sisson appreciates Shonda Rhimes in particular for showing women getting an abortion in more representative ways. “I mean she showed an abortion, on a top rated, network prime time show, during Christmas,” Sisson noted. But even then, Olivia Pope had to have her abortion in an operating room, which again, is totally exaggerated.

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Sisson said,So we’re getting there, it’s getting more diverse, and getting more representative…but it’s not just about checking off a box. Like one black characters gets an abortion — it’s not like ‘OK, we’ve done that.’ Every woman getting an abortion has different reasons for getting an abortion, different circumstances in her life, different barriers she has to navigate, for every abortion in our country every year which is over a million, there’s a different story to be told, and on TV we see very very similar stories being told rather than that diversity of experience.”

We already know that representation and diversity on TV is important to women for so many reasons. Why not abortion, too? They least creators could do is get their facts straight 45 years after Roe v. Wade.