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Research Blog: How are TV shows depicting reproductive choice?

by Laura Hooberman

If you, like me, are a big fan of reproductive freedom and offbeat, female character-driven television shows, 2016 was a good year for you (I mean…good for you as a television fan. 2016 overall? Pretty rough). That year, episodes of Crazy Ex-Girlfriend and Jane The Virgin both featured plotlines where characters had abortions, and in neither instance was the abortion portrayed as a traumatic experience. Characters in both shows were thoughtfully depicted, shown considering the impact a child would have on their lives, and then deciding, without guilt, tears or uncertainty, not to proceed with an unwanted pregnancy. No drama. No regrets. No bells and whistles. Just two women, each making the choice that that they knew was right for them, and then moving forward with their lives.

Of course, not everyone experiences an abortion this way. For many people, deciding whether to have an abortion is deeply complicated, emotionally charged, and can inspire feelings of guilt or uncertainty. That’s totally valid. But it does seem to me that as a culture, we tend to push only certain abortion stories, like ones where abortions are traumatizing or medically complicated, to the forefront. This can make abortion seem scary, shameful and stigmatizing. It also doesn’t feel like it reflects the reality of how many people in our culture experience abortions. Did you know, for instance, that having an abortion has not been found to be predictive of any negative mental health outcomes?[1] Or that a first trimester abortion is among the safest medical procedures performed in the United States?[2] There’s also the simple fact that abortions are incredibly common. Nearly one in four people with uteruses living in the United States will have an abortion before the age of 45.[3] That means there’s tens of millions of unique abortion narratives in this country. Thinking about this, in the wake of watching these two television episodes, made me wonder whether TV depictions of abortion are accurately representing the breadth and diversity of these experiences.

Just based on the media I’ve consumed, I thought it was unlikely. The moments depicted across these two particular episodes felt unique. Personally, I hadn’t previously seen a single televised representation of abortion where the decision to terminate a pregnancy wasn’t depicted as a moment of pivotal and terrible intensity in a person’s life, riddled with medical and emotional consequences. But then again, despite being an avid consumer of televised media, I haven’t watched and analyzed all depictions of abortion-related plotlines in American television over, say, an eleven year timespan. Fortunately, however, Gretchen Sisson and Brenley Rowland, two researchers from the University of California, San Francisco, did just that, and the results are pretty fascinating.

In 2017, Sisson and Rowland conducted a study analyzing depictions of abortion and medical risk on American television between 2005-2016.[4] They were interested in identifying televised representations of abortion complications, instances of medical intervention in routine abortion procedures, and plotlines focused on long-term physical and psychological health consequences as a result of a character having an abortion.

The researchers identified 80 abortion-related plotlines in tv shows between these years. Of these, they found that nearly 40% of the plotlines depicted characters experiencing medical complications, requiring medical intervention, or experiencing negative health consequences as a result of having an abortion. Wondering what the actual rate is of complications during an abortion? At the time of the study, it was a whopping 2.1%. Moreover, in reality, the majority of complications patients report are minor, while in televised depictions, major medical interventions, like hysterectomies, were grossly overrepresented. In fact, if you’re looking at the rate of major complications during an abortion, at the time of the study, it was estimated at 0.23%.

In addition, the authors found that nearly a quarter of characters were shown to face a long-term adverse health consequence, including mental illness, infertility or death, as a result of having an abortion. Remember when I mentioned that research has found no link between having an abortion and any negative mental health outcomes? Yeah, so, not super accurate on that front. Research has also not found any link between having an abortion and experiencing infertility later in life. And although the researchers found an abortion mortality rate of 5% on television, in reality, the mortality rate is 0.00073%. So a character on television having an abortion is more than 7,000 times more likely to die from the procedure than a patient having an abortion in real life. But there was one small glimmer of hope (and by ‘small,’ I do mean really, really small): in 5% of the plotlines the researchers analyzed, having an abortion was shown to have a positive impact on a person’s life.

There are a few things we might consider here. First, as it turns out, the two episodes I was discussing earlier, where abortion was depicted as a straightforward medical procedure, and where the people having abortions weren’t shown to be traumatized by their experiences? Turns out, these are definitely anomalies across the television landscape over the last twenty or so years. But we also might wonder, does this really matter? Television, after all, isn’t reality. Shouldn’t audiences be able to identify a plotline exaggerated for dramatic effect? Is it really fair to accuse fictional narratives of playing a part in constructing abortion in the public imagination as a dangerous, shameful secret?

I would argue it is fair, and I think the authors would, too. Sisson and Rowland point out that previous research has shown that individuals who have not given birth themselves tend to rely on media representations to form their own expectations of what pregnancy and childbirth are like. The authors speculate that this is likely to be even more so the case with developing opinions and beliefs about abortion, because abortion in our culture is so stigmatized and hard to talk about openly. There’s also just the fact that there’s so much misinformation about abortion out there already, and one could argue that putting forth misleading narratives about what abortion is like just adds to that already gigantic pile of falsehoods. As the authors highlight, previous research has shown that individuals, even those who have had abortions themselves, tend to overestimate the physical and psychological risks of abortion. Of course, that messaging is likely coming from a lot of different places, but the authors make a compelling case that televised depictions of abortion are a real part of the problem.

In sum, representation matters. From where we stand in 2018, with Brett Kavanaugh confirmed to the Supreme Court, Roe v. Wade in jeopardy, and wading through an onslaught of restrictions to abortion access enacted through state legislation across the United States, there’s a ton of work that needs to go into safeguarding and bolstering access to reproductive choice. I’m not suggesting that calling NBC and demanding more nuanced abortion plotlines on television is going to solve anything. But I am hopeful that a tide has turned in recent years, and that we’ll have the opportunity to witness abortion narratives on television that are treated with the honesty and care that these stories deserve. And I’m hopeful that this will make it easier for us, too, as a society, to have better conversations about abortion, rooted in compassion, curiosity, and most importantly, reality.

[1] ANSIRH: Advancing New Standards in Reproductive Health (2018) The mental health impact of receiving vs. being denied a wanted abortion. (Issue Brief). Retrieved from: https://www.ansirh.org/sites/default/files/publications/file/mental_health_issue_brief_7-24-2018.pdf

[2] Guttmacher Institute. (2018). Induced Abortion in the United States. (Fact sheet). Retrieved from: https://www.guttmacher.org/fact-sheet/induced-abortion-united-states

[3] Guttmacher Institute. (2017). Abortion is a Common Experience for U.S. Women, Despite Dramatic Declines in Rates. (News Release) Retrieved from: https://www.guttmacher.org/news-release/2017/abortion-common-experience-us-women-despite-dramatic-declines-rates

[4] Sisson, G. & Rowland, B. (2017). “I was close to death!”: abortion and medical risk on American television, 2005-2016. Contraception, 96, pp. 25-29.

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