Two doctors sit, despondent, on the side of a busy road as they watch an EMT zip up the body of their patient into a body bag. The patient died as a direct result of a fatal ectopic pregnancy, which her OB-GYN refused to treat because of a new anti-abortion law in her home state.
Tears in her eyes, one of the doctors responds to questions from the EMT about the death. Then she shouts: “It’s the lawmakers, they should actually be made to come out here … look at the carnage they’ve caused. I mean, how are we supposed to be doctors? Women’s lives are on the line, and our hands that are trained to help them, our hands are tied.”
While this could have easily appeared in a documentary about post-Dobbs obstetrical care in the U.S., it’s actually a scene from a recent episode of the popular medical drama “Grey’s Anatomy,” a show committed to nuanced abortion storytelling. But it isn’t the only show to grapple with these issues. In five years of studying abortion onscreen, I’ve never seen the kinds of depictions appearing on TV today.
Yet even with these poignant scenes, there’s evidence that Hollywood also continues to miss the mark in terms of who is most affected by abortion restrictions – and what the reality of abortion access looks like in 2023.
Hollywood tackles barriers to care
In research I’ve conducted with sociologist Gretchen Sisson, we found that the vast majority of television characters who obtained abortions encountered few, if any, of the legal, financial or logistical barriers that have long been the troubling hallmarks of abortion access in the U.S., even before the Dobbs decision that revoked the constitutional right to abortion.
Over the past year, that’s started to change. In a recent episode of the legal drama “Accused,” a teenager turns to her teacher for help driving from Texas to New Mexico and paying US$750 for a medication abortion. Others, like “P-Valley,” “FBI: Most Wanted” and “Law & Order” show characters encountering abortion bans that prevent them from getting local abortion care, forcing them to venture out of state.
These plot lines differ from earlier story arcs in that the characters deal with the compounding barriers so many people face when seeking abortion care. It’s not just having to travel out of state, but having to pay for a flight, lodging, food and the abortion itself. And then there are the logistical hurdles of finding child care and taking time off work. All represent the often invisible costs of abortion.
We’re also seeing new kinds of conversations about abortion on television. On “The Connors,” one character considers an abortion but is hesitant to download a pregnancy tracking app, fearing that the government might be alerted to her pregnancy.
On “American Auto,” writers deploy some dark humor, showing corporate executives trying to come up with abortion-friendly employee policies, such as sending a fruit basket – “but not with cantaloupe” – and gifting tickets to amusement parks for some post-abortion relaxation.
And on medical dramas like “The Good Doctor” and “New Amsterdam,” fictional clinicians share their own past abortions and support patients through abortions.
Who’s actually getting abortions?
In a world in which many people have such limited information about abortion, popular media can play an important role in increasing knowledge about these critical issues.
But despite these newer, nuanced plot lines, television continues to perpetuate myths about which kinds of people are actually seeking abortion care.
Television has long misrepresented the demographics of abortion patients, choosing to tell the stories of characters who are whiter and wealthier than their real-life counterparts. In our analysis of abortion plot lines in 2022, Sisson and I found that the vast majority of characters who obtained abortions were middle-class or wealthy white women.
These patterns appear to be continuing in 2023. As of this writing, nearly 50% of the characters seeking abortions in this year’s plot lines are white. About one-third are middle-class or wealthy.
In the real world, white women make up only about one-third of U.S. abortion patients, and the majority of patients seeking abortion care live at or below the federal poverty line.
This misrepresentation not only obscures the types of people who are actually seeking abortions, but it also downplays the fact that abortion access is an issue of sex, race and class.
Yet demographics aren’t the only inaccuracies perpetuated by these plot lines; the majority of abortion patients – 59% – are parenting at the time of their abortion. Yet only 18% of 2022’s abortion plot lines and just 9% of 2023’s so far include characters raising children. This perpetuates a false dichotomy between having kids and having abortions.
While wealthy white women certainly may have trouble getting an abortion, research continues to show how Dobbs exacerbates the damning effects of systemic racism on health care access and quality for communities of color.
It’s not just who gets abortions, but the types of abortions they get that’s not reflective of the post-Dobbs reality.
Medication abortion makes up more than half of all U.S. abortions, yet in 2022, only four plot lines, or fewer than 6%, specifically portrayed a character having an abortion by pill. Only three thus far in 2023 – about 10% – have done so.
No plot lines have portrayed characters safely obtaining an abortion on their own by using pills, without input or help from a doctor. This option is medically safe but comes with significant legal risk in many states, including prosecution and arrest.
Why these inaccuracies persist
Months before the opening arguments in Dobbs, Sisson and I interviewed over three dozen Hollywood directors, executive producers and writers who’d all had a role in getting an abortion plot line from page to screen.
We wanted to understand their experiences behind the cameras and inside the writers’ rooms, particularly after a decade of studying the tremendous rise in the number of abortion depictions on film and television alongside a host of inaccuracies.
We recently published these findings. Though our interviews took place when Roe was still in place and before the Dobbs decision struck it down, they nevertheless provide some eye-opening context.
First, the content creators we spoke with repeatedly emphasized that they hoped for emotional accuracy in their abortion depictions. They were less concerned with the political and logistical realities. In media interviews post-Dobbs, several prominent showrunners expressed regret for leaving out this important context.
Our research also uncovered the significant barriers many writers face, like unsupportive showrunners and risk-averse executives. Several interviewees lamented that despite Hollywood’s progressive reputation, many networks feared negative repurcussions from advertisers or audiences as a result of airing abortion plotlines.
These anxieties are truly out of step with the reality that the majority of the American public supports abortion access, knows someone who has had an abortion and has responded positively to abortion plotlines since the 1960s.
In a country where some legislators want to ban even the sharing of information about abortion, popular media may be the most accessible, reliable way to widely disseminate information about abortion. We need to understand both what these depictions do and don’t tell us about abortion, and what it takes to get them onscreen, so we can demand better information and representation.