Steph Herold on Hollywood’s Role in Stigmatizing Abortion

In Season 3 of ABC’s A Million Little Things, Maggie Bloom (Allison Miller, right) decides to have an abortion.

Hollywood’s Role in Stigmatizing Abortion

And its responsibility now

By Steph Herold

As we collectively reel from the Supreme

Court decision in Dobbs v. Jackson Women’s Health, every reproductive rights movement conflict, messaging failure, and cultural flashpoint is facing public scrutiny, in an attempt to place a retrospective narrative on the unraveling of abortion rights in the United States. Many are looking to entertainment media, noting its role in promoting support for other progressive issues, and asking, Why hasn’t Hollywood told more stories about abortion?

But this is the wrong question. Hollywood has always told stories about abortion, from the earliest silent films to television’s pre-Technicolor era. In recent years, the number of abortion stories on-screen has increased dramatically; we tracked just 13 plotlines in 2016, compared to 47 in 2021. Yet the stubborn endurance of cultural myths about abortion—that it is unsafe, that it is uncommon, or that it is easy to access—is no doubt facilitated, at least in part, by the ubiquity of these myths on-screen.

Take safety, for example. Abortion is one of the safest outpatient procedures in the United States; fewer than 0.25 percent of abortions result in a major complication. Yet on television, nearly 19 percent of abortions result in a major, adverse medical complication, a over 70-fold exaggeration. On a 2021 Law & Order: SVU episode, a character unknowingly ingests the abortion pills mifepristone and misoprostol and is later discovered unconscious and bleeding out on the side-

walk. An American Horror Story: Cult episode depicted a woman hemorrhaging on a gurney post-abortion. In many separate plotlines on the period piece Call the Midwife, characters are often rendered infertile or suffer grisly deaths as a result of unsafe illegal abortions. Some of this is driven by the conventions of drama, particularly in the genres noted above (legal procedural, horror, and historical fiction). Risk makes for a compelling narrative; even car accidents on television are often more dangerous than they are in real life. But while viewers have a way of contextualizing car accidents with their own experiences of regularly driving or riding in vehicles, they do not have a similar ability to do so for abortion. Even though Movies and Television abortion procedures are very common (about 1 in 4 women will have an abortion by age 45), they are often hidden from view. Few people, especially those who are anti-abortion, know that their loved ones have had abortions. This creates a huge personal, political, and cultural void in our collective understanding of abortion experiences, and leaves people lacking the understanding that a medically risky abortion on TV is depicting

The majority of characters who have abortions are younger, whiter, and wealthier than their real-life counterparts.

an extreme anomaly. Because viewers tend to incorporate what they watch on television into their political views, even if it’s fictional, these inaccurate depictions could lead people to mistakenly believe that abortion needs to be more regulated to address nonexistent safety concerns. Research actually suggests the opposite problem—existing restrictions serve to make abortion less safe, instead of contributing to better patient outcomes. Some inaccuracies are more subtle yet still troubling. Television misrepresents both who obtains abortions and why. The majority of characters who have abortions are younger, whiter, and wealthier than their real-life counterparts, and they are rarely depicted as raising children at the time of their abortions. More than half of the abortion plotlines over this past year have included characters with these demographics, such as Max on Better Things, Shauna on Yellowjackets, and Maggie on A Million Little Things. It’s not that these stories are unimportant or should not be told, it’s that they should not be the singular abortion stories depicted in popular culture. This means that the majority of people who have abortions do not see themselves or their experiences represented on-screen, and viewers do not understand the intersectional nature of abortion access. In depicting abortion as an issue for (mostly) young, white non-mothers, media erases the ways that racism and classism impact access to abortion. If viewers don’t see that people have trouble paying the hundreds or thousands of dollars for the cost of an abortion out of pocket because their insurance doesn’t include that service, they may be less inclined to understand the desperate need to ensure that both Medicaid and private insurance cover abortion costs. Relatedly, the most common reasons real patients seek abortions—being financially unprepared to care for a(nother) child, a mistimed pregnancy, not wanting to parent with their current partner, and wanting to focus on parenting the children they already have— are rarely represented on-screen.

It’s not just the who and why of abortion that’s inaccurate in television and film, it’s the how. Sixty-seven percent of characters who have abortions encounter no barriers at all, meaning that when they decide they want an abortion, they face none of the logistical and financial hurdles that their real-life counterparts must overcome. When discussing past abortions, many characters recall the emotionality of the moment, and that is the complete story of their abortion. On Queens, pop star Valeria talks about not regretting prioritizing her career over motherhood, and on The Good Doctor, medical resident Jordan confesses that she doesn’t regret a past abortion despite being religious. The story of how they accessed the abortion, and what logistical and financial hurdles they had to clear along the way, remains completely untold. Even on shows with characters who otherwise struggle to make ends meet (Annie on Shrill, Ruth on GLOW), when it comes to their abortions, there’s no mention of how they come up with the money. These types of omissions obscure the reality of abortion care in the United States, a reality made more dire by the recent Dobbs decision but which, for most people seeking abortion, was present well before it.

The vast majority of abortion patients must take days off work and find child care to travel dozens or hundreds of miles to the nearest clinic. Once there, patients face a barrage of abortion restrictions designed to delay or impede their care, from mandatory waiting periods (which forces them to pay for extra nights at a hotel), gestational age bans, prohibitions on specific types of abortion procedures, and many other cruelly tedious and medically extraneous rules. Yet on-screen, these barriers are rarely visible, despite the fact that they would no doubt make for excellent drama, conflict, humor, and character development. This may cause viewers to buy into the anti-abortion myth that abortion is too easy to access, causing them to support policies that place abortion further out of reach for the millions who need this care.

When an actual abortion is depicted, what do viewers see? Half of the abortions in the U.S. are medication abortions, yet portrayals of abortion pills in both television and film remain scarce, leaving audiences without depictions of the most common type of abortion in the country today. This pattern contributes to confusion about abortion pills: their risk, the experience of taking them, and, importantly, the difference between emergency contraception like Plan B, taken within three days after sex to prevent pregnancy, and medication abortion, either with the pills mifepristone and misoprostol or misoprostol alone, taken to end a pregnancy.

The majority of Americans are deeply confused about this difference, and more accurate and common portrayals could help viewers distinguish between these medications, understand how safe abortion pills are and that buying abortion pills online is an option (even if legally risky), and learn how to support someone who needs an abortion in a legally restricted landscape.

These misrepresentations are not just

alarming because they are inaccurate. The American public knows so little about abortion that the explicit and implicit messages these portrayals impart generate a disproportionate impact relative to their prevalence. After all, television has a profound influence on attitudes about a variety of health topics, from organ donation to cancer screenings, that are much less stigmatized than abortion. When audiences encounter an abortion plotline onscreen, it may be the first time that they are seeing abortion depicted as a personal experience instead of as a political or cultural lightning rod. The more connected they feel to the character, the more likely the depiction is to influence their attitudes and beliefs.

Of course, no one expects television to present a mirror image of reality, especially entertainment television. But again, because abortion is both highly stigmatized and uniquely politicized in American culture, every representation of abortion carries much more significance than depictions of other medical procedures. When content creators misrepresent every facet of abortion access, we cede the public imagination to misinformation provided by anti-abortion campaigns and policies.

In the days since the Dobbs decision, Hollywood actors and creators alike have shared their political outrage and their personal experiences with abortion. This is both wonderful to see and not nearly enough. It’s time for Hollywood to embrace

Never Rarely Sometimes Always (2020) offers a more realistic portrait of the realities of obtaining an abortion.

its liberal reputation and tell braver stories about abortion. We don’t just need more abortion stories, we need more compassionate, loving, accurate, and stigma-free stories that also contend with the reality of abortion access in the U.S. today.

We need stories that uncover the nittygritty of not having insurance that covers abortion and the creative ways people raise money, including seeking care from abortion funds and practical support organizations. We need to make visible the scramble to find child care and coverage at work shifts so you can show up for your appointment, and the endless drive to find an open clinic.

Some recent films—including Never Rarely Sometimes Always (2020), Unpregnant (2020), and Little Woods (2019)—have taken this on, though their protagonists are young white women. We need to see more showrunners, producers, and writers following in their footsteps, but centering the narratives and experiences of people of color. We need depictions that give life to abortion as an issue of race, class, gender, and family. This could look like parents of color supporting each other through their abortions with love, compassion, and kindness as they deal with all the messy parts of life (that make for such good television). We need to see queer, trans, and nonbinary characters having abortions, providing abortions, and supporting friends through their abortions.

Diligent showrunners and writers often turn to experts for support and guidance on how to portray health topics on television, and abortion is no exception. Yet even today, the experts who are consulted on abortion depictions are often friends of writing staff or researchers (myself included!). Undoubtedly, TV and film writers have had abortions, but writing rooms and Hollywood in general remain dominated by middle-class white people whose experience of abortion access is very different from the typical abortion patient’s. There are abortion storytellers from organizations like We Testify who frequently share their experiences with news media; showrunners and producers could invite these storytellers into writing rooms to share their experiences and partner on future story lines, giving those plots an emotional, social, and logistical accuracy.

In interviews with over 40 television showrunners, writers, and producers, I heard over and over again about barriers to getting series about abortion from page to screen, including preconceived notions that American audiences would not tune in for this kind of content, and fears about objections from advertisers or anti-abortion viewers. Networks should not let abortion stigma and misinformation drive their decision-making. The American public vastly favors access to abortion, and abortion has infinite storytelling potential, involving sex, love, death, family, religion, power, relationships, gender, and politics.

A single character who has an abortion, or one abortion disclosure in an entire series, is simply not enough. To make significant strides in changing cultural attitudes about abortion, we need multiple series with abortion at the center, instead of pushed to the margins of a single episode arc. We need a Parks and Recreation–style workplace comedy set in an abortion clinic, time-traveling abortion providers who provide care to famous historical figures, dramas about parents who journey from state to state with their kids in tow providing abortions and raising their families. The narrative possibilities are limitless if only networks put the resources behind writers ready to tell these stories.

Hollywood has always found ways to tell stories about abortion, and these flawed portrayals have contributed to cultural myths and misinformation. As content creators wrestle with their responsibility in a post-Roe world, they should explore every avenue and every genre to tell diverse, nuanced, accurate stories. With the nation’s largest anti-abortion group seeking to ban even sharing information about abortion, television and film may soon be one of the only forums that provides depictions of the safety and necessity of abortion care. Storytellers can show the public that, no matter the national or state-by-state laws, everyone deserves access to a safe abortion. n

Steph Herold, MPH is an award-winning researcher with Advancing New Standards in Reproductive Health (ANSIRH), where she studies the portrayal of abortion on television and in film in the Abortion Onscreen program.