Medication Abortion Is Everywhere. Except TV

When writers consistently refuse to explore medication abortion as a safe and effective possibility for characters, despite its popularity in reality, they deliberately and purposefully perpetuate myths about abortion access that become truth to a viewing audience.

Recently, coverage of abortion on television has picked up. Over the last decade we’ve seen a distinct and welcome evolution surrounding abortion-driven episodes. In the beginning, shows that dared to broach the idea of a character having an abortion most often ended with them deciding to go through with the pregnancy. This trope showed up in all kinds of shows from Andrea Zuckerman on 90210 to Gail Leary on Dawson’s Creek to Miranda Hobbs in Sex and the City. This time also had the popular “natural/medical-ending” of a pregnancy including miscarriages on Party of Five and Girls, an ectopic pregnancy on Grey’s Anatomy, and even a stillbirth on The Secret Life of the American Teenager. For a while, it seemed, abortion was allowed to be discussed as a possibility, but writers who wanted to keep their characters childless could not or would not pursue that option.

Then, powerhouse character Olivia Pope on ratings juggernaut Scandal had an abortion and everything changed. Shonda Rhimes chose to portray Pope’s decision to have an abortion not with the emotionally fraught rhetoric typical around the issue, but as a pragmatic and straightforward decision. A woman making the best decision for herself and moving forward with her life.

That two-episode arch – showing Pope having her abortion and openly standing by her decision – opened a floodgate for how abortion could be shown on television.

Suddenly, (thankfully!) it seemed abortion was everywhere. Young women were choosing abortion on GLOW. Mothers were choosing abortion on Crazy Ex-Girlfriend. Women of color were choosing abortion on the BoJack Horseman. We even saw women using abortion to end very wanted pregnancies for their own health and safety on The Fosters. The abortion storyline became so commonplace it was even relegated to B-plot on You’re the Worst.

Even more important than the amount of abortion storylines was the fact that these TV shows were no longer using abortion as a melodramatic, emotional flashpoint but were instead showcasing accurate and realistic depictions of both the process of someone choosing an abortion and the abortion procedure itself.

Yes, there were still stumbles (including some big ones). Recent studies have shown that television abortions featured “a complication, intervention, or major heath consequence” at 20 times the actual rate of abortion-related complications. And there’s also still a need for diversity in those seeking abortions – moving away from showing it primarily as a choice for young, childless, white girls.

Still, many reproductive rights advocates were buoyed by the surge. Abortion becoming less taboo on screen would likely lead to reduced stigma of the procedure in real life.

But, for all this good, something was missing.

In September 2000, mifepristone was approved by the Food and Drug Administration to be marketed in the United States for nonsurgical abortions. Commonly referred to as “the abortion pill,” the protocol calls for two drugs, mifepristone and misoprostol (one of which can be taken at home following a provider visit) to safely and effectively end a pregnancy within the first 10 weeks. According to Guttmacher Institute, the amount of medication abortions rose from just 6% of all non-hospital abortions to 31% by 2014.

If this is what’s happening in real life, why does TV keep serving us characters reporting to the clinic to receive surgical abortions? Though gestation is rarely stated, the characters are most often discovering their pregnancies by their first missed period, which would put them in the timeframe of being able to pursue a medication abortion. And, even though it is grossly over-regulated, one would think the ease and convenience of taking a pill in a clinic and then another at home, would be an appealing option to pursue both for the characters themselves and the writers that craft their narratives.

So where is medication abortion on television?

Unfortunately, the public is getting limited exposure to this common and necessary abortion option and the little we are seeing is often wrong. In December 2017, Netflix’s episodic sci-fi series Black Mirror was rightfully called out for incorrectly conflating the abortion pill with Plan B. It was the latest in a line of mixing up the two. The Walking Dead had a character taking a handful of morning after pills as if it would cause an abortion. And Veronica Mars was taken to task for an episode that had the teen detective searching for who, according to the episode synopsis, slipped a classmate “the morning after pill, causing her to have a miscarriage.”

This type of mistake is not only lazy; it reinforces ignorance around the vast spectrum of options that comprise women’s reproductive choices. And in a political environment filled with men hell-bent on stripping away abortion access, television should not be handing them easy ammunition.

But, arguably more disturbing than the inaccurate depiction of medication abortion, is its continued absence. In 2018 almost one-third of all abortions at 8 weeks gestation or less are medication abortions. But that rise in popularity seemed to have little effect on the decisions characters made surrounding their abortion choices.

In fact, one of the only depictions of medication abortion never actually showed a character going to a clinic or doctor’s office, receiving pills, or taking medication. Xiomara’s abortion on Jane the Virgin was certainly welcome – not only did it show a character who was already a mother choosing abortion, Xiomara was the first Latina character to have an abortion on television. But, it chose to center the episode entirely after Xiomara’s abortion was completed, leaving the journey to procure the abortion pill and process for having one mostly in the dark.

Jane the Virgin is, of course, a telenovela-style show complete with far-flung plot twists, but the episode could have kept it real by not only showing how the abortion pill is taken and the aftereffects one might experience, but also highlighting how difficult it can be to receive. Despite multiple reports confirming its safety, mifepristone is still subjected to restrictions known as the Risk Evaluation and Mitigation Strategy or REMS, which state a pregnant person must only be administered mifepristone at a clinic, medical office, or hospital from a provider that has pre-registered with the manufacture and stocks mifepristone at their healthcare facility. This not only means a pregnant person must find a provider with mifepristone in stock (not a given) but that they must also make multiple trips to the clinic, a difficult imposition that keeps medication abortion out of reach for many.

Though the episode’s back-and-forth between Xiomara and her mother who is against her abortion but ultimately respects her daughter’s choice, was a huge step forward, Jane the Virgin so often mixes emotional pathos with humor and could’ve easily done a quick, educational line about the hoops one can be forced to jump through to receive the abortion pill. (An easy miss, especially considering the episode was done in collaboration with Planned Parenthood, which knows all too well about the unnecessary overregulation of mifepristone, and with a show runner and executive producer who specifically referenced the “tightening of abortion restrictions and this new [Trump] administration” when discussing the episode.)

Even plotlines speculating about the abortion access of the future seem deliberately ignorant to the reality that abortion can be as simple as taking a pill. As Gretchen Sisson and Renee Bracey Sherman discuss in their Salon article, it appears writers would rather spend time inventing the future of pregnancy (a smart tablet that immediately detects pregnancy! A pregnancy test that tells you the sex of the fetus!), than updating the tired abortion tropes of “dangerous” and “botched” in the future dystopian worlds that have become so popular.

This deliberate ignorance extends past television, into literature, which arguably has the best platform to discuss abortion. Not hemmed in by the time constraints a television show is subjected to, nor forced to answer to overcautious network executives fearing public retaliation, literature seems like the perfect place for a lengthy exploration into abortion options. And it’s what Red Clocks, a novel by Leni Zumas, seemed poised to do. Set in a not-too-distant future (which we are rapidly hurtling toward with a Trump administration) Red Clocks imagines a world where abortion has recently become illegal. The novel does a great job imagining the very real possibility of what would happen in the United States immediately following the fall of Roe v. Wade and the loss of our constitutional right to an abortion. A “Pink Wall” springs up on the U.S./Canada border to keep women from fleeing the country to get an abortion. Desperate women seek means to end their pregnancies wherever they can find them.

Despite this likely and realistic depiction of America post-Roe, Red Clocks remains doggedly unrealistic about the possibility of people getting or using the abortion pill.

The future, Red Clocks would have us believe, will have a hermit-in-the-woods healer who can concoct an abortifacient tea with herbs, but not a teenager who, wanting to end her pregnancy, can surf the Internet and order abortion pills to her doorstep from one of the many websites selling them, despite it happening right now in real life.

No matter what is being shown in popular culture, the reality is abortion access is shrinking. Overreaching regulations have forced many clinics to close their doors (as of August 2017 seven states have only one abortion clinic), which puts the ability to have an abortion – whether medical or surgical – in jeopardy for many, many people. And even though one in four women will have an abortion in her lifetime, it remains one of the most stigmatized medical procedures.

Though studies consistently prove otherwise, dangerous misinformation about the safety of abortion abounds. When writers consistently refuse to explore medication abortion as a safe and effective possibility for characters, despite its popularity in reality, they deliberately and purposefully perpetuate myths about abortion access that become truth to a viewing audience.

If storytellers want to dabble into the abortion narrative, they have an obligation to accurately reflect what is happening is real life, which includes the full range of abortion options.

Elizabeth Skoski is development lead at Reproaction, an organization working to increase access to abortion and advance reproductive justice.

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