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What television thinks of abortion providers

The sneaky way that TV shows may play into abortion restrictions.

Xiomara, Jane’s mother in Jane the Virgin CREDIT: screenshot, Netflix
Xiomara, Jane’s mother in Jane the Virgin CREDIT: screenshot, Netflix

Popular entertainment is pervasive. On average, Americans watch five hours of television per day. The stories we see there are important, because they grow out of mass culture — and can either challenge or cement the pervasive stories we tell ourselves.

For a controversial and politicized subject like abortion, that makes popular culture a ripe area for study. The stories we tell about abortion on screen can play a critical role in shaping how we view the procedure.

That’s one of the motivating factors for the researchers at Advancing New Standards In Reproductive Health (ANSIRH) at the University of California San Francisco, who have done a series of studies on how abortion is portrayed in pop culture. Their previous research has shown that entertainment often perpetuates harmful and inaccurate myths about the procedure.

Most recently, they’ve turned their attention to how abortion providers — be they a doctor, a witch, a nun, or anyone else who attempts to help women end a pregnancy — are represented on screen. These results, recently published in Perspectives on Sexual and Reproductive Health, are “a little bit more nuanced” than some of their previous studies, Gretchen Sisson, the study’s lead author and a sociologist at ANSIRH, told ThinkProgress.

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Sisson’s results reveal that for the most part, medical abortion providers on television are portrayed as safe and effective, and motivated by care for their patients. That portrayal, she suggests, may help legitimize and destigmatize abortion care.

However, they also found a small but significant subset of story-lines that perpetuate harmful myths about abortion, largely set during times when abortion was illegal. Though these narratives were set apart from our world today — either through time or mysticism — they may still play into rhetoric used today to restrict women’s reproductive rights.

Who provides abortions on American television

To study this, the researchers examined all the story lines involving abortion providers on American television they could find from 2005 to 2014. In total, they identified 52 portrayals of abortion providers in 40 television shows.

Data from “Doctors and Witches, Conscience and Violence: Abortion Provision on American Television” CREDIT: ANSIRH
Data from “Doctors and Witches, Conscience and Violence: Abortion Provision on American Television” CREDIT: ANSIRH

Within this sample, the majority of on-screen abortions were performed by a doctor in contemporary medical facilities.

The abortion providers who appear in these story lines were actually portrayed pretty well, according to Sisson — as “safe, effective providers, compassionate, concerned about their patients’ well being, and motivated for positive reasons to do this work,” she said.

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Considering the fact that the medical professionals who provide abortions are often smeared as “baby killers” and can face threats and violence simply for doing their jobs, this finding is encouraging. TV shows that depict abortion providers as safe, effective, compassionate medical professionals may help counter the stigma that accompanies this work.

But that finding didn’t hold true for the people depicted helping women end pregnancies outside the official medical system.

Some story lines the researchers examined — most often those in television shows set before abortion was legalized — showed abortions being performed in thoroughly non-medical spaces: A cabin by the edge of the woods in the CW show Reign, for example, or deep in the woods in Salem and True Blood. The people who helped women end a pregnancy in these settings were portrayed much more in a gray area.

Data from “Doctors and Witches, Conscience and Violence: Abortion Provision on American Television” CREDIT: ANSIRH
Data from “Doctors and Witches, Conscience and Violence: Abortion Provision on American Television” CREDIT: ANSIRH

“It’s not so much that they were portrayed as providers, but it was almost like they were portrayed as villains,” Sisson said. “They were motivated by greed or for more negative reasons, and they didn’t care about their patients.”

In those cases, abortion itself was often depicted as unsafe and ineffective.

For example, in the CW show Reign, which focuses on Mary Queen of Scots, Mary rides to the edge of the woods to save her lady in waiting from an abortion in a leaky, cold, dirty cabin. While the show is set in the 1600s and hardly known for historical accuracy, it’s also particularly interesting given that it’s aimed at a teenage audience. The show, says Sisson, is addressing the procedure “in a way that says that abortion is risky, abortion is dangerous, this might cost your life, you cannot do this.”

The abortion provider in Reign CREDIT: screenshot, Netflix
The abortion provider in Reign CREDIT: screenshot, Netflix

Another striking example comes from Call the Midwife, a BBC show aired on PBS about women working as midwives in a poor section of London before abortion is legal. The abortion story on the show doesn’t involve one of these midwives, who are largely portrayed as compassionate and skilled. Instead, a woman in the neighborhood named Mrs. Pritchard assists a woman who wants to end her pregnancy — and her portrayal, says Sisson, is “particularly villainous.”

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The first abortion technique that Mrs. Pritchard employs, an herbal remedy, fails. She then demands a high price for further care, forcing the woman who wants an abortion to sell her curtains. Finally, Mrs. Pritchard’s surgical abortion procedure causes severe blood loss, nearly killing the woman and forcing her to get a hysterectomy.

Nora (left) who wants an abortion, confronts Mrs. Pritchard on Call the Midwife CREDIT: screenshot, Netflix
Nora (left) who wants an abortion, confronts Mrs. Pritchard on Call the Midwife CREDIT: screenshot, Netflix

This plays into a common trope that Sisson found: any abortion procedure falling outside our contemporary legal and medical frameworks was portrayed as ineffective, and most non-medical doctors were portrayed negatively.

“There are actually plenty of herbal remedies that will end a pregnancy. They are dangerous, and risky, but the idea of an herbal remedy not being effective is inaccurate,” said Sisson. “So we get back to this: The non-medical method doesn’t work, and the medical method does work, but it’s quite dangerous.”

Propping up myths about abortion

Of course, there is some truth to the idea that illegal abortion is unsafe. Reproductive rights advocates often point out that banning abortion forces these procedures into the shadows, where they are outside medical regulations and may be less safe for patients. According to the World Health Organization, over forty thousand women die each year from unsafe abortions, mainly in developing countries.

But TV shows’ bright line between depictions of abortions performed by medical doctors and abortions performed by others also sets abortion apart as something more dangerous than other medical procedures.

“Even though this is a medical setting, that abortion stands apart as a risky procedure,” Sisson said of the story line in Call the Midwife. “Abortion is much safer than birth. And on this show you have, goodness knows, one birth per episode and many end happily and quite safely. And then the abortions you have are very violent and dangerous? I think that creates a narrative.”

That narrative is also what props up the maze of regulatory laws that have rapidly spread across the country, forcing clinics to close and making abortions more difficult for patients to obtain.

Known as the Targeted Regulation of Abortion Providers — or TRAP —these laws require abortion providers to comply with unnecessary and often expensive rules, like bringing their buildings up to the same code as a surgical center. Unable to afford the costly renovations to upgrade their facilities, clinics are forced to close, making women travel further for care.

“Even though this is a medical setting, that abortion stands apart as a risky procedure…Abortion is much safer than birth.”

Proponents of TRAP laws say they’re necessary to help protect women because abortion is a dangerous medical procedure — a claim that isn’t supported by facts or science.

Television narratives that portray abortion as a dangerous medical procedure that must be directly overseen by a medical doctor support this myth.

“That supports this idea that the more medicalized an abortion is, the safer it is,” said Sisson. “When you look at TRAP laws, that require hospital admissions, or ambulatory surgical centers, requirements, well those might make sense if you really believe that abortion is a very serious medical procedure that can only be performed by a doctor and that’s the only way to make sure women are safe.”

Contrary to the divide that the researchers observed in pop culture, direct supervision by a doctor is not the only way to safely receive an abortion in the real world.

Data from “Doctors and Witches, Conscience and Violence: Abortion Provision on American Television” CREDIT: ANSIRH
Data from “Doctors and Witches, Conscience and Violence: Abortion Provision on American Television” CREDIT: ANSIRH

In California, for example, nurse practitioners can administer abortions, and in countries where abortions are illegal, women can be safely prescribed medication abortions by doctors remotely — a concept the nonprofit organization Women on Waves uses to provide safe medication abortions to women in other countries.

“If we see doctors in medical settings as the only safe providers, than what about the other procedures that have been shown to be very safe, but could be perceived to be more remote from direct medical supervision?” asked Sisson.

How abortions on television are changing

There’s evidence, though, that depictions of abortion on screen are becoming more ubiquitous and more diverse.

The current research sample ended in 2014, so it doesn’t necessarily capture the way that pop culture has recently evolved on this issue. “I know if we did this paper now, this would be different,” said Sisson.

In the past few years, abortion plot lines have been featured on prime time dramas like Scandal and comedies like Girls and BoJack Horseman. And just last week, Jane the Virgin featured a storyline about abortion that Sisson pointed to as revolutionary for a number of reasons : Xiomara, Jane’s mother, is the first Latina woman to get an abortion on network television, her abortion, which is a medication abortion with pills, isn’t dramatized, and unlike the vast majority of women on television getting abortions, she’s already a mother.

“The fact that her maternity does not make her incompatible with a women who wants to have an abortion is not a narrative we see very often,” Sisson said of Xiomara’s character. In reality, the majority of women obtaining abortions — 59 percent — are already parenting at least one other child, according to the Guttmacher Institute.

Diversifying the public narrative around abortion is a revolutionary act.The real problem with isolated, potentially problematic abortion story-lines such as the ones in Reign and Call the Midwife is that they are part of a fairly homogeneous aggregate that largely show abortion as a dramatic, medically-fraught procedure — which is not the reality.

So the fact that different types of stories are being told is “really important first step,” said Sisson. “It’s groundbreaking, for a number of reasons.”