Although you might not naturally see similarities between BAFTA TV nominees I May Destroy You, Bridgerton, and the latest documentary from filmmaker Deeyah Khan, they all share a common thread in their depiction and discussion of abortion.
A study of the past 60 years of film and television shows how far we have come in stories that portray abortion, but also highlights the endurance of negative tropes that perpetuate misrepresentation and stigma.
Decades of progress
In the past five years, there have been nearly four times as many discussions of abortion on screen in the US than between 1996 and 2000, according to data from Abortion On Screen database managed by Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco. Twelve films and 32 TV episodes released last year touched on the subject. In the past two years, there has been a noticeable rise in films with an abortion as a central part of the plot, rather than just a mention – including Unpregnant, Never Rarely Sometimes Always and Saint Frances.
While recent years have revealed a particularly sharp increase, the database shows that abortion has been visible in popular culture throughout the past 60 years, with mentions rising appreciably since the mid-90s.
Not only the number but the nature of these mentions has been changing over time, says Stephanie Herold, an analyst and researcher at ANSIRH.
“We used to see a lot of this kind of inverted abortion narrative, where a character would be pregnant and there would be a lot of emotional hand wringing about whether or not to have the abortion, and then if she showed up at the clinic she would have miraculously had a miscarriage or would turn out not to be pregnant at all,” she says. “Now we’re seeing less of the emotional handwringing, and often when a character decides they want an abortion they actually get it.”
As the number of abortions shown and discussed has increased, fearmongering has become less common. In the past five years, a fifth of abortion depictions have been shown to result in negative health outcomes. This is an improvement, but still makes abortion seem far more dangerous than it really is. Part of the problem, says Louise McCudden, advocacy and public affairs adviser at MSI Reproductive Choices, is that abortion is still seen as unusual.
“One in three women in the UK will have an abortion by the time she’s 45,” says McCudden. “So if you calculate, chances are that when someone in a TV show has an abortion and then she tells her friends about it, some of them will also have had an abortion! It’s always presented as if it’s much rarer than it is.”
The database also shows the way the shifting legal landscape has affected our cultural understanding of abortion. In the 1960s, there were 17 depictions of abortion, of which all were illegal and 40 per cent of which had negative outcomes. In the Seventies, after the decriminalisation of abortion in the UK and the passage of Roe v. Wade in the US, we began to see some portrayals of legal abortions (four out of 18 total) but in those four, three have negative outcomes and two result in death.
But by the 1980s we see a culture shift – three-quarters of abortions portrayed in the decade are legal. Three-quarters of illegal abortions have negative health outcomes, while less than 20 per cent of legal abortions do.
“Often a character has an abortion and then becomes infertile or something like that, as a kind of poetic justice,” says McCudden. “You can see why writers think it’s an interesting way of telling the story but there’s lots of ways to find interesting drama and tension in those storylines without using abortion as a device to tell us a morality tale.”
The gap between screen and reality
One of the key disparities, Herold says, is in the demographics of characters who have abortions. On screen in the past five years, 70 per cent of those who had abortions were white, nearly twice the proportion in real-life in the US (though actually a lower proportion than in the UK).
Age disparity is another key difference: in film and TV over the past five years, almost a fifth of those seeking abortions have been teenagers, even though under 20s only account for one in 10 abortions in the US and UK, and many people who get abortions are in fact already parents.
“It’s often shown as being young women, and often somebody very vulnerable,” says McCudden. “And it’s important to show those kind of stories as well, but most of the time when someone’s having an abortion, they’re choosing it because it’s just not the right thing for them to have a child.”
Overwhelmingly, McCudden and Herold say, the most glaring misrepresentation of abortion on screen is in the methods of abortion, and the experience of the patients. Clinics are often portrayed as drab, depressing or dirty places, with uncaring or uninterested staff, such as the bubblegum-popping receptionist in Juno. MSI have found that clients are often surprised by how positive their experience visiting a clinic is, and that they do not feel judged or stigmatised by the staff. According to Herold, when the procedure itself is shown on screen – which isn’t often, in 2020 only four of the 30 depictions actually showed the abortion itself – it’s often vastly overmedicalised.
Herold says abortions on screen are usually in hospital settings, with staff in scrubs and machines beeping, which makes surgical abortions seem far scarier than they are. Medical abortions – those administered by pill – are still extremely under-represented. In the UK before Covid-19, only 40 per cent of abortions were surgical, and in the pandemic that figure has dropped to around one in 10. In the US it’s higher – around 60 per cent of abortions are surgical – but that number is declining significantly over time.
Rarer still on screen are self-administered medical abortions – despite the fact that in the UK, even before Covid, a quarter were at least partially self-administered. That figure has now risen to 65 per cent. While the US is more restrictive on self-managed abortions, recent investigations estimate more than 20,000 people order abortion pills online every year.
But we never see medical abortions self-administered on screen, at least not in a modern-day setting. The depictions of at-home abortions we see tend to be historical settings: with herbs or poisons, such as in Bridgerton or Portrait of a Lady on Fire. Modern depictions of a self-administered abortion tend to be illegal, such as in prison, and usually end with a visit to hospital.
This isn’t just inaccurate cliche but also wasted dramatic potential, says Herold. Medical abortion – usually experienced at home and often with the support of family and friends – could allow for interesting plotlines about personal relationships.
“There’s this moment that happens in so many episodes when the character is on the operating room table and the camera focuses on her face,” says Herold. “What exactly are they trying to tell us? That she’s an emotional pain and physical pain? That she’s lonely?
“I want to know more about the people in that character’s life. It doesn’t have to be this moment of loneliness, it can be a moment of incredible community and friendship and support and love.”
These depictions reflect a cultural narrative, Herold and McCudden say, of a society that wants to think of abortion as a traumatic experience for the young and vulnerable, because its uncomfortable with the idea that abortion could be chosen freely and without regret.
“A really common experience that we find from a lot of our clients is that they’re made to feel that there’s something wrong with them because they don’t feel more guilty,” says McCudden.
We have come a long way since the portrayals of pain and suffering of 50 years ago, but current depictions still tend to be neither realistic nor nuanced. Instead of using outdated moral turmoil as a dramatic device, abortion stories could explore the many barriers that still face those trying to access it both in the US, the UK and across the world.
“Abortion itself is not the big event,” says Herold. “What is the big event is trying to find time, trying to find childcare, trying to take the day off work.”
And, McCudden says, by focusing on the emotion trauma of an abortion, we end up with flat characters, rather than being able to explore the multitudes of emotions and experiences that reflect real life.
“This is probably going to sound quite insulting to a lot of writers. Sorry, but I want more good writing!” says McCudden. “More complexity and nuance around a character, and perceptiveness about what it’s like when you’re thinking about having an abortion, because there is so much to explore. It’s lazy writing a lot of the time and they’re only using what the audience expects to see, and it is absolutely a missed opportunity to be creative.”