Contraception 89 (2014) 413–418

Original research article

Telling stories about abortion: abortion-related plots in American film andtelevision, 1916–2013☆

Gretchen Sisson⁎, Katrina KimportUniversity of California, San Francisco

Received 26 July 2013; revised 29 December 2013; accepted 31 December 2013

Abstract

Objectives: Popular discourse on abortion in film and television assumes that abortions are under- and misrepresented. Research indicatesthat such representations influence public perception of abortion care and may play a role in the production of social myths around abortion,with consequences for women’s experience of abortion. To date, abortion plotlines in American film and television have not beensystematically tracked and analyzed.Study design: A comprehensive online search was conducted to identify all representations of pregnancy decision making and abortion inAmerican film and television through January 2013. Search results were coded for year, pregnancy decision and mortality outcome.Results: A total of 310 plotlines were identified, with an overall upward trend over time in the number of representations of abortion decisionmaking. Of these plotlines, 173 (55.8%) resulted in abortion, 80 (25.8%) in parenting, 13 (4.2%) in adoption and 21 (6.7%) in pregnancyloss, and 16 (5.1%) were unresolved. A total of 13.5% (n=42) of stories ended with the death of the woman who considered an abortion,whether or not she obtained one.Conclusions: Abortion-related plotlines occur more frequently than popular discourse assumes. Year-to-year variation in frequency suggestsan interactive relationship between media representations, cultural attitudes and policies around abortion regulation, consistent with culturaltheory of the relationship between media products and social beliefs. Patterns of outcomes and rates of mortality are not representative of realexperience and may contribute to social myths around abortion. The narrative linking of pregnancy termination with mortality is of particularnote, supporting the social myth associating abortion with death.Implications: This analysis empirically describes the number of abortion-related plotlines in American film and television. It contributes tothe systematic evaluation of the portrayal of abortion in popular culture and provides abortion care professionals and advocates with an initialaccurate window into cultural stories being told about abortion.© 2014 Elsevier Inc. All rights reserved.

Keywords: Media; Culture; Unintended pregnancy; Pregnancy outcomes; Maternal death

1. Introduction

In the past decade, popular discourse has alternatelydeclared abortion to be “television’s most persistent taboo”[1], “no longer taboo” [2] and “still taboo” [3]. Newsaccounts have asserted that abortion is underrepresented infilm and television [4–10], estimating the quantity ofabortion-related plotlines anywhere from “a single instance”

☆ Disclosures/conflict of interest: none.⁎ Corresponding author. University of California, San Francisco,

Oakland, CA 94612. Tel.: +1 510 986 8951.E-mail address: sissong@obgyn.ucsf.edu (G. Sisson).

0010-7824/$ – see front matter © 2014 Elsevier Inc. All rights reserved.http://dx.doi.org/10.1016/j.contraception.2013.12.015

[11] to “on average only once every two and a half yearssince 1972” [12], with the further assertion that narrativedevices such as false pregnancies or pregnancy losses arespecifically used to avoid abortion-related storylines [4,7].The presumption that abortion stories are rare, avoided andenduringly taboo in American popular culture is prevalent.Yet, a comprehensive investigation of the number ofabortion stories in film and television and the pregnancyoutcomes in such stories has remained absent from theliterature, leaving researchers without a clear picture of howpopular culture portrays abortion.

Research analyzing specific abortion stories on film andtelevision has found that, like many depictions of medicalexperiences [13,14], they are not always representative of the

414 G. Sisson, K. Kimport / Contraception 89 (2014) 413–418

reality of abortion care in the United States [15–18],inaccurately depicting medical procedures, clinics and whoseeks abortions for what reasons. Such inaccuracies inentertainment television typically function in ways that upholdconservative, hegemonic structures [19], though we do notknow whether or how this applies to abortion stories. Fewscholars have examined fictional depictions of abortion decisionmaking. Condit [20] represents a notable exception, finding thatthe overall pattern of fictional unintended pregnancies resolu-tion in the 1980s overrelied on the narrative trope of a falsepregnancy. Nonetheless, research has not systematicallyexamined the number and overall outcome trends in abortion-related plotlines. The dearth of such an investigation into thesetrends is problematic, as without one we do not know if and inwhat ways abortion is represented inaccurately.

This absence is of consequence as research has shown thatmedia portrayals influence viewers through a variety ofmeans. Scholars have shown that news coverage, particularlyin the form of in-depth stories about people with whomviewers identify, can sway not only personal opinions butalso political priorities [21]. In-depth fictional programming,especially plotlines showcasing characters in whom viewersare invested, functions in a similar way [22,23]. Scholarshave demonstrated that this holds for fictional depictions ofpregnancy decision making and abortion. Mulligan andHabel [24] found that after viewing one of two fictional filmsabout pregnancy-decision making — one in which abortionwas framed in a favorable light and one in which it wasportrayed more negatively — subjects were significantlymore likely to support access to legal abortion in a greaterrange of circumstances after viewing the former film. On anaggregate scale, abortion stories, to the extent that theyrepeat similar themes, can alter public understanding [25]:the cinematic construction of a poignant ultrasound scene,the rhetorical avoidance of the word “abortion” or thecircumstances of a fictional character’s pregnancy allcultivate a common cultural idea about what pregnancy,abortion and women seeking abortion are like [16,20,26–28]and may play a role in the production of social myths aboutabortion and abortion stigma, with consequences for thelived experience of women seeking abortions [29].

In this paper, we conduct a census of plotlines that engagewith abortion in US television and film since the beginningof American cinema. In addition to empirically describingtheir number, we make an opening contribution todeveloping a systematic evaluation of abortion decisionmaking, analyzing the plotlines for the pregnancy outcome.This work provides abortion care professionals and women'shealth advocates with an initial accurate window into thecultural stories being told about abortion.

2. Methods

To produce a comprehensive list of all film and televisionrepresentations of abortion, we conducted several online

searches. First, we searched the International Movie Database(IMDB.com) for all titles that were tagged with “abortion” as akeyword or contained the word “abortion” in their plotdescription. As a catalog of 2.5 million titles from 1887 to thepresent — including films, television series and televisionepisodes — that has been both crowd- and industry-sourced,IMDB represents the largest freely available database fortracking entertainment representations. We searched IMDBtwice, first in December 2012 and then in February 2013, tocross-check results and add recent titles. Titles that met thefollowing criteria were included in the results: (a) available toAmerican audiences; (b) English language; (c) full-length,scripted stories (short films were excluded); (d) aired beforeFebruary 1, 2013. Nonscripted stories (documentaries, realitytelevision programming and talk shows) were excluded topreserve a focus on the portrayal of abortion when the creatorsof the media had full creative license to determine outcomes.

Because an abortion plotline might be just one ofhundreds of plotlines on a long-running television showand thus not be included in either a keyword tag or a showsummary on IMDB, in February 2013, we used the searchengine Google to conduct a secondary online search for Websites discussing shows featuring abortion plotlines. Specif-ically, we reviewed results from the search string “abortionon television” and added any titles included on these pages.No new titles were found in the 11th through 15th searchresult, so we stopped reviewing results.

Finally, we included titles analyzed in publishedacademic literature reviewed for this paper.

Repetitions were removed from the full list, with furtherrelevancy exclusions for results that were misclassified andfailed to fulfill the original inclusion criteria, or results wherethe use of the word “abort” or “abortion” did not refer to themedical procedure.

We coded the remaining titles for individual abortion-related plotlines, as television shows could have multiplesuch plotlines over a series, and coded each plotline for yearof release. Movies were coded for producing studio andtelevision shows for broadcast network and, if possible, fortime of day first aired (e.g., primetime, daytime). Plotlineswere sorted into five categories: (a) abortion as a major plotpoint, e.g., a character making a decision around anunplanned pregnancy; (b) one of the primary characters isa provider, but the plotline does not directly engage with awoman considering or choosing abortion; (c) the plot is aninvestigation of the murder of an abortion provider but doesnot directly consider the experience of providing abortion;(d) abortion as a minor plot point, e.g., a character reveals apast abortion without discussion; (e) abortion is discussedonly in the abstract within a religious, political or socialcontext rather than as an experience.

For the first two categories, we coded each plotline foroutcome of the pregnancy. Possible outcomes includedabortion, parenting, adoption, pregnancy loss (includingfalse pregnancy) and unresolved. We additionally coded forthe woman’s mortality at the end of the plotline.

Table 1Total plotlines by decade (N=310)

Combined movie & TV Movies TV

1913–1922 7 7 01923–1932 3 3 01933–1942 9 9 01943–1952 7 7 01953–1962 13 11 21963–1972 29 22 71973–1982 24 12 121983–1992 44 16 281993–2002 58 33 252003–2012a 116 49 67Total 310 169 141

a 2012 includes January 2013.

415G. Sisson, K. Kimport / Contraception 89 (2014) 413–418

2.1. Analysis

For the purposes of this analysis, we restricted our sampleto plots in the first two categories. We charted the quantity ofrepresentations each year over time. We then analyzed thechanging proportions of pregnancy outcomes by decade,followed by an analysis of the rates and patterns of womendying in these plotlines. All analyses and descriptivestatistics were calculated using Microsoft Excel.

3. Results

The IMDB searches yielded 472 titles, Google searchresults found an additional 43 titles, and the review of thepublished literature added 35 more unique titles. Of these550 titles, 208 were excluded for relevance. The remaining342 titles represented 385 individual abortion plotlines,

Table 2Total abortion plotlines by year (N=310)

which were categorized as follows: 291 plotlines hadabortion as a major plot point; 19 plotlines had an abortionprovider as a primary character; 7 plotlines solely investi-gated the death of an abortion provider; 45 plotlines hadabortion as a minor plot point; 23 plotlines involved abortiononly being discussed religiously, politically or socially. Forthe purposes of this paper, we restrict our analyses below tothe 310 plotlines of the first two categories.

3.1. Number of representations

As Table 1 shows, the number of representations ofabortion stories in American film and television hasincreased, though not steadily, since the earliest identifiedabortion plotline in a 1916 silent film. Since the 1973 Roe v.Wade decision, representations have increased each decadeover the decade before by at least 31%. The number ofabortion plotlines from 2003 to 2012 was a 105% increaseover the total from the previous decade, representing a highof 116 plotlines. Television depictions were not restricted tomarginalized viewing times or places; 69% (n=97) of thetelevision plotlines aired on network television (ABC, CBS,Fox, NBC, PBS) and 90% of these aired during primetime.

While there was an overall upward trend, the increase hasnot been smooth. Table 2 illustrates the drastic fluctuations inthe number of abortion stories airing in any single year.

3.2. Pregnancy outcome trends

For 302 of the 310 plotlines, we were able to identifypregnancy outcomes. Of these 302 plotlines, 173 (57.3%)included an abortion. This proportion fluctuated by decade,

Table 3Pregnancy outcomes by decade (n=302)

416 G. Sisson, K. Kimport / Contraception 89 (2014) 413–418

with a high from 1933 to 42 (88.9%) and a low from 1953 to62 (30.8%) (Table 3).

Representations of pregnancy decisions produced beforeRoe, while fewer, were more often resolved with an abortionthan plotlines produced post-Roe: from 1913 through 1972,64.7% (n=44) of abortion plotlines resolved in abortion,compared to 55.1% (n=129) from 1973 through February2013. While abortion represented about 60% of the outcomesin each of the three decades from 1973 to 2002, abortionrepresented a smaller percentage of all outcomes between2003 and 2012 (48.6%), even as the volume of pregnancyresolutions through abortion was the highest to date (n=54).

Table 4Prevalence and causes of death in abortion plotlines

Rates of resolution through adoption and pregnancy losssimilarly shifted after the Court’s decision: before 1973,2.9% (n=2) of plotlines concluded with adoption and 1.5%(n=1) concluded with pregnancy loss; after 1973, thesepercentages increased to 4.7% (n=11) for adoption and 8.5%(n=20) for pregnancy loss. The increase in adoptionoutcomes is even more historically recent: 2003–2012 sawan increase in the proportion of plotlines ending in adoption(9.0%; n=10) after no stories resolved in adoption in the twopenultimate decades (1983–1992 and 1993–2002).

Sixteen plotlines were coded as unresolved, eitherbecause the story concluded before a decision was made

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(n=6) or because the woman died before she could make adecision about the pregnancy (n=10).

3.3. Prevalence and causes of death in abortion-relatedplotlines

In all, 13.9% (n=42) of the stories ended with the death ofthe woman who considered an abortion, whether or not sheobtained one.

In 10 stories, the pregnant woman died before apregnancy decision could be made. As a pregnancyresolution, death decreased proportionally over time: 7.3%(n=5) of plotlines pre-Roe versus 2.1% (n=5) of plotlinespost-Roe. All 10 deaths were the result of violence: 9instances of murder and 1 suicide.

In addition to these 10 characters who died before makinga pregnancy decision, 27 (15.6%) who had abortions laterdied: 16 died as a direct result of the abortion, 6 weremurdered, 3 committed suicide or died as a result of self-injury, 1 died in an accident, and 1 died with no specifiedcause of death (Table 4).

Five characters died after choosing to parent (6.2%), allduring childbirth. No characters died after choosing adoptionor experiencing a pregnancy loss.

4. Discussion

This analysis established the volume and distribution overtime of abortion-related plotlines in American television andfilm, offering a useful starting point for considering waysabortion is represented in culture. We found that abortionstories are more common and have always been morefrequent than popular discourse suggests [1–12]. We furtherdocument a general growth trend in the quantity of abortion-related plotlines over time and, more pointedly, whenconsidered by decade, an increase in the volume of suchplotlines that culminate in an abortion. Although these datacannot explain the fluctuations in the volume of abortion-related plotlines and outcomes, the patterns we find suggestan interactive relationship between media representations,cultural attitudes and policies around abortion regulation,consistent with both cultivation analysis and agenda settingtheories of the relationship between media products andpolitics [15,17,20,21,23,24,26]. Further investigation of therelationship between the number of media representations ofabortion and culture is warranted.

Our analysis found that the news media’s assertion thatabortion is absent from fictional plotlines is unsupported, butalso points to inaccuracies in its depiction. While we findoverall that many outcomes are represented, most women inthese fictional plotlines who consider abortion do obtain anabortion, though data from the most recent decade suggestthis trend may be reversing. Consistent with existingliterature critiquing the accuracy of fictional portrayals ofabortion [15–18,20], we found that the overall patterns ofpregnancy outcome do not match statistics from real life. For

example, in the most recent decade, 9% of fictional womenplaced their newborn for adoption, whereas the real-lifenumber of women making such a choice is closer to 1% [30].

We also found an unexpectedly high prevalence of deathin storylines about abortion, including the use of death as apregnancy resolution for women who considered abortion.The 9% (n=16) rate of death directly caused by abortion inthe fictional stories is inaccurately exaggerated; current riskestimates place risk of death from abortion as statisticallyzero [31]. (We note that some of the representations in whichabortion led directly to death were either produced or set —or both — before legal abortion made the procedure safer.)This result is especially important in light of findings thatsuch fictional depictions not only reflect social discoursesbut also influence them [18,22–24]; such discourses will beshaped by the portrayal of abortion as dangerous. Whilemedical procedures are often represented in inaccurate ways[13,14], the frequency with which abortion is portrayed ashaving adverse outcomes may be unique. Cardiopulmonaryresuscitation, for example, is consistently shown as less riskyand more successful on television than is true of real life[13]. We speculate that the overrepresentation of bothadoption and mortality outcomes could skew the audiences’perceptions of the legitimacy and safety of abortion. Onelimitation of our research is that it does not address theoccurrence of morbidity following fictional abortions, whichmay be an additional way in which obtaining an abortion isportrayed as more risky than it in fact is.

This analysis exposed another, unanticipated patternwhich may further perpetuate the social myth of abortionas physically risky [29]: the high death rate for women whoconsidered, but did not obtain, abortions. The frequency ofdeath for non-procedure-related reasons (e.g., murder)among women who considered abortion may have evenlarger consequences for social understandings of abortion.Discursively, this association of death with the contempla-tion of abortion contributes to the ongoing production ofabortion stigma, narratively linking the consideration ofpregnancy termination with violence and death.

This analysis provides insight into the presence andpatterns of abortion-related plotlines in US film andtelevision, offering an important corrective for the popularassumption that abortion is absent from these media.Additionally, insights such as the overrepresentation ofdeath following abortion are valuable for assessing howcurrent representations produce and replicate social mythsaround abortion, making the lived experiences of obtainingand providing abortions more difficult. These findings canbe used by abortion care professionals and women’s healthadvocates to better understand the cultural landscape ofabortion stories.

Acknowledgments

Funding for this analysis was provided by the David andLucile Packard Foundation (2012-37676).

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