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Facts and fictions: Characters seeking abortion on American television, 2005–2014

      Abstract

      Objectives

      We aim to describe how women who seek abortions are portrayed on television, recognizing that onscreen fictional stories can shape the public’s beliefs.

      Study design

      Drawing on a comprehensive online search, we identified all fictional representations of abortion decision making on U.S. television from 2005 through 2014. Characters who considered abortion in these plotlines were quantitatively content coded for their demographic details and reasons for abortion, with 95% intercoder reliability.

      Results

      Seventy-eight plotlines were identified, including 40 plotlines (51%) wherein a character obtained an abortion. Characters who considered abortion were mostly white, young, in committed relationships and not parenting. Comparing all abortion-considering characters to the subset of abortion-obtaining characters, the higher rates of abortion were found for characters who were white, of lower socioeconomic status and not in committed relationships. Compared to statistics on real women, characters who obtained abortions were disproportionately white, young, wealthy and not parenting. Compared to reports on real women’s reasons for abortion, immaturity or interference with future opportunities was overrepresented; financial hardship or pregnancy mistiming was underrepresented.

      Conclusions

      Taken in aggregate, televised abortion stories misrepresent the demographics of women obtaining abortion and their reasons for doing so, overrepresenting younger white women and underrepresenting women of color, poor women and mothers. Overrepresented reasons were more often self-focused rather than other-focused, contributing to a perception that abortion is a want rather than a need. Findings hint at the politics of onscreen abortions, suggesting that it is easier to portray with peripheral characters and among some demographics (e.g., teens).

      Implications

      Onscreen representations may influence public understandings, contributing to the production of abortion stigma and judgments about appropriate restrictions on abortion care. Understanding the particular shape of inaccuracies around abortion portrayals can enable advocates and healthcare practitioners to identify and respond to popular misperceptions.

      Keywords

      1. Introduction

      Medical procedures and patient experiences are often portrayed in inaccurate ways in American popular culture — and abortion stories are no exception [
      • Sisson G.
      • Kimport K.
      Telling stories about abortion: abortion-related plots in American film and television, 1916–2013.
      ,
      • Diem S.
      • Lantos J.
      • Tulsky J.
      Cardiopulmonary resuscitation on television.
      ,
      • Turow J.
      Playing doctor: television, storytelling, & medical power.
      ,
      • Condit C.
      Decoding abortion rhetoric: communicating social change.
      ,
      • Dow B.
      Prime-time feminism: television, media culture, and the women’s movement since 1970.
      ]. Such inaccuracies are to be expected in the fictional world of television, where unlikely turns of events can be used to create drama or humor and bizarre or fantastical circumstances allow for escapist entertainment. Onscreen depictions, however, impact public perceptions and beliefs about reality. Cultivation theory [
      • Gerbner G.
      • Gross L.
      • Morgan M.
      • Signorielli N.
      Living with television: the dynamics of the cultivation process.
      ] describes how the immersive “world” of television leads people to more readily accept social realities as portrayed on television; this leads viewers to incorporate fictional stories into their understanding of an issue and even dramatically shape their perceptions of the world [
      • Gerbner G.
      • Gross L.
      • Morgan M.
      • Signorielli N.
      Living with television: the dynamics of the cultivation process.
      ,
      • Gerbner G.
      • Gross L.
      • Morgan M.
      • Signorielli N.
      • Shanahan J.
      Growing up with television: cultivation processes.
      ]. Research shows that, consistent with cultivation theory, fictional portrayals of abortion impact viewers’ beliefs and political opinions [
      • Condit C.
      Decoding abortion rhetoric: communicating social change.
      ,
      • Gerbner G.
      • Gross L.
      • Morgan M.
      • Signorielli N.
      Living with television: the dynamics of the cultivation process.
      ,
      • Mulligan K.
      • Habel P.
      An experimental test of the effects of fictional framing on attitudes.
      ,
      • MacGibbon H.
      Screening choice: the abortion issue in American film from 1900–2000.
      ,
      • Iyengar S.
      • Kinder D.R.
      News that matters: television and American opinion.
      ,
      • Holbert R.
      • Shah D.
      • Kwak N.
      Political implications of prime-time drama and sitcom use: genres of representation and opinions concerning women’s rights.
      ,
      • Press A.
      • Cole E.
      Speaking of abortion: television and authority in the lives of women.
      ], with historical evidence that representations of abortion in popular culture had a greater impact on changing opinions of abortion than did abortion’s increasing legality [
      • Weingarten K.
      Abortion in the American imagination: before life and choice, 1880–1940.
      ]. Fictional portrayals of abortion-seeking characters, it follows, are likely to have notable influence on how the general public thinks about women who consider abortion. Television viewing represents the majority of Americans’ daily leisure time [
      • Bureau of Labor Statistics
      American time use survey summary.
      ] and, thus, television portrayals, in specific, of women who seek abortion are likely to have a strong influence, offering a rich opportunity for analysis.
      Our previous work identified over 300 plotlines in American film and television in which a character considers abortion, and it demonstrated that abortion plotlines overrepresent abortion-related death [
      • Sisson G.
      • Kimport K.
      Telling stories about abortion: abortion-related plots in American film and television, 1916–2013.
      ], presenting abortion as more risky than it is in real life [
      • Pazol K.
      • Creanga A.
      • Burley K.
      • Jamieson D.
      Abortion surveillance — United States, 2011.
      ,
      • Upadhyay U.
      • Desai S.
      • Zlidar V.
      • Weitz T.
      • Grossman D.
      • Anderson P.
      • et al.
      Incidence of emergency department visits and complications after abortion.
      ]. Here, we extend this analysis to examine recent fictional television representations of the women who consider abortion. Our data allow us to identify and compare subgroups within this sample (e.g., those who obtain an abortion) and to compare characters who obtain abortions to the reported demographics of real women who obtain abortions [
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      ,
      • Biggs A.
      • Gould H.
      • Foster D.
      Understanding why women seek abortions in the US.
      ,
      • Finer L.
      • Frohwirth L.
      • Dauphinee L.
      • Singh S.
      • Moore A.
      Reasons US women have abortions: quantitative and qualitative perspectives.
      ]. In aggregate, these findings provide insight into how women who consider abortion are represented in entertainment media, with potential consequences for public understandings of abortion patients. Understanding the inaccuracies in fictional abortion portrayals can enable advocates and healthcare practitioners to identify and respond to popular misperceptions.

      2. Methods

      We produced a comprehensive compilation of abortion-related plotlines in American television and film via three online searches: Movie Database (IMDB) keyword results, IMDB descriptor results and Google results for the string “abortion on television.” All searches were initially conducted in December 2012 and were repeated in February 2013 and January 2015. Titles not found through these means but discussed in previously published academic literature were also included. See Sisson and Kimport [
      • Sisson G.
      • Kimport K.
      Telling stories about abortion: abortion-related plots in American film and television, 1916–2013.
      ] for further detail. Individual plotlines were identified from the full list of titles. All plotlines that aired on U.S. television from 2005 to 2014 and detailed a character’s abortion decision making were included in our sample.
      All episodes related to each plotline were viewed and quantitatively content coded by a member of the study team. Variables relevant to this analysis included the pregnant character’s demographic details (age, race, socioeconomic status, education, relationship status and prior births), centrality to the show (main character, peripheral character or single-episode appearance), the outcome of the pregnancy (abortion, adoption, parenting, pregnancy loss or other) and whether or not the character died, as well as reasons for abortion. Socioeconomic status was coded broadly (high, middle or low), determined by considering specific references to money, financial status and occupation. We note that most characters were judged to fall in the “middle” category. The primary coder utilized online fan resources when the abortion-related episodes did not include the desired content (e.g., discerning a character’s educational level by reading summaries of previous episodes). The study team met weekly to discuss coding questions. Coding decisions were reached by consensus. When primary coding was complete, a second coder independently coded a 10% sample of plotlines. We achieved 95% intercoder reliability.

      2.1 Analysis

      We charted the frequency of demographic variables for the sample and for the subgroup of characters who obtained an abortion, calculating relative proportions. We charted the frequency of each reason for abortion, the number of reasons offered and the proportion of characters to whom that reason applied. We restrict our analyses of reasons for abortion to the subgroup of characters who obtained abortions due to the volume of missing values for characters who considered but did not obtain an abortion. All analyses and descriptive statistics were computed in Microsoft Excel.

      3. Results

      3.1 Characteristics of characters

      We found 415 onscreen abortion plotlines, with 78 television plotlines in the last 10 years. As Table 1 shows, characters considering abortion were most frequently white (80%), middle class or above (85.7%), in a committed relationship (63%) and not parenting (83.3%). They were most frequently in the 30- to 39-year-old age group. Abortion plotlines were not relegated to peripheral characters; of the 78 characters who considered abortion, 47 (60%) were main characters.
      Table 1Characteristics of TV characters considering and obtaining abortions
      Number of characters considering abortionNumber of characters obtaining abortion
      Age (years)
      <202513
      20–291912
      30–392912
      40+53
      Race/ethnicity
      White6335
      Black52
      Asian/Pacific Islander42
      Latina/Hispanic40
      Middle Eastern10
      Biracial11
      Social class
      Middle class or above6632
      Working class or below117
      Unable to determine11
      Relationship status
      Committed relationship4622
      Casual or no relationship2715
      Unable to determine/other53
      Parenting status
      Parenting137
      Not parenting6533
      Centrality of character
      Main character4718
      Existing peripheral character97
      New peripheral character32
      Single-episode character1913
      Fifty-one percent of the characters (n=40) who considered abortion obtained one, making it the most frequent pregnancy outcome (there occurred parenting in 28.2% of plotlines, pregnancy loss or false pregnancy in 11.5% and adoption in 6.4%, with other outcomes such as death or infanticide in 2.6%).
      The subgroup of abortion-obtaining characters was distributed across the age groups (Table 1). However, as with the larger group of characters considering abortion, characters obtaining abortion were most often white (87.5%), middle class or above (80.0%), in a committed relationship (55%) and not parenting (82.5%). The largest group of characters who obtained abortions were main characters, although they represented less than half (45%) of all abortion-obtaining characters.
      Comparing all characters who considered abortion to the subset that obtained abortions, the racial homogeneity in the former group was exaggerated in the latter: 55% of white characters obtained an abortion, compared to 33% of characters of color. For all other variables, though, the highest rates of abortion were found in the least frequently represented categories. For example, most characters considering abortions were middle class or above (higher socioeconomic status). However, working class or below characters (lower socioeconomic status) had a higher rate of abortion (48% of higher-socioeconomic-status characters who considered an abortion obtained one, compared to 63% of lower-socioeconomic-status characters). This pattern was also found for relationship status, parenting status and centrality of the character. Compared to characters in committed relationships, characters not in relationships had a higher rate of obtaining abortion (55% compared to 47%) but still represented a minority (40.5%) of the characters getting abortions. Similarly, parenting characters had a slightly higher rate of abortion than their nonparenting counterparts (53.8% versus 50.7%), even though the majority of abortion-obtaining characters were not parents (82.5%). Finally, peripheral and single-episode characters both had higher rates of abortion than did main characters (75% and 68.4%, respectively, compared to 38.2%).

      3.2 Mortality outcomes

      The overall mortality rate for characters considering (but not necessarily obtaining) abortion was 10.2%. These characters’ deaths were attributed to homicide (2.4%), complications of childbirth (2.4%) or complications of the abortion (4.8%). Of the 4 characters whose deaths were attributed to the abortion, 1 was a direct medical complication and 3 were later-emerging mental health difficulties attributed to the abortion that contributed to suicide and drunk driving.

      3.3 Comparing characters and real women

      In aggregate, the population of characters who have abortions on television is notably different from the population of real women who have abortions in the U.S. (Table 2). While the fictional women who have abortions are most often teenagers, nulliparous and white, women who obtain abortions in real life are most often between 20 and 29 years old, have given birth at least once and are nonwhite [
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      ].
      Table 2Demographic characteristics of U.S. women and television characters who obtain abortions
      Percentage distribution of U.S. women obtaining abortions, 2008 (n=9493)
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      Percentage distribution of TV characters obtaining abortions, 2005–2014
      For Age group, Race, and Prior births, n=40. For Marital status, n=38. For Education, n=23. These variations are the result of limited information about some television characters.
      Age group (years)
       <2017.632.5
       20–2957.830.0
       30–3921.730.0
       ≥402.97.5
      Race
       White36.187.5
       Black29.65.0
       Hispanic24.90.0
       Other9.47.5
      Education
       <High school degree12.350.0
       High school degree28.30.0
       Some COLLEGE39.54.5
       ≥College graduate19.945.5
      Prior births
       039.185.0
       126.55.0
       ≥234.510.0
      a For Age group, Race, and Prior births, n=40. For Marital status, n=38. For Education, n=23. These variations are the result of limited information about some television characters.
      Although white women accounted for 36.1% of actual abortions, 87.5% of fictional abortions were obtained by white women. In contrast, black women obtained 29.6% of actual abortions, but only 5.0% of fictional ones and Hispanic women received 24.9% of actual abortions but no fictional abortions [
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      ]. Fictional characters obtaining abortions were generally younger than real-life women, with real women nearly twice as frequently in the 20- to 29-year-old age range than characters (57.8% compared to 30.0%) and nearly half as often teenagers (17.6% compared to 32.5%) [
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      ]. Most characters obtaining abortions had either less than a high school degree (n=20, of which 17 of the characters were in high school at the time of their abortion) or more than a college degree, making them both more and less educated than real women who obtain abortions [
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      ]. Finally, while over 40% of U.S. women obtaining abortions are below the federal poverty level [
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      ], over 82.0% of the characters obtaining abortions were upper or middle class. Only two characters that got an abortion were living in poverty.

      3.4 Comparing real and fictional reasons for abortion

      Overall, the reasons television characters obtained abortions substantially varied from the reasons real women give for seeking abortion (Table 3). For 75.0% of characters, only one reason was identified, 22% gave two reasons and only one character (2.5%) offered more than two reasons. This contrasts with real women, 35.0% of whom identify three or more reasons for abortion [
      • Biggs A.
      • Gould H.
      • Foster D.
      Understanding why women seek abortions in the US.
      ].
      Table 3Comparing reasons for abortion for U.S. women and television characters
      Percentage of women reporting reason contributed to decision to have an abortion, 2013 (n=954)
      • Biggs A.
      • Gould H.
      • Foster D.
      Understanding why women seek abortions in the US.
      Multiple reasons could be indicated for both real and fictional women.
      Percentage of TV characters obtaining abortion to whom reason applies, 2005–2014 (n=38)
      Multiple reasons could be indicated for both real and fictional women.
      Not financially prepared40.010.5
      Not the right time for baby36.05.3
      Partner-related reasons31.05.3
      Need to focus on other children29.02.6
      Interferes with future opportunities20.047.4
      Educational plans14.031.2
      Vocational plans7.015.8
      Health related reasons12.07.9
      Maternal health6.07.9
      Fetal health5.00.0
      Not independent/mature enough for baby7.028.9
      Influences from family or friends5.05.3
      Doesn’t want children3.010.5
      Pregnancy is the result of a rapeNA13.2
      Abortion is coercedNA7.9
      a Multiple reasons could be indicated for both real and fictional women.
      Nearly half of television characters (47.4%) indicated that parenthood would interfere with their future educational or vocational opportunities, while only about 20.0% of real women cite this reason as part of their decision [
      • Biggs A.
      • Gould H.
      • Foster D.
      Understanding why women seek abortions in the US.
      ]. Reasons such as a character’s immaturity or their lack of desire to ever parent were also overrepresented. Further, while 13.2% of characters sought abortion because their pregnancies were the result of rape, research finds that only 1.0% of women reported sexual assault as the reason for their abortion [
      • Finer L.
      • Frohwirth L.
      • Dauphinee L.
      • Singh S.
      • Moore A.
      Reasons US women have abortions: quantitative and qualitative perspectives.
      ]. Finally, 7.9% of characters were coerced into getting their abortions. While a real-world comparison is difficult, coercion has been framed as a subset of intimate partner violence [
      • Moore A.
      • Frohwirth L.
      • Miller E.
      Male reproductive control of women who have experienced intimate partner violence in the United States.
      ]. Only 3% of real women cited partner abuse as a contributory reason for their abortion [
      • Biggs A.
      • Gould H.
      • Foster D.
      Understanding why women seek abortions in the US.
      ], suggesting that coerced abortions are overrepresented.
      In contrast, major reasons real women report for choosing abortion were underrepresented. Compared to real women obtaining abortions, many of whom are living below the federal poverty level [
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      ], characters obtaining abortions infrequently portrayed financial unpreparedness as a reason for abortion (40% of women, compared to 10.5% of characters). Other reasons that were more common among real women, such as the mistiming of a pregnancy and the need to focus on existing children, were also portrayed much less frequently.
      Even within the umbrella reason categories, the specific reasons given by real women and those portrayed onscreen varied. For example, under “partner-related reasons,” given by 31.0% of real women, the most common specific reasons were the relationship being poor or new (9%) or the partner not being supportive (8%); only 3% of women cited an “abusive” partner as a contributory reason [
      • Biggs A.
      • Gould H.
      • Foster D.
      Understanding why women seek abortions in the US.
      ]. For television characters, partner-related reasons were underportrayed as a whole (5.3%), and the specific reasons were partner abuse or the partner’s death.

      4. Discussion

      Our findings demonstrate that television characters obtaining abortions are not representative of American women obtaining abortion, whether measured by demographic variables or by women’s reasons for abortion. On some demographic variables, such discrepancies are consistent with a generally unrepresentative character population on television that is whiter, wealthier and younger than the real American population [
      • Gerbner G.
      • Gross L.
      • Morgan M.
      • Signorielli N.
      Living with television: the dynamics of the cultivation process.
      ,
      • Mastro D.
      • Behm-Morawitz E.
      Latino representation on primetime television.
      ,
      • Tukachinsky R.
      • Mastro D.
      • Yarchi M.
      Documenting portrayals of race/ethnicity on primetime television over a 2-year span and their association with national-level racial/ethnic attitudes.
      ,
      • Donlon M.
      • Ashman O.
      • Levy B.
      Re-vision of older television characters: a stereotype-awareness intervention.
      ]. However, other discrepancies are harder to contextualize in the general pattern of television. Although no research suggests that parents are underrepresented on television, they were notably underrepresented among characters obtaining an abortion [
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      ]. Generally, the underrepresentation of certain populations of women considering abortion onscreen could contribute to feelings of internalized stigma or isolation among real women who obtain abortions but do not see themselves or their experiences represented in popular culture. For example, the dearth of Latina and black characters shown obtaining abortions may convey the idea that women of color do not need or willingly get abortions, potentially contributing to antiabortion framings of abortion among women of color as “genocide” [
      • Joyce K.
      Is abortion “black genocide”?.
      ].
      Onscreen reasons for abortion contain similar problems of representativeness. Television characters had fewer reasons for abortion than did real women, suggesting that fictional depictions of women’s lives and abortion-decision-making processes are simpler than that of real women. Additionally, while onscreen reasons for abortion overlap with the primary reasons real women cite for choosing abortion, they disproportionately represent some reasons and underrepresent others. Some of these differences in reasons are consistent with the demographic differences between fictional and real abortion patients. For example, compared to real women, characters were more often teenagers and more often cited immaturity as a reason for abortion; they were also less frequently parents and less frequently cited needing to care for existing children as a reason for abortion. Viewed broadly, the overrepresented reasons, including youth and immaturity, a desire not to ever parent and a desire to avoid disruption of career and educational goals, frame abortion as chosen for self-focused reasons. In contrast, the underrepresented reasons include other-focused reasons, such as financial unpreparedness and prioritizing the needs of existing children. Taken together, this pattern of reasons can contribute to the construction of abortion as a self-focused decision and to the belief that abortions are “wanted” because of personal desires rather than “needed” because of circumstances such as poverty. Similarly, that lack of portrayals of mothers getting abortions may produce a distinction between women who are mothers and women who get abortions. This dichotomization does not match real women’s lives and decision making: the majority of women who obtain abortions are mothers [
      • Jones R.
      • Finer L.
      • Singh S.
      Characteristics of U.S. abortion patients, 2008.
      ] and may construct abortion as a violation of maternity and contribute to abortion stigma [
      • Norris A.
      • Bessett D.
      • Steinberg J.
      • Kavanaugh M.
      • De Zordo S.
      • Becker D.
      Abortion stigma: A reconceptualization of constituents, causes, and consequences.
      ,
      • Kumar A.
      • Hessini L.
      • Mitchell E.
      Conceptualising abortion stigma.
      ].
      Although we do not investigate the motivations of creators of these portrayals of abortion, our findings offer some provocative insights into what might be called the politics of depicting abortion. For example, though many of the depicted abortions were obtained by a main character, the majority of onscreen abortions were obtained by peripheral or single-episode characters. As a consequence, there were fewer depictions of abortion as part of a richer character’s story and more where it was the defining aspect of the character. This may impact viewers’ understanding of how abortion fits into a person’s broader reproductive experience. Perhaps creators find it easier to shape abortion stories around characters in whom viewers have less investment or perhaps structural forces like advertisers discourage such storylines among regular characters. Future research should investigate the creative process behind abortion plotlines.
      Ultimately, the aggregate pattern of onscreen representations in the portrayal of abortion patients creates an inaccurate portrait of who gets abortions and for what reasons. Among the implications, the overrepresentation of teenagers, for example, might encourage support for parental notification and consent laws, as viewers may believe minors to comprise a large proportion of the real patient population. Similarly, the underrepresentation of characters of lower socioeconomic status might portray abortion as less of a financial necessity for some women while also representing it as affordable and thus impacting perceptions of the need for public funding for abortion care. Understanding the shape of these inaccuracies can enable advocates and medical providers to better identify and correct common misperceptions. Additional research examining fictional portrayals of barriers to abortion access, patient safety and health outcomes, as well as abortion clinics and providers, will offer further insight into how popular culture might influence mainstream ideas about additional abortion regulations and restrictions.

      Acknowledgements

      The authors wish to thank Aliza Gordon and Brenly Rowland for their research assistance on this project.

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