Telling Stories about Abortion: Abortion-Related Plots in American Film and Television, 1916–2013

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Original research article
Telling stories about abortion: abortion-related plots in American film and
television, 1916–2013
☆
Gretchen Sisson⁎, Katrina Kimport
University 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 indicates
that 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 been
systematically tracked and analyzed.
Study design: A comprehensive online search was conducted to identify all representations of pregnancy decision making and abortion in
American 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 decision
making. Of these plotlines, 173 (55.8%) resulted in abortion, 80 (25.8%) in parenting, 13 (4.2%) in adoption and 21 (6.7%) in pregnancy
loss, 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 suggests
an interactive relationship between media representations, cultural attitudes and policies around abortion regulation, consistent with cultural
theory of the relationship between media products and social beliefs. Patterns of outcomes and rates of mortality are not representative of real
experience and may contribute to social myths around abortion. The narrative linking of pregnancy termination with mortality is of particular
note, 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 to
the systematic evaluation of the portrayal of abortion in popular culture and provides abortion care professionals and advocates with an initial
accurate 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 alternately
declared abortion to be “television’s most persistent taboo”
[1],“no longer taboo”[2] and “still taboo”[3]. News
accounts have asserted that abortion is underrepresented in
film and television [4–10], estimating the quantity of
abortion-related plotlines anywhere from “a single instance”
[11] to “on average only once every two and a half years
since 1972”[12], with the further assertion that narrative
devices such as false pregnancies or pregnancy losses are
specifically used to avoid abortion-related storylines [4,7].
The presumption that abortion stories are rare, avoided and
enduringly taboo in American popular culture is prevalent.
Yet, a comprehensive investigation of the number of
abortion stories in film and television and the pregnancy
outcomes in such stories has remained absent from the
literature, leaving researchers without a clear picture of how
popular culture portrays abortion.
Research analyzing specific abortion stories on film and
television has found that, like many depictions of medical
experiences [13,14], they are not always representative of the
Contraception 89 (2014) 413 –418
☆
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

reality of abortion care in the United States [15–18],
inaccurately depicting medical procedures, clinics and who
seeks abortions for what reasons. Such inaccuracies in
entertainment television typically function in ways that uphold
conservative, hegemonic structures [19], though we do not
know whether or how this applies to abortion stories. Few
scholars have examined fictional depictions of abortion decision
making. Condit [20] represents a notable exception, finding that
the overall pattern of fictional unintended pregnancies resolu-
tion in the 1980s overrelied on the narrative trope of a false
pregnancy. Nonetheless, research has not systematically
examined the number and overall outcome trends in abortion-
relatedplotlines.Thedearthofsuchaninvestigationintothese
trends is problematic, as without one we do not know if and in
what ways abortion is represented inaccurately.
This absence is of consequence as research has shown that
media portrayals influence viewers through a variety of
means. Scholars have shown that news coverage, particularly
in the form of in-depth stories about people with whom
viewers identify, can sway not only personal opinions but
also political priorities [21]. In-depth fictional programming,
especially plotlines showcasing characters in whom viewers
are invested, functions in a similar way [22,23]. Scholars
have demonstrated that this holds for fictional depictions of
pregnancy decision making and abortion. Mulligan and
Habel [24] found that after viewing one of two fictional films
about pregnancy-decision making —one in which abortion
was framed in a favorable light and one in which it was
portrayed more negatively —subjects were significantly
more likely to support access to legal abortion in a greater
range of circumstances after viewing the former film. On an
aggregate scale, abortion stories, to the extent that they
repeat similar themes, can alter public understanding [25]:
the cinematic construction of a poignant ultrasound scene,
the rhetorical avoidance of the word “abortion”or the
circumstances of a fictional character’s pregnancy all
cultivate 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 about
abortion and abortion stigma, with consequences for the
lived experience of women seeking abortions [29].
In this paper, we conduct a census of plotlines that engage
with abortion in US television and film since the beginning
of American cinema. In addition to empirically describing
their number, we make an opening contribution to
developing a systematic evaluation of abortion decision
making, analyzing the plotlines for the pregnancy outcome.
This work provides abortion care professionals and women's
health advocates with an initial accurate window into the
cultural stories being told about abortion.
2. Methods
To produce a comprehensive list of all film and television
representations 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 a
keyword or contained the word “abortion”in their plot
description. As a catalog of 2.5 million titles from 1887 to the
present —including films, television series and television
episodes —that has been both crowd- and industry-sourced,
IMDB represents the largest freely available database for
tracking entertainment representations. We searched IMDB
twice, first in December 2012 and then in February 2013, to
cross-check results and add recent titles. Titles that met the
following criteria were included in the results: (a) available to
American audiences; (b) English language; (c) full-length,
scripted stories (short films were excluded); (d) aired before
February 1, 2013. Nonscripted stories (documentaries, reality
television programming and talk shows) were excluded to
preserve a focus on the portrayal of abortion when the creators
of the media had full creative license to determine outcomes.
Because an abortion plotline might be just one of
hundreds of plotlines on a long-running television show
and thus not be included in either a keyword tag or a show
summary on IMDB, in February 2013, we used the search
engine Google to conduct a secondary online search for Web
sites discussing shows featuring abortion plotlines. Specif-
ically, we reviewed results from the search string “abortion
on television”and added any titles included on these pages.
No new titles were found in the 11th through 15th search
result, so we stopped reviewing results.
Finally, we included titles analyzed in published
academic literature reviewed for this paper.
Repetitions were removed from the full list, with further
relevancy exclusions for results that were misclassified and
failed to fulfill the original inclusion criteria, or results where
the use of the word “abort”or “abortion”did not refer to the
medical procedure.
We coded the remaining titles for individual abortion-
related plotlines, as television shows could have multiple
such plotlines over a series, and coded each plotline for year
of release. Movies were coded for producing studio and
television shows for broadcast network and, if possible, for
time of day first aired (e.g., primetime, daytime). Plotlines
were sorted into five categories: (a) abortion as a major plot
point, e.g., a character making a decision around an
unplanned pregnancy; (b) one of the primary characters is
a provider, but the plotline does not directly engage with a
woman considering or choosing abortion; (c) the plot is an
investigation of the murder of an abortion provider but does
not directly consider the experience of providing abortion;
(d) abortion as a minor plot point, e.g., a character reveals a
past abortion without discussion; (e) abortion is discussed
only in the abstract within a religious, political or social
context rather than as an experience.
For the first two categories, we coded each plotline for
outcome of the pregnancy. Possible outcomes included
abortion, parenting, adoption, pregnancy loss (including
false pregnancy) and unresolved. We additionally coded for
the woman’s mortality at the end of the plotline.
414 G. Sisson, K. Kimport / Contraception 89 (2014) 413–418

2.1. Analysis
For the purposes of this analysis, we restricted our sample
to plots in the first two categories. We charted the quantity of
representations each year over time. We then analyzed the
changing proportions of pregnancy outcomes by decade,
followed by an analysis of the rates and patterns of women
dying in these plotlines. All analyses and descriptive
statistics were calculated using Microsoft Excel.
3. Results
The IMDB searches yielded 472 titles, Google search
results found an additional 43 titles, and the review of the
published literature added 35 more unique titles. Of these
550 titles, 208 were excluded for relevance. The remaining
342 titles represented 385 individual abortion plotlines,
which were categorized as follows: 291 plotlines had
abortion as a major plot point; 19 plotlines had an abortion
provider as a primary character; 7 plotlines solely investi-
gated the death of an abortion provider; 45 plotlines had
abortion as a minor plot point; 23 plotlines involved abortion
only being discussed religiously, politically or socially. For
the purposes of this paper, we restrict our analyses below to
the 310 plotlines of the first two categories.
3.1. Number of representations
As Table 1 shows, the number of representations of
abortion stories in American film and television has
increased, though not steadily, since the earliest identified
abortion plotline in a 1916 silent film. Since the 1973 Roe v.
Wade decision, representations have increased each decade
over the decade before by at least 31%. The number of
abortion plotlines from 2003 to 2012 was a 105% increase
over the total from the previous decade, representing a high
of 116 plotlines. Television depictions were not restricted to
marginalized viewing times or places; 69% (n= 97) of the
television 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 has
not been smooth. Table 2 illustrates the drastic fluctuations in
the number of abortion stories airing in any single year.
3.2. Pregnancy outcome trends
For 302 of the 310 plotlines, we were able to identify
pregnancy outcomes. Of these 302 plotlines, 173 (57.3%)
included an abortion. This proportion fluctuated by decade,
Table 1
Total plotlines by decade (N= 310)
Combined movie & TV Movies TV
1913–1922 7 7 0
1923–1932 3 3 0
1933–1942 9 9 0
1943–1952 7 7 0
1953–1962 13 11 2
1963–1972 29 22 7
1973–1982 24 12 12
1983–1992 44 16 28
1993–2002 58 33 25
2003–2012
a
116 49 67
Total 310 169 141
a
2012 includes January 2013.
Table 2
Total abortion plotlines by year (N= 310)
415G. Sisson, K. Kimport / Contraception 89 (2014) 413–418

with a high from 1933 to 42 (88.9%) and a low from 1953 to
62 (30.8%) (Table 3).
Representations of pregnancy decisions produced before
Roe, while fewer, were more often resolved with an abortion
than 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 February
2013. While abortion represented about 60% of the outcomes
in each of the three decades from 1973 to 2002, abortion
represented a smaller percentage of all outcomes between
2003 and 2012 (48.6%), even as the volume of pregnancy
resolutions through abortion was the highest to date (n= 54).
Rates of resolution through adoption and pregnancy loss
similarly 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, these
percentages increased to 4.7% (n= 11) for adoption and 8.5%
(n=20) for pregnancy loss. The increase in adoption
outcomes is even more historically recent: 2003–2012 saw
an increase in the proportion of plotlines ending in adoption
(9.0%; n= 10) after no stories resolved in adoption in the two
penultimate decades (1983–1992 and 1993–2002).
Sixteen plotlines were coded as unresolved, either
because the story concluded before a decision was made
Table 3
Pregnancy outcomes by decade (n= 302)
Table 4
Prevalence and causes of death in abortion plotlines
416 G. Sisson, K. Kimport / Contraception 89 (2014) 413–418

(n= 6) or because the woman died before she could make a
decision about the pregnancy (n= 10).
3.3. Prevalence and causes of death in abortion-related
plotlines
In all, 13.9% (n= 42) of the stories ended with the death of
the woman who considered an abortion, whether or not she
obtained one.
In 10 stories, the pregnant woman died before a
pregnancy decision could be made. As a pregnancy
resolution, death decreased proportionally over time: 7.3%
(n= 5) of plotlines pre-Roe versus 2.1% (n= 5) of plotlines
post-Roe. All 10 deaths were the result of violence: 9
instances of murder and 1 suicide.
In addition to these 10 characters who died before making
a pregnancy decision, 27 (15.6%) who had abortions later
died: 16 died as a direct result of the abortion, 6 were
murdered, 3 committed suicide or died as a result of self-
injury, 1 died in an accident, and 1 died with no specified
cause of death (Table 4).
Five characters died after choosing to parent (6.2%), all
during childbirth. No characters died after choosing adoption
or experiencing a pregnancy loss.
4. Discussion
This analysis established the volume and distribution over
time of abortion-related plotlines in American television and
film, offering a useful starting point for considering ways
abortion is represented in culture. We found that abortion
stories are more common and have always been more
frequent than popular discourse suggests [1–12]. We further
document a general growth trend in the quantity of abortion-
related plotlines over time and, more pointedly, when
considered by decade, an increase in the volume of such
plotlines that culminate in an abortion. Although these data
cannot explain the fluctuations in the volume of abortion-
related plotlines and outcomes, the patterns we find suggest
an interactive relationship between media representations,
cultural attitudes and policies around abortion regulation,
consistent with both cultivation analysis and agenda setting
theories of the relationship between media products and
politics [15,17,20,21,23,24,26]. Further investigation of the
relationship between the number of media representations of
abortion and culture is warranted.
Our analysis found that the news media’s assertion that
abortion is absent from fictional plotlines is unsupported, but
also points to inaccuracies in its depiction. While we find
overall that many outcomes are represented, most women in
these fictional plotlines who consider abortion do obtain an
abortion, though data from the most recent decade suggest
this trend may be reversing. Consistent with existing
literature critiquing the accuracy of fictional portrayals of
abortion [15–18,20], we found that the overall patterns of
pregnancy outcome do not match statistics from real life. For
example, in the most recent decade, 9% of fictional women
placed their newborn for adoption, whereas the real-life
number of women making such a choice is closer to 1% [30].
We also found an unexpectedly high prevalence of death
in storylines about abortion, including the use of death as a
pregnancy resolution for women who considered abortion.
The 9% (n= 16) rate of death directly caused by abortion in
the fictional stories is inaccurately exaggerated; current risk
estimates place risk of death from abortion as statistically
zero [31]. (We note that some of the representations in which
abortion 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 that
such fictional depictions not only reflect social discourses
but also influence them [18,22–24]; such discourses will be
shaped by the portrayal of abortion as dangerous. While
medical procedures are often represented in inaccurate ways
[13,14], the frequency with which abortion is portrayed as
having adverse outcomes may be unique. Cardiopulmonary
resuscitation, for example, is consistently shown as less risky
and more successful on television than is true of real life
[13]. We speculate that the overrepresentation of both
adoption and mortality outcomes could skew the audiences’
perceptions of the legitimacy and safety of abortion. One
limitation of our research is that it does not address the
occurrence of morbidity following fictional abortions, which
may be an additional way in which obtaining an abortion is
portrayed as more risky than it in fact is.
This analysis exposed another, unanticipated pattern
which may further perpetuate the social myth of abortion
as physically risky [29]: the high death rate for women who
considered, but did not obtain, abortions. The frequency of
death for non-procedure-related reasons (e.g., murder)
among women who considered abortion may have even
larger consequences for social understandings of abortion.
Discursively, this association of death with the contempla-
tion of abortion contributes to the ongoing production of
abortion stigma, narratively linking the consideration of
pregnancy termination with violence and death.
This analysis provides insight into the presence and
patterns of abortion-related plotlines in US film and
television, offering an important corrective for the popular
assumption that abortion is absent from these media.
Additionally, insights such as the overrepresentation of
death following abortion are valuable for assessing how
current representations produce and replicate social myths
around abortion, making the lived experiences of obtaining
and providing abortions more difficult. These findings can
be used by abortion care professionals and women’s health
advocates to better understand the cultural landscape of
abortion stories.
Acknowledgments
Funding for this analysis was provided by the David and
Lucile Packard Foundation (2012-37676).
417G. Sisson, K. Kimport / Contraception 89 (2014) 413–418

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