"I was close to death!": abortion and medical risk on American television, 2005-2016.

OBJECTIVES: To examine the portrayal of complications and long-term health consequences associated with abortion on television, recognizing the impact that fictional stories can have on public beliefs about abortion's safety.

STUDY DESIGN: Using a systematic online search, we identified all instances of abortion on US television from 2005 to 2016. We qualitatively coded these plotlines to identify any occurrences of complications, interventions or long-term health consequences associated with abortion care, with 95% intercoder reliability. We calculated the frequencies and rates of these occurrences in Microsoft Excel.

RESULTS: Our search identified 80 abortion plot lines. A percentage of 37.5 of characters who obtained an abortion experienced complications, interventions and/or negative health consequences. This rate contrasts with the 2.1% of real patients who experience complications or require intervention as a result of their abortions. Most onscreen complications were major events (e.g., hemorrhage), as opposed to real women, whose complications are mostly minor. Major medical interventions (e.g., hysterectomy) were similarly overportrayed, while the most commonly used interventions for real patients (e.g., medication) were not depicted at all. Finally, 22.5% of characters faced a long-term adverse health consequence, including mental illness, infertility or death. The onscreen abortion mortality rate was 5%, about 7000 times the actual mortality rate.

CONCLUSIONS: Overall, television dramatically exaggerates the risk associated with abortion procedures, overportraying medical complications - particularly major and life-threatening complications - and long-term adverse health consequences. This pattern of misrepresentation may be partially attributable to the occurrence of stories about illegal abortions or abortions taking place outside of modern medical contexts.

IMPLICATIONS: Onscreen abortion portrayals may contribute to inaccurate beliefs about abortion's risk that are common among the public, broadly, and abortion patients, specifically. Abortion advocates and providers will be more equipped to respond misinformation if they understand how and to what extent our popular culture portrays abortion as unsafe.