How 'Period Pills' Could Reduce The Stigma Surrounding Abortion
Back in 2007, Showtime's groundbreaking drama "The L Word" portrayed two things that were rarely shown on television: a Black woman being tricked into going to a crisis pregnancy center — and then in Season 4, Episode 2, women talking openly and honestly about their abortion experiences in public. There have been multiple powerful scenes on network television since "The L Word" aired Kit's experience, but when it comes to talking about abortion, there remains a heavy stigma.
Long before Pam Grier's Kit had her off-screen abortion was Bea Arthur's character on "Maude." In 1972 Maude was the first main character on primetime television to have an off-screen abortion, per KQED. But until recently, not many television shows or movies have followed in their footsteps—not without network pushback and content warnings before episodes (via Refinery 29). Shonda Rhimes told Vulture in 2011 that she had originally wanted Cristina Yang's Season 8 abortion to happen much earlier in "Grey's Anatomy," but got pushback from ABC's Broadcast Standard and Practices. She told The Hollywood Reporter the same thing happened with Olivia Pope's abortion in Season 5, Episode 9 of ABC's "Scandal."
But our reality is working to join Rhimes' fictional worlds where abortion is an undramatic, unstigmatized choice for pregnant people. One review of studies found that the majority of people who have had or provided abortions "experience fear of social judgment, self-judgment, and a need for secrecy." But according to Scientific American, a pre-Roe method may help change the conversation.
Studies show people don't want to know if they're pregnant
According to the New York Times, despite the fact that abortion is banned in Bangladesh, providers have been able to administer procedures to help with "menstrual regulation" since its war of independence in 1971. At the time, hundreds of girls and women were reportedly raped and tortured, resulting in suicides and infanticides — something this pregnancy ambiguity helped end.
Today just as in the 1970s, the Times reports health care providers in Bangladesh are allowed to either aspirate the contents of a uterus or provide patients with mifepristone and misoprostol to induce menstruation until 10 weeks after the patient's last period.
Given the choice between having to confirm they're pregnant or not, studies are showing patients want this pregnancy gray area. One study participant was even cited saying looking at first-trimester abortion as restarting their period would help make them feel less guilty about a choice they wanted to make (via Ms. Magazine).
What was most shocking about the study, the study's authors wrote in Ms. Magazine, was how prevalent the internalized abortion stigma still is. This stigmatization, they argue, is because of the "anti-abortion movement's mean-spirited, relentless and decades-long efforts to intimidate and shame abortion clients and providers." This includes saturating the knowledge pool about abortion with misinformation, which research has continuously found proof of.
Abortion stigmatization is based on misinformation
California Congresswoman Jackie Speier told Elle that when she was hearing colleagues talking about "sawing off limbs" as part of an abortion procedure back in 2011, she knew she had to stand up and share her experience. The discussion was around surgical abortions, which happen after a pregnancy passes into the second trimester and according to UCLA's detailed explanation of the procedure, saws are not involved.
It's misinformation like what Congresswoman Speier heard on the floor of the House of Representatives that Planned Parenthood explains is what perpetuates the stigma against abortion. It doesn't help, either, that abortion was represented in the media in ways that perpetuated the stigma. Vice points to the 2001 episode of HBO's "Sex and the City" where Carrie initially lies to Aiden about her stance on or history with abortion for fear of judgment.
While Carrie's fears are realistic, Vice explains her need to justify her reasons is part of the stigma shows like "Scandal" started trying to subvert. Why someone is choosing to have an abortion is a private medical decision between the patient and their provider.
A decade after Carrie told Aiden she was pro-abortion, Christina Yang had an abortion on "Grey's Anatomy" — only the second lead Asian actor to have on-screen abortion representation in history, per Refinery 29. But it wasn't until 2015 when "Scandal" let a woman have an abortion on primetime TV without justifying it first.
Why Cristina Yang and Olivia Pope's on-screen abortions were groundbreaking
During the Season 5 mid-season finale of "Scandal," Olivia Pope's abortion was over before viewers really knew what was happening. For The Atlantic, the scene was unremarkable in the most audacious way: there was no pre-procedure debate, no weighing of morals. But as The Atlantic also highlights, you see Olivia's "wide-eyed gaze" as she went through the procedure. The procedure itself is routine, and can be emotionally complicated for the patient — but they don't have to justify their decision to anyone.
But studies have shown that in reality, patients who have had abortions today don't feel this same sense of normalcy "Scandal" was trying to create, nor the peer support Cristina Yang recieved in Season 8 of "Grey's Anatomy." Talking to Vulture, Shonda Rhimes explained that it didn't make sense in a show where main characters have talked about previous abortions or are even abortion providers, like Addison Montgomery, for a character to tip-toe around having an abortion. But Rhimes explains she didn't have the power to tell Cristina's story until long after she originally wanted to tackle on-screen abortions.
Media representation of abortion has changed, Refinery 29 writes, but in reality, the topic is still heavily stigmatized. In June, things got worse when Dobbs v. Jackson Health Organization rolled back federal protections for abortion. Since then, advocates have been doing everything from working with underground abortion networks to rebranding medications in order to continue providing patients with care.
Menstrual regulation has been around for decades
Studies have repeatedly shown that people seeking abortions and abortion advocates experience abortion stigmatization in equal measure. But Wendy R. Sheldon and Beverly Winikoff wanted to know what would happen if someone just had a late period and a doctor gave them a treatment to help restart their menstruation cycle (via Scientific American).
The treatment plan is actually from before Roe v. Wade legalized abortion. According to a 1972 article in Time, the process — referred to as "menstrual extraction" — was "becoming medically respectable" as more physicals began studying the method to circumvent the legal and medical hardships of abortion. At the time, the procedure was done through aspiration before tests could prove pregnancy, mirroring what was happening in Bangladesh (via New York Times).
Today's version of "menstrual extraction" are abortion pills rebranded as "period pills." Michele Gomez, a physician in California who provides patients with period pills, told Scientific American since mifepristone and misoprostol were already proven to be safe for abortion after pregnancy was confirmed up to a certain point, it made sense to prescribe the treatment as soon as pregnancy was suspected.
With how easy at-home pregnancy tests are to get, however, the idea of not being able to confirm pregnancy is baffling to some medical professionals, per Scientific American. But as Ms. Magazine points out, this unwelcome experience is unnecessary if you don't want to be pregnant and continues to perpetuate shame around wanting to restart your period.