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TV’s Dangerous Plan B Confusion

| Reproaction

By: Elizabeth Skoski

Warning: This blog post contains spoilers to Black Mirror’s season four episode of “Arkangel” and of Superstore’s episode titled “Guns, Pills, and Birds.”

Like a lot of people, I spent the holidays binge watching the latest season of Black Mirror. The show, kind of an updated Twilight Zone, explores a future defined by the unintended consequences of new technologies.

But during “Arkangel,” the second episode of season four, the fear I felt was not caused by futuristic technologies, but instead by the perpetuation of a dangerous present-day misconception about a crucial women’s health service.  The episode, which was written and directed by Jodie Foster, conflates emergency contraception and the abortion pill.

The colloquially named abortion pill and emergency contraception are not the same.

First, the “abortion pill” works to end an already established pregnancy and consists of two pills: mifepristone and misoprostol. When taken together, mifepristone blocks the body’s progesterone, a hormone needed for pregnancy to continue, and misoprostol causes the uterus to contract and expel the embryo, embryonic sac, and lining of the uterus, similar to an early miscarriage. Though a medical abortion can also be done safely using misoprostol alone, more is needed than if the person terminating the pregnancy had a combination of misoprostol and mifepristone. A person would only use misoprostol alone if no mifepristone is available, typically outside of a clinic setting. When taken alone, the process of cramping and bleeding to expel the pregnancy may take longer and the method is slightly less effective, but the World Health Organization  recommends it as an effective alternative if mifepristone is unavailable.

Mifepristone and misoprostol are heavily, punitively, and unnecessarily regulated by the Food and Drug Administration, though many feminist and health organizations are working to change this, and receiving an abortion via medicine requires multiple visits with an authorized doctor and a litany of other unnecessary restrictions, which can create hardships that often bar people from receiving the abortion care they need.

On the other hand, emergency contraception, such as the widely known and advertised Plan B, does not cause an abortion. Instead, it reduces the risk of pregnancy when taken within 120 hours of unprotected intercourse by delaying or inhibiting ovulation. Emergency contraception will not induce an abortion; it prevents pregnancy. Unlike the abortion pill, emergency contraception has been authorized for sale on the shelf for several years, and is available over-the-counter in many pharmacies.

This incredibly important distinction has not stopped the anti-abortion community from claiming Plan B causes an abortion, a falsehood that unfortunately is widely believed due in large part to their misinformation and propaganda campaigns about emergency contraception. It’s always wrong to purposefully prevent people from understanding the truth about their medical care and choices. This misconception can lead people who do not want to be pregnant to mistakenly believe there’s something wrong with emergency contraception, just as abortion stigma, which shouldn’t exist in the first place, leads people to mistakenly believe there is something wrong with abortion. Also, on an institutional level, this assertion can put people’s reproductive healthcare decisions in jeopardy, with anti-abortion colleges and universities attempting to restrict access to Plan B and using opposition to abortion as their justification for doing so, when in fact access to both medical contraception and abortion should be readily available on campus.

Which is why it’s so infuriating when television gets it wrong. Throughout history, television has been a medium used by progressive directors and producers to normalize once taboo issues related to sexual and reproductive rights — from couples sharing a bed to interracial and gay relationships, and more recently abortion.

But for some reason, television writers can’t seem to get emergency contraception right.

In the “Arkangel” episode of Black Mirror, a mother, Marie, spies on and tracks her daughter, Sara, via an implant in the girl’s brain. Ultimately, Marie discovers that Sara is having sex and is unknowingly pregnant. Instead of talking to Sara, Marie goes to the pharmacy, purchases emergency contraception, grinds it up and puts it in Sara’s morning smoothie. Later, after getting sick at school, a nurse explains to Sara what caused her to vomit.

“Emergency contraception,” the nurse tells her. “For terminating your pregnancy. You’re not pregnant anymore.”

The episode’s remaining storyline is Sara realizing what her mother has done, leading to a violent confrontation. The storyline certainly would not have suffered if emergency contraception had been portrayed correctly, either secretly given to Sara within 120 hours after unprotected sex to prevent a pregnancy or if Marie had sought out the abortion pill, which research shows is typically safely available online (though not legally in the United States).

The clash between characters after the betrayal is discovered is not tied to emergency contraception, but instead to reproductive coercion, a timely and important issue that is beginning to be discussed widely. While reproductive coercion often involves a relationship member forcing their partner to carry a pregnancy or tricking their partner into getting pregnant without their knowledge, forcing a partner to have an abortion against her wishes also falls under the term. Reproductive coercion is a scary form of partner violence that could have benefited from exploration on a high profile show like Black Mirror. But instead, the writers used their platform to spread the myth that emergency contraception and the abortion pill are the same.

And Black Mirror isn’t the only show peddling false information about emergency contraception. A little over a year ago, Superstore, a NBC comedy about a Walmart-like store aired an episode — titled “Guns, Pills, and Birds” — in which the store’s devote Christian manager Glenn is aghast when he learns that the store’s pharmacy sells Plan B.

In the episode Glenn observes a couple discussing their emergency contraception needs with a pharmacist, who then retrieves the pill from behind the counter. It’s this depiction of a Plan B sale that was so disconcerting. Plan B has actually been authorized for sale over-the-counter — stocked on shelves inside the store, like Tylenol or other easy to obtain medications, as opposed to other more highly regulated drugs that have to be disseminated by pharmacists. It’s been that way since 2013, without age or point-of-sale restrictions. By showing the couple first having to speak to a pharmacist and then to add the extra barrier that the pills are behind the counter gives the viewer the impression that emergency contraception is harder to get than it should be; emergency contraception should be for sale on the shelf, without having to talk to anyone.

Reproaction knows how damning it can be for people when store chains refuse to stock emergency contraceptives on the shelf where they belong. It was real-life grocery and pharmacy chain Harris Teeter’s refusal to put emergency contraception on the shelf where it belongs that launched the Reproaction awareness campaign, leading to protest and action events to educate the public about the dangerous consequences of impeding access to emergency contraception, particularly for the most marginalized, including young people, the LGBTQ+ community, and immigrants who might be scared or intimidated by talking to a pharmacist and unable to get the medicine they need.

Like Black Mirror, the plot in the Superstore episode would have lost nothing by portraying the sale of emergency contraception the way it should be.

Representation on television affects how viewers understand sensitive topics and form opinions about complex issues. Studies have shown people’s opinions can be affected from viewing movies around controversial topics on everything from access to healthcare (As Good As It Gets) to faith in the government (JFK), and yep, even abortion (The Cider House Rules.) There’s no denying that we as viewers are affected and have reactions to what we see characters doing on screen. We are more likely to accept and internalize things as “the way it is” when it is reflected back to us in the popular entertainment narrative.

Black Mirror and Superstore both missed easy and vital opportunities to show Plan B in a factual light, in a way that would not only entertain viewers but educate them about the differences between Plan B and a medical abortion, the accessibility (or lack thereof) of these vital reproductive healthcare choices, and the very scary effects of reproductive coercion. Instead, they chose to peddle false information about an already misunderstood issue, an unforgivable sin in a political climate where the radical right is already working overtime to restrict reproductive access.

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