Chapter 7: Communicating Abortion in the Mass Media: A Literature Review of the Challenges and Possibilities

Safe abortion care is among the nine recognised essential services for sexual reproductive health and rights (SRHR; African Union, 2003; Durojaye et al., 2021; Starrs et al., 2018; WHO, 2022). Since the International Conference on Population Development held in Cairo in 1994 and the Beijing Declaration and Platform for Action in 1995, respecting and protecting SRHR have been considered an important responsibility for governments across the world (Durojaye et al., 2021). The UN sustainable development goals link SRHR to goals and targets and commit governments to ensuring access to SRHR and promoting gender equality (goal 5.6) and to healthy lives and well-being for all (goal 3.7) by 2030 (Munyati, 2018; Starrs et al., 2018; UNFPA, 2023). Respecting women’s rights to safe abortion is linked with respecting women’s right to life (African Union, 2003; UNFPA, 2023; WHO, 2022). However, many countries are falling behind in their provision of this essential SRHR service (Starrs et al., 2018).

The Maputo Protocol (2003) is recognised as the first African document on human rights that specifically mentions access to safe abortion as a woman’s right. More than 15 years later, research shows that there are significant gaps in protecting and respecting SRHR in Africa, specifically in Sub-Saharan countries (Durojaye et al., 2021; Poku, 2020; Starrs et al., 2018). As a key source of political and social information, the media has an important role to play in shaping public discourse and can impact on how SRHR are advanced or restricted (Feldman & Zmerli, 2019). This chapter aims to explore how mass media coverage facilitates the public sphere’s engagement in discussion about abortion as a social issue and how its framing of abortion issues can create or dilute a sense of moral panic among audiences.

This chapter uses the term ‘mass media’ to refer to all those forms of media facilitating communication to a large and dispersed audience, including newspapers, radio, television, and online media (McQuail & Deuze, 2020). It employs the concept of the ‘public sphere’ to describe the domain of social life where public opinion can be formed and where citizens can freely share their opinions (Habermas, 1989, p. 398). ‘Moral panic’ as explored in the chapter refers to media coverage that exaggerates an event represented as a threat to societal values and interests (Cohen, 2002, p. 1).

Mass media in its varied forms can reach a wide audience and offer the space to discuss issues affecting their societies in a ‘public sphere’ (Habermas, 1989; McQuail & Deuze, 2020). Indeed, mass media is seen as possibly the most credible and effective source of information on SRHR generally, and abortion specifically, and plays a key role in influencing the formation of public opinion about abortion (Fraile & Hernández, 2024). How media frames and represents abortion depends largely on the countries’ context in terms of religious beliefs, social and cultural values, and legislation as well as current scientific justifications and international human rights conventions (Davis Kempton, 2024; Fraile & Hernández, 2024; Hadley, 2023; McDonnell & Murphy, 2019; Nyathi & Ndhlovu, 2021).

The recent increase in coverage of abortion issues and the negative representations of abortion in the media can result in amplified moral panic in societies (Goode & Ben-Yehuda, 2009; Jewkes & Linnemann, 2018). The creation or reinforcement of negative representations and stereotypes among audiences can promote misconceptions and abortion stigma among the public (Jewkes & Linnemann, 2018; Purcell et al., 2014), whereas the increased coverage of abortion that advocates for women’s rights to abortion as a human right can not only change social-cultural attitudes to be more accepting of women and girls’ need for and right to abortion but also impact legislation (Davis Kempton, 2024; McDonnell & Murphy, 2019).

Several factors influence how much and what kind of coverage abortion receives in the mass media. The reviewed literature focuses predominantly on four: the newsworthiness of the topic, the political and social context, media freedom, and media ownership.

Successful journalists know what interests their audience, and when issues are considered important and interesting to the public, mass media can increase the coverage of a topic by changing the way those issues are communicated to better meet the audiences’ appetite and boost sales by abiding by the ‘rule of newsworthiness’:

This suggests that before journalists choose to cover issues related to abortion, they consider criteria to identify what is relevant, two of which include a new subject or a subject interesting to the public. Decisions about whether to cover the topic of abortion may be influenced by this concept of newsworthiness.

A country’s political and social context and level of freedom of the press also impact how mass media covers abortion. South Africa provides a strong example of how these contexts impact the media coverage of abortion: there is a marked difference between newsprint media representation of abortion by commentators in South Africa before 1990, when there were restrictive laws and media freedom was limited, and after 1990, after democratic reform, the liberalisation of abortion laws, increased gender activism, and the establishment of an environment of greater media freedom (Feltham-King & Macleod, 2015).

Media ownership status (i.e. whether an organisation is government-controlled or privately owned) also affects how media houses represent abortion issues (Nyathi & Ndhlovu, 2021). On the one hand, media houses owned by interest groups that oppose the right to abortion are more likely to emphasise anti-abortion perspectives, frame abortion rights arguments negatively, and potentially limit the diversity of viewpoints available to the public (Feltham-King and Macleod, 2015; Nyathi & Ndhlovu, 2021). On the other hand, pro-rights media ownership is more likely to provide coverage of abortion-related issues that support and normalise such perspectives and highlight the importance of reproductive rights (Nyathi & Ndhlovu, 2021). In other words, privately owned media houses can either contribute to a sense of moral panic about abortion or facilitate the informed rational discourse envisioned in Habermas’ public sphere by providing factual information on the topic.

A recent case study of media coverage in Zimbabwe reveals that government-controlled media houses also suffer from bias. Nyathi and Ndhlovu (2021) found that the government-owned newspaper tends to criminalise abortion and promote restrictive laws on abortion, which is consistent with the current legislation in Zimbabwe, where abortion is illegal except in limited circumstances. Most of The Chronicle’s coverage of abortion frames the women who seek abortion services as criminals and killers. What is more, the study found that the government-owned newspaper draws readers’ attention to the dangerous consequences of abortion for women, without clarifying the difference between safe abortion and unsafe abortion. The three privately owned and independent newspapers examined, however, participate in debate about abortion and advocate for decriminalisation. Articles that discuss the consequences of unsafe abortion on women’s health, advocate for women’s rights to abortion, criticise the restrictive abortion law in Zimbabwe, and call for review of the laws to provide access to legal and safe abortion and prevent the consequences of unsafe abortions were prominent in the private media’s coverage. Nyathi and Ndhlovu (2021) argue that how the government-owned newspaper in Zimbabwe criminalises abortion not only spreads fear about the risks of having an abortion and discourages women from seeking medical assistance to terminate an unwanted pregnancy safely but also discourages abortion supporters’ movements and increases stigma for women who have an abortion.

As women are the population most impacted by abortion, the framing, language, and focus of abortion-related media coverage often demonstrate underlying biases and power dynamics and reveal how media narratives can reinforce or challenge traditional gender norms and the social status of women. How mass media frames abortion can add to or reduce stigma and a sense of moral panic around abortion. More often than not, media coverage of abortion is not advocacy for human rights but the presentation of a controversial topic related to what women’s bodies are expected to be and how they are intended to work (Jewkes & Linnemann, 2018; Lagos & Antezana, 2018; Purcell et al., 2014). For example, a 2014 study of newspaper coverage of abortion in Great Britain found that only a few newspapers framed abortion positively, advocated for the right of women to abortion services, and challenged the stigmatising and negative discourse surrounding abortion and women who decide to terminate their pregnancies (Purcell et al., 2014). A much larger number of the analysed newspapers presented abortion as a criminal act and portrayed women who terminate their pregnancies as ‘incompetent’ or ‘unnatural’ women who are unable to deal with motherhood. This deviation from the ‘norm’ of womanhood and motherhood can be exaggerated in the media and result in moral panic. The study also indicated that British newspapers tended to associate abortion with post-abortion complications and health risks, which discourages women from seeking abortion services.

The framing of abortion in South American mass media operating online also condemns or stigmatises women who have or seek abortions. Lagos and Antezana (2018, p. 136) criticise the online media public sphere ‘as a male domain’, where men’s voices are seen to encourage gender-based violence with their violent discourses. Lagos and Antezana further contend that even if mass media is a good space for the public to express freely their opinions, what is said in that sphere and how it is said can contain elements that lead to moral panic. Their study indicates that in the context of South American countries, online public opinion often propagates a distorted picture of abortion and holds the survivors of rape and sexual assaults accountable for the pregnancies that result from these crimes. The impact of this media coverage has serious consequences; increased negative portrayals and representations of abortion and those who seek them reinforce stigmatisation, discourage women from seeking abortion services, and pose a barrier to the activists engaged in advocating for women’s rights to abortion (Lagos & Antezana, 2018).

Men’s voices are more often heard in the media’s discussion and representation of the topic of abortion. As Davis Kempton’s (2024) assessment of the coverage of the change in abortion laws in the United States of America (USA) indicates, mass media privileges men’s voices because men hold more political power and more actively participate in the decision-making processes. Women’s voices claiming their reproductive health rights are not boosted in the same way as the voices of men opposing legal access to abortion are. Many other studies also argue that the mass media coverage of the legalisation of abortion is more politicised than any other health issue (Davis Kempton, 2024; Fraile & Hernández, 2024).

Mass media also can unwillingly convey a negative image of abortion to its audience even if they had an intention of advocating for the right to abortion when the media content does not match the reality of abortion. An analysis of four American and British television dramas from different television stations shows that even though these dramas positively portray abortion and highlight women’s rights to seek abortion, they fail to portray abortion realistically (Freeman, 2022). Instead, the dramas portray the abortion procedure as surgical only and people seeking abortion as white, rich, and young. Freeman argues that television producers exclude information that viewers should know, like such alternatives to surgical interventions as medical abortion (i.e. taking oral medication), and the fact that all women can seek abortion, no matter where they live, their age, or the colour of their skin. Freeman (2022) further notes that such misinformation can ‘exaggerate the risks of seeking abortion services’ and can ‘reinforce the assumption that abortion is violent and dangerous’ to fuel abortion-related stigma (p. 600). What is more, when mass media does not cover the whole truth about abortion, it can be at risk of reinforcing the existing concerns associated with post-abortion complications and women’s fears about seeking abortion services:

Media coverage focussing on newsworthiness of issues regarding abortion can also foster biased information. When the voices opposing the legalisation of abortion are considered newsworthy, they are the most heard in the mass media and gain further prominence among audiences (Rohlinger, 2015; Sambaiga et al., 2019). In such countries as Tanzania and Uganda, which have restrictive laws on abortion and the majority of the population holds strong religious beliefs, the mass media focuses on anti-abortion movements’ discourses because they are the most prominent (Larsson et al., 2015; Sambaiga et al., 2019). When the voices of activists supporting safe abortion and advocating for legal changes are few and of marginal interest to the public, they do not attract media attention and lose visibility in mass media. When mass media provides a public platform to voice opinions opposing women’s rights to abortion, these rights are often ignored among the population (Davis Kempton, 2024).

While mass media can amplify dominant voices of power that demonise abortion, it can also advocate for abortion rights. The media can promote debates and give a voice to activists in order to influence public opinion and change conservative attitudes and restrictive laws (Feltham-King & Macleod, 2015). Mass media has the power to set the agenda and influence social norms around abortion, and media coverage has contributed to the amendment and repeal of restrictive laws and protection of women’s rights to abortion (McDonnell & Murphy, 2019).

The increased coverage of incidents justifying the right of women to request abortion services brought about a change in the abortion law in the United States of America (Rohlinger, 2015). Although USA law allowed abortion in cases of sexual assault, incest, and foetal malformation during the 1940s and 1950s, Rohlinger narrates that this changed in the 1960s after increased coverage of the request for abortion by TV celebrity Sherri Finkbine, who realised that ‘she had ingested a drug known to cause fetal deformity’ (Rohlinger, 2015, p. 43). Her ordeal and travels to Sweden to obtain a safe abortion combined with the rubella measles epidemic received important TV coverage, and, as a result, abortion laws were amended in the country.

McDonnell and Murphy (2019) argue that mass media coverage of the 2012 death from sepsis after a prolonged miscarriage of Savita Halappanavar, who was refused an abortion because the law did not permit medical doctors to perform an abortion while the heart of the baby was still beating, brought about a similar change in Irish law. McDonnell and Murphy (2019) analysed how six Irish newspapers framed the issue of abortion to demonstrate that Savita Halappanavar’s death provided an opportunity for newspapers to highlight the gap in the existing legislation which did not give medical doctors a clear framework. The law was accused of prioritising the rights of the unborn over the rights of the mother. The international media attention and debates reflected negatively on Ireland’s image which gave way to a historical change in the Irish constitution, from ‘the protection of the unborn’ to ensuring that abortion was available on request up to 12 weeks (McDonnell & Murphy, 2019, p. 18).

The mass media has significant power to provide factual information to assist individual women of reproductive age’s decision-making about abortion services because mass media exposure allows them to acquire information on the existing laws guiding abortion in their countries and their rights to make decisions about their own bodies (Aalmneh et al., 2022; Ahinkorah et al., 2020; Dickson et al., 2018). For example, a 2018 study conducted in Ghana and Mozambique that identified socio-demographic factors influencing the termination of pregnancy among women in the two countries found that exposure to newspaper, radio, television, or social media impacted the likelihood that a woman would decide to terminate a pregnancy:

A 2020 study in Ghana further supports the relationship between mass media exposure and self-efficacy in abortion decision-making by revealing that adolescent girls and young women who consume mass media messages are more likely to develop independent decision-making about their own access to abortions than those who are not exposed to this information (Ahinkorah et al., 2020). Women’s exposure to mass media provides them with a variety of ideas and knowledge about the importance of safe abortion, and the researchers recommend that

Mass media’s potential to build capacity for decision-making around abortion was also confirmed by a 2021 study of three popular media outlets in Kenya that found that when mass media provides adolescents with accurate information on sexual reproductive health and abortion, cultural mindsets can change and encourage adolescents to make informed, independent decisions about their reproductive health (Kafu et al., 2021).

The review literature demonstrates that mass media coverage can be a double-edged sword when it comes to abortion. Coverage can satisfy either the pro-rights movement or the anti-rights movement. Mass media can serve as a model of the ideal public sphere, whereby the population has various opportunities to participate in public life by expressing their views on matters affecting them, but it is also a platform from which the dominant voices in this public sphere exercise the extant power dynamics and relationship, including men and governments who are against abortion rights. In other words, this can drown out other arguments for women’s right to abortion and prevent accurate media coverage of abortion issues.

Mass media coverage of abortion, in general, reveals that abortion is a controversial subject worldwide even in countries where abortion is legalised. The consistently negative framing of the issue in the media can result in moral panic (McDonnell & Murphy, 2019; Nyathi & Ndhlovu, 2021). When media content amplifies negative attitudes towards abortion, this increases abortion stigma, discourages women from seeking safe abortions, and prevents activists from advocating for abortion (Nyathi & Ndhlovu, 2021, p. 1474). This can perpetuate the problem of women continuing with unwanted pregnancies or accessing unsafe abortion, and the latter is a significant factor in the high maternal mortality rates in Sub-Saharan Africa (Durojaye et al., 2021; Nyathi & Ndhlovu, 2021). When media content promotes independent decision-making and women’s sexual and reproductive rights, it also has the power to influence not only an audience’s attitudes and social norms around abortion but also abortion legislation.

Well-informed and responsible mass media coverage of abortion issues can result in a more informed public, reduced stigma, a more nuanced understanding of the complexities surrounding sexual and reproductive rights, and ultimately, better health outcomes and expanded options for women. While much of the available research focuses on the coverage of abortion in newspapers, television, and online media, there is little available literature on radio coverage of abortion. Given the influence of radio on its audience in Sub-Saharan Africa and its reach to all social groups (e.g. Chiumbu & Motsaathebe, 2021; Munoriyarwa, 2021), how radio covers and frames abortion needs more attention. This was the impetus behind a study conducted in 2024 into radio stations’ coverage of the decriminalisation of abortion for minors in Rwanda.