One in three women in the US have an abortion in their lifetimes, while nearly 40 percent of Americans claim they do not know anyone who has had an abortion.

I left the latter group, not coincidentally, around the same time I joined the former. When I got pregnant as a 20-something in Brooklyn five years ago and started telling people I was getting an abortion, I quickly discovered I actually knew three women who’d had one. Again not coincidentally, this was around the time I started to become interested in how the stigma around abortion—in our daily lives, in the media, in pop culture—makes it so hard to speak openly about, even as a pro-choice advocate like me. A couple months after my abortion, I watched a short film called Obvious Child about a 20-something in Brooklyn who gets an abortion, created by young women who were equally frustrated with the narrow representations of abortion in pop culture, and dreamed that one day I’d see an abortion narrative like that on the big screen.

That day came quicker than I’d imagined it would. Obvious Child, now grown up into a full-length rom-com and getting its wide release next week, has become the darling of the pro-choice movement for offering a portrayal of abortion that has been variously called “honest,” “realistic,” “unapologetic” and “positive.” My own preferred adjective is “normal”—which marks a pretty radical departure from a long history of Hollywood abortion narratives that have tended to be stereotypical even when they’ve been realistic, and stigmatizing even when sympathetic.

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The ways that pop culture has reinforced abortion stigma extend beyond just the visibility—or lack thereof—of the choice. A recent census by researchers at the University of California, San Francisco—the first comprehensive, quantitative look at abortion storylines in TV and film—tallied over 300 plot lines in which a character considered an abortion between 1916 and 2013, including 87 on primetime network television. Given how common the procedure is in real life—not to mention how frequently totally uncommon things happen in Hollywood—that’s a small number, but it’s not nothing. And there’s been a general upward trend. The last decade, in particular, has witnessed an explosion of such storylines—more than double the total from the previous decade.

These storylines diverge from reality in some significant ways though. Since 1973, the percentage of characters considering an abortion who actually gets one has fallen as they’ve become increasingly likely to choose parenting or conveniently lose their pregnancy before making—or going through with—a decision (think Dawson’s Creek, Party of Five, and most recently Girls). In the last decade, adoption has become a popular choice. Between 2003 and 2012, nine percent of the plotlines ended in adoption (most famously in Juno), while it’s a choice that only 1 percent make in real life.

Fictional abortions are also frequently portrayed as far riskier than they actual are. Whether or not she actually got one, 13.5 percent of characters who considered abortion ended up dead. In many of these cases, she died as a direct result of complications from the abortion—making the risk of death for a fictional abortion 9 percent, while the actual risk is statistically zero. Given that misinformation about abortion is the rule, not the exception, such misrepresentations matter. Astudy of women who had received abortions found that over three fourths overestimated the health risks, and almost half overestimated the risk of depression, after a first-trimester abortion.

“More accurate representations of the reality of abortion are needed,” says Gretchen Sisson, one of the study’s authors. “Women are getting abortions. They have the right to know what they’re doing is safe.”

But there’s more than just inaccuracy lurking behind the disturbing number of fictional women who end up dead after considering abortion. Many of the characters who didn’t die directly from abortion-related complications were murdered or committed suicide—a linking of violence to the contemplation of abortion that, the researchers note, “contributes to the ongoing production of abortion stigma.” Difficult to measure in a quantitative study, this stigma is a large part of the reason that feminists critics have, with depressingly few exceptions, found fault in the way Hollywood portrays abortion—even in storylines that are mostly sympathetic to the choice.

Narratives that present abortion only as an unacceptable option to reject—or avoid the issue entirely—obviously contribute to stigma by perpetuating the idea that the choice is taboo and illicit. Knocked Up is the quintessential example. Katherine Heigl’s character never even considers ending her pregnancy and the procedure is referenced in hushed euphemisms—“A-word” and “shmashmortion”—as if the choice is so shameful if can’t even be uttered aloud. Likewise, it’s fairly easy to see how stories that portray women who end their pregnancies as straight-up villains deserving of judgement and scorn are stigmatizing.

But even stories in which the character does get an abortion—and even when she isn’t condemned for it—can often reinforce stigma in more subtle ways.

For one thing, Hollywood, ever concerned that audiences will reject female characters who aren’t sufficiently “likable,” seems convinced that the only way a woman can have an abortion and remain sympathetic is if we’re given ample justifications for her choice. Thus, on screen, we’re far more likely to see tales of pregnant teens (Friday Night Lights), rape or incest victims (Cider House Rules) or women impregnated by assholes (Dirty Dancing; Fast Times At Ridgemont High; The Godfather: Part II) than we are the story of, say, an adult woman in a stable relationship who just doesn’t want to have a kid (Grey’s Anatomy). All are worthy stories to tell, but in the context of a broader culture—and even pro-choice movement—in which we’re more likely to hear about the “exceptions,” the cumulative effect of such narratives affirms a hierarchy of abortions.

Suffering seems to offer another way for characters to partially avoid being marked by the stigma of abortion. According to Hollywood’s logic, the more she judges herself—the more heart-wrenching the decision, the more episodes spent in self-flagellating soul-searching, the more guilt she feels after the fact—the more acceptable her choice apparently becomes. Which, of course, is not an unfamiliar logic in the broader culture too. Recently, abortion counselor Emily Letts explained that part of her motivation for filming her abortion was seeing how so many women “pressure themselves to feel bad” about their choice. “Even women who come to the clinic completely solid in their decision to have an abortion say they feel guilty for not feeling guilty.” Abortion can inspire many emotions—including guilt—but guilt for not feeling guilty? That’s solely stigma talking. (Predictably, some accused Letts of “trivializing” abortion by admitting to her own lack of guilt.)

Better still, if other characters condemn and reject her, a woman who gets an abortion may become enough of a victim to earn the audience’s sympathy. In many cases, the film or TV show isn’t endorsing the punishment the character receives for her choice. In fact, quite often such narratives are clearly highlighting the dire consequences that social disproval of abortion can have in an effort to condemn them (Revolutionary Road or Friday Night Lights, for example). But Kate Cockrill, executive director of Sea Change, an organization that works to end abortion stigma, says that the punishment does not necessarily have to be condoned to be harmful. “She’s still punished. Even if it’s trying to demonstrate that this shouldn’t happen, it reinforces this idea that it will happen,” she explains. “There’s a way that they reinforce the norm that women who have abortions are going to be left high-and-dry by their partners, they’re going to be alone, they’re going to be harmed—or even dead. Their abortions are going to become larger than they are.”

It’s not that these common tropes can’t be true-to-life—some people are raped, some do feel guilty, some are punished for their choice. It’s just that they’re not the only story. “When you have those stereotypes over and over again,” Cockrill says, “it narrows the public’s understanding of what’s possible.”

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The idea that telling abortion stories can help combat stigma—and in turn transform cultural attitudes about the issue—is nothing new. A belief in the potential power of “coming out” about our abortion experience dates back at least to the abortion speak-outs of the pre-Roe era and, in the last decade, has been resurrected in “I had an abortion” t-shirts and hashtags, as well asapolitical spaces for people who’ve had abortions to connect. In the years since my own abortion, I’ve continued talking about it—online and at dinner parties. And I’ve been just one of many. Aspen Baker, executive director of the “pro-voice” organization Exhale founded in 2000, says that for awhile, whenever someone revealed they had an abortion story on the internet, someone would email her to make sure she’d seen it. But now there are too many stories to keep track of. “There are just people who are saying, ‘I want this to be different than it is. And because I have all these tools at my finger tips, I’m going to be a part of making that different thing.’”

Still, while the research backs up the idea that increased visibility does, over time, reduce stigma, it’s a long and rocky road. And while pop culture has generally served to reinforce stigma, it has incredible potential to help combat it too.

For one thing, a fictional abortion story doesn’t expose an actual person to judgement. After all, part of the catch-22 that makes abortion stigma so difficult to fight is that it’s both cause and consequence of the polarized political debate over the procedure; there can be very real social risks to revealing you’ve had one. On an interpersonal level, people have good reason to be selective about who they tell. In fact, one study found that when women who had an abortion told loved ones who were 100 percent supportive, it helped them cope. But if they if they told people who were even just a little bit unsupportive, it negatively affected their ability to cope even more than not telling anyone at all. And those who decide to “come out” more publicly—writing or speaking or tweeting about their experience—are usually knowingly accepting that they’ll receive some hateful comments about selfish baby-killers. Obvious Child’s protagonist, Donna, though, does not give a damn if anti-choice protestors show up at the theater because Donna does not exist.

In addition, we often allow fictional characters even more complexity than we allow all but those closest to us in real life. In a good fictional narrative, at least, we’ve spent some time getting to know a character, understanding their perspective, and often investing—sometimes embarrassingly deeply—in their story. As Baker explains, “They have the capacity to exist as a whole person”—layered, multifaceted, often flawed. An abortion becomes just one part of their story, not the whole thing. While this intimate knowledge—and its attendant potential for empathy—is part of what makes revealing an abortion to a friend or family member so powerful, when women more publicly speak out about their abortions, it often is the only part of their story we know.

Furthermore, in the context of the rancorous politics around abortion, it remains maddeningly difficult for real-life abortion stories to avoid becoming politicized. While some who share their stories do so as an overtly political act—I definitely did—Baker says that the majority are doing it for other reasons: “They’re saying, ‘I want to get this thing off my chest, I want to connect with other people, and I don’t want other women to feel like I felt—I don’t want someone else to feel alone.’” Yet with lack of visibility comes the heavy pressure of representation. For example, despite the fact that Letts explicitly said, “This is my story. This is ONLY my story. I do not pretend that it is anything more or anything less,” she was taken to task by some for not being a good enough spokesperson for the pro-choice cause. (An almost identical dynamic played out when Angie Jackson live-tweeted her abortion a few years ago.) This is changing rapidly as abortion stories have become far more common over the last decade, Cockrill says, but a fictional narrative side-steps the problem. Donna’s story—in all its rom-com quirks—cannot be mistaken for anything other than one women’s experience.

Most importantly, fictional narratives can spark conversations—and hopefully lead to the sharing of still more stories. “It’s a wonderful opportunity to create in-person connections,” Cockrill explains. In fact, one of Sea Change’s projects is exploring how to reduce stigma using a similar model—by bringing an anthology of first-person accounts of pregnancy experiences into book clubs across the country. The book offers an jumping place—an in-road to talking about abortion in a way that doesn’t necessarily have to be personal. And usually it prompts at least one women in the group to tell her own abortion story—which, in turn, often leads other to as well. It turns out my experience of discovering who I knew who’d had an abortion once I started talking about my own is a very common one—stories tend to beget more stories.

This, above all, is what Obvious Child does so well; by honestly and unapologetically showing one woman’s experience, it opens space for others. Ultimately, that ability to encourage—not stifle—the telling of more stories is the difference between a narrative that reinforces stigma and one that can help subvert it. Because as decades of stigmatizing Hollywood portrayals of abortion have demonstrated, a single story can be just as dangerous as silence. What is required to end abortion stigma is not just increased visibility but increased diversity—a range of stories so complicated and specific that they defy being slotted into easy boxes. To that end, we should think of greater representations of abortion in pop culture not as an end point in itself, Cockrill says, “but really a starting point for more conversation.”

Maya Dusenbery is the executive director of editorial at Feministing.com.

This story is part of a joint reporting project on reproductive rights in pop culture that includes Bitch Media, Feministing, and Making Contact. This work is part of a Media Consortium collaboration made possible in part by a grant from the Voqal Fund.

Read another articles in this collaboration: Songs in the Key of Choice — Pop Music and Reproductive Justice and The Dramatic History of American Sex-Ed Films.