In an episode exploring the boundaries of parental control, the Netflix series “Black Mirror” fudges the limits of emergency contraceptives.
Episode 2 of the show’s fourth season brings us Marie (played by Rosemarie DeWitt). She is a nervous, hovering mom, who thanks to an implant in her daughter Sara’s head, is able to see the child’s life as if through her own eyes.
She uses this to protect her toddler from stressors like a neighborhood dog, and to be able to track her location should she ever go missing. When Sara grows into a rebellious teen (played by Brenna Harding), Marie learns that she’s having sex and then that she’s pregnant.
And this is where the show flies afield of pharmacological fact.
We watch Marie enter a pharmacy, and then crush a pill into her daughter’s morning smoothie. Next, Sara is at school rushing to the bathroom to vomit.
“Honey, it was an EC pill that made you sick,” the school nurse tells the teen, before leaning in to explain that she’s referring to emergency contraception, “for terminating your pregnancy.”
Sara’s visibly puzzled. She hadn’t known she was pregnant, and as far as she knows, she didn’t take any pills. “It will work in spite of the vomiting,” the nurse assures Sara: “You’re not pregnant anymore.”
In its preceding three seasons, “Black Mirror” has taken viewers to undefined moments in the future to depict what could happen if humanity continues giving in to its worst impulses. It has shown gamification taken so far that people need to exercise in order to earn points for daily food rations; it imagines social media’s influence expanding to exclude anyone with an inadequate following from participating in the economy. There have been plays on brain or eye implants (replaying past conversations, like an emotional Netflix of your own mistakes, was a particularly brutal application). And so it is possible that in the future that “Black Mirror” exists in, emergency contraceptive pills would induce abortion.
“Maybe in this dystopian future, EC means something else, but the EC we have now does not cause an abortion. It will not affect an established pregnancy,” says Daniel Grossman, a professor of obstetrics and gynecology at the University of California San Francisco, and director of ANSIRH (Advancing New Standards In Reproductive Health), a policy-oriented research program.
He points to how Sara’s pregnancy was detected (immediately, sooner than pregnancy actually happens) and how quickly the nurse says the pregnancy ended, as evidence that “Black Mirror’s” creators failed to consult a physician on their medical plot.
“I think, especially in a case like this when there’s already so much confusion on this topic, this kind of screw-up is really irresponsible,” says Grossman.
According to the American College of Obstetricians and Gynecologists, emergency contraceptives — also known colloquially as the morning-after pill, or by popular brand name, Plan B One-Step — can prevent pregnancy by stopping or delaying ovulation, much like everyday hormonal birth control. However, if pregnancy has already occurred, such contraceptives will do nothing. They certainly will not induce an abortion. There’s a whole separate medication for that and, at least in present-day America, it’s way harder to come by.
In its most effective regimen that currently exists, Grossman explains, medication abortion is actually a two-step process (continuity error number two for Sara’s abortive smoothie). It requires a prescription, and in states with tighter regulations on women’s healthcare, it needs to be administered in a doctor’s office. The first pill weakens the connection between the pregnancy and the uterine lining. And the second, usually taken within 24 hours, induces cramping to empty the uterus, a process that can include up to 10 days of bleeding, and is much more like experiencing a miscarriage than it is like Sara’s instantaneous stomach upset at school.
“We don’t necessarily expect realism from ‘Black Mirror,’” says Gretchen Sisson,a research sociologist at the University of California San Francisco who leads ANSIRH’s Abortion Onscreen project.
“It can and should be a little dystopian, a little futuristic, a little fantastical, but the way it was unrealistic didn’t feel like any of those things, it just felt like a mistake.”
Perhaps that’s because the rest of the episode stayed pretty true to modern-day America. Devices that allow parents to track their children’s whereabouts already exist, as do monitors that spy hormonal and other health factors (though they are wearable, not eyeball implants). The technology in this episode hardly required the show’s signature suspended disbelief.
“That was a choice that I wanted to make,” Jodie Foster told the Hollywood Reporter of her directorial turn on this episode (the series’ first-ever woman in that role). “I said, ‘What is America in the immediate future? Where is America going to be five years from now, or less?’ I felt that some of what informed this mom’s life is that she was from this hard-scrabbled American town that had died… Her world had been disappointing and she had been a disappointment.”
It was evident in the wardrobes that reflected an unfussy ’80s upbringing and a playground that seemed frozen in time.
“These were choices we were making to reflect America,” Foster said, “that this is America and not a clean, modern version of the future in England, for example.”
For some, using this chance to look in the mirror was missing an opportunity to do more. “With ‘Black Mirror’ and other science-fiction shows or fantasy shows, there’s an opportunity to look at what abortion or reproductive control or reproductive coercion might look like in these fantastical, dystopian environments that aren’t contingent on our contemporary medical or technological limits,” says Sisson.
If the writers had gotten the drug right, and had Sara unwittingly take an abortifacient pill, she says, “that’s not a flight of fancy — that would have been factual.”
Those pills exist, and it is possible for someone to drug another person with them. And so this storyline itself is boring, she says; mixing up EC and the abortion pill on top of that is a common misconception. But even worse, it is “a deliberate talking point of the anti-abortion movement to conflate the two.”
Though the court of public opinion has largely remained in favor of legalized abortion, according to a half-century of Pew statistics, the bar for contraceptive access is currently being raised. Mistakes like this one in “Black Mirror” don’t just contribute to an ill-informed society that neither understands reproductive biology nor prioritizes making healthcare related to it accessible, it takes us into that dystopian present where alternative facts impact real policies.
“It plays into the hand of the anti-choice movement,” Grossman says.
According to the Guttmacher Institute, nine states have restrictions on access to emergency contraceptives — either it’s excluded from the contraceptive coverage mandate, or pharmacists are allowed to refuse to dispense it even when presented with a valid prescription.
“It’s quite clear that there are efforts underway to undo the contraceptive coverage guarantee under the Affordable Care Act,” Grossman says. “There’s been increasing restrictions on abortion. It’s very much clear that reproductive health and rights is under attack and, unfortunately, by highlighting this confusion between EC and abortion-causing medications, in some ways plays into that further.”
Sticking to that script isn’t just repaving the same old anti-choice routes we’re all too familiar with these days, it’s lame storytelling, according to Sisson.
“You can make these departures, like, what might abortion look like in 300 years, or what might a magical abortion look like? Screenwriters aren’t taking these opportunities to envision what this might look like. We are so tied to this political, fraught framework of what abortion looks like right now that we’re not thinking about what it could be.”
But, forget for a minute that the pill in “Black Mirror” was called a contraceptive, and say it was called an abortion pill.
Then the episode does imagine a future that’s quite different from American life right now. It shows us an America in which someone can pick up abortifacients at the pharmacy.
Currently, 19 states mandate that a physician be present to administer medication abortion drugs, according to Guttmacher, which means that a doctor stands there to watch their patient swallow a pill, and then another pill. This requirement makes telemedicine prescriptions impossible and would certainly bar anyone from walking into a pharmacy to pick up a tablet to secretly slip into their daughter’s drink.
“Black Mirror” was so close to, just this once, painting a utopic future, in which a quick stop at the CVS is all anyone would need to take their reproductive destiny into their own hands. Instead, it got the medication wrong.
“It’s sloppy,” says Grossman. “It’s such a silly mistake to make that, unfortunately, I think does have important repercussions.”