It’s 10 a.m. on a Tuesday at Planned Parenthood’s New York headquarters, and I’m watching TV. Specifically, I’m watching a series of scenes clipped from movies and TV shows, all of which have two things in common: The woman beside me, Caren Spruch, had a hand in them, and each one features an abortion.
Spruch and I began our viewing session with her most recent such project, the Hulu series “Shrill.” Now, seated at a table in a white-walled conference room, we’re watching the first movie she worked on, 2014’s “Obvious Child.” Spruch is petite and animated, with a long face and dark bangs, like a more pixie-ish Anjelica Huston. She calls “Obvious Child” — a romantic comedy about an unemployed 20-something who finds herself pregnant after a one-night stand — “the one that changed the world,” setting a new standard for stories about abortion. She has seen it, she estimates, more than 25 times. Still, when she watched it to prepare for our interview, she was overcome yet again by happy disbelief that such a movie could exist. The protagonist, Donna, never questions her decision to have an abortion, nor does she feel bad about it. “In the middle of watching, I just emailed Jenny” — the film’s star, Jenny Slate — “because I couldn’t take it anymore,” Spruch says. “I wrote, ‘You were fantastic. This was such a game-changing moment.’ ”
Spruch is the rare person in the abortion rights movement for whom the past few years represent a long-awaited breakthrough in addition to a series of terrifying setbacks. She’s Planned Parenthood’s woman in Hollywood — or, in official terms, its director of arts and entertainment engagement. She encourages screenwriters to tell stories about abortion and works as a script doctor for those who do (as well as those who write about any other area of Planned Parenthood’s expertise, such as birth control or sexually transmitted infections). It’s a role she slipped into sideways, but one that now seems to be increasingly welcome in Hollywood.
In the past year or two, word of Spruch’s services has started to filter through the film industry. “Nobody used to call me,” she says. “I would be watching TV and going to the movies and figuring out who I thought might be open to including these story lines. Now I have a couple of repeat clients. Now people call me.” She estimates that Planned Parenthood has advised on more than 150 movies and shows since that first effort with “Obvious Child.” Writers who have relied on her advice tell me they feel a secret kinship with one another. “We could see hints of her in all the TV shows coming out, from ‘Shrill’ to ‘Jane the Virgin,’ ” says Gillian Robespierre, writer-director of “Obvious Child.” “It’s really wonderful. She’s like Planned Parenthood’s secret weapon.”
For nearly 50 years, it has been legal to have an abortion in America yet stubbornly taboo to show one on television or film. But both those things are now changing: Abortion could soon be outlawed in much of the country, and the impending loss of the right to end a pregnancy in real life seems to be fortifying a new freedom to do so on-screen. With Spruch’s help and encouragement, Hollywood is writing abortion into its story lines, including it as one more possible plot point. “A lot of people learn about sexual and reproductive health care through pop culture and entertainment programs,” says Melanie Roussell Newman, Planned Parenthood’s senior vice president of communications and culture. “We’ve seen pop culture change views around LGBTQ issues, for example, and pop culture has the power to challenge abortion stigma, too.”
Even antiabortion activists acknowledge that this is a natural tactic. “You can’t just change laws; you have to change culture, and young people are the drivers of culture,” says president of Students for Life of America Kristan Hawkins, whose organization encompasses more than 1,200 student groups nationwide. “Planned Parenthood is trying to influence this generation.” At the same time, opponents argue that, as the largest provider of abortions in the nation, Planned Parenthood is an inappropriate source of information for filmmakers. “It’s like the tobacco industry getting to fact-check how smoking is treated in films,” argues Lila Rose, founder of the antiabortion group Live Action (which is known for releasing sting videos — criticized for being heavily edited — that have targeted Planned Parenthood clinics). “They have no business influencing anyone’s screenwriting. … It’s a real injustice.”
Spruch’s corner of Planned Parenthood is becoming more important given the current state of the abortion debate. “We’re in a place where abortion rights advocates don’t have a lot of hope of progress, particularly on the federal level,” says Gretchen Sisson, a sociologist at the University of California at San Francisco who studies abortion in pop culture. “The potential of popular culture, and particularly television, is that it doesn’t need to wait for policy progress to happen. It’s an area where we can continue to do work, no matter who’s on the Supreme Court.” Facing antiabortion majorities in D.C., Planned Parenthood is pinning some of its hopes on L.A. In the abortion wars, Hollywood is becoming a theater of last resort.
It’s 1972, and a husband and wife are sitting on their bed in pajamas, trying to decide whether to have a baby. She has recently learned that she’s pregnant. Abortion has been made legal in the state of New York — a development they supported in the abstract, never thinking it would affect them personally. Both nearing 50, they live with her grown daughter from a previous marriage and that daughter’s young son. They enjoy a glass of scotch in the evening and card games with friends; it’s hard to imagine how a baby would fit in. “I love you, and I love my life,” she tells him. Still, she needs reassurance that the choice she wants to make is the right one. “For you,” he tells her. “For me. In the privacy of our own lives, you’re doing the right thing.” Then the credits roll.
The woman is the eponymous heroine of the Norman Lear sitcom “Maude,” which aired on CBS in the 1970s. Before Maude decided to get an abortion, after a double episode of deliberation (“Maude’s Dilemma,” parts 1 and 2), no character had ever approached the choice so frankly in prime time. Moreover, Maude wasn’t just any character — she was a protagonist, and Lear had been warned against risking his audience’s regard for the person who kept them coming back to a show. “Maude’s Dilemma” was hugely controversial, flooding CBS with at least 7,000 protest letters the first time it aired (and roughly 17,000 when it was rebroadcast the next year). But the episodes also attracted an estimated 65 million viewers, vaulting “Maude” into the Nielsen top 10. Two months later, the Supreme Court decided Roe v. Wade. Maude’s choice seemed to signal the beginning of a new era for abortion, on and off the screen.
But instead, in the decades after Roe v. Wade, the country grew more conservative, and so did the portrayals of abortion on American televisions. In the 1980s, Sisson says, the subject appeared on legal and medical shows, where the main characters were insulated from viewers’ disapproval by their professional distance from patients and clients who had abortions. In the ’90s and early aughts, secondary characters — best friends, classmates — started to have the occasional unwanted pregnancy. By then, the country had elected Bill Clinton, who famously declared that abortion should be “safe, legal and rare”: in other words, politically permitted but culturally discouraged. Interviewed in 1992 by the Chicago Tribune, the team behind “Maude” agreed that the abortion episodes would never have aired then.
“The cultural narrative was one of hesitation and stigma,” Sisson says, and screenwriters’ stories conveyed that ambivalence. On TV, miscarriages became de rigueur twists, as did false-positive pregnancy tests. Some stories were altered to assuage anxious networks: In 2005, “Grey’s Anatomy’s” Cristina Yang had an ectopic pregnancy after ABC balked at showrunner Shonda Rhimes’s plan to portray an abortion. (Rhimes has said that she regretted her capitulation for years, and she wrote an abortion into the show in 2011.) In a raft of other stories on TV and film, such as “Juno” (2007) and “Blue Valentine” (2010), characters who wanted abortions were struck by last-minute changes of heart.
When abortions did happen, they tended to be serious and dramatic, shrouded in regret framed as inevitable. Even on HBO’s staunchly feminist “Sex and the City,” when an accidentally pregnant Miranda asked Carrie in 2001 how long it took her to get over an abortion she’d had 13 years earlier, Carrie’s answer was, “Any day now.” Miranda had the baby. In 2010, Fox refused to air an episode of “Family Guy” that included an abortion, which it deemed inappropriate for a comedy. Forty years passed without a character who had Maude’s sense of certainty.
When Spruch arrived at Planned Parenthood as a senior field organizer in 1989, she wasn’t thinking about the political potential of TV. She was worried about a generational divide. Young people who had grown up in a world where abortion was legal had never had to fight for it. But opposition to abortion had become Republican orthodoxy in the 1980s — an outcome of President Ronald Reagan’s alliance with white evangelicals — and a series of Supreme Court decisions were beginning to roll back the right that Roe had established. Part of Spruch’s job was to combat antiabortion legislation, and she started thinking about ways to reach young people who might need Planned Parenthood’s services or support its cause. She began by asking rock musicians like Santana and Dave Matthews Band to allow Planned Parenthood to distribute information at concerts. “Then I thought: Oh, everyone says Hollywood is so liberal,” Spruch recalls, “but what are we doing with actors?”
It was slow going at first. “I didn’t know anybody,” she says. “But I would put myself where actors were.” She went to screenings, film festivals, fundraisers. “I would do so much homework before I went anywhere,” she says. “I would read everything about whoever might be there and think about what I would say to each person.” She remembers pacing rooms packed with wealthy and famous people, mustering the courage to start a conversation. By the mid-’90s, her efforts to organize celebrities, a role she’d invented for herself, had ballooned into a full-time job. “The work with the actors got so big that slowly, we started moving all my other projects out of my supervision because I didn’t have time,” she says.
Once, Spruch was at the off-Broadway Public Theater with her father when she spotted Maggie Gyllenhaal in the audience at intermission. “So then, of course, I did not pay attention at all to the second half of the play,” she recalls. At the end, she was torn between waiting to speak to Gyllenhaal, who was talking to the cast, and escorting her father, who was ill and in a wheelchair, onto his Access-A-Ride. Her father told her to wait for the actress. She stalled in the emptying theater for an hour and a half — “I don’t want to be rude; I will never interrupt a conversation” — before she saw an opening to talk to Gyllenhaal. “And that was it,” Spruch says. “She’s been a hardcore activist ever since.” Gyllenhaal recalls being introduced to Spruch by Tony Kushner, author of the play showing that night. “I think I said to her, ‘Just use me however you want,’ ” Gyllenhaal says. “She has asked me to give some speeches that I’m really proud of.”
Over the years, there were some setbacks. In the early 2000s, Spruch recalls, she read the script of “The 40-Year-Old Virgin.” It included a scene in a health center that had been envisioned as a Planned Parenthood clinic, and Spruch sent posters and books to adorn the set. It would be years before she saw the potential in editing scripts, but she was already dreaming of what it might mean to introduce the Planned Parenthood name in a major movie. Months later, she received a call. “They said they were having so much fun improvising, and could it still be a Planned Parenthood?” Spruch says. “I stayed up all night thinking, ‘Oh, my God, this is going to be such a big movie. But I guess I have to say no.’ ” She knew that improvisation could introduce inaccuracies. When she later attended a screening, she found herself weeping because the movie “was clearly a hit,” she says. But the cast’s clowning had indeed departed from the script she’d signed off on. “Through the tears, I thought, ‘Okay, I definitely made the right decision.’ ”
Then, in 2012, she was put in touch with “Obvious Child’s” Robespierre and the movie’s producer, Elisabeth Holm. The women wanted to film at a Planned Parenthood clinic. As they recall, Spruch said she would need to make sure that their scene was entirely accurate, and they were delighted when they realized that she was offering to fact-check it. She ended up working on the script for nearly two years. Holm remembers Spruch offering sample doctor language and pointing out that the patients in the waiting room would be of diverse ages, races and backgrounds. Spruch also noted that one of the laugh lines in their original scene wasn’t accurate because a Planned Parenthood doctor wouldn’t curse.
In Spruch’s telling, inaccurate scenes are the only ones she won’t endorse. She views movies and shows as an important source of information for people who might not know how to find it elsewhere, but she emphasizes that she doesn’t meddle with characters’ emotions or impose an ideological purity test. “My job is to correct with facts,” she told me. “Those are the types of issues I address and look for.”
Planned Parenthood’s opponents, of course, argue that accuracy is the opposite of the organization’s aim. “I think they’re marketing to a specific demographic,” says Steven Aden, chief legal officer of the antiabortion group Americans United for Life. “I am concerned that people who haven’t experienced much of life, the younger set, may be led into thinking that abortion is normal and glamorous and painless and lacking in consequences, all those things that Hollywood would like them to believe.” Live Action’s Rose is less circumspect. “When Planned Parenthood tries to create positive story lines around abortion, it’s not good art, it’s propaganda,” she says. “You’ll never find content coming from Planned Parenthood and friends of Planned Parenthood that is honest about what abortion is.”
Spruch does attempt to ensure that if a script features a Planned Parenthood clinic specifically, the organization isn’t put in an unflattering light. In her conversations with the writers of the Netflix comedy “GLOW,” for example, she suggested casting a receptionist who “didn’t look forbidding,” says co-creator Liz Flahive. She also suggested “that the exam or procedure room would probably have a soothing picture on the wall,” Flahive says. “She put in details that felt specific, like that the posters would probably say things about birth control or getting yourself tested for STDs. It was important that the Planned Parenthood wasn’t cold or mechanical.”
But watching clips with Spruch in the darkened conference room, it’s clear she works with scripts that approach abortion from a range of angles, sometimes with ambivalence. I find myself glancing at her untroubled expression as we sit through a clip from the soapy drama “The Fosters,” in which two teenagers are in a clinic waiting room, looking stricken. “Doesn’t that make me a coldhearted b—-, if I don’t feel bad?” one asks in a choked voice. Her friend tells her he knows that in her position, he wouldn’t feel ready to be a parent, but he would still feel sad. When Spruch hits pause, cutting off the mournful piano chords of a pop song, I ask whether she finds this scene a bit overdramatic. “You know, most of the scene is about the question of, ‘How should I feel?’ ” she says. “And we know there’s no one way anyone should feel, or does feel. That’s a very important thing to show.”
“I respect the art,” she adds, after we turn on the lights. “If it’s not inaccurate, and it’s true to the character, then I don’t change certain things, even if I may have written it differently. Those are the things that I’ve learned along the way that are important to having trusting collaborations.”
Spruch’s popularity with filmmakers may be built on her openness to moments that are open to interpretation. “If there’s a word or two that isn’t entirely accurate, she helps me drill down on that and make sure that we’re not putting misinformation out there,” says Jennie Snyder Urman, the showrunner of “Jane the Virgin,” the recently concluded CW show about a religious Venezuelan American family whose members disagree about the morality of abortion. “But for the feelings of the characters, I rely on the writers in the writers’ room, who have crafted the characters for 100 episodes.”
“Caren by no means pressured us to write anything,” says Robespierre. In “Obvious Child,” a single tear tracks down Donna’s face as she sits in the recovery room after her abortion. Robespierre and Holm told me that Spruch paused on that page of the script. “We had a conversation [with Spruch] about, ‘What is the emotionality behind this, and how does it look and feel and play in the larger whole?’ ” Holm says. Robespierre described how she wanted the scene to convey “that you’re allowed to feel many things at once,” she recalls. “Some of it can be shame and fear and relief and happiness, all of them. … You can have sadness alongside the feeling that you’ve made the right decision for you.”
“Caren is thoughtful,” Holm told me. “She understands that the message, above all, needs to be that [abortion] is a complex human experience.”
Whether or not Spruch is right that “Obvious Child” changed everything, the world does look different five years after its release. “That film transformed, not only the industry, but in some ways my own colleagues,” Spruch says, recalling how the response to the movie brought home the potential of entertainment. Since then, abortions have propelled plots on “Crazy Ex-Girlfriend,” “BoJack Horseman,” “GLOW,” “You’re the Worst” and more than a dozen other comedy shows.
Spruch meets many writers through Planned Parenthood’s annual event at the Sundance Film Festival, where she has been pitching attendees on telling abortion stories every winter for the past seven years. Often, when a screenwriter sends her a script, she sets up a call with a medical practitioner, sex educator or policy expert who provides sample doctor spiels or answers questions. When the creators of “GLOW” got in touch about an abortion scene set in the 1980s, she spent weeks tracking down a retired doctor who had worked at a Planned Parenthood clinic in that period. (Among other small fixes, he pointed out that receptionists in those pre-HIPAA days read out first and last names. “They would never do that now,” she says.)
Spruch has also suggested ideas that eventually worked their way onto the air: “I talked to Lena” — Dunham, of course — “about how you never see people using a condom on television. And then she did a scene where Adam uses a condom on ‘Girls.’ ” In addition, Spruch makes it her business to keep an eye on shows that might provide opportunities. In 2014, after watching the pilot of “Jane the Virgin” — in which the devout Jane, who is saving sex for marriage, gets accidentally inseminated by an ob-gyn and decides to go ahead with the pregnancy — she wrote to the director to offer her services. Two years later, she helped fine-tune an episode in which Jane’s mother, Xiomara, has an abortion. The stakes felt especially high because Xiomara would be the first Latina to have an abortion on prime-time television, where the preponderance of stories are about young white women.
Perhaps the best measure of the state of the abortion plot is “Shrill,” a half-hour comedy based on Lindy West’s essay collection of the same name. In the pilot episode, ending an unwanted pregnancy empowers the lead character to take control of her life, speaking up at work and dumping her puerile boyfriend. West says that she encountered no resistance when she set out to sell the show. “We pitched it in the Trump era, and people are looking for ways to make a little bit of a difference politically,” she told me. “It’s totally possible that [the abortion] helped us.” After the episode aired, the New York Times declared the advent of “the matter-of-fact abortion” in Hollywood.
In addition to her well-known feminist writing, West is a co-founder of the activist campaign “Shout Your Abortion,” which encourages people who’ve had the procedure to talk about it. Celebrated as a new frontier for abortion rights activism when it launched in 2015, the campaign looks in many ways like the moment when the movement caught up with the argument that Caren Spruch has been making for more than 20 years.
Nevertheless, the politics of the issue are mostly moving in the other direction. So far this year, five states have passed laws banning abortion at the sixth week of pregnancy, before most people even know they are pregnant. (In addition, Alabama has passed a law banning the procedure in nearly all cases, and Missouri has passed one banning it at the eighth week of pregnancy.) Republicans hope that these measures will reach the Supreme Court. I asked Spruch if the promise of entertainment is in part that movies and TV will still be available vehicles even if the justices overturn Roe. She paused. “In my world,” she said, “focusing on culture would hopefully activate more people and prevent that from happening.”
But do stories about abortion really have the power to change minds? Could there be a “Will & Grace” effect for abortion, reducing prejudice against the procedure, as studies have found that the popular TV show did for LGBT people? Like Spruch, Kate Langrall Folb, director of a program called Hollywood, Health and Society at the University of Southern California, works with screenwriters to make stories about health care, including abortion, more accurate. Her organization also seeks to study how effectively its efforts change minds. Folb says they found that people’s attitudes “became softer and more accepting” after viewing an episode of a USA Network show featuring a transgender teenager — but they have yet to research reactions to an on-screen abortion.
The fact is that attitudes about abortion have barely budged since the 1970s. And even if movies and TV can change those opinions, it’s not clear who’s winning the battle for the viewing public. Planned Parenthood and its Hollywood allies, after all, aren’t the only ones putting abortion on-screen. For a time this past winter, the DVD of “Gosnell” — a movie about a Philadelphia physician who performed dangerous illegal abortions — was the No. 1 seller on Amazon, ahead of “A Star Is Born” and “Bohemian Rhapsody.” (Amazon CEO Jeff Bezos owns The Washington Post.) In the spring, conservative Christian filmmakers Chuck Konzelman and Cary Solomon released “Unplanned,” based on the memoir of a former Planned Parenthood clinic director named Abby Johnson, who became a hero in the antiabortion movement after she renounced her former employer. Extensive reporting by Texas Monthly and Salon has cast doubt on much of Johnson’s story; Planned Parenthood has said that the film, which accuses the nonprofit organization of performing abortions because they are lucrative, “promotes many falsehoods.” Many theaters refused to show the movie, and major TV networks wouldn’t air the trailer. Still, “Unplanned” was a hit, raking in more than $14 million at the box office in its first two weeks.
That success didn’t temper the filmmakers’ fury about what they perceive as an effort to silence their side. When I called Konzelman and Solomon, they described Hollywood’s embrace of Planned Parenthood as unfair and unseemly. “It’s an open secret that there’s a tremendous industry-wide push for more story lines” about abortion, Konzelman told me. “But I don’t think they’re pushing for more stories from our side of the fence. … We knew from the beginning that there would be no studio money for us and that we would have trouble finding distribution.”
Solomon told me that Hollywood’s liberalism, including its positive portrayals of abortion, had forced him into the role of political crusader. “I came to Hollywood to make movies and entertainment — all I wanted to do was be a filmmaker who told great stories that made people happy,” he said. “But I had to go and become someone taking on moral causes. The media is the most powerful tool of evangelization in the history of the world. If Peter and Paul and John and James were around today, they wouldn’t go knocking on doors. They would make a TV show.”
But the apostles may have been better off with their original method. “It’s very hard to change people’s minds about abortion,” Sisson says. “I think that the potential of storytelling is to bring people who are slightly to one side a bit further. You’re not trying to reach people on the other end of the spectrum; you’re trying to bring your allies closer.” In her view, a movie like “Unplanned” or “Gosnell” “takes people who are already opposed to abortion and makes it a higher priority for them.”
The majority of Americans believe that abortion should be legal — but that belief is often complicated. In a July Washington Post-ABC News poll, 60 percent of Americans said abortion should be legal in “all” or “most” cases, while 36 percent said it should be illegal in all or most cases. In the past decade, a wave of new laws — requirements that abortion clinics be built to the standards of surgical centers, for example, or obtain admitting privileges at local hospitals — have made abortion harder to access even as it has remained legal, forcing at least a quarter of all American abortion clinics to close, increasing the distance that women must travel to obtain the procedure and the waiting time for an appointment. Though Republican lawmakers argue that these measures are for patient safety, early studies suggest that they cause women to abort later in pregnancy, when the procedure is more expensive and the risk of complication higher. (The American College of Obstetricians and Gynecologists points out that abortion is still a “low-risk procedure” and significantly safer than giving birth.) Though Planned Parenthood and its allies decry these laws — often referring to them as Targeted Regulation of Abortion Providers, or TRAP laws — that hasn’t rallied popular resistance sufficient to prevent their passage.
The most recent wave of legislation might be another story. Early polling suggests that most Americans oppose the laws that would establish a window of legality so narrow that it is all but impossible to meet. According to a June Gallup poll, 58 percent oppose laws that would ban abortions after fetal cardiac activity can be detected. So do a majority of voters in Ohio, according to a July Quinnipiac poll, and a plurality in Georgia, according to a spring Atlanta Journal-Constitution poll, two states that have passed but not enacted such legislation. Overall, the July Post-ABC poll found that a majority of Americans — 73 percent — want to see abortion access in their state left as is or made easier.
For Planned Parenthood, making abortion access a higher-priority issue for those people might mean helping tell stories about the restrictions, and dramatizing impacts that viewers may not have considered. The current wave of abortion stories shows the decision as sometimes emotionally difficult and sometimes simple, but always actionable once made. “Pretty much everyone has an abortion provider in their town on TV,” Sisson says. In reality six states, all led by Republicans, have only one functioning clinic. Likewise, though Spruch has worked on a few films about women struggling to pay for procedures (“Grandma” and “Little Woods” and, to a lesser extent, “Obvious Child”), most movies and shows ignore the issue of cost. Nearly half of abortion patients live below the federal poverty level, but the Hyde Amendment bars federal Medicaid funds from covering the procedure (except in cases of rape, incest or danger to the pregnant person).
In Hollywood, it’s still considered a strong statement to show abortion as a choice that a woman doesn’t have to be ashamed of. But for Spruch, it may be more practical to push viewers to empathize with women who choose to get abortions — then can’t. In fact, that might be her next project: She’s been nudging her Hollywood contacts to think about the dramas that could unfold around abortion restrictions, or the stories they could tell from abortion providers’ perspectives. “I always talk about the things that I think are missing,” she says. “And they come to be.”
Nora Caplan-Bricker is a writer in Boston. Illustration by Ellen Weinstein.