'Black Mirror' Equated the Morning-After Pill with the Abortion Pill

This post contains spoilers from the Arkangel episode of Black Mirror, Season 4.

The fourth season of Black Mirror hit Netflix on Friday and people were less than pleased with how the show portrayed emergency contraception, a form of birth control more commonly known as the morning-after pill or Plan B.

The "Arkangel" episode, directed by Jodie Foster and written by Charlie Brooker, follows a woman named Marie and her daughter Sara. Marie has a young Sara implanted with a chip called Arkangel that lets parents see through their child's eyes and track their child's bodily functions and stress levels. Fast forward to when Sara is a teenager, and one day Marie accidentally sees her have sex via the implant. Marie learns from the implant that Sara is pregnant. So Marie goes to the pharmacy and gets "emergency contraception" which she puts into Sara's morning smoothie.

Once she's at school, Sara starts puking and heads to the nurse who tells her that she's sick from the emergency contraception she took to terminate her pregnancy. Except emergency contraception (EC) doesn't end a pregnancy, it can only prevent someone from getting pregnant in the first place, according to the American College of Obstetricians and Gynecologists.

Viewers slammed the show on Twitter for conflating the morning-after pill with the abortion pill, which has bigger implications than you might realize: Anti-choice activists and legislators have long used this falsehood as an argument for not covering EC or the copper IUD, which can also be used as emergency contraception, because they say they cause abortions. This is not true. Right-wing site The Federalist has already seized on the Twitter controversy.

The medical definition of pregnancy is when a fertilized egg implants in the lining of the uterus. EC only works before an egg has implanted by preventing fertilization and it's only effective for up to five days after unprotected sex. It does not cause abortions. ACOG wrote in 2014 very clearly: "Review of the scientific evidence suggests that EC cannot prevent implantation of a fertilized egg. EC is not effective after implantation; it cannot end a pregnancy and is not an abortifacient."

So either Sara wasn't actually pregnant and the EC prevented fertilization of an egg or what Marie got at the pharmacy was really the abortion pill, not EC. (The abortion pill is highly regulated and can often only be dispensed by a doctor.) Either way, this episode is an inaccurate portrayal of how emergency contraception works. We've reached out to Netflix for comment and will update this post if we hear back.

Daniel Grossman, the director of Advancing New Standards in Reproductive Health (ANSIRH) and professor of obstetrics, gynecology, and reproductive sciences at University of California San Francisco, called out the show for not only misrepresenting EC but also for portraying reproductive coercion.

Lumping in EC with the abortion pill is particularly enraging since it's a myth perpetrated by multiple Trump administration appointees to the Department of Health and Human Services, including Teresa Manning and Charmaine Yoest. Craft store chain Hobby Lobby even went to the Supreme Court in 2014 because the company's Christian owners objected to covering EC including Plan B, Ella, and the copper IUD (the Affordable Care Act mandated that health plans cover IUDs at no cost). Hobby Lobby won, and the ruling allowed private companies to opt out of birth control coverage based on the owner's religious beliefs.

In October, the Trump administration tried to allow companies to opt out of birth control coverage if they had "religious or moral objections," but the rule has been blocked by two state attorneys general and it is not in effect. Still, HHS's draft strategic plan defined life as beginning at conception (aka fertilization), a stance which, if formally adopted, could put both the morning-after pill and the copper IUD in the same category as abortion as far as the government is concerned. (And we know how this administration feels about abortion.)

Having a wildly popular show feed into the idea that taking EC is just like having an abortion is one of the very last things our country needs right now.

Correction 1/3/18: This post has been corrected to show that emergency contraception does not prevent implantation of a fertilized egg, it prevents fertilization of the egg, either by delaying or preventing the release of an egg from the ovaries or making it more difficult for sperm to reach an egg.

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