What's missing from news coverage of emergency contraception?

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The United States has one of the highest rates of unintended pregnancy in the developed world; approximately 3.4 million such pregnancies occur each year. Given this fact, when there's a pill that can prevent pregnancy after sex occurs — if taken within hours of unprotected intercourse — you would think it's just common sense to make that pill as widely available as possible.

But of course, in the U.S., nothing about sexuality and contraception is as common sense as I might like it to be. I was reminded of this when I delved into news coverage of the controversy over the Federal Drug Administration's 2013 decision, after years of delay, to make the emergency contraception (EC) pill available over the counter.

What I found is very familiar to those who follow news coverage of public health issues: a battle of values. In this case, it boiled down to a tug-of-war between political outrage over the FDA's inaction on the one side and parental discomfort with increased access to contraception on the other.

On the side against making EC more accessible, the predominant arguments were characterized by a morals-based perspective reflecting parental unease with teen sexuality. Interestingly, this was not portrayed as an extreme right-wing morality; unlike the debate over contraception in the Supreme Court's Hobby Lobby case, these were not arguments that life begins at conception. Rather, these were arguments presented as "reasonable," "common sense" concerns about the implications of making EC available to young teens.

On the side in favor of making EC more accessible, arguments chiefly focused on political outrage that this safe, useful drug had not been made available sooner. Reproductive health advocates — and the judge in the EC case himself — rebuked the FDA for the delays and accused the administration of putting politics over science.

Unfortunately, the coverage so focused on the political controversy that it failed to convey the public health facts and human reality behind the debate. It missed an opportunity to explore why increased access to contraception matters to everyday people. In a trend that I have now seen in coverage of other reproductive health issues, women's personal stories were virtually absent from the coverage.

Frankly, I am surprised to find myself suggesting that news should include more personal stories. For years, the good folks at Berkeley Media Studies Group have tried hard to shift news coverage away from exclusive individualistic frames on public health issues. Research has shown that news stories that emphasize individuals can discourage the news consumer from thinking about issues in collective terms and can undermine support for policies that would help solve the problem at the governmental or other institutional level.

For example, a "positive" TV news story on how a family supported each other to lose weight might lead viewers to believe that if they could do it, anyone can — and to discount the importance of such environmental factors as neighborhood food sources, food and beverage marketing, opportunities for safe exercise, and community poverty. All of these are factors outside any single individual's control that play critical roles in obesity and health.

As a result, part of BMSG's work has been to help advocates present policy issues in compelling terms and use their own personal stories merely as hooks to shift to the wider issue, rather than dwelling on a narrow individual narrative. The object is to shift news stories from the individual portrait to the broader landscape perspective, illustrating the context within which individuals confronted various public health problems. Without this context, individual stories can often be problematic.

However, given the almost total dearth of personal stories in this sample of news on EC, I believe stories that more accurately reflect more women's real experiences may be necessary to bring the issue to life. A wider range of women's stories would convey a more balanced picture of why women of all ages need access to EC. This is just one of our recommendations to reporters and advocates in the study.

One personal note: The attentive reader will notice that this study focuses on a news event that took place nearly two years ago. I wish publishing research were instantaneous, but alas, getting from raw results to a published paper can take a long time, with many events conspiring to slow the process. In this case, some of those events involved my return to graduate school. As a current doctoral student in public health at the University of California, Berkeley, I'm excited to explore further the issue of how personal stories of reproductive health challenges may impact public empathy, public support for healthy policies, and, ultimately, health itself. More on that to come.

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