OPINION | 'Grey's Anatomy' Takes On the Northwest's Abortion Politics

by Megan Burbank

Grey's Anatomy is one of those TV shows set in a version of Seattle that often feels like it has nothing to do with the real city. There are the obligatory aerial shots of the Sound and the Space Needle in the pilot episode, sure, but it can be hard to suspend disbelief when you know Grey Sloan Memorial Hospital — with its glass walls perpetually rain-streaked, and an endless parade of increasingly baroque tragedies unfolding within them — is really in California. Aside from the Queen Anne exterior location for Meredith Grey's house, this is a show that mostly takes place in a hospital. It could be set anywhere.

So I was surprised recently when a source I often speak to for stories on reproductive health told me the new season of the show — its 19th, all hail the endless creativity of Shonda Rhimes — features an issue that actually hits close to home if you live in Washington State: the Northwest's abortion politics. Even more surprising is that in many ways, Grey's Anatomy gets a lot of it right.

In "When I Get to the Border," general surgeon Miranda Bailey (Chandra Wilson) and OB-GYN Addison Montgomery (Kate Walsh) find themselves road-tripping from Seattle to Pullman to provide abortion counseling and reproductive health care for patients crossing over into Washington State from Idaho, "flooding the place ever since the state restricted abortion."

As a reproductive health policy reporter, I was genuinely surprised by this level of specificity. Rhimes is a showrunner who often takes on abortion and reproductive health: Scandal's Olivia Pope and Grey's Anatomy's Cristina Yang both have had abortions, and Grey's Anatomy has approached reproductive health care storylines with the maximalism it brings to everything else, covering everything from infertility to ectopic pregnancy long before other shows dared to consider such material.

I have enough SVU enthusiast friends to know TV shows often concoct stories based on real-life current events. I just never expected a TV show to take on the kind of headlines I think about all the time. And yet this episode does, as Bailey and Montgomery are tasked with transporting a patient from Idaho to Pullman to treat her for a cesarean scar ectopic pregnancy, a rare, life-threatening pregnancy complication in which a developing embryo attaches to a scar from a previous C-section.

Because she's in Idaho, where abortion is banned in most cases, the patient's doctor is afraid of legal recourse for providing an abortion and won't treat her. "There's cardiac activity," explains Montgomery. "They didn't want to take the risk. The law's confusing. Nobody wants to be the first to lose their license or be charged with a felony."

This is true: Abortion bans introduce ambiguity into urgent situations like the one in this episode, which devolves into a life-threatening emergency when the patient hemorrhages on the way to the clinic in Pullman. Montgomery uses a uterine balloon to try to stop the patient's bleeding, but there's not enough time: The woman's pulse stops and she dies on the side of the road as Bailey and Montgomery perform desperate lifesaving measures. When Montgomery, an OB-GYN and an abortion provider, expresses her fury at not being able to save her patient, it reminded me of things providers and clinic staff often say to me: Abortion bans make them feel powerless to provide adequate patient care. "I mean, how are we supposed to be doctors?" Montgomery asks. "How are we supposed to treat patients if we're hamstrung by laws that are written by people that are so far away from this?"

Like many Shondaland shows that turn Big Issues into storylines, Grey's Anatomy's take on the Northwest's abortion politics is about as didactic as TV gets. "When I Get to the Border" clearly wants to teach viewers a lesson, and at times, the dialogue verges on political talking points. But the lesson is accurate and distills the complexity of abortion bans into a compelling story without losing its grip on reality, which is more than can be said for a lot of fictional storylines covering abortion.

Earlier this year, I reported on Advancing New Standards in Reproductive Health's "Abortion Onscreen," an annual analysis of abortion-related storylines on TV. It found that TV depictions of abortion care from 2021 adequately portrayed what emotional support for someone having an abortion might look like, but the organization didn't address real-life barriers to care and too often focused on white women, when in reality, abortion bans tend to disproportionately impact People of Color, young people, and low-income patients.

"When I Get to the Border" also does this: The patient Bailey and Montgomery care for is a 39-year-old white woman from Idaho. But the episode also acknowledges that a wide array of patients seek abortion and reproductive health care, including Bailey herself, who discloses her own experience with abortion care in a poignant monologue about having a miscarriage followed by dilation and curettage (D&C), a procedure that removes tissue from the uterus.

"I did not choose abortion, but I've had a D&C. It is the same procedure," she says, in a line reading Wilson imbues with her usual no-nonsense gravitas. "And I'm worried doctors are afraid to use it. I'm worried the next generation won't get enough training on it. … I want to offer it at Grey Sloan — training, anyone who wants it. I want to prepare health care professionals to help."

Wilson's imaginary doctor is describing a very real concern. Half of medical schools don't provide abortion training, and Bailey's commitment to providing it at fictional Grey Sloan has an interesting parallel in Seattle's real-life University of Washington, whose department of obstetrics and gynecology now only accepts residents willing to provide abortion care as part of their scope of practice.

No TV storylines on abortion addressed barriers to treatment in 2021, but this Grey's Anatomy episode front-loads them, from the gaps in training Bailey describes to localized challenges tied to specific legislation: The overrun clinic trying to treat out-of-state patients squares with real-life reports from abortion clinics in Eastern Washington that they've received more patients from Idaho since the state banned abortion in August.

For a show that sometimes seems like it's set more in a Pacific Northwest of the popular imagination than in the real thing, that's saying something. It shows that 19 seasons in, Shonda Rhimes is still finding new ways to challenge and educate her audience — and making it clear that the struggles of states preserving abortion access in a post-Roe world haven't gone unnoticed.

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