‘Pregnancy’ used to be the focus in abortion local news stories. Now, it's ‘vote.’

Immediately after the Supreme Court struck down Roe v. Wade, the most popular health- or politics-related word used in local newspaper stories about abortion was “pregnancy.”

Now, the most commonly used is “vote.”

That shift is just one measure of how the Supreme Court’s decision reshaped public discussion of abortion, and how it has been reflected in the news media.

To examine the reaction to the court’s ruling, POLITICO compiled more than 15,700 local newspaper articles that mention abortion published in states where abortion is banned or restricted past 15 weeks of pregnancy.

This analysis captures what happened after the explosive decision reshaped health care policy and reignited a long-deadlocked debate over medicine, gender, sexual autonomy and the law.

On the week in June 2022 of the Dobbs decision, which gave states broad power to restrict abortion, there was an equal amount of political and health coverage of abortion.

Politics has dominated ever since.

Since the Supreme Court struck down Roe v. Wade, local newspaper articles mentioning abortion have focused on politics 2.5 times as often as they’ve focused on its effects on maternal health, families and health care providers.

On one level, this trend reflects the plain reality of how a political debate has changed. Abortion, debated for a generation in courtrooms, has returned to the center of electoral politics. Democrats have made protecting or restoring abortion rights one of the party’s defining priorities; Republicans have struggled to both appease their base and build broad voter coalitions as hardline conservative policies on abortion have been codified in law.

But experts say there is a cost to the consuming focus on politics: Treating abortion chiefly as a campaign issue can also obscure the human and medical consequences of changing policies.

“What's lost in that is the fact that these are real policies that affect real people,” said Danielle Vinson, a political science professor at Furman University who studies the relationship between politics and media. “It really does allow the politicians, I think, to skate through some of the accountability they would otherwise have.”

The way voters perceive Dobbs’ consequences — and what information is available about them — will surely matter in the 2024 elections: One year out, polls and primary debates show abortion is already a central theme among candidates. According to a poll from KFF, the health research nonprofit formerly known as the Kaiser Family Foundation, one in four registered voters said their vote will be determined by whether a candidate shares their views on abortion. The group also found that 58 percent of voters trust the Democratic party to best handle the issue.

Newspapers — which have reduced staff nationwide by over half between 2008 and 2020, according to a study from the Pew Research Center — hold a unique ability to find stories of how citizens are affected by national decisions. Local journalists have first reported some of the most widely shared examples of Dobbs’ fallout, such as a 10-year-old girl denied an abortion in Ohio.

“We need to explain how access to care is affected,” said Orlando Sentinel health care reporter Caroline Catherman on the role of health care reporting following the Dobbs decision. “There are all these political changes happening, but we need to write local stories that only we can really write.”

The Supreme Court decision in Washington has given new powers to lawmakers in state capitals around the country, but much of the focus has been its importance as a national political issue. Even as local newspapers have written about Dobbs’ consequences for their own states, the fallout has influenced congressional races and military nominations and has already seeped into the forthcoming GOP presidential primaries.

POLITICO read hundreds of stories on abortion out of the thousands compiled and identified two themes: a focus on abortion as a political issue and a focus on the real-world effects of abortion restrictions. We measured the number of times certain words appeared in each of these areas. We placed keywords into two groups: “politics” words that relate to elections, political parties and national and state governments, and “health care” words that relate to the policies’ effects on reproductive care and families — including words like “pregnancy,” “doctor” and “child.”

Even with a larger pool of health care words, the skew toward politics held true in each of the 21 states included in the analysis. In most swing states, newspaper coverage has been even more likely to focus on the politics of abortion.

These 21 states are where the consequences of restricted abortion access will be felt the most: Before Dobbs, they were responsible for providing 29 percent of the total abortions performed in the United States according to estimates from The Society of Family Planning, a nonprofit that publishes research on contraception and filed an amicus brief supporting abortion access in the Dobbs case.

In Georgia, Florida and North Carolina — three of the states with restrictions that had the most abortions per capita before Dobbs — political keywords appeared 3.6 times as often as health care ones in stories that mentioned abortion.

Fear among potential sources and the decline of local journalists, including health care reporters, help explain why political reporting has been more plentiful.

In early 2022, months before the Dobbs decision, Pew Research conducted a survey of nearly 12,000 journalists across the country. Among local reporters surveyed, 12 percent covered the health beat. Nearly three times as many covered government and politics — the most common among local reporters.

In Tennessee, where an initial six-week trigger ban made performing abortions a felony, the newspapers included in the analysis employ a total of two health care-focused journalists and 11 government and politics journalists.

“You could have one reporter that was 100 percent on reproductive health care in Tennessee, and that's their entire beat, and have endless stories," said Elizabeth Fite, the health care reporter for the Chattanooga Times Free Press.

POLITICO’s review of local newspaper articles shows that coverage of abortion has been divvied up not just among health care reporters, but politics reporters, education reporters and sports reporters — a reflection of how many facets of American life intersect with abortion policy.

However, journalists new to covering the issue may not be as well-versed in the nuances of abortion, said Katie Woodruff, a public health social scientist at the University of California San Francisco School of Medicine who is researching abortion coverage in national media.

“Every story of a public health legislative issue needs to include a few basic facts to frame that issue for the public,” she said.

Of course, abortion was not the exclusive domain of health care journalists prior to Dobbs, either. Abortion coverage for the Chattanooga Times Free Press had largely fallen to the paper’s Nashville-based politics reporter and its faith and religion reporter, Fite said. Fite had previously focused on Covid-19, the opioid epidemic and the business of health care in the Chattanooga community, which is one of the largest industries in the area. Otherwise, “there’s not a lot of papers in Tennessee that have health care reporters,” she said.

Fite, who’s turned more of her reporting on abortion during the past year, says it’s particularly difficult to get people seeking abortions to speak on the record. The stigma surrounding abortion, particularly in states where it is banned or restricted, can influence the types of stories journalists are able to report.

“What I have the hardest time getting are patients who have traveled to get an abortion,” she said. “It’s really hard to get them on the record because Chattanooga is a small town. … Abortion is very politically unpopular here.”

In 2021, Tennessee medical facilities provided nearly 12,200 abortions, according to the CDC. Today, abortion is banned in the state with limited exceptions.

In Florida, where Republican Gov. Ron DeSantis signed a six-week abortion ban that has yet to go into effect due to an ongoing challenge in the state Supreme Court over the state’s 15-week ban, abortion is a familiar news topic. Florida newspapers have published more articles on abortion than any state in the analysis: nearly 4,400 stories across 14 local papers.

Cindy Goodman, the health reporter for the South Florida Sun Sentinel in Fort Lauderdale, said abortion providers have asked her to not name them in stories because of concerns for their safety and their businesses.

Earlier this year, Goodman reported abortion clinics in her state were flooded with patients attempting to access the procedure before the state’s current 15-week limit and to meet the state’s requirement for a 24-hour waiting period. Clinics in the state can face thousands of dollars in fines when that 24-hour period is not properly documented for patients.

“These are little abortion clinics that operate on a shoestring, so they can't afford these big fines. So they're very afraid. They're afraid to talk to me,” Goodman said. “They're afraid to bring any attention to themselves.”

Among the thousands of articles Florida newspapers published, politics came up roughly four times as often as health care in stories where abortion is mentioned, the most of any state.

Take, for example, the week that would have marked the 50th anniversary of Roe v Wade. Across 68 stories published on abortion during the seven days prior in Florida, just two covered what would soon become a national flashpoint: “Florida agency warns pharmacists not to dispense abortion pills,” read one headline.

Most other news stories were preoccupied by political updates, including a visit from Vice President Kamala Harris to the state capitol to mark the anniversary of Roe — coverage that often focused on the presidential politics between Harris and Republican-hopeful DeSantis.

“It's important who wins the White House for a whole host of reasons,” said Michael Wagner, the director of graduate studies at the University of Wisconsin-Madison’s School of Journalism and Mass Communication, who has published research on how abortion became a partisan issue in the news. “But for those who have become pregnant and don't want to be, the election does not come in time to provide them a remedy.”

KFF found that in states where abortion is banned, more than half of voters surveyed said they were unsure of the abortion pill laws in their state.

In swing states, where votes in the 2024 election will have the greatest impact, political coverage of abortion is often even more dominant. Out of the top five states where coverage favored politics over health care the most, four are expected to be competitive in the 2024 election.

Recent voting shows that while abortion is an intensely political issue, it is not a purely partisan one. Since the Dobbs decision, seven states passed ballot measures protecting access to abortion. Voting margins for abortion rights outperformed Biden’s 2020 support in both Republican and Democratic counties, indicating a level of bipartisan backing not found in presidential politics.

The political coverage of abortion, Woodruff says, leads readers to “think of it as more controversial and more politically divided than it actually is.

In Wisconsin, where voters this year backed a Supreme Court candidate who campaigned on supporting abortion rights, nearly 80 percent of abortion-related articles discussed politics more than health care. The procedure was initially halted after Dobbs, making it an animating force behind the 2022 midterm elections and state Supreme Court race. Abortions resumed this year, but a court case to settle the matter is ongoing.

Wagner said he has observed “a complete shift in who wants to talk about abortion” in Wisconsin.

“For years, Democrats, for the most part, would not mention [abortion] unless they were in front of an exclusively partisan audience,” Wagner said. “Even then, it would be relatively milquetoast language about, ‘We need to protect a woman's right to choose,’ but not talk about abortion as health care, or talk about individual rights.”

As both parties refine how they talk about abortion in 2024, the data so far suggests those decisions will be covered far more than Dobbs’ effects on patients, families and doctors.

Methodology

All articles included in POLITICO’s analysis come from the LexisNexis library. POLITICO searched for articles that mention the word “abortion” among states where the procedure has been banned or restricted past 15 weeks of pregnancy. Twenty-one states met this criteria, including Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, West Virginia and Wisconsin.

POLITICO included all articles from publications that published at least 200 articles mentioning “abortion” between June 24, 2022, and Sept. 30, 2023. If a state did not have any publications that met this criteria, the outlet that published the most articles mentioning abortion was included. POLITICO manually tagged reader opinions, such as letters to the editor, and excluded them from the final analysis.

Nationally syndicated content was also excluded from our analysis, but articles syndicated across local papers were included. Every article in the final dataset was published once per publication, but some articles may appear across multiple publications.

In order to measure the degree of focus within each focus area, “politics” or “health care,” POLITICO created two lists of keywords, giving more words to the health care category: The politics category contained 26 words and their variations, and the health care category contained 35 words and their variations.

POLITICO also measured the degree of depth each article discussed the topic of abortion. POLITICO measured the number of times the word “abortion” and its variations were used in an article relative to the length of a story. Articles that did not mention a version of the word “abortion” at least once for every 600 words in a story — roughly a page of content — were given a “low” degree of depth. Even excluding these articles, the focus on politics was stronger than health care. Therefore, we did not exclude “low-depth” articles from the overall analysis.