Online pregnancy termination videos: Providers, messages and audience reactions

The termination of an unwanted pregnancy is statistically a widespread phenomenon – both nationally and internationally: In Germany, around 100,000 abortions are performed every year (Destatis, 2022), while worldwide one in three pregnancies is terminated intentionally (WHO, 2023).

Medication and surgical pregnancy terminations are medical services and therefore the subject of health communication and healthcare. At the same time, in many countries, pregnancy termination is a criminal offence and therefore the subject of political consideration. In Germany, pregnancy termination is illegal under §218 StGB and can result in a prison sentence of up to 5 years. However, it is also exempt from punishment under Paragraph 218a StGB, provided medical professionals carry it out at the request of the pregnant woman in the first 3 months of pregnancy, and that pregnancy conflict advice takes place at least 3 days previously. Compared to other Western or Northern European countries such as France or Sweden, pregnancy termination law in Germany is particularly restrictive (Krolzik-Matthei, 2019). In the current 20th legislative period of the German Parliament, the current legal regulations are to be reviewed per the coalition agreement, which could eventually lead to decriminalisation.

Pregnancy termination is ethically and politically controversial, as there are two opposing positions that respectively place either the pregnant woman or the embryo/foetus at the centre of consideration (Krolzik-Matthei, 2019): If the pregnant person¹ is at the centre of attention, it is about their freedom of choice and their human right to carry an unwanted pregnancy to term or to end it legally and safely (the so-called pro-choice position); if the focus is on the embryo/foetus, it is about its right to life, resulting in a ban or at least a very severe restriction on pregnancy termination, regardless of the life, health and well-being of the pregnant woman (the so-called pro-life position).

Women experiencing an unwanted pregnancy need medical, legal and practical information if they want to consider a pregnancy termination and have it carried out in good time. They also need to clarify their position in favour of or against carrying the pregnancy to term. Finally, to avoid being devalued and ostracised for immoral behaviour, they are forced to weigh in whom they can confide and from whom they would rather hide their situation. These challenges in the search for information and support make online media an important point of contact for unintendedly pregnant women because of the low threshold and discretion involved. This is true for adults (Bomert, 2022) as well as for adolescents, only a third of whom state that they learned about pregnancy termination in sexuality education lessons at school (Scharmanski & Hessling, 2021). However, media representations of pregnancy termination are not only relevant for people acutely affected by an unwanted pregnancy; such representations can also influence the shaping of pregnancy termination opinions among the general population.

The specialist literature unanimously asserts the major role of online media in the field of sexual and reproductive education (Conti & Cahill, 2027; Döring, 2017), but it is ambivalent about its outcomes. This is because social media in particular provide not just needed information (Duggan, 2023); they can also spread misinformation or targeted disinformation. Few studies to date have systematically analysed online pregnancy termination information. The limited data available mostly relate to English-language media content (Pleasure et al., 2023).

Therefore, this study² is the first to analyse the German-language presentation of pregnancy termination on the two leading video platforms, YouTube and TikTok. These three research questions guide the study:

Q1: Who publishes high-reach pregnancy termination videos on YouTube and TikTok?

Q2: What are the main messages of high-reach pregnancy termination videos on YouTube and TikTok?

Q3: How does the audience comment on high-reach pregnancy termination videos on YouTube and TikTok?

To answer these research questions, I selected the 50 top-ranked videos for the search term “abortion”³ and the 50 top-ranked videos for the search term “termination of pregnancy” on YouTube and TikTok in February 2023. I chose to analyse the top-ranked videos in the video search as they have the greatest influence because of their visibility and reach. I included only German-language videos that deal with pregnancy termination as a central topic. After excluding duplicates, this resulted in a sample of N = 167 videos (YouTube: n = 75 and TikTok: n = 92). For each video, I also recorded the six most-liked topic-related comments, i.e., excluding irrelevant comments such as greetings or adverts. Not all included videos had at least six topic-related comments, so the overall comment sample lay below the theoretical maximum size of 167 x 6 = 1,002 comments, i.e., N = 807 comments (YouTube: n = 326 and TikTok: n =  481).

I analysed the videos and audience comments using a reliability-tested codebook (average reliability coefficient: Gwets AC1 = 0.84). The statistical data analysis included calculating the sum, mean and percentage values. In accordance with relevant online research ethics guidelines, for transparency purposes, I specify the published online videos in detail in this article, whereas the associated comments from the audience are anonymised. The main findings are reported separately for the three research questions.

The vast majority of the top YouTube videos on pregnancy termination come from media professionals such as journalists (83 %), with health professionals (11 %), political or religious actors (4 %) and laypeople (3 %) far behind. Thus, journalists shape the pregnancy termination discourse not only in the traditional media, such as newspapers and television, but also on YouTube. Their contributions consist mainly of approximately half-hour reports, talkshows or interviews taken from public broadcasting. Examples include videos such as “7 Tage … in der Abtreibungsklinik” (SWR Doku; 7 Days … in the Abortion Clinic) or “Sollten Schwangerschaftsabbrüche legalisiert werden? 13 Fragen” (ZDF heute; Should Pregnancy Terminations Be Legalised? 13 Questions). Among the top 100 YouTube videos on the topic, only two are by laypeople reporting on their personal experiences: “fraeulein chaos” dominieren die Gesundheitslaien (69 %) und verweisen die Medienprofis (21 %) auf den zweiten Platz. Denn während auf YouTube heutzutage von Inhaltsanbietern professionelle Videoqualität erwartet wird, können TikToks einfach schnell per Smartphone gedreht und bearbeitet werden, sodass sich niedrigschwellig viele Menschen an der Video-Produktion beteiligen können.

(“Die schwerste Entscheidung meines Lebens: Mein Schwangerschaftsabbruch”, The Most Difficult Decision of My Life: My Pregnancy Termination) and Jacko Wusch (“Mein Schwangerschaftsabbruch”; My pregnancy termination).

A different picture emerges on the short-video platform TikTok (see Figure 1). There, health laypeople dominate (69 %), relegating media professionals (21 %) to second place. While professional video quality is expected from content providers on YouTube these days, TikToks can be simply shot and quickly edited using a smartphone, meaning that many people can participate in video production at a low threshold.

A look at the political messages on pregnancy termination conveyed by the top-ranked videos shows that both YouTube and TikTok are dominated by the pro-choice position, which focusses on the human rights of women experiencing an unwanted pregnancy and emphasises their right to decide for or against carrying an unwanted pregnancy to term (see Figure 2). The second most frequently represented position in the top videos is the neutral position, whereas the pro-life position that strives to make pregnancy termination more difficult or prohibit it altogether is only marginally represented (YouTube: 3 % of videos; TikTok: 5 % of videos).

The top-ranked online pregnancy termination videos included in this analysis (N = 167) totalled around 41 million views. The publicly visible metrics of audience reactions (number of views, likes, shares, comments) follow a clear pattern: The more frequently a video is viewed, the more likes, shares and comments it collects over time. There is a systematic difference between YouTube and TikTok: TikToks, often short videos lasting just one minute, reach larger audiences much faster than the average 15-minute YouTube videos.

A look at the content of the most-liked topic-related comments reveals a similar picture as with the video messages: The pro-choice position dominates and is represented in 76 % of the analysed comments (N = 807). A comparison of the platforms (see Figure 3) shows a very similar distribution of positions: Around three-quarters of the top comments of the top-ranked videos on both YouTube and TikTok represent a pro-choice position (e.g., “Ich lasse sicher keinen Zellhaufen über mein Leben bestimmen. Es werden ja auch keine Zwangskastrationen eingeführt”, I certainly won’t let a bunch of cells decide my life. No forced castrations either.). On the other hand, pro-life comments (e.g., “Schwangerschaftsabbrüche sollten außer in Härtefällen grundsätzlich bestraft werden”, pregnancy terminations should be penalised except in cases of hardship.) are rarely represented on both platforms (YouTube: 8 %; TikTok: 6 % of comments).

The topic of pregnancy termination is present in high-reach videos on both YouTube and TikTok. On the provider side, journalists dominate YouTube, while laypeople dominate TikTok. Regarding the messages conveyed, the pro-choice position has a clear lead in the top videos and most-liked topic-related comments, while the pro-life position is only marginally represented. These main findings correspond to those of an analysis of the most-liked English-language TikTok videos on pregnancy termination (N = 200; Pleasure et al., 2023), which also shows that video providers are primarily laypersons and journalists, and that the pro-choice position is represented in the main. Thus, the current political efforts to critically examine the existing criminalisation of pregnancy termination in Germany harmonise with the opinions on social media shown here.

The relatively small video and comment samples and the focus on political messages limit the present study. Future studies should analyse larger samples and further content dimensions (e.g., type and quality of medical information on pregnancy termination). It is also important to investigate the use and effects of the videos by means of surveys and experiments. Finally, research is required to pick up on current media trends, such as what information on pregnancy termination is being conveyed by artificial intelligence (AI), e.g., in enquiries to AI tools such as ChatGPT.

¹ Girls and women of childbearing age (core group: 15 to 45 years) are directly affected by pregnancy and possible pregnancy termination. One could also speak more inclusively of childbearing or pregnant “persons” to include the fact that transgender men, for example, can also have children (cf. Mehring, 2022).

² This analysis is part of a larger research project in communication science led by the author which examines the representation of sexual and reproductive health issues on social-media platforms. This project, entitled “Erstes Mal, Menstruation und Schwangerschaftsabbruch in Sozialen Medien” (EMSA, Sexual Debut, Menstruation and Pregnancy Termination on Social Media) is funded by the Federal Centre for Health Education (BZgA) from 2023 to 2026. The author would like to thank Eva Kubitza for her support in carrying out this analysis.

³ I used the German terms “Abtreibung” (abortion) and “Schwangerschaftsabbruch” (termination of pregnancy) as search terms because they are the two central terms in the German language.