Tens of thousands of women and girls have carried pregnancies resulting from rape in American states that outlawed abortion after Roe v. Wade was overturned in June 2022, a new study suggests.
Federal crime and sexual violence survey data show that about 520,000 rapes have occurred in the 14 states restricting abortion, leading to 64,565 pregnancies, according study results published in JAMA Internal Medicine. More than 90 percent of these pregnancies took place in states with abortion bans and no exceptions for rape.
“Thousands of people in the U.S. become pregnant from rape every month, and many of these people live in states where abortion is now illegal, and traveling or self-managed abortion is out-of-reach for many of them,” says Corinne Rocca, PhD, MPH, a professor of obstetrics, gynecology, and reproductive sciences at the University of California in San Francisco, who wasn’t involved in the new study. “Abortion bans are already having a devastating effect on people’s bodily autonomy and lives, including those of rape victims.”
During the study period — which ranged from 4 to 18 months in each of the 14 states based on the amount of time abortion bans were in effect — Texas accounted for roughly 26,000 rape-related pregnancies, or 45 percent of the total, followed by Missouri with about 5,800 and Tennessee with almost 5,000.
Almost No Legal Abortions Occurred in States With Restrictions
While the study wasn’t designed to explore how many rape survivors wanted abortions or how many chose to remain pregnant, 10 or fewer legal abortions were provided each month in states with bans in place, Dr. Rocca says. “These people either had to endure the practical and emotional challenges of getting an out-of-state abortion, self-manage an abortion, or carry the rape-related pregnancy to term,” Rocca says.
It’s unknown how many rape survivors in states with abortion bans try to obtain abortion medications from out-of-state or cross state lines to get to a clinic, says the senior study author, Steffie Woolhandler, MD, MPH, a public health professor at the City University of New York at Hunter College.
“The circumstances of the tens of thousands of rape survivors who become pregnant vary greatly,” Dr. Woolhandler says. “Our point is that the survivor of a rape is the one who should be making the decision as to whether to continue or terminate their pregnancy.”
The Difficulty of Reporting Rape Restricts Access to Abortion in States With Exceptions
Five states in the study — Idaho, Indiana, Mississippi, West Virginia, and North Dakota — had abortion bans with exceptions for rape. But a legal abortion under this exception may require a person to report the rape to police or go through invasive medical exams to document the crime.
“Some may remain pregnant because of strong religious objections to abortion or the misery of alleging rape,” says Nada Stotland, MD, MPH, a past president of the American Psychiatric Association who has done extensive research on reproductive health.
But “most would want an abortion rather than endure a pregnancy and raising a child that is a constant reminder of the assault,” Dr. Stotland says. “There is also the fear that the child would inherit a genetic tendency toward criminality, and the challenge of responding to the child’s inevitable questions about their father.”
Any pregnant person who lives in a state where abortion is banned would face a variety of hurdles to terminating a pregnancy, Rocca says.
Traveling out-of-state requires knowing how and where to access abortion care, which might be hundreds of miles away, and might also require time off work, child care, and money for medical care and travel expenses, Rocca says. In order to get a medication abortion, a person needs to know this is a safe option, and then know where and how to get the pills.
“Fear of legal ramifications is also highly likely to hinder people’s willingness to either travel for care or to self-manage,” Rocca says. “We haven’t looked explicitly at rape-related pregnancy; it is certainly possible that rape victims face additional obstacles.”
