Abortion exceptions "have no meaning at all" — and estimates of pregnancies by rape prove it

For years, Dr. Samuel Dickman was an abortion provider in Texas. Currently, he works as the chief medical officer of Planned Parenthood in Montana. But in both states, he’s had patients who have spontaneously revealed that they were pregnant as a result of rape.

Dickman and his colleagues thought if some people are revealing this to their abortion providers, without being prompted, there have to be more who aren’t because they understandably don’t feel comfortable doing so. Moreover, what was happening to pregnant survivors of rape in states with abortion bans?

Since the U.S. Supreme Court made the unprecedented decision to end the constitutional right to abortion, striking down the 1973 Roe v. Wade ruling that legalized the right to choose abortion nationwide, 14 states have enacted abortion bans. Few of these states have exceptions for rape. And those that do have exceptions require people to report the rape to law enforcement, creating yet another barrier to access abortion care. Since Dobbs, how many rape-related pregnancies have there been in abortion ban states? Dickman and his colleagues came to a startling estimate: 64,565 pregnancies.

“All of this data is very hard to collect for obvious reasons related to stigma and under-appreciation of how important of a problem this is,” he told Salon in a phone interview. “But we used the best data that we could find to come up with what we think are reasonable estimates.”

Specifically, data in the research letter published on Wednesday in JAMA Internal Medicine estimated that nearly 520,000 rapes have occurred in states with abortion bans during the 4 to 18 months that bans were in effect, a time period that varied. Of that estimate, 9 percent of rape-related pregnancies occurred in states with rape exceptions, and 91 percent in states with no rape exception. The core part of the data analysis relied on a survey that the Centers for Disease Control and Prevention (CDC), and data from the Bureau of Justice Statistics on criminal victimization and FBI Uniform Crime Reports that looked at the number of vaginal rapes of women between the ages of 15 and 45 that happened in those 14 states while abortion bans were in effect.

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“This affects a huge number of people across the country, and it’s not just women in states with abortion bans. Sexual assault is unfortunately extremely common everywhere, and survivors deserve a medical system that protects them and is allowed to help take care of them,” Dickman said. “And that includes abortion care.”

In the research letter, the authors emphasized that rape exceptions fail to provide reasonable access to abortion for survivors of rape. He emphasized that one major barrier is that these exceptions require reporting the law enforcement and getting a provider who is willing to take a legal risk.

“Even if, in theory, the patient meets all of the criteria for that exception, it's just not happening in real life,” Dickman said. “To my knowledge, there's really no provider in any of these in any of these states that is quickly providing abortion care for rape survivors”

Survivors, he said, are having to order abortion pills online if that’s an option, travel out of state for abortion care or continue the pregnancy. Exceptions, he added, are a very “powerful political tool.”

“They make it seem like abortion bans include some goal of understanding that survivors need medical care, including abortion care,” Dickman said. “But I think what we see in our study and others is that that's purely theoretical, and in practice those exceptions have no meaning at all.”