Since the U.S. Supreme Court overturned Roe v. Wade in 2022, 14 states have enacted near-total abortion bans. Among these, ten states, including Texas, have no exceptions for survivors of rape or incest. A recent study estimated that around 65,000 pregnancies related to rape may have occurred in these states since Roe was overturned, Sara Cincurova and Virginia Williams write on TheGuardian.com
While there are no specific studies on rape-related pregnancies among minors since the ruling, experts and advocates highlight unique challenges faced by young people in states with abortion bans.
“States with abortion bans, regardless of rape exceptions, lack specific provisions for minors,” said Dr. Samuel Dickman, one of the study’s authors. “Many places where abortion is still legal impose additional restrictions on minors, like parental consent or notification laws. The logistical and financial challenges of traveling out of state for an abortion are often exacerbated for minors, who may lack access to transportation and funds.”
In contrast, eleven states with abortion bans or restrictions allow exceptions for rape and incest. However, these exceptions are frequently ineffective in practice, according to a KFF analysis. Barriers include limited availability of abortion providers, requirements for survivors to report crimes to the police, and stringent gestational limits.
Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights, points out that the law enforcement reporting requirement is a significant hurdle. Survivors of rape often avoid police due to fear of retaliation or inaction; the KFF study notes that only about 21% of sexual assaults are reported. “In states with abortion bans and shuttered clinics, survivors may need to travel out of state for care,” Smith said.
For minors who are incest survivors, the abuser is often a close family member, making reporting even less likely, according to Dr. Peta-gay Ledbetter, a psychotherapist and former maternity nurse in Texas. Ledbetter recounted a case where a 10-year-old, pregnant due to her mother’s boyfriend’s assault, faced severe complications, including a uterine rupture. “An abortion would have prevented immense suffering and trauma for this child,” Ledbetter said.
M, an activist helping minors obtain abortion pills, describes how some young people resort to unsafe methods to terminate their pregnancies. In 2023, M assisted a 16-year-old from Texas who became pregnant after a rape. “She tried to overdose on medications,” M said. Unable to travel for an abortion, the girl delivered a baby with a heart defect and continues to face severe mental health struggles. “I’ve met several girls who have attempted dangerous methods, like overdosing on Nyquil and Fentanyl,” M added. “One colleague had to contact suicide hotlines and poison control.”
Jennifer Toof, a trauma-informed psychologist in Pennsylvania, notes the lack of research on the mental health impacts of rape-related pregnancies. “Rape and incest are significant risk factors for PTSD and other mental health disorders, especially in children. Being forced to carry an unwanted pregnancy exacerbates these risks,” Toof said.
An extensive network of activists is working to provide safe abortion access. M, who prefers to remain anonymous, said, “We rely on a network of supporters in blue states to provide supplies and help with travel.” These activists offer more than just pills—they also assist with financial aid and logistical support for minors seeking care.
The issue gained national attention in 2022 when a 10-year-old Ohio girl had to travel to Indiana for an abortion due to her home state’s six-week ban. The Indiana doctor, Caitlin Bernard, faced backlash from anti-abortion activists and politicians after reporting the procedure as required by law.
Another case involved a 13-year-old in Mississippi who, after being raped at 12, was unable to obtain an abortion due to financial constraints. Although the rape was reported to law enforcement, the family could not afford the procedure, and the child is now raising the baby with family support.
Attempts to create exceptions in abortion bans for minors have faced resistance. For example, a Louisiana legislative committee recently rejected a bill to include rape and incest exceptions, and a proposal to limit the exception to minors under 17 was also rejected.
Other states are imposing stricter regulations, such as Idaho and Tennessee’s laws aiming to penalize adults who assist minors in crossing state lines for abortions.
Alison Brysk, a political science professor at UC Santa Barbara, criticizes these measures as “falsely presented as ‘parents’ rights’” which can leave children dependent on abusers for permission to access care.
For support related to rape or sexual abuse, the U.S. National Sexual Assault Hotline is available at 800-656-4673.
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