As children in Texas, A and her sister were raped multiple times by their stepfather and his friends before she discovered she was pregnant earlier this year.
“We both had an STD because neither of us used condoms,” A. said. Their stepfather stopped having sex with them when he found out the sisters were being treated for sexually transmitted diseases at a clinic. One of his friends was not.
The sisters fled to a shelter for victims of domestic violence when A discovered she was pregnant, and through a network of underground activists, they managed to obtain abortion pills. “If I hadn’t been able to have an abortion, I would have committed suicide,” A said. “The man who raped me was a pig, and I didn’t want his baby inside me.”
Since Roe v Wade was overturned by the U.S. Supreme Court in 2022, 14 states have passed nearly total abortion bans. Ten of those states, including Texas, have no exceptions for survivors of rape or incest. A study published earlier this year estimated that there have likely been 65,000 rape-related pregnancies in states with abortion bans since Roe was struck down.
While there are no studies on the number of rape-related pregnancies among minors since Roe was overturned, young people in states where abortion is illegal face unique barriers, according to doctors and advocates who spoke to the Guardian.
“States that ban abortions, both with and without exceptions for rape, have no exceptions for minors,” Dr. Samuel Dickman, one of the authors of the study on rape-related pregnancies since Roe fell, said via email. “Many states where abortion care remains legal impose burdensome additional restrictions on abortion access for minors, such as parental consent or notification laws. And of course, the logistical and financial burdens for people trying to obtain an abortion out of state are often worse for minors, who may not have access to transportation or the funds needed to travel and pay for abortion services.”
Eleven states that have banned or restricted abortion since the overturn of Roe v. Wade have exceptions for rape and incest — but if a recent analysis KFF shows that they are often impractical due to a lack of abortion doctors, the requirement that survivors report the crime to the police, and strict pregnancy limits.
Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights, calls the law enforcement requirement a particularly difficult barrier. Rape survivors are known to avoid going to the police for fear of retaliation or inaction; as the KFF study notes, it is estimated that 21% of sexual assaults are reported“We know that sexual abuse often goes unreported for a variety of reasons; in states where abortion is banned and clinics are closed, everyone, including rape and incest victims, will likely have to travel to another state to get care,” Smith said.
When a minor child is a survivor of incest, it is often the primary caregiver – a parent, stepparent or grandparent – who raped them, said Dr. Peta-gay Ledbetter, a psychotherapist and former maternity nurse who worked with low-income communities in Texas. That makes it even less likely that she or a family member will report the crime to police.
Ledbetter said she witnessed a 10-year-old girl become pregnant after her mother’s boyfriend sexually abused her, with the mother’s knowledge. “Her small body was unable to carry the pregnancy and she suffered a ruptured uterus before the fetus was viable.” The complications of the premature birth and ruptured uterus required a C-section to save the child’s life; the fetus did not survive. “An abortion would have spared this 10-year-old a lot of suffering and trauma for the rest of her life,” Ledbetter said.
M, the activist who helped A obtain abortion pills, says the minors she encounters seeking help often resort to unsafe measures to try to induce their own abortions. In 2023, she was approached by another 16-year-old from Texas who became pregnant after a stranger raped her. “Like other girls I’ve met, she tried to overdose on borrowed medication,” M said. Forced to carry the child, she dropped out of school and gave birth to a baby with a heart defect. Mary says she remains suicidal. “I’ve met at least three other girls who have tried everything from drinking bottles of Nyquil and isopropyl alcohol to taking Fentanyl,” M added. “One of my coworkers had to call the suicide hotline and poison control.”
There’s a dearth of literature on the mental health effects of pregnancies caused by rape, says Jennifer Toof, a trauma-informed psychologist in Pennsylvania who is writing a book about the ethical responsibilities of mental health professionals in the wake of Roe. “We know that rape and incest are significant risk factors for the development of post-traumatic stress disorder and other mental health disorders, particularly in children, so having pre-existing trauma and mental health conditions on top of being forced to carry an unwanted pregnancy to term while still a child is a dangerous combination.”
A sprawling, underground network of activists is trying to bridge the gap by providing women and girls with the means to safely end their pregnancies. According to M, who is not sharing her real name due to the nature of her work, “we rely on a network of women living in blue states to keep us ‘supplied.’” These activists often provide support beyond the pills themselves—M told the Guardian they also provide money and help minors travel to get the care they need.
Stricter restrictions
The impact of abortion bans on young rape victims came into national focus in 2022, when a 10-year-old Ohio girl pregnant as a result of rape was forced to travel to Indiana for an abortion because her home state banned the procedure after six weeks. (Abortion rights are now enshrined in Ohio’s constitution.) The Indiana doctor who performed the abortion, Caitlin Bernard, reported that the procedure was required by state law, sparking a campaign against her by a group of anti-abortion activists and politicians.
In another high-profile case, in Mississippi, a 13-year-old girl became pregnant after being raped by a stranger at age 12 and was forced to carry the child because her family didn’t have enough money to drive to the nearest abortion clinic in Chicago or pay for the procedure. Although the child and her mother reported the rape to the police, she was unable to terminate the pregnancy due to a lack of clarity about the exception. She is now raising the child with the help of her family; her rapist was caught and charged.
Some lawmakers have tried to create exceptions to abortion bans for minors, but have faced opposition in conservative states. In May 2024, a Louisiana legislative committee rejected a bill that would have added cases of rape and incest as exceptions to Louisiana’s abortion ban. They also rejected an amendment introduced by Democratic Rep. Delisha Boyd that would have limited the bill to minors under 17.
Other states are trying to make it even harder for children to access care. Laws in Idaho and Tennessee seek to punish any adult who helps a minor cross state lines for an abortion.
Such laws are “misrepresented as ‘parental rights’ measures,” says Alison Brysk, a political science professor at the University of California, Santa Barbara, who studies the politics of abortion. “This means that access to abortion for a child who is pregnant as a result of parental abuse may be contingent on the consent of the abuser.”
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Information and support for anyone affected by rape or sexual abuse is available from the following organizations. In the US, Rain offers support at 800-656-4673. In the United Kingdom, Rape Crisis offers support on 0808 500 2222. In Australia support is available on 1800Respect (1800 737 732). Other international helplines can be found at ibiblio.org/rcip/internl.html