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Texas alone accounted for 26,313 pregnancies because of its large population and total ban without exceptions. Photograph: PhotoAlto/Frederic Cirou/Getty Images
Texas alone accounted for 26,313 pregnancies because of its large population and total ban without exceptions. Photograph: PhotoAlto/Frederic Cirou/Getty Images

Nearly 65,000 US rape victims could not get an abortion in their state, analysis shows

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Researchers estimated likely number of rape-related pregnancies in 14 states with near-total abortion bans since Dobbs ruling

Nearly 65,000 rape-related pregnancies likely occurred in the 14 US states with near-total abortion bans following the US supreme court’s 2022 Dobbs decision – yet just 10 legal abortions are performed monthly on average in these states, researchers found in a new analysis.

The data demonstrates that abortion bans likely make it impossible for most victims of rape to obtain abortions in their home states, even for the minority of people who live in states with exemptions for rape, researchers said.

The figures come as rape exemptions have fallen out of favor among anti-abortion activists and politicians, despite the fact that most Americans, including Republicans, believe that victims of assault should have access to abortion, and that most Americans believe abortion is “morally acceptable”.

“The large number of estimated rape-related pregnancies in abortion ban states compared with the 10 or fewer legal abortions per month occurring in each of those states indicates that persons who have been raped and become pregnant cannot access legal abortions in their home state, even in states with rape exceptions,” researchers wrote in a research letter in the journal JAMA Internal Medicine.

Although the observational nature of the study might draw criticism, it is part of an important and growing number of analyses documenting the effect of abortion bans on women’s lives, health and fertility. This growing body of evidence crosses disciplines, with contributions from clinicians, economists and researchers.

In July 2022, the US supreme court overturned Roe v Wade, a nearly 50-year-old precedent that provided a constitutional right to terminate a pregnancy, in a case called Dobbs v Jackson Women’s Health Organization (or simply “Dobbs”).

The decision caused a seismic change in reproductive rights in the US – states were suddenly permitted to ban the procedure. Fourteen moved to do so immediately and almost totally, with five of those providing exemptions for victims of rape. Twenty-five million women of childbearing age now live in states that ban the procedure.

In JAMA Internal Medicine, researchers estimated the number of women who are likely victims of “completed” vaginal rape – forced and/or drug/alcohol–facilitated vaginal penetration – using estimates from the Centers for Disease Control and Prevention of intimate partner violence. They then determined the fraction that were likely to be of childbearing age (15-45) using Bureau of Justice Statistics data, arriving at a figure of roughly 520,000 total rapes. (Importantly, as noted by JAMA, data from BJS undercounts rapes.) Finally, they apportioned assaults to the 14 US states that ban abortion using the Federal Bureau of Investigations’ uniform crime statistics, which include rapes reported to law enforcement in 2019.

The estimate found that the overwhelming majority of rape-related pregnancies, 58,979, likely occurred in states without exceptions to their abortion ban. Texas alone accounted for as much as 45% of that number (26,313) because of its large population and total ban without exceptions.

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An estimated 5,586 rape-related pregnancies occurred in states with exceptions for victims of rape. Although not all women who become pregnant from a rape want an abortion, those who do are likely confronted with the reality that their state offers no access to abortion. Researchers found that even states with exemptions likely fail to provide any meaningful opportunity to terminate a pregnancy, given the low number of legal abortions per month in these states.

At least in part, researchers surmise this is driven by requirements for victims to report rape to law enforcement, which few feel comfortable doing. It would likely be worsened by the near total lack of providers who would be willing to perform an abortion in a state with severe criminal and professional penalties for doing so.

The analysis stops short of estimating the number of women who might have been forced to carry a rape-related pregnancy to term. Abortion remains legal in most circumstances in 30 US states, and nearly three-quarters of women seeking an abortion have shown a willingness to travel to states where abortion is legal, recent research has found.

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