Since Roe vs. Wade was repealed in June 2022, there was quite a lot of media consideration and authorized scrutiny over the well being and life exceptions to state abortion bans. This might turn out to be a marketing campaign challenge, as former President Trump has said that he helps exceptions to abortion bans for rape, however the 2024 Republican Get together platform says that states ought to set their very own abortion legal guidelines — with out naming exceptions. The overwhelming majority of People — about 8 in 10 — help authorized entry to abortion for pregnancies ensuing from rape or incest. Whereas exceptions for rape and incest have been a part of the political debate, the feasibility of entry to abortion care below these exceptions has obtained far much less consideration.

Regardless of broad help for authorized entry to abortion in instances of rape or incest, 10 of the 21 states with abortion bans or being pregnant limits don’t have an exception for pregnancies ensuing from sexual abuse. Within the 11 states with exceptions for rape and incest, lack of supplier availability, legislation enforcement reporting necessities, and restrictions in early being pregnant might stop pregnant survivors of sexual abuse from accessing abortion care (Determine 1).

Exceptions to the abortion ban or the gestational age restriction in instances of rape and incest are sometimes restricted to abortion in early being pregnant. Of the 21 states with abortion bans or early being pregnant limits, 11 make exceptions for pregnancies ensuing from rape or incest and 10 don’t. Of the 14 states with whole abortion bans, 9 (Alabama, Arkansas, Kentucky, Louisiana, Missouri, Oklahoma, South Dakota, Tennessee, and Texas) haven’t any exception for rape or incest. The remaining 5 (Idaho, Indiana, Mississippi, North Dakota, and West Virginia) have exceptions for instances of rape or incest, however restrict these exceptions to the sooner phases of being pregnant. Most pregnant folks uncover their being pregnant by 5.5 weeks LMP, though lower-income people, youthful people, black and Hispanic people, and unintended pregnancies usually uncover their pregnancies later. Of the seven states with basic being pregnant limits between 6 and 15 weeks LMP, six (Florida, Georgia, Iowa, Nebraska, North Carolina, and South Carolina) have exceptions for rape or incest. Arizona has no exception for rape or incest in its legislation.

Most exceptions for rape or incest require police involvement, which may limit entry to abortion for girls who’ve turn out to be pregnant because of sexual abuse. In 5 of the states with rape or incest exceptions—Florida, Georgia, Idaho, Mississippi, and West Virginia—pregnant girls should report the assault to legislation enforcement earlier than receiving abortion care. Many of those states additionally require the pregnant lady to present the physician a duplicate of the report earlier than receiving care. In Iowa, survivors of sexual abuse should report the incident “to the police or a public or personal well being care supplier, together with a household doctor”—inside 45 days of the incident (140 days for incest instances). In South Carolina, survivors don’t have to report their assault to legislation enforcement earlier than receiving abortion care, however medical doctors who carry out abortions below the rape/incest exception should report the allegation of sexual abuse to the sheriff within the county the place the abortion was carried out.

It’s estimated that solely 21% of sexual assaults are reported. Survivors are sometimes afraid to report sexual violence to the police attributable to concern of reprisal and the assumption that legislation enforcement will do nothing to assist.

These necessities can even delay care. There aren’t any clear tips specifying how rapidly legislation enforcement should challenge a duplicate of the report in these states. Advocates argue that it’s troublesome to acquire a duplicate of a police report whereas the sexual abuse remains to be being investigated. Of the states that require legislation enforcement reporting, solely Idaho specifies that survivors of sexual abuse have the correct to a duplicate of the report inside 72 hours of submitting the request.

Pregnant girls might have problem discovering an abortion physician or making an appointment. In states with whole abortion bans, few abortion suppliers stay. Suppliers in states with early being pregnant limits (and the few remaining suppliers in states with whole bans) could also be unwilling to offer abortion care in instances of rape or incest—even when there may be an exception—for concern of prosecution. The sexual abuse exceptions usually don’t particularly define how physicians can keep away from prosecution for performing an abortion below the exception. In Idaho, Mississippi, and North Dakota, clinics and abortion rights have suggested sufferers to journey out of state to acquire abortion care, discovering that it’s simpler for folks to acquire abortion care out of state than to aim to obtain care in state below the exception.

It’s instructive to contemplate a hypothetical state of affairs in West Virginia, a state with an abortion ban with a rape/incest exception. The state’s whole abortion ban has an exception for pregnancies ensuing from rape or incest, however solely as much as 8 weeks LMP (Final Menstrual Interval) for adults, often about 4 weeks after a missed interval. Since most individuals uncover they’re pregnant by 5.5 weeks LMP, an individual pregnant because of rape or incest in West Virginia sometimes has solely 2.5 weeks to:

1. Discover and make an appointment with a physician who’s prepared and in a position to carry out the abortion
2. File a report of the assault with the police and request a duplicate of the report to present to the physician performing the abortion at the very least 48 hours earlier than the abortion.
3. Present ample funding to pay for the abortion
4. Prepare different logistical challenges, comparable to childcare and go away.

West Virginia's ban provides to abortion restrictions that had been in place earlier than the Dobbs determination: a 24-hour ready interval, obligatory counseling, a proposal of an ultrasound, and for minors, notification from the guardian or authorized guardian or approval from a decide. The flowchart beneath reveals how tight this timing is. (Determine 2)

Medicaid protection for abortion care might not be out there, even for many who qualify for an exception for rape or incest. Though the federal Hyde Modification requires state Medicaid applications to cowl abortions in instances the place the being pregnant outcomes from rape or incest, many state Medicaid applications impose prior authorization necessities and medically pointless restrictions. In consequence, few, if any, pregnant folks obtain Medicaid protection for his or her abortion care. For low-income survivors of sexual violence, price may be an insurmountable barrier to accessing abortion care. In 2021, the median price of abortion companies was greater than $500. Nonetheless, 43% of girls ages 18-49 can not cowl an emergency price of at the very least $500 with their present financial savings, with even bigger shares of Black and Hispanic girls (57% and 58%, respectively) unable to cowl such emergency medical bills.

Few folks have had entry to abortion care below the exceptions to state abortion bans for rape or incest. Whereas knowledge from states with abortion bans and rape or incest exceptions are scarce, estimates present that only a few abortions are carried out in states with whole abortion bans, even in states with sexual abuse exceptions. For instance, Mississippi and Idaho every had 5 documented abortions in 2023, although neither specifies the exception below which the abortions had been carried out. West Virginia had 23 abortions carried out from January 2023 by way of June 2024, however none are reported as being carried out below the state’s rape/incest exception. Since Indiana’s whole ban went into impact in late August 2023, suppliers have reported 5 abortions carried out for rape or incest. The precise variety of pregnancies ensuing from rape is unknown. Given the extraordinarily low variety of abortions that states declare qualify for exceptions to the rape ban and what’s identified in regards to the excessive charges of sexual violence girls face, it seems that these exceptions haven’t offered the extent of entry to abortion for pregnant rape victims that the legal guidelines are presumably meant to guard.