She was only 10 years old, so young that many people were horrified when they heard it, and others refused to believe it. But the ordeal of an Ohio rape victim who had to cross state lines for an abortion, and the ugly political battle that followed, underscored two uncomfortable facts: Such pregnancies are not as rare as people think, and they are likely to have new abortion bans to have a pronounced impact on the youngest pregnant girls.
The new bans in nearly a dozen states make no exceptions for rape or incest, leaving young adolescents — already among the most limited abortion options — with less access to the procedure. Even in states with rape and incest exemptions, requirements including police reports and parental consent can be overwhelming for children and teens.
“The situation outside of Ohio is by no means unique,” said Katie McHugh, an OB-GYN in Indiana and a board member of the abortion-rights group Physicians for Reproductive Health. “This is a situation that every abortion provider has seen before.”
The number of pregnancies in the United States among girls under the age of 15 has declined sharply in recent decades with greater access to contraception and a decline in adolescent sexual activity. But state and federal data show there are still thousands of such cases each year. And nearly half of those pregnancies end in abortion, according to the Guttmacher Institute, which supports abortion rights and regularly surveys clinics.
In 2017, the most recent year for which data is available, the institute concluded that there were 4,460 pregnancies among girls under 15, with about 44 percent ending in abortion. In Ohio alone, 52 girls under 15 had an abortion in 2020 — an average of one every week, according to the state Department of Health.
It is not clear how often these pregnancies are the result of incest or rape. Children in this age group are usually below the age of sexual consent, although sexual contact between two young teenagers of a similar age is not always considered a crime. And some countries allow children to marry with parental permission.
In Ohio, having sex with a person under the age of 13 is a first-degree felony. Abortion is now prohibited in the state after about six weeks of pregnancy, with no exceptions for rape or incest.
The Ohio rape victim’s startling age helped fuel suspicion surrounding her story, which quickly became a political firestorm after it was reported in The Indianapolis Star. Abortion rights advocates and President Biden have pointed to the girl’s experience as a tragic consequence of abortion bans. Conservatives questioned whether the child existed, and even Ohio’s attorney general initially said he had found no evidence of such a victim.
That doctor, Caitlin Bernard, later tweeted: “My heart goes out to all the survivors of sexual abuse and violence. I am so sad that our country is failing them when they need us the most.”
Read more about the end of Roe v. Wade
Lauren Ralph, an epidemiologist at the University of California, San Francisco, said her research shows that adolescents seeking abortions tend to be firm in their choices, but face barriers such as lack of transportation and notice-and-consent laws. parents that exist in most states. Minors who seek to avoid parental notification, such as in the case of incest or where a parent would try to force the pregnancy, often must file a police report or appear before a judge.
Those are high and sometimes impossible thresholds to overcome, experts said, especially for individuals without legal assistance and young victims who may have been harmed by the adults closest to them.
With some Americans living up to 400 miles from the nearest legal abortion provider, the new state bans will hit teenagers hard.
“We know that young people already faced many more barriers to accessing abortion before Roe v. Wade,” said Dr. Ralph. “What will happen with this decision is that those barriers for young people living in restricted states will now multiply.”
Dr. Bernard, the Indiana obstetrician who performed the abortion on the 10-year-old Ohio girl, said in an interview in early July before the political firestorm erupted that he had experience treating other very young rape victims.
The most difficult case of her career, she said, was when a mother brought her 14-year-old daughter on a date after the girl had been raped. The mother wanted her daughter to have an abortion.
“But the patient said, ‘I don’t want to kill my baby,'” Dr. Bernard recalled. “She felt like abortion wasn’t a bad thing.”
Dr. Bernard said she told the mother she could not perform an abortion without the 14-year-old girl’s verbal consent. In the end, the mother convinced her daughter to undergo the procedure.
Indiana, which currently allows abortions up to 22 weeks, may soon enact its own stricter restrictions in a special legislative session scheduled for late July.
In Oklahoma, a law that bans nearly all abortions makes exceptions for cases of rape or incest, but only if those crimes are reported to law enforcement.
Wendy Sturman, the Republican lawmaker behind the law from Oklahoma, defended the high bar for exemptions.
As for the 10-year-old in Ohio, “What happened there is terrible,” she said. “But it’s even more horrible to take another child’s life.”
Ms Spearman said the laws should not cater for worst-case scenarios.
“Laws should be made for the general, and this is an incredibly rare case,” she said.
It is not unusual for some lawmakers and anti-abortion organizations to oppose rape exceptions to abortion bans, sometimes even in the case of child victims. In a statement welcoming the arrest of a 27-year-old suspect in the Ohio case, Right to Life Ohio expressed concern for the young girl and her family, but called her abortion a “band-aid solution” that “only exacerbates the pain and violence perpetuated In front of her. The victim deserved more.
Kristan Hawkins, president of Students for Life in America, said, “The violence of rape will not be cured by the violence of abortion. The love and support this child needs will be constant, not momentary.”
Yet abortion providers and doctors who care for the youngest patients say this approach fails to recognize the needs and desires of young victims and their families.
In Colorado, Christina Toche, medical director of Planned Parenthood of the Rocky Mountains, said she performed an abortion on a 13-year-old incest victim and recently treated her youngest patient: an 11-year-old Texan who flew to Denver for an abortion together with a parent. Although this patient was treated before Roe was overturned, the child was forced to leave Texas because the state found a legal solution to ban abortions after six weeks of pregnancy, with no exceptions for rape or incest.
It was the 11-year-old’s first time on an airplane, Dr. Toche said.
In Texas, state records show more than 200 children age 15 and younger had abortions in 2021, before the ban passed. One of these patients was 11 or younger, and 30 were 12 or 13 years old.
Dr. Toche predicts an influx of patients in Colorado, where abortion remains legal with no pregnancy limit. Even in states that allow the procedure in cases of rape or incest, the burden of proving that patients qualify for an exemption can intimidate providers who won’t want to risk prosecution, she noted.
“These exemptions are printed, but they basically mean nothing when everyone who practices there is too scared,” she said.
In Madison, Wis., Jennifer Ginsberg, executive director of the Safe Harbor Children’s Advocacy Center, said she was saddened but not surprised to hear the Ohio victim’s story.
Just a few months earlier, her center, which works with victims of child abuse, sent a 10-year-old girl, impregnated by her stepfather, for an abortion at Planned Parenthood.
Ms. Ginsburg and her team provide counseling and support to young victims of abuse and their family members, while ensuring that any forensic evaluations performed for police investigations do not compound the child’s trauma. If a victim wants an abortion, the center will help connect them with nearby providers.
But shortly after the Supreme Court overturned Roe, doctors in Wisconsin stopped performing abortions. Gov. Tony Evers, a Democrat, is fighting the Republican-led Wisconsin Legislature over the validity of a century-old law that criminalizes nearly all abortions, including those resulting from rape and incest. Mr. Evers and his lead attorney sued in an attempt to block the ban.
Ms. Ginsburg said Safe Harbor is not waiting on the results of the governor’s case. She planned with other local organizations to help young victims travel out of state for abortions, a plan advocates are increasingly turning to as more states ban the procedure.
“How are we going to help the pregnant children?” she asked.
Margot Sanger-Katz contributed reporting.
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