The US Supreme Court’s decision in the Dobbs v Jackson Women’s Health Organization case allows individual states to determine access to abortion. Since the decision, 14 states have prohibited abortion at any gestational age. Restricting abortion access to survivors of rape can have particularly devastating consequences. While some states with very limited access to abortion allow an exception for rape, the very nature of rape may make it difficult for survivors of rape to take advantage of these exceptions. Many of these states require that the rape be reported to law enforcement, which most survivors of rape are reluctant to do, and even when reported, the process often markedly slows the timing of early abortion. In this issue of JAMA Internal Medicine, Dickman et al1 demonstrate the scope of the problem. In the 14 states that have made abortion highly restrictive,2 the estimated number of rapes resulting in pregnancy is exponentially larger than the number of persons having legal abortions, even in those states that have an exception for rape. Whether these survivors of rape had illegal abortions, received medication abortion through the mail, traveled to other states, or carried the child to birth is unknown. One avenue that has been available for terminating pregnancies in states that restrict abortion is medication abortion, such as with mifepristone and misoprostol. Medications can be prescribed in a state with less restrictive policies and mailed to persons needing an abortion. The US Supreme Court is planning to take up a case that could impede access to these medications. If these medications are not available, persons who wish to end their pregnancy, including survivors of rape, would have to travel to another state as their only option for obtaining an abortion, an option that many low-income individuals cannot afford...
Language: en
", language="en", issn="2168-6106", doi="10.1001/jamainternmed.2024.0019", url="http://dx.doi.org/10.1001/jamainternmed.2024.0019" }