New research shows that women who become pregnant from sexual assault are too often blocked from accessing abortion care by state laws that provide no exceptions for rape or by barriers set up in state abortion bans that do include a rape exception.1,2
For example, in one state, the verification of rape is the role of the provider, who is given no guidance on how to make this determination — making the rape exception useless.1
About 5% of rapes result in pregnancy, and one-third of these women are unaware of their pregnancy until the second trimester. This also leads to problems with accessing abortion because some states allow abortion only until six to 12 weeks of pregnancy.2
Another barrier is if alcohol was involved in the rape. These victims have more difficulty accessing abortion through the state’s rape exception, partly because they might not label their experience a rape when alcohol is involved. They might say it was caused by a serious miscommunication. The victim’s credibility also is questioned when alcohol is involved.1
“We know from the literature how alcohol works in sexual assault, both from the victim’s perspective and the perpetrator’s perspective,” says Kelly Cue Davis, PhD, MS, professor at Edson College of Nursing and Health Innovation at Arizona State University. “We know that victims who were drinking at the time of their assault were viewed less credible than those who were not drinking at the time of their assault. They’re also less likely to report their assault to the police or seek medical care.”
Alcohol Involvement Is a Barrier
Factors related to alcohol-involved rape also could be barriers to obtaining an abortion through rape exceptions. “There’s a tendency they will not be believed and what happened to them was not actually an assault,” Davis explains. “There’s a stigma associated with reporting, and there are concerns with trying to access healthcare in general after an assault.”
Unacknowledged rape is a factor as well. “It takes many victims a while to acknowledge that what happened to them is a rape,” Davis says. “If it takes a while to acknowledge the rape, then they could be beyond the [legal] time frame for an abortion.”
Both law enforcement and medical professionals view victims who were intoxicated as less credible than sober victims, Davis says. “If your state requires a police report to prove you were raped in order to get abortion access with a rape exception, to what extent do [victims] have information on how to go about this?” she asks. “Often, the state requires a police report. Sometimes, there’s a report from the healthcare institution.”
Another type of assault that is not covered by most sexual assault statutes is nonconsensual condom removal, where the partner removes the condom without the woman’s knowledge or permission, and this results in a pregnancy.
“It depends on the state whether that’s considered a form of rape, and it often is not by criminal standards,” Davis says. “Oftentimes, people don’t know that the person removed the condom without their permission until they’re pregnant — and how do you prove it was rape?”
Women who become pregnant as a result of sexual assault also face mental health issues, suffer financially, and are more likely to stay with an abusive partner, research shows. Abortion restrictions could lead to women continuing to drink during pregnancy, which could increase cases of fetal alcohol spectrum disorder and neonatal abstinence syndrome.2
“The other piece of this is a lot of states don’t have rape and incest exceptions,” Davis says. “Rape exceptions do not do any good where they exist — and in a lot of states, [abortion is] just banned.”
Reproductive health practitioners should consider the phenomenon of unacknowledged rape when they see patients who seem to have experienced sexual trauma but are not labeling it as rape, Davis says. “It’s a very difficult psychological process to get to that point where you are able to label it as rape,” she notes. “We have this idea of the stereotypical rape as a stranger jumping out of the bushes, but when it’s your friend, husband, boyfriend, or someone at a party where you were drinking, and you blame yourself for it, all those things come into play.”
When victims have been drinking, they may not have the cognitive ability to accurately perceive the risk in these situations, Davis says. “Even if they did, they might be physically impaired and might not resist effectively.”
Perpetrators who have been drinking also may be cognitively impaired and are unable to assess the woman’s sexual interest and consenting or nonconsenting behavior, Davis adds. “It’s a perfect storm. Afterward, there is this double standard where an intoxicated victim is blamed but the perpetrator is exonerated,” she says. “‘She is drinking and should have known better;’ it’s a double standard that we see.”
Reproductive health clinicians can warn teenage patients that the first six to eight weeks of living on a college campus have been called in some studies “the red zone” because of the danger of alcohol-involved sexual assault. “You have young people who are inexperienced drinkers, who suddenly have a lot of access to alcohol, and they’re inexperienced sexually. A lot of things can go wrong easily,” Davis says. “We talk to our young women and tell them all the different ways to reduce the risk of being raped, and we definitely need to do that. But we also need to be talking to the boys and young men and make sure they’re aware of what’s going on and how they can watch their own behavior and their friends’ behavior.”
REFERENCES
- Davis KC, Neilson EC, Stappenbeck CA. Alcohol-involved rape: Limitations of the “rape exception” for abortion access. Psychol Addict Behav 2024;38:167-172.
- Davis KC, Fortino BR, O’Shea NG. Potential consequences of the Dobbs v. Jackson Women’s Health Organization decision. Psychol Addict Behav 2024;38:161-166.
