By Sarah Kolick, Former Amara Legal Intern, George Washington University of Law Graduate, Smith College Graduate

*All views expressed in this blog are my own and do not necessarily represent those of Amara Legal Center.

**Trigger Warning: This blog post contains personal stories that individuals have shared online regarding their experiences of sexual violence, domestic violence, trafficking and forced pregnancy.

With the overturn of Roe v. Wade, states are enacting abortion bans that do not contain exceptions for pregnancy resulting from rape or incest. Ohio House Representative Jean Schmidt justified these bans, saying “Rape is a difficult issue… but there’s an opportunity for that woman.” Similarly, Florida State Senator Ileana Garcia argued that “Human traffickers, as long as their commodities… are not pregnant, they continue to use them…When… they can’t make her get an abortion…. they don’t use her anymore…” Anti-abortion activists’ blatant disregard for the trauma resulting from acts of sexual violence has obvious consequences for survivors of sexual exploitation, human trafficking and domestic violence. Rape is never an “opportunity,” and the denial of abortion rights will not “free” survivors but will subject them to legal dehumanization and infantilization while increasing their risk for criminalization. 

Because there is limited empirical data on the reasons for seeking abortions among trafficking survivors, I frequently reference research studying abortions among domestic violence survivors because the power and control dynamics in domestic violence cases are similar to the techniques traffickers employ against Amara’s clients. Given the gender dynamics involved in trafficking relationships and in the politics of abortion, I typically refer to survivors and patients using she/her pronouns. More research is needed on the impact that abortion bans have on trans men and non-binary survivors with uteruses.

Abortion Bans Are Not the Solution to Traffickers’ Coercive Control
Survivor-to-advocate Taylor Hirth’s attackers “reached inside [her] and pulled out [her] NuvaRing” while raping her. Even though she did not become pregnant, she would have chosen to have an abortion if she became pregnant because she “didn’t deserve to be forced to carry and birth and raise [her] rapists’ babies.” Taylor’s story underscores the key reason why abortion rights are essential to the bodily autonomy rights of survivors: 

this was my body before it was ever home to my child…. I have a right to say that a baby cannot use or access my body the same way I have the right to say that a man cannot use or access my body. 

Among survivors of domestic violence and trafficking, incidents of reproductive coercion like Taylor experienced are not uncommon. Reproductive coercion is defined as “behaviors that a partner uses to maintain power and control in a relationship that are related to reproductive health,” such as attempts to impregnate, interfering with birth control, forcing a partner to carry a pregnancy to term, coercing a partner to end a pregnancy. In one study of 54 domestic violence victims, 74% of participants’ male partners used reproductive coercion as an attempt to or to successfully impregnate their partners through means such as verbal threats about getting her pregnant, refusing to wear a condom and contraception sabotage. Given this higher rate of unintended pregnancy among victims of domestic violence, 15 to 25% of people who have had abortions have experienced or are experiencing domestic violence. Similarly, women and other people with uteruses who are trafficked are at an increased risk of unintended pregnancy with 71.2% of sex trafficking victims reporting at least one pregnancy while being trafficked, and 21.2% reporting five or more pregnancies. Among trafficking survivors, 55.2% reported having at least one abortion and 29.9% reported multiple abortions. Although many of these abortions may be forced or coerced, reproductive justice, including abortion access, is critical for survivors.

Although anti-abortion advocates emphasize that forced and coerced abortions violate a person’s right to reproductive autonomy, they neglect the prevalence of forced pregnancy among victims of gender based violence. Anti-abortion proponents’ claims that abusers frequently coerce their victims into undergoing abortion care are refuted by statistical data, which shows that domestic violence victims are actually less likely to disclose their abortions to their partners. One study conducted at a Texas clinic found that 20.9% of all participants who were seeking abortion care did not disclose their abortions to their partners, 7.9% of non-disclosing participants feared that disclosure would result in acts of physical violence, and 23.7% experienced sexual or physical violence in the year preceding the abortion. Comparatively, 12% of non-disclosing participants reported neither a fear of violence nor a history of physical/sexual violence. Another study revealed that 62% of domestic violence victims had discussed their abortions with their partners whereas 84% of patients who had not experienced abuse discussed their abortions with their partners. If a patient has not discussed her abortion with an abuser, then it is unlikely that he is even aware that she is seeking an abortion.

Although the choice to end a pregnancy should always be made voluntarily and free from fear of future violence, abortion is a critical medical procedure for domestic violence victims. Abortion patients subjected to abuse experience increased levels of violence during their pregnancy. Homicide remains a leading cause of death among pregnant women, an indication that violence does not stop once a person becomes pregnant. As one victim interviewed described, “When I got pregnant, it was as if he took ownership of me. (…) Physical violence started after the end of the term when I could get an abortion.” Domestic violence survivors who had an abortion experienced less physical violence over time whereas “having a baby from an unwanted pregnancy appears to result in sustained physical violence over time.” As is discussed below, children create a continuing link between abusers and victims. 

Although the issue of the use of children as a means of coercion in sex trafficking cases has not been extensively studied, one ICE investigation suggests that traffickers use forced pregnancy and children as a means of coercing victims. In at least one case, federal agents worked to reunite a victim with her child who was fathered by her trafficker and remained in Mexico while the mother was forced to engage in sex work in the United States. This case suggests that traffickers may subject victims to forced pregnancy in order to use children as a means to coerce victims.

Even if states include rape and incest exceptions in their abortion bans, these exceptions will not empower trafficking and domestic violence victims to access abortion. Not only is it unconscionable to force a survivor to prove her trauma, but “our laws… were designed to respond to stranger violence, not intimate abuse.” Because survivors of trafficking frequently do not self-identify as victims and may not perceive non-consensual sex at the hands of an intimate partner as rape, rape exceptions will be of little use to survivors.

In the context of human trafficking, abortion is neither good or bad – it is simply a medical procedure that can be weaponized to strip a victim of her bodily autonomy or become a source of empowerment, providing a victim the ability to gain a sense of control over her own body. As Legal Voice et al. write,

Both types of coercion – to carry an unwanted pregnancy to term or to have an abortion – are violation of the dignity and autonomy of survivors. The solution, however is not to disempower and demean survivors by further depriving them of control over their own bodies… response[s] should target the abusive behavior, not the rights of survivors. 

The fear of future violence should not be a means of coercing a person into having an abortion. To prevent coerced abortions, we must stop gender-based violence, not strip victims of their right to a medical procedure that has the potential to empower them to re-assert control over their lives.

No, Senator Garcia, Forced Pregnancy Does NOT “Free” Trafficking Survivors
Contrary to Senator Garcia’s belief that forced pregnancy “frees” survivors, abortion bans increase a victim’s dependency on a violent male partner due to the nature of child custody proceedings and economic consequences of carrying a pregnancy to term. It is only by addressing the root causes of a masculine “justice” system’s control over the female and non-cisgender male body that will liberate victims from their traffickers and abusers.

Custody: The Continuing Link
When she was 19, Carolle’s 32-year-old boyfriend began throwing her birth control pills away and piercing his condoms. Wanting an abortion, Carolle went to Planned Parenthood, only to be dragged home by her boyfriend who threatened to kill her if she ended her pregnancy since he “likely did not want her to terminate the one permanent tie he could force upon her.” Abusers are aware of the power that the child custody system gives to them: the power to forever remain in their victims’ lives.

Since all parents, even abusive parents, have a constitutional right to child custody and visitation, carrying a pregnancy to term results in an 18 plus year connection to an abuser. Mothers who allege that their male partner is committing acts of domestic violence or child abuse are often accused of parental alienation, a pseudo-scientific term used to (wrongly) accuse mothers of making abuse allegations in order to win custody. This results in abusive fathers being “more likely to seek child custody than non-abusive fathers, and…  succeed[ing] in gaining it more than 70 percent of the time.” Even though false accusations of domestic violence and child abuse are rare, stereotypical notions surrounding women as being “irrational” and mothers as being “overbearing” undoubtedly contribute to the judicial system’s reluctance to acknowledge the prevalence of violence within the home. Although there is an urgent need to reform the child custody system to protect parents and children who experience violence in the home, abortion continues to remain a means by which survivors can sever an otherwise permanent link to an abuser.

As I experienced as an intern at Amara Legal Center, abusers and traffickers know how to manipulate the child custody system. They file frivolous petitions to force their victims back into court in an attempt to exercise control over the survivor and her children’s lives. Because abusers and traffickers too often prevail in custody courts, victims who are denied abortions are less likely to leave an abusive relationship than victims who receive wanted abortions.

Economic Consequences: Deepening The Dependency
Victims of human trafficking and domestic violence are subjected to tight financial controls by their abusers; this financial dependency is only worsened by forced pregnancy. As Brenda, a survivor of domestic violence who was denied a wanted abortion, described:

I had no money, no employment prospects, because you’re not going to hire someone who is fucking four months pregnant, five months pregnant…. So it left me entirely dependent on him for my income… We all know that a major contributing factor in domestic violence is being financially dependent on the person. Where you’re like, oh no,… I can’t be homeless with this kid. I need him for money, and then he can do whatever the fuck he wants because he’s a douchebag… Pregnancy is an incredibly scary thing, especially if you cannot trust the person you’re with.

 Victims are often unable to leave an abusive relationship because they lack financial, career and educational resources. In a country where it costs an average of $233,610 to raise one child and the average middle-income family spends 29% of their income on child-rearing costs, most people seek abortions because they cannot financially support a(nother) child. This is especially true for 49% of abortion patients who live below the federal poverty line, and the six out of ten abortion patients who are already parents. For abuse survivors, having a child increases a survivor’s risk of being trapped in an abusive relationship because she lacks the resources to be economically self-sufficient.

Women who were able to receive an abortion in Diane Foster Greene’s Turnaway Study were more likely to be able to continue working, studying and planning for their dream futures. Broken down further, 56% of women denied an abortion had an aspirational plan for the coming year, compared to 86% of women who received an abortion. 60% of women denied an abortion were unemployed, compared to 45% of women who received an abortion, and “it took four years for women who were turned away and gave birth to catch up to the level of employment experienced by women just under the limit who received their abortion.” 6 months after being denied or receiving an abortion, “61% of those who were turned away were living below the poverty level, compared to 45% [of economically similarly situated participants] who received the abortion.” Patients who were denied an abortion were more likely to remain in poverty for the next four years. Forced pregnancy forces a victim of trafficking to once again surrender her dreams since the patriarchal government, like her trafficker, has decided to infiltrate her uterus and control her life.

The Particular Health Dangers Trafficking Survivors Will Face
In the context of human trafficking, the pro-choice narrative does not capture the complexities a survivor who has an abortion faces. Because a victim of trafficking is subjected to a trafficker’s coercive control, many trafficking survivors report feeling that their abortions were not choices they were able to freely make. Forced and coerced abortions are an egregious denial of survivors’ rights to bodily autonomy. Although abortions among trafficking survivors are not always a free choice, abortion bans further isolate victims and endanger their lives. Banning abortion does not stop it from happening; it only endangers the lives of women and other people with uteruses. For trafficking survivors in particular, abortion bans pose serious health risks to victims who, of their own free volition or at their traffickers’ demands, will undergo unsafe abortions. 

Even when abortion is legal and a patient is not in an abusive relationship, the high cost of abortion has deadly consequences that disproportionately impact low-income and BIPOC women and uterus holders. Currently, the average cost of an abortion in the first trimester is $500, $750 in the second and $1875 at 20 weeks or later. These costs are further compounded by state abortion restrictions such as travel expenses, waiting periods and telemedicine bans. As one survivor of sex trafficking recounted: 

I got pregnant six times and had six abortions during this time.… At least one of my abortions was from Planned Parenthood because they didn’t ask any questions. But they were expensive and on the street you didn’t want to pay $200, $300 or more. So you went ‘back door’ where the charge was more like $150. I had so much scar tissue from these abortions because there was no follow-up and in a couple of cases, I had bad infections, so bad that I eventually lost my fallopian tubes…

The restrictive cost of abortion care has devastating consequences even when abortion is legal.

In the developed nation with the highest maternal mortality rate, being forced to carry a pregnancy to term jeopardizes women and other people with uteruses’ health. With the risk of high blood pressure, gestational diabetes, preeclampsia, depression, anxiety, severe morning sickness, anemia, placenta accrete spectrum, cervical lacerations, debilitating postpartum pain and the many other changes the body goes through to accommodate a pregnancy, a person is 14 times more likely to die from complications related to pregnancy than from those related to safe abortions. As several prominent Reproductive Scholars note, “while forcing gestation is always cruel… there is an additional cruelty involved in forcing black women to gestate a fetus…: black women… are almost three times more likely to die than their white counterparts due to causes related to or aggravated by pregnancy or its management.” Although access to free and universal healthcare is necessary to ensure the safety of pregnant people in the United States, abortion remains lifesaving treatment even in countries where healthcare is accessible.

Even if abortion bans have medical exceptions, these bans still endanger pregnant people’s lives because “life endangerment is not a black and white thing.” Women and pregnant people die when their doctors refuse to provide life-saving abortions because healthcare professionals now face civil suits and possible criminal sanctions if, after the abortion, the patient survives (since anti-choicers believe that true life-endangerment requires maternal death). In Ireland, Savita Halappanavar was 31 years old when she died because doctors refused to perform an abortion despite her request and the fact that her “cervix was fully dilated, amniotic fluid was leaking out,” and the pregnancy was no longer viable. Savita “developed shakes and [was] shivering and she was vomiting…” Because of Ireland’s abortion ban, Savita died a preventable death. Similarly, in Poland, Agnieszka T. was 37 years old when doctors refused to remove a fetus that was no longer viable because a twin’s heartbeat was still present. Although the second twin’s heart stopped a week later, she was unable to get an abortion until two days later in spite of Poland’s law allowing for abortion in cases of life endangerment. As a result of the delay in receiving abortion care, Agnieszka T. died of septic shock. For trafficking victims under the control of traffickers who delay or prevent medical care, abortion bans are deadly for survivors.

Contrary to anti-choice politicians’ lies, abortion is not linked to any adverse mental health consequences, with patients experiencing similar mental health outcomes before and after the procedure as well as 95% of patients reporting that they do not regret their abortions. Many studies report that “women denied abortions because of gestational age limits are more likely to experience negative psychological health outcomes – such as anxiety, lower self-esteem, and lower life satisfaction – than those women who obtained a needed abortion.” For trafficking victims who are already suffering severe physical and mental health consequences from the trauma they experienced while being trafficked, forced pregnancy will only serve to compound their psychological and physical trauma.

Abortion access provides a person being trafficked access to resources that can empower her to leave her trafficker. Approximately 87.8% of sex trafficking survivors will come into contact with a healthcare provider, with 29.6% of those encounters occurring at a Planned Parenthood. Medical professionals who are trained to recognize the signs of sexual exploitation and trafficking have the ability to intervene by providing the victim with resources in a way that centers patient autonomy. 

Banning abortion will not help trafficking survivors who are subject to forced abortions, but will only increase their traffickers’ power by cutting off resources that offer safe abortion care and an opportunity for healthcare providers to intervene. To end forced abortions among trafficking survivors, we as a society must eradicate the root causes of trafficking, namely, the patriarchal control that cisgender men continue to exercise over women and people of other marginalized genders in the form of sexual exploitation, domestic violence and abortion bans.

No, Live Action, Planned Parenthood Does NOT Aid and Abet Traffickers
In recent years, anti-abortion advocates have accused what they label the “abortion industry” as fueling forced abortions among victims of sex trafficking and child sexual exploitation. It is hard to discern in an academic fashion the prevalence of forced abortion among trafficking survivors given the lack of empirical data. Nevertheless, in an amicus brief submitted by American Center for Law and Justice and Bioethics Defense Fund, the parties argue that abortion access fuels sex trafficking. These claims should be read with a grain of salt given that their amicus brief is riddled with misinformation such as defining abortion as the “intentional killing of a human being before birth” (even though medicine does not define the beginnings of life), claims that fetuses can feel pain at 15 weeks (contrary to medical evidence) and citing to (debunked) studies regarding (the fictitious) post-abortion psychosis.

Such tokenization of trafficking victims to attack abortion providers escalated after the anti-abortion group Live Action published a heavily edited video of its members posing as sex workers and speaking with a clinic manager at a Planned Parenthood. In the video, clinic manager Amy Woodruff is told by Live Action members that they have girls who are 14 or 15 year olds engaging in sex work and are in need of abortion care. Woodruff explains that minors can come to Planned Parenthood without parental consent, the mandatory reporting laws and how to bypass reporting laws. Woodruff also makes a referral to an abortion clinic that asks less questions of patients who are 14 years old or younger. After Live Action’s actors left with their secret recording, Woodruff reported the incident to her supervisor who subsequently reported it to the FBI.

Even though Planned Parenthood was likely aware of Live Action’s trafficking hoax, Live Action’s condemnation of Planned Parenthood’s provision of care to minors demonstrates that anti-abortion activists lack an understanding of the nuances healthcare professionals face when providing comprehensive patient centered care. First, anti-abortion advocates do not understand that not every young person comes from a loving home. This belief in the sanctity of the (heterosexual) family is not a reality for many child victims of sexual exploitation who are victimized by their families, who are in the foster care system or who run away from their homes. Even for young people who are born into loving households, privacy between doctors and teenage patients is an essential aspect of providing comprehensive healthcare since teenage patients “place a premium on confidentiality when seeking sexual and reproductive healthcare service; it significantly increases their willingness to engage with providers.” Planned Parenthood providers who explain to their minor patients that they will not tell their parents of their visit and instruct them on how to obtain judicial permission for abortion care are acting in a manner consistent with medical ethics by placing their patients’ needs and healthcare goals first.

Second, anti-abortion activists’ assertion that Planned Parenthood’s failure to report young patients who seek abortion or contraceptive care aids traffickers is premised on the notion that mandatory reporting laws are an effective means of intervention. However, there is mixed evidence supporting the assertion that mandatory reporting laws are successful at stopping child sexual exploitation, domestic violence, sex trafficking and child abuse. In one survey conducted, 62% of emergency room patients reported that mandatory reporting laws did not make a difference in their decision to seek care. In another survey, 2 out of 3 women believed that mandatory reporting laws would decrease the likelihood of facing abuse. As those of us working in the domestic violence/human trafficking field know, leaving an abuser is the most dangerous time for many victims. A healthcare professional who only had a brief encounter with a victim is not in a position to assess whether the victim is safe to leave her abuser, if she has the financial resources needed to live independently, if she will face a contentious custody battle, if she will lose her children to child protective services (CPS) for failing to previously report the abuse, or if she will be placed in deportation proceedings. For child victims of trafficking, many healthcare providers are hesitant to report cases because of “previous negative experiences with CPS.” Because CPS and the foster care system lack adequate resources, victims of child abuse are at an increased risk of child sexual exploitation and human trafficking when removed from their homes.

Many doctors fear that mandatory reporting laws infringe on doctor-patient confidentiality which empowers the patient herself to make informed decisions. In one study, women experiencing domestic violence “felt that their autonomy was lost and they ‘resented’ the physician” who reported the violence to the police. In a “justice” system that is slow to believe victims, reporting trafficking against the will of the victim herself is not likely to result in arrests and convictions, but is likely to discourage victims from seeking medical care. 

When one in five women will visit a Planned Parenthood in her lifetime, Live Action fails to realize that Planned Parenthood is in a position to provide services and intervene in a patient centered manner when interacting with clients who are victims of domestic violence, sex trafficking or child sexual exploitation. Because traffickers are not likely to pay for reproductive healthcare services, “Planned Parenthood’s sliding scale payment system… allows the organization to be in the best position to serve the health needs of trafficking victims.” Although there is always room to improve survivor-centered trauma informed healthcare intervention, defunding Planned Parenthood and banning abortions will not stop sex trafficking, but will only harm the healthcare interests of survivors.

Funding Wars, Abortion and the TVPA
Even before the Supreme Court heard oral arguments in Dobbs, anti-abortion extremists tokenized survivors of sex trafficking to justify their abortion bans while using abortion as a justification to deny those same victims access to essential services. Even though the need for reproductive healthcare services among trafficking victims is crucial, the Department of Health and Human Services (HHS) awarded the United States Catholic Counsel of Bishops (USCCB) a $16 million grant in 2006, despite USCCB’s refusal to reimburse the survivor service organizations for abortion and contraceptive services. In an attempt to stop USCCB from using federal grant funding to impose its religious ideology on survivors, HHS announced in 2011 that it would not provide grant funding to USCCB. Anti-abortion lawmakers allowed the Trafficking Victims Protection Act (TVPA) to expire in 2011, claiming that their rights as Christians were violated by the government providing federal funds to victim service providers who offered comprehensive reproductive healthcare and mandating that organizations that did not offer comprehensive reproductive healthcare must provide referrals to organizations that did. It was not until 2012 that the TVPA was reauthorized. 

Anti-choice Republican lawmakers have shown a callous disregard for the needs of trafficking survivors through their opposition to the reauthorization of the TVPA, refusal to expand the social safety net, and raids of undocumented communities. In short, “Pro-life is a lie, [they] don’t care if women die!”

Criminalizing Survivors to “Protect” Fetal “Life”
The attack on trafficking victims who miscarry will escalate in post-Roe America. While living in solitary confinement after screaming that she was pregnant at a guard about to tase her, Tammy Loertscher asked herself, “am I really in hell?” After she found out she was pregnant, Tammy sought medical help for a thyroid condition which caused her to experience severe depression. Believing that what she told her doctor would be kept in confidence and wanting to ensure a healthy pregnancy, Tammy confided in her doctor that she self-medicated with methamphetamines. Although she immediately stopped self-medicating after finding out she was pregnant, the hospital reported Tammy to CPS who initiated an ex parte petition to take the 14-week-old fetus into protective custody. By reaching into Tammy’s body to protect the fetus, Tammy was treated like a criminal. 

Such attacks on pregnant people will worsen with Roe being overturned, as the recent arrest of Lizelle Herrera foreshadows. But attacks on pregnant people are already occurring across the United States, with an estimated 1,600 cases like Tammy’s occurring between 1973 and 2020. These attacks disproportionately impact BIPOC and low-income communities. Recently, Brittany Polaw, a 21-year-old Native American woman from Oklahoma, was arrested, tried and convicted for a miscarriage at 4 months even though the fetus was not viable and the medical examiners did not determine that Brittany’s substance use caused the miscarriage. Similarly, Adora Perez, who was molested as a child and abused as a teen/young adult, was convicted of voluntary manslaughter after having a miscarriage because she used methamphetamines while pregnant. Although the judge overturned her 11-year prison sentence, prosecutors have reinstated murder charges, and Adora is once again jailed for suffering a miscarriage.

Low income and BIPOC uterus holders in the United States are already living in Margaret Atwood’s dystopia Gilead as their pregnancies are policed by a state who incarcerates them in the name of fetal rights. Although fetal “homicide” laws were initially passed by several states in response to the murder of pregnant women by male abusers, these laws are weaponized against uterus holders who are Black, Brown, Indigenous and poor as “prosecutors… charge women whose behavior may have contributed to a miscarriage or stillbirth.” Even though the United States Medical Association opposes categorizing drug use during pregnancy as a form of child abuse, and even after many of the 1980s studies on children whose parents used illicit substances while pregnant have been debunked, pregnant women and people are denied the right to bodily autonomy by 23 states whose child welfare statutes equate substance use during pregnancy as a form of child abuse. As Reproductive Justice activist Cherisse Scott said, “We are separating women from the pregnancy they have as if we are just the shell that holds the baby.”  

For trafficking victims, the risk of criminalization for miscarrying is especially likely given the harrowing reality that the majority of sex trafficking victims experience some form of substance use. In one published study, 84.3% of survivors of sex trafficking used alcohol, drugs or both. With the rise of the fetal personhood movement, trafficking survivors are at an even greater risk of being arrested and imprisoned for having miscarriages since our punitive patriarchal “justice” system will inevitably prioritize the developing cells within a victim’s uterus over a survivor’s right to life.

All Abortion Stories are Valid
Although the focus of this post has been on the impact that abortion bans will have on Amara Legal Center’s client population, the vast majority of abortions do not involve patients who experience such trauma. Women and other people with uteruses seek abortion care because they are not in a financial position to support a child, they wish to pursue their hopes and dreams, and/or they wish to care for the children they already have. And that is OK. As Abortion Diva Kenya Martin said, “…whatever your reason for having an abortion is the right reason. Whether you had abortion to save your life or because you didn’t want to be pregnant after you conceived from having some hot good sex or not so good sex, your story is valid….We did what’s best for us and that’s all that matters.”

Anti-Trafficking Efforts Must Incorporate a Reproductive Justice Lens
As board certified OBGYN and social media personality Mama Doctor Jones said, “Abortion is not good or bad. It just is.” For a trafficking victim who wants an abortion, the end of Roe’s protections against states’ intrusions into her uterus will deny her a way of reclaiming power over her body. For a trafficking victim who is coerced or forced to have an abortion, the repeal of abortion laws will not “free” her, but will only heighten her risk for unsafe abortions and criminalization.

When advocating for the rights of survivors of sex trafficking, the Reproductive Justice framework created by Black Feminists is best suited to address the reality of both forced pregnancy and forced abortions. The three prongs of the reproductive justice framework are (1) the right not to have children, (2) the right to have children and (3) the right to parent with dignity. For trafficking survivors who are at higher risks of unintended pregnancy as well as whose trauma, skin colors and income levels render them increasingly susceptible to unjustified CPS intervention, Reproductive Justice must be incorporated into the work of anti-trafficking organizations to ensure victims are able to regain control over their bodies and lives.

[1] Arwa Mahdawi, According to one Republican, Pregnancy from rape is “an opportunity,” The Guardian (Apr. 30, 2022),

[2] Garcia Comments on Human Trafficking, (May 1, 2022),

[3] See also Dominique E. Roe-Sepowitz et al., Victim or Whore: The Similarities and Differences between Victim’s Experiences of Domestic Violence and Sex Trafficking, 24 J. Human Behavior in the Social Environment 883, 884 (noting that “victims of sex trafficking frequently report being a victim of domestic violence”); T.W. Leung et al., A Comparison of the Prevalence of Domestic Violence Between Patients Seeking Termination of Pregnancy and other General Gynecology Patients, 77 International J. Gynecology & Obstetrics 47, 48 (“Domestic Violence is defined as ‘a pattern of intentionally coercive and violent behavior toward an individual with whom there is or has been an intimate relationship…”); Freedom Network USA, Human Trafficking and Reproductive Rights, (updated Apr. 2015),, (“women who had been trafficked into commercial sex had a high incidence of subsequent abusive relationships after leaving trafficking situations”).

[4] Diana Greene Foster, The Turnaway Study: Ten Years, a Thousand Women, and the Consequnces of Having – or Being Denied – an Abortion, 9 (2020) (noting similar concerns regarding the lack of research on trans men and non-binary abortion patients’ experiences).

[5] Taylor Hirth, Pandora’s Box: Overturning Roe is Only the Beginning of the Threats to Women, Missouri Independent (May 9, 2022),

[6] Planned Parenthood Federation of America, Inc., Intimate Partner Violence and Reproductive Coercion, (Updated August 2012),  See also Shane M. Trawick, Birth Control Sabotage as Domestic Violence: A Legal Response, 100Cal. L. Review 721, 722 (2012) (“Birth control sabotage is a tactic of domestic violence when an intimate partner ignores the reproductive preferences of his or her partner by tampering with contraception or refusing to use condoms to induce pregnancy”).

[7] Ann M Moore et al., Male Reproductive Control of Women who have experienced IPV in the United States, 1 (Unpublished Manuscript) (

[8] Cote and Lapierre, Abortion and Domestic Violence: Women’s Decision-Making Process, 29 J. Women and Social Work 285, 285 (2014); TW Leung et al., supra, note 3, at 48 (estimating that 11-41% of abortion patients have experienced DV in their lifetime and 4-24% of patients are current victims); Sofia Kazi et al., The Prevalence of Domestic Violence in Volunteers for Abortion and Contraceptive Research Studies, 78 Contraception 79, 82 (2008) (17% of abortion seekers, 15% of contraception seekers and 30% of other OBGYN patients reporting domestic violence).

[9] Laura J. Lederer and Christopher A. Wetzel, The Health Consequences of Sex Trafficking and Their Implications for Identifying Victims in Healthcare Facilities, 23 Annals of Health Law 61, 71 (2014).

[10] See, e.g., Amicus Brief for the American Center for Law and Justice and Bioethics Defense at 24-29, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021) (claiming that women who choose abortions are coerced or pressured by partners or other people in their lives, expressing its concern that abortion allows human traffickers and sexual predators to continue to exploit their victims and arguing that abusive partners force their victims to have abortions).

[11] Becca Most, Roe v. Wade Reversal Could Harm Victims of Sexual Assault, Trafficking in Central Minnesota, St. Cloud Times (May 16, 2022),  (“Abusive partners also can weaponize pregnancy to force dependency”),

[12] Cote and Lapierre, supra note 8, at 287 (“Since violence tends to escalate during pregnancy, some women can make the decision to abort in order to prevent further violence, or they may realize they do not want to raise a child in a violent home”). See also Susan Bewley, Abortion and Domestic Violence, The Obstetrician & Gynecologist (2009).

[13] Cote and Lapierre, supra note 8, at 287.

[14] Cote and Lapierre, supra note 8; LySaundra Campbell, The Hidden Link Between Domestic Violence and Abortion, Rewire News Group (Oct. 24, 2019),

[15] LySaundra Campbell, supra note 14.

[16] Cote and Lapierre, supra note 8, at 290.

[17] Sarah CM Roberts et al., The Risk of Violence from the Man Involved in the Pregnancy After Receiving or Being Denied an Abortion, 12 BMC Medicine 5 (2014). See also Diana Greene Foster, The Turnaway Study, supra note 4, at 232 (“At the time of abortion-seeking, there was no difference in experiences with abuse between women who received versus those who were denied an abortion. But for women who received the abortion, there was a dramatic reduction in the incidence of violence that was not experienced by women who were turned away”).

[18] United States Immigration and Customs Enforcement, HIS Investigation Leads to the Extradition of Mexican Sex Traffickers (Dec. 10, 2012),

[19] Jane K. Stoever, Abusive Partners – Like Abortion Bans—Limit the Reproductive Rights of their Victims.

[20] Id.

[21] Amici Curiae for Legal Voice at 27-28, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021).

[22] Shane M. Trawick, supra note 6, at 723.

[23] Id.

[24] Ann Moore et al., supra note 7.

[25] See, e.g., Joan S. Meier, U.S. Child Custody Outcomes in Cases Involving Parental Alienation and Abuse Allegations: What do the Data Show?, 42 J. of Social Welfare & Family L. 92 (2020) (finding that “mothers’ claims of abuse, especially child physical or sexual abuse, increase their risk of losing custody, and that fathers’ cross-claims of alienation virtually double that risk”); CSW 66 Side Event: Towards Gender-Sensitive and Child-Centered Justice Proceedings in Custody Cases: The Use of the Pseudo and Regressive Theory of ‘Parental Alienation’ (Mar. 17, 2022).

[26] Amici Curiae for Legal Voice at 25, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021).

[27] See, e.g., Joan S. Meier, supra note 25, at 93.

[28] Amici Curiae for Legal Voice at 25, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021).

[29] Diana Greene Foster, The Turnaway Study, supra note 4, at 269 & 276.

[30] Dominique E. Roe-Sepowitz et al, supra note 3, at 890 (“The lack of economic control is key to preventing domestic violence and sex trafficking victims from escaping”).

[31] Mark Lino, The Cost of Raising a Child, U.S. Department of Agriculture (Feb. 18, 2020)

[32] Diana Greene Foster, The Turnaway Study, supra note 4, at 35.

[33] Guttmacher Institute, US Abortion Demographics (Updated 2022)

[34] Id.

[35] Diana Greene Foster, The Turnaway Study, supra note 4, at 165.

[36] Id. at 168.

[37] Id. at 174.

[38] Id. at 176-77.

[39] Id.

[40] See, e.g., Cote and Lapierre, supra note 8, at 289 (describing how several domestic violence survivors felt that their abusers pressured them into having abortions); Freedom Network USA, Human Trafficking and Reproductive Rights, supra note 3.

[41] See, e.g., Anusha Ravi, Limiting Abortion Access Contributes to Poor Maternal Health Outcomes, Center for American Profess (June 13, 2018); Amanda Jean Stevenson, The Pregnancy-Related Mortality Impact of a Total Abortion Ban in the United States: A Research Note on Increased Deaths Due to Remaining Pregnant, 58 Demography 6 (2021) (finding that estimated pregnancy related deaths will increase by 21% in a post-Roe United States).

[42] Amanda Jean Stevenson, supra note 41 (estimating that Black people will experience a 33% increase in pregnancy-related deaths compared to 21%).

[43] Amici Curiae for Abortion Funds & Practical Support Organizations at 18, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021).

[44] Id. at 10.

[45] Laura J. Lederer and Christopher A. Wetzel, supra note 9, at 79.

[46]  Lisa Marshall, Study: Banning Abortion Would Boost Maternal Morality by Double-Digits (Sept. 8, 2021),’s%20health,the%20Centers%20for%20Disease%20Control (“Carrying a pregnancy to term is 33 times riskier than having an abortion”); Kimberly Hernandez et al, supra note 57; Carrie N. Baker, Pregnancy and Childbirth Endanger Women’s Lives and Health: ‘Pregnancy is Not a Benign Condition’, Ms. Magazine (February 13, 2022) (“putting aside the surprisingly callous assumption that giving up a baby is not burdensome, Barrett’s argument ignores the physical and psychological effects of pregnancy, labor and childbirth”).

[47] Amici Curiae for American College of Obstetricians and Gynecologists et al. at 19, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021).

[48] Id. at 10 (abortion is safe as only 2% of abortion cases will result in complications, with major complications comprising only 0.23 to 0.50% of all cases).

[49] Id. at 33.

[50] Mama Doctor Jones, ObGyn Explains Abortion Ban in Texas, (Sept. 13, 2021),

[51] Id.

[52] Irish Central Staff, On This Day: Savita Halappanavar Dies After Being Denied An Abortion in Galway, Irish Central (Oct. 28, 2021),

[53] Weronika Strzyznska, Polish State has ‘Blood on Its Hands’ After Death of Woman Refused an Abortion, The Guardian, (Jan. 26, 2022),

[54] Id.

[55] Id.

[56] Diana Greene Foster, The Turnaway Study, supra note 4, at 99-129; Amici Curiae for American College of Obstetricians and Gynecologists et al. at 11, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021); Corinne H. Rocca et al., Decision Rightness and Emotional Reponses to Abortion in the United States: A Longitudinal Study, 10PLOS One (2015) (finding that 99% of women reported that abortion was the right decision for them and that both negative and positive emotions regarding the abortion declined over time); M. Antonia Biggs, Perceived Abortion Stigma and Psychological Well-Being Over Five Years After Receiving or Being Denied An Abortion, 15 PLoS ONE (2020) (97.9% of women who reported that abortion was a hard decision reported that it was the right decision 5 years later, 99.6% of women who said it was somewhat difficult reported that abortion was the right decision 5 years later and 99.8% of women who said that the decision was not difficult reported that abortion was the right decision 5 years later).

[57] Amici Curiae for American College of Obstetricians and Gynecologists et al. at 20, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021).

[58] Dominique E. Roe-Sepowitz et al.,supra note 3; Laura J. Lederer and Christopher A. Wetzel, supra note 9.

[59] Laura J. Lederer and Christopher A. Wetzel, supra note 9, at 74.

[60] Amicus Brief for the American Center for Law and Justice and Bioethics Defense at 24-29, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021).

[61] See, e.g., Amici Curiae for American College of Obstetricians and Gynecologists et al. at 20, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021); Howard A. Schniederman Interview of Professor of Biology Scott Gilbert, Lecture at Swarthmore: When does Personhood Begin, [hereinafter Gilbert Interview] (“I hope public education on the scientific notions of personhood may finally quash the idea that a zygote is a person”); Hugo Lagercrantz & Jean-Pierre Changeux, The Emergence of Human Consciousness: From Fetal to Neonatal Life, 65 Pediatric Research 255 (2009); Sally Faith Dorfman et al., The Facts Speak Louder than “The Silent Scream,” Planned Parenthood Federation of America (March 2002).

[62] Live Action, Planned Parenthood Manager Offers Help to Sex Ring Gets Fired, (In addition to this video, Live Action’s site is riddled with misinformation regarding abortion information, abortion access and abortion providers). See also, Sarah Primrose, Killing the Messenger: The Intersection Between Sex Trafficking, Planned Parenthood and the Marginalization of Young Victims, 22 U. Fla. J.L. & Pub. Pol’y 299 (2011).

[63] Live Action, supra note 62.

[64] Id.

[65] Brian Montopoli, Planned Parenthood Under Fire Over New Video, (Feb. 2, 2011),; Planned Parenthood, Planned Parenthood Informs Federal Authorities of Potential Sex Trafficking (Jan. 24, 2011); Sarah Primrose, supra note 62, at 319.

[66] Planned Parenthood, Planned Parenthood Informs Federal Authorities of Potential Sex Trafficking, Supra note 65.

[67] Sarah Primrose, supra note 62, at 313 (noting that pimps target children from poor and broken households and form emotional bonds with their victims).

[68] Holly G. Atkinson et al., U.S. State Law Addressing Human Trafficking: Education of and Mandatory Reporting by Health Care Providers and Other Professionals, 2 J. Human Trafficking 111, 132 (2016).

[69] Devin Dwyer, Abortion Activists Attempt to Discredit Planned Parenthood with Second Video, ABC News, (Feb. 3, 2011),

[70] Laura G. Iavicoli, Mandatory Reporting of Domestic Violence: The Law, Friend or Foe (Manuscript), (

[71] Id. at 8.

[72] Abigail English, Mandatory Reporting of Human Trafficking: Potential Benefits and Risks of Harm, 19 AMA J. Ethics 52, 58 (2017).

[73] Holly G. Atkinson et al., supra note 68. (stating that healthcare providers will find an alternative way of intervention if they believe CPS intervention would be more harmful than beneficial).

[74] Abigail English, supra note 72, at 59.

[75] Laura G. Iavicoli, supra note 70.

[76] See, e.g., Ariella Hyman et al., Laws Mandating Reporting of Domestic Violence: Do They Promote Patient Well-Being, 273 Health L & Ethics 1781.

[77] Sarah Primrose, supra note  322.

[78] Sarah Primrose, supra note 62, at 330.

[79] Elizabeth Bewley, A New Form of Ideological Capture: Abortion Politics and the Trafficking Victims Protection Act, 8 Harv. L. & Pol’y Rev. 229, 241 (2014).

[80] Id. at 248.

[81] Id. at 250.

[82] Rise Up for Abortion Rights,

[83] Personhood: Policing Pregnant Women in America (Prime Video 2019).

[84] Id.

[85] Id.

[86] Id.

[87] Id.

[88] Carrie N. Baker, Texas Woman Lizelle Herrera’s Arrest Foreshadows Post-Roe Future, Ms. Magazine (Apr. 16, 2022),

[89] Robin Levinson-King, US women are being jailed for having miscarriages; Gilbert, After Miscarriage, woman is convicted of Manslaughter, BBC News (Nov. 12, 2021),

[90] Id.

[91] Gregory Yee, California Judge Overturns 11-year Prison Term for Woman Whose Baby was Stillborn, Los Angeles Times, (Mar. 18, 2022),

[92] Margaret Atwood, The Handmaid’s Tale (1986).

[93] Alison Tsao, Fetal Homicide Laws: Shield Against Domestic Violence or Sword to Pierce Abortion Rights, 25 Hastings Const. L.Q. (1998); Robin Levinson-King, supra note 89.

[94] Robin Levinson-King, supra note 89.

[95] Robin Levinson-King, supra note 89.

[96] Personhood: Policing Pregnant Women in America (Prime Video 2019).

[97] Id.

[98] Diana Greene Foster, The Turnaway Study, supra note 4, at 204; Jeannie Ludlow, The Things We Cannot Say: Witnessing the Trauma-tization of Abortion in the United States, 36 Women’s Studies Quarterly 28 (2008).

[99] Speech of Kenya Martin, Center for Reproductive Rights in Partnership with Liberate Abortion, Abortion is Essential: Rally for Our Rights, Facebook (December 1, 2021).

[100] Amicus Brief for Reproductive Justice Scholars at 26, Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (2021).