The former Jackson Women's Health Organization building in Jackson, Miss., Friday, September 9, 2022. Credit: Eric Shelton/Mississippi Today

Mississippi law theoretically allows rape victims access to abortion, an exemption state leaders tout. But the doctors and advocates who work with victims say in reality, that access is almost nonexistent.

Since the U.S. Supreme Court overruled Roe v. Wade, allowing Mississippi’s 2007 trigger ban to take effect in July, abortion has been legal in the state in only two cases: when necessary to save the life of the mother and when a pregnancy resulted from a rape that has been reported to law enforcement. 

“It does in fact have an exception for rape and it has an exception for life of the mother,” Gov. Tate Reeves said in a television appearance earlier this year. “I think that there’s no doubt that there are instances, there are individuals that certainly push for exceptions, and that’s okay.”

But doctors told Mississippi Today that they’re not aware of anyone in the state who will provide the procedure for rape victims because of concerns about potential legal consequences and logistical hurdles. 

Mississippi Today surveyed more than 20 hospitals and hospital chains in the state about whether they would provide legal abortions to people who have reported a rape to law enforcement. Some of the state’s biggest hospitals – including the University of Mississippi Medical Center and North Mississippi Health Services – refused to comment at all. 

Of those that responded, none said that its doctors would provide abortions for people who had reported a rape to law enforcement.

“I don’t think people in Mississippi can have comfort around, ‘Oh, if I’m raped, I will have access,’” one Jackson-area OB/GYN told Mississippi Today, speaking on the condition of anonymity because the physician did not have permission from their employer to talk to the media. “You probably won’t. You’ll have to find someone to do it that includes a hospital with the whole team there supporting that, and that’s much more difficult.”

A medical professional could face up to 10 years in prison if convicted of providing an illegal abortion. Because for years all of the state’s elective abortions – which includes all procedures that are not medically necessary – took place at Mississippi’s sole abortion clinic, many OB/GYNs around the state lack the training to perform the procedure. 

That means victims of sexual violence will likely be forced to travel hours away from home to end a pregnancy that resulted from rape. 

Reeves’ office did not respond to a request for comment for the story. 

Before Mississippi’s trigger ban took effect, the state’s sole abortion clinic, the Jackson Women’s Health Organization, provided abortions for rape victims. The clinic is now closed.

Diane Derzis, the clinic’s owner, said most of the time clinic staff did not know when they were serving a patient who had been raped. But a few times a year, law enforcement came to the clinic to pick up fetal remains, which could be used to gather DNA evidence to identify an assailant.

Derzis said she doesn’t believe anyone in Mississippi will provide abortions for people who have reported a rape.

“They’re screwed,” she said of rape victims. “Plain and simple. No one is going to take the responsibility or the liability … People are scared to death, not just there but all over the country about what they can and can’t do. And they’re just not going to be willing to put themselves or their licenses on the line.”

Even before Dobbs, Mississippi doctors were wary of providing abortions. The Pink House exclusively employed out-of-state OB/GYNs who flew in monthly for a few days at a time. 

Anti-abortion activists protested at the homes of Mississippi-based abortion providers. 

“We go to the neighborhoods and tell everybody in the neighborhood what they do,” long-time anti-abortion activist David Lane told Mississippi Today in June. “They don’t like that. But if it’ll get rid of them, and it’s legal, we’ll do it.”

It’s unlikely that any Mississippi doctors who do provide legal abortions will talk publicly about it – both for fear of legal action and to avoid attracting anti-abortion activists. 

Rob McDuff, an attorney at the Mississippi Center for Justice, which represented the clinic before it closed this summer, said he does not expect to see prosecutions of medical providers for performing abortions under the law’s exceptions. 

“I fully expect that state officials will allow health care professionals to use their best judgment in the difficult situations they will encounter, and I don’t think those doctors and nurses will be prosecuted,” he said. “If any are, we stand ready to defend them without charge, just as we will defend any others who are arrested for abortion-related crimes.”

Mississippi is one of a handful of states that bans abortion but has an exception for rape. There is no exception for incest. 

Michele Goodwin, a law professor at the University of California, Irvine and an expert in reproductive rights, said that exceptions for rape and incest can serve a political purpose without actually ensuring victims have access to abortion.

“Lawmakers get to satisfy part of their base that is skeptical about their anti-abortion lawmaking, or they get to say, ‘We put into the law these exceptions,’ hoping that people won’t pay close attention,” Goodwin said. “But if you unpack what that looks like, those burdens are inordinate.”

Now that the Pink House is closed, Mississippians’ nearest options for a legal abortion are in Florida, where it is permitted up to 15 weeks of pregnancy, or southern Illinois, where the town of Carbondale has become an access point for people living in ban states across the South and Midwest. 

When lawmakers added an exception for rape to Mississippi’s pre-Roe abortion ban in 1966, they considered requiring a local judge to first certify that a rape had taken place. But they rejected that idea on the grounds that it embarrasses victims.

The exception now requires victims to file “a formal charge of rape … with an appropriate law enforcement official.”

Forensic nurses told Mississippi Today that they’re also concerned about leaving their patients’ ability to access a medical procedure in the hands of law enforcement.

Nationally, only about a third of sexual assaults are reported to police. And only about a sixth of those reports result in arrests. 

In the vast majority of rape cases, the victim knew the assailant, so filing a police report could have life-altering consequences. 

Fear of retaliation, the belief that police won’t help them, and considering the assault a personal matter are among the reasons people choose not to report, according to Department of Justice statistics.

Chance Lovern, a nurse at the Ochsner Rush emergency room in Meridian, said his experience aligns with the national data: Most of the patients he has worked with knew their attacker. 

The sexual assault exams he performs are careful and detail oriented. Patients stand on a sheet to change so any physical evidence can be collected. Nurses document physical injuries like bruises and fractures, and perform vaginal and anal swabs for DNA. At every stage, a patient can ask to stop or skip part of the exam. 

He asks victims if they have contacted the police, but he never urges them to do so.  

“It’s a traumatizing event already,” he said. “It’s going to be their decision in the long run if they want to.”

Alizbeth Eaves, one of the state’s few certified sexual assault nurse examiners (SANE) and the trauma and SANE program manager at Ochsner Rush in Meridian, said the language of the rape exception is also unclear. What constitutes “a formal charge?” Is it simply filing a police report, or does someone have to be charged with the crime? 

A Mississippi forensic nurse who spoke on the condition of anonymity said she routinely sees police demonstrate skepticism and even hostility toward victims. She has heard officers ask victims whether they actually wanted to have sex with their assailants and suggest that they should not have been alone with them. 

After the Supreme Court overturned Roe v. Wade and Mississippi’s trigger ban took effect, Stephanie Piper, sexual assault program manager at the nonprofit Gulf Coast Center for Nonviolence, helped a woman who had become pregnant after unwanted sex get an appointment for an abortion in Florida. Instead of a six-hour round trip drive to Jackson, she had a 10-hour round trip to Tallahassee. 

Stephanie Piper is the sexual assault program manager at the nonprofit Gulf Coast Center for Nonviolence, serving victims of sexual violence on the Mississippi Gulf Coast. Credit: Stephanie Piper

In that case, the woman knew the man who impregnated her and had previously had consensual sex with him. She had no interest in filing a police report. 

“She was scared if she didn’t have sex with him something worse was going to happen,” Piper said. “In my eyes that’s a sexual assault. If she came forward to law enforcement and said everything I just said, they’re probably not going to go forward with the case.”

Lovern, a native of Philadelphia, Miss., grew up in the Pentecostal church, surrounded by opposition to abortion. His work as a nurse has changed his perspective, introducing him to situations where abortion was medically necessary. And he can see how carrying a pregnancy to term could change a sexual assault victim’s life forever. 

“I’m not saying that they wouldn’t love their child any differently, but it’s always going to bring back a physical presence of that assault,” he said. 

Editor’s note 9/19/22: This story has been updated to remove details about one health care provider’s experience due to privacy concerns.

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Isabelle, an Atlanta native, covers health as part of Mississippi Today’s community health team. Prior to joining Mississippi Today, she was a reporter for the Biloxi Sun Herald and a Report for America corps member.