IMPACT OF ABORTION BANS IN TEXAS ON SEXUAL ASSAULT SURVIVOR CARE: A QUALITATIVE STUDY

Abstract

Objectives

We aimed to assess how the community and health workforce support survivors of sexual violence in Texas, an abortion ban state without exceptions for rape or incest.

Methods

Between May and December 2024, we recruited paid staff at interpersonal-violence-focused organizations (eg, rape crisis centers), healthcare providers, and emergency medical facilities in Texas that worked directly with sexual assault survivors for in-depth interviews. Eligible participants were aged 18 or older, had worked with survivors for at least six months, and spoke English or Spanish. Interviews explored how Texas Senate Bill 8, which prohibited abortions after embryonic cardiac activity, and Dobbs v. Jackson Women’s Health Organization affected participants’ practices and capacity to support survivors, including those who experienced unwanted pregnancies. We used thematic analysis to develop themes in participants’ understandings and experiences.

Results

Participants (n=36) reported that abortion restrictions made it more difficult to support survivors of sexual assault; they also shared that violent partners used restrictions to enact more control. While participants understood that abortion was no longer legal in Texas, some were uncertain about the legality of providing information about abortion providers’ locations. Participants noted that clients were less open to disclosing unwanted pregnancies or need for abortion, chilling communication and weakening provider-client relationships. Participants also experienced moral injury from the dissonance between professional best practices and the personal and professional liability associated with enacting them.

Conclusions

Staff who work directly with sexual assault survivors in Texas identify state abortion policy changes as limiting their capacity to provide best-practice support to survivors, and disempowering survivors post-assault.