When Trish Mitchell got an abortion three decades ago in Missouri, she didn’t tell the doctor her pregnancy was a result of sexual assault.
She couldn’t bring herself to.
It would be years before she told anyone that she had been raped.
“Speaking for myself, it was literally almost impossible,” said Mitchell, who was 21 at the time of the assault. “I wasn’t able to talk about what happened to me for many, many years.”
When the U.S. Supreme Court struck down the constitutional right to abortion, a near total ban on the procedure went into effect in Missouri. It doesn’t include exceptions for victims of rape like Mitchell.
An initiative petition effort to add an exemption for rape victims to Missouri’s abortion ban is officially underway, alongside provisions that would prohibit the government from interfering with access to an abortion in the first 12 weeks of pregnancy and provide immunity from prosecution for women who receive abortions and for those who help them.
But the proposed constitutional amendment would require women seeking an abortion following a rape to report the assault to a crisis hotline, an idea that has drawn criticism from some survivors and advocates who worry it will be a barrier to accessing care.
“If that’s what’s required, then I say yes, it’s better than telling someone ‘no, you can’t make this decision about your own body,’” Mitchell said. “But at the same time, I really wish they would talk with people who’ve had that experience and understand the amount of trauma that they actually go through before they even arrive at the decision to have an abortion.”
Reporting requirement
The initiative petition campaign is being led by Jamie Corley, a longtime Republican congressional staffer who formed a 501c4 nonprofit in June to jumpstart the effort.
When crafting the proposal, Corley and her team at the Missouri Women and Family Research Fund decided a reporting element was necessary to establish a qualifying event for the rape exception. She believes it also makes for a stronger ballot initiative. The group has until May to garner enough signatures to get the proposed initiative on the ballot.
Corley said she studied reporting requirements in other states, including Florida, where victims have to provide proof of a police report or restraining order. But she felt that was too “onerous,” since there are myriad reasons survivors may not report an assault to police.
“Our intention is to give crime victims access to care,” Corley said of the crisis hotline requirement, which she said is unique from any other state and would only apply to women seeking abortions beyond 12 weeks of pregnancy.
She pointed to 2019 numbers from the Missouri Rights of Victims of Sexual Assault Task Force which showed more than three times as many people reached out to a crisis hotline as reported sexual assaults to police.
As she sees it, the reporting can be done confidentiality, anonymously, via text, call or email, and done locally or through national groups. It can be as simple as writing “I am a survivor of sexual assault,” to meet the reporting requirement, she said.
But Corley hopes it would also provide access to care for survivors that they might not have known about previously.
Hotlines and how they work
Dozens of crisis hotlines are operated by victim agencies across Missouri. Many are 24/7 and don’t require survivors to share their identity. All are voluntary.
National hotlines are also plentiful. For example, the National Sexual Assault Telephone Hotline, run by the Rape, Abuse & Incest Network, is confidential and does not even record the caller’s full phone number.
Hotlines provide survivors a space to process what they are going through with an advocate who is trained to listen. From there, the advocate suggest information and services that could be helpful to the survivor, said Matthew Huffman, a spokesman for the Missouri Coalition Against Domestic and Sexual Violence.
Huffman’s group has not taken a position on any of the initiative petitions at this point.
“I’m very hesitant to ever say that a survivor should have to make a decision in order to qualify for another service,” Huffman said of Corley’s proposal, adding that he also has concerns about asking someone to relive the trauma of a sexual assault. “It’s important that we are able to preserve the intent of what a hotline is, so that there isn’t a chilling effect where survivors feel like they would be uncomfortable calling a hotline for any reason.”
No one would be required to tell the story of their assault, Corley said, only required to report that it happened.
It can also be dangerous to call a hotline, Huffman said, as some survivors fear being found out by their abuser. During the pandemic, hotline calls were down in many states as victims remained stuck at home with abusers, unable to get help as easily.
Corley said if there are concerns about calling a hotline, those same concerns would exist in making the abortion appointment in the first place.
Huffman said he does see a benefit to the proposal, in that it could be a path to bodily autonomy for survivors.
“These conversations and these efforts are important for us to be having, but I think we also have to be cautious about how they aren’t actually implemented,” he said. “And so I take a very pragmatic “both/and” approach where we can see benefits, but we can also see risks.”
Survivors’ perspectives
Mitchell was a young mother with two boys when she was raped on a first date.
She learned she was pregnant 12 weeks after the assault. Mitchell was already in survival mode, trying to stay present for her boys despite the rape playing on repeat in her head.
“I was very young and didn’t know how to begin to understand what happened to me,” she said.
Mitchell, who comes from a “very religious” upbringing, said the decision to seek out abortion care was met with much prayer and consideration. Calling a hotline was the last thing on her mind. Even if it was, Mitchell said did not have the mental or emotional capacity at the time to do so.
Mitchell has worked with the Metropolitan Organization to Counter Sexual Assault. While she agrees calling a hotline is recommended and can be helpful, survivors should be able to seek those services on their own timeline.
Contacting a hotline is not as cut and dry as it seems on paper, she said. After her assault, Mitchell said she waded through guilt, shame and embarrassment, and that reaching out to a hotline would have been extremely taxing.
“Even to make a quick call to say, ‘hey by the way, I got raped and I need abortion care,’ it just feels so impersonal and uncaring,” Mitchell said.
After she was raped in 2016, Taylor Hirth said calling a rape crisis center was the furthest thing from her mind.
“This requirement adds one more thing to the extensive to-do list that further traumatizes survivors of sexual violence when they are just trying to move on with their lives,” said Hirth, a survivor and advocate who has occasionally written columns for The Independent and lives in the Kansas City area.
While Hirth said she will take any “scraps of bodily autonomy the government is willing to offer me,” she would rather do without the requirement.
“While I’m grateful for any attempt at improved access to abortion, inherent in the fight for reproductive rights is the belief in the bodily autonomy of the person seeking an abortion,” she said, later adding: “This is just one more unnecessary expectation.”
Trojan horse?
While Corley has settled on an initiative to move forward with, 11 more expansive abortion-rights amendment proposals filed in March by St. Louis physician Anna Fitz-James remain in limbo.
Corley’s initiative has been met with criticism from both sides of the abortion debate, including from groups that oppose any abortion exclusions and from groups that oppose any limitations to abortion.
Emily Wales, Planned Parenthood Great Plains’ CEO and president, said Corley’s ballot initiative reinforces stigma around abortion by allowing the government to declare what is a “good abortion versus a bad abortion.”
Planned Parenthood has not yet taken a public position on any of the proposed initiative petitions.
“At the end of the day,” she said, “what it does is have non-physicians sitting in a position of determining what an individual’s private healthcare should be.”
She remains skeptical that other abortion restrictions in place that have driven providers out of the state will allow providers to reasonably return to Missouri. But if they did, she argued the reporting requirement could affect a patient’s experience.
“This type of reporting requirements doesn’t do anything but further restrict the rights of the individual who has already been violated,” Wales said. “It is deeply upsetting to me to read this and to hear that from somebody who thinks they are advocating for abortion access or individual rights.”
Both Wales and Huffman raised questions about how the government would maintain patient and provider confidentiality.
“I have a real concern about how those conversations which are intended to be confidential for a reason, end up being documented,” Huffman said.
“We’ve seen the state be really irresponsible when it comes to patient information when it comes to tracking periods and patient data. I don’t want to give the government any more reason to be watching Missourians private lives,” Wales added, referencing a 2019 incident in which the state’s then health director, Randall Williams, testified that the state monitored personal information of Planned Parenthood patients, including women’s menstrual cycles, with the goal of identifying who had failed abortions. The patients’ names were not included.
Missourians deserve better, Wales said.
“This is not the moment for something is better than nothing,” she said.
Corley said to get an abortion in Missouri before the ban, some level of reporting was always required. But she emphasized privacy would always be respected.
“Just like Planned Parenthood tries to make it as easy as possible with their confidential online portals to make an appointment, and confidential phone lines to make an appointment, we have the same amount of respect and understanding for patient privacy,” Corley said.
Her biggest priority, Corley said, is in getting access to survivors as quickly as possible. Her proposal is not some sort of “Trojan horse to get reporting requirements in place.”
“Survivors have no access right now,” Corley said. “And so to sit on the sidelines and complain about ballot initiatives, without offering your own real solution is disrespectful to sexual assault survivors.”
