13-year-old rape victim has baby amid confusion over state's abortion ban

Regina, a mother of three daughters, lives in one of the poorest counties in one of the country's poorest states -- Mississippi. She holds down a job during the day and is attending nursing school. Life for her is hard, but she manages as best she can.

In late 2022, that changed. Regina noticed that Ashley, her middle daughter, began withdrawing -- she quit her cheer team and stopped going outside. Then Ashley started to get really sick, vomiting a lot.

"We took her to the hospital and rushed her in and they took her to the back …The nurse [was] like 'You pregnant.'  And that's when I just broke down and started crying," Regina said.

Ashley, who was 11 weeks pregnant at the time, said she was raped by a stranger in the yard of the family's home.

"She's just 12. She don't know nothing about having no babies. Nothing," Regina said.

But amid confusion over what abortion care is allowed in Mississippi, Regina says she was unaware Ashley qualified for an abortion in Mississippi under the law's exception for cases of rape. Yet, even if she was aware, it's unlikely Ashley would have been able to get an abortion in Mississippi; with heavy restrictions in effect and the high penalties on physicians who violate the abortion ban, it is unlikely she would have found a doctor willing to perform a procedure.

Ashley, now 13 years old, is the mother of an 8-month-old baby boy nicknamed Peanut.

In addition to her homework, the seventh-grader now prepares bottles and changes diapers when she gets home.

To protect their privacy, ABC News is using the same pseudonyms as TIME Magazine, which first reported this story.

The OB-GYN on call the night Ashley went to the hospital, Dr. Erica Balthrop, says the conversation they had still weighs on her.

"You see this timid little girl -- she's literally a little girl -- and she was like a deer in the headlights. She had no idea what was going on," Balthrop said.

"That was probably one of those days that will just stick in my head. Forever," she said. "It's sad … I think about a woman -- a girl with no rights of her own, basically. She can't make a decision about her own body."

Regina and Ashley reported the rape to law enforcement -- which should have allowed her to get abortion care in the state.

Mississippi's strict abortion ban has narrow exceptions for cases of rape and to save the life of the mother, but -- caught in the confusion caused by a web of conflicting laws -- Regina says she was unaware her daughter could have qualified for an abortion in Mississippi under the exception. Mississippi has several conflicting laws and even experts, doctors and patients are having a hard time navigating them

Regina said when she asked about their options, Dr. Balthrop told her the closest abortion clinic was in Chicago -- with Mississippi boxed in by states with bans in place.

"That's like $800; $1,500 to have an abortion up there. And I'm like, I have to drive, I leave work. I can't afford that," Regina said.

So the family was out of options. Regina decided to keep her daughter's pregnancy private, homeschooling Ashley.

Police arrested the accused rapist last year. Regina says they used DNA from the baby to prove the link. He remains behind bars, charged with felony rape.

"He took my child's innocence," Regina said.

"She didn't have to go through this. It's not her time to go through this," she said.

Only four abortions in the state in 2023

One expert says the family was failed by the system.

"It could be fair to say that there is a lot of confusion and misinformation about abortion across the country … People hear that it's banned and they think that they don't have options in the state," Alina Salganicoff, senior vice president and director of Women's Health Policy at Kaiser Family Foundation, told ABC News.

Had Regina known about the exception, Salganicoff says finding a physician to perform the procedure could also have been a challenge.

"Physicians have so much at stake in terms of losing their medical license, financial penalties, and, in some cases, criminalization leading to jail time. So it is very concerning for them to take the risk of performing an abortion unless they are absolutely certain that they won't be penalized for this," she said.

Dr. Balthrop acknowledged many providers in the state would not be willing to take the risk.

"Most people wouldn't do it here in the state. They would refer you out," Balthrop said.

Mississippi is just one of at least 14 states that have ceased nearly all abortion services in the aftermath of Roe v. Wade being overturned. The impact of bans has been drastic on women and girls seeking abortions in those states.

In 2023, the state only recorded four abortions performed under the exceptions, according to documents ABC News obtained from the Mississippi Department of Health. The department said the state does not track whether any of the abortions were in cases of rape.

That is compared to about 3,800 abortions provided in Mississippi in 2021.

One study estimates that across the 14 states that have ceased nearly all abortions, there may have been nearly 65,000 pregnancies caused by rape, according to a study published in the Journal of the American Medical Association.

"The reality is that rapes are underreported… and so when you have a situation where you have an abortion ban that requires a report, women are much less likely to use that pathway to get an abortion when they feel they need one," Salganicoff said.

ABC News reached out to Mississippi Gov. Tate Reeves' office, several state lawmakers and the state's senators and congressional representatives in Washington regarding this story, but none responded.