Abortions in young girls are not uncommon, experts say

The story of a 10-year-old rape victim traveling from Ohio to Indiana to receive abortion care captured headlines earlier this month, illustrating what impact the Supreme Court decision to overturn Roe V. Wade, a landmark decision which established a federal right to abortion, has had on access to abortion for people around the country.

While many attempted to discredit reporting surrounding the case, the identity of the suspected rapist was ultimately revealed when charges were filed against him. But still, it remained unclear how common abortions are among young people, especially minors.

According to the Guttmacher Institute, a reproductive health policy research organization, there were 4,460 pregnancies among people ages 14 and younger in 2017. The institute estimates that around half of those pregnancies, 1,960, ended in abortion.

The institute gathers its data by conducting a census of all known abortion providers in the U.S. every few years, but its most recent publicly released national data is from 2017.

While data released by the Centers for Disease Control and Prevention in 2019 is more recent, the data is incomplete as not all states mandate reporting from all their health facilities and not all states report their data to the agency, Isaac Maddow-Zimet, a researcher at Guttmacher, told ABC News.

Lauren Ralph, an epidemiologist at the University of California, San Francisco's Department of Obstetrics, Gynecology and Reproductive Sciences, told ABC News in an interview that she believes the CDC's abortion data is an underestimate by about 1/3.

Abortions in minors represent about 4% of all abortions in the U.S. every year, Ralph said, speaking of data gathered by the Guttmacher Institute.

The Guttmacher data shows that abortions among people between the ages of 15 and 17 account for 3.4% of abortions in the U.S and abortions among people under the age of 15 account for 0.2% of abortions in the U.S.

Ralph estimates that there are around 1,800 abortions in people under the age of 15 in the U.S. every year.

An abortion provider in Indiana told ABC News in an interview that it is relatively common to see patients who are minors.

"These patients exist, this was not a one off type of situation. Instead, this is something that every abortion provider has seen and has taken care of, and has experience with," Katie McHugh, an abortion provider in Indiana said.

McHugh works at three abortion clinics, and said just one of those clinics saw 400 patients last month. She said the two other clinics each see between 300 and 350 patients, per month.

"It is certainly not the majority of the cases that I take care of but, when I queried my clinics where I work, we estimated that between 3 and 5% of our patients are minors," McHugh said, calling it a rough estimate of the number of minors they see.

McHugh said about half or so of those patients report that the pregnancies were as a result of rape.

McHugh's most recent case of a young girl was a pre-teen patient around the age of 12 or 13, who she was able to provide abortion care.

Before the Supreme Court ruling, McHugh said she had begun seeing some patients from Kentucky, where some abortion restrictions limiting access to abortion were being put in place. But, since the Supreme Court ruling, McHugh said more than half of the patients she has seen are from Kentucky and Ohio.

She also said she has been seeing a fewer number of patients coming from as far away as Alabama, Texas, Tennessee and Oklahoma.

"We've seen more people have younger ages, but we've just seen more people in general," McHugh said, speaking of patients she has seen after Roe was overturned.

But even before the Supreme Court decision, experts said minors faced more barriers to abortions than adults.

Some states, including Indiana, have laws requiring minors, generally people under the age of 18, to get legal consent from their parents to get an abortion, or go through judicial bypass and get a judge to sign off on getting the procedure.

According to Guttmacher, 36 states require parental involvement, either parental consent or parental notification, in a minor’s decision to get an abortion and 21 states require parental consent.

"The system is so challenging to navigate and to try to do so as a minor who can't drive themselves, who can't pay for things themselves, because they're too young to legally work and yet, they're having to face these kinds of major health care decisions on their own, is so tragic to see," McHugh said.

McHugh said the judicial bypass system in Indiana runs relatively smoothly in the state, but said it is designed to be "cumbersome" and to "place burden on patients."

"It works very well to do those things where it puts up lots of barriers, especially for minors and for the very young minors," McHugh said.

"Because of legal requirements to either have parental consent, or to go through the court system, to prove to a judge that the person is competent enough to make a decision like this on their own, there is a significant delay in care," she added.

McHugh called the system "ridiculous," saying that delaying care could possibly increase a patient's risk for more complicated abortion care depending on what stage of the pregnancy they are in.

In young girls, carrying a pregnancy to term is riskier than getting an abortion, when compared with adults, McHugh said.

"When we look at studies, [young patients are] at a higher risk of developing medical problems like diabetes and high blood pressure. They're at a much higher risk, especially in very young patients, of needing a C-section, simply because their bones and their joints are not developed enough to accommodate a vaginal birth," McHugh said.

C-sections also come with their own risks, including the possibility that the patients would need the procedure again in the future, McHugh said.