How abortion bans are undercutting efforts to prevent domestic violence
As more abortion bans have gone into effect across the country, it has become far more difficult to perform a standard element of gynecological care: screening patients for domestic abuse.
Research shows that OB-GYNs are often the first or only doctors to learn if a patient is facing intimate partner violence. While women of all ages experience intimate partner violence, it is most prevalent among women of reproductive age, the people most likely to see an OB-GYN. Meanwhile, abortion bans have contributed to reproductive health care providers leaving states, retiring early or declining to practice where the procedure is restricted.
There is little data on the trend, but doctors and experts agree that as a result, people experiencing domestic violence are less likely to be appropriately screened — let alone connected to resources or support.
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Because the state’s laws threaten criminal penalties for abortion and helping someone to access abortion, doctors and sexual and domestic violence program advocates alike are under an acute pressure that has left even non-clinical program workers in social support network programs afraid to help survivors, especially if their work could be construed as having connected pregnant survivors of violence to abortion services, Miller said.
Though concerns for intimate partner violence screening are particularly visible in Idaho, clinicians told The 19th that barriers to care have emerged across the country as abortion bans proliferate. So far, 14 states have almost-completely banned the procedure, and seven more have imposed gestational limits before viability, the point at which a fetus can live independently outside the uterus.
The impact is visible at the Washington, D.C.-based DuPont Clinic, one of the few providers to offer abortions through all trimesters of pregnancy and a national destination for people seeking abortions later in pregnancy.
While the clinic has always seen patients who have traveled to D.C. for care, the share of such patients has only increased over the past year, said Elizabeth Bastias-Butler, DuPont’s director of clinical services. Before patients arrive at DuPont, clinicians perform an intimate partner violence screen as part of their intake process, as well as a safety screen with each patient when they arrive in person at the clinic. Since more abortion bans have taken effect post-Dobbs nationwide, Bastias-Butler said the clinic now sees more patients also experiencing intimate partner violence.
Many patients do not disclose over the phone during their intake screen that they are unsafe at home and in need of help, Bastias-Butler said. “Sometimes, they’ve never told anyone what their experiences are until they are in clinic with us when we do our intake,” she said. The in-person visit is often the very first time a person feels comfortable disclosing that they are experiencing domestic violence.