As members of the Missouri House debated HJR 98 last week — a bill that would create a ballot initiative to assign fetuses full personhood — we’ve heard some of the most harmful rhetoric about women and rape that we have heard since Todd Akin’s run for Senate.
As practicing obstetrician-gynecologists, and representatives of the Missouri section of the American Congress of Obstetricians and Gynecologists, we feel compelled to speak out about such language. Regardless of personal feeling about abortion, we hope that everyone could agree that violence against women is unacceptable.
However, during a House floor debate last week, Rep. Tila Hubrecht, R-Dexter, suggested that a pregnancy resulting from a rape is a “silver lining.”
We find the notion that good may come of such a violation to be dangerous at best. Rape is one of the most violent attacks against women, and any suggestion that there is a bright side to sexual violence is an offense to all survivors.
First of all, rape has clear medical consequences in addition to risk of pregnancy. Perpetrators of sexual assault may not use condoms, exposing victims to sexually transmitted infection. Acute traumatic injuries may range from scratches, bruises and welts to severe lacerations, fractures, head and facial trauma, and more.
There are also long-term physical consequences, including chronic pelvic pain and sexual dysfunction, which can impact women throughout their lives.
But let’s not forget the extreme, debilitating psychologic and mental health consequences associated with sexual assault. These consequences are very real, and they should not be diminished by the claim that any rape has a silver lining.
Immediately after a sexual assault, survivors may suffer from a rape-trauma syndrome that can present as generalized pain throughout the body; eating and sleeping disturbances; and any combination of anger, fear, guilt, humiliation, anxiety, and even — tragically — self-blame. The next phase is often characterized by flashbacks and phobias, including nightmares; these may be accompanied by physiological symptoms, especially of a gynecologic nature. This stage of suffering may last for months, forcing women to live with their trauma for a prolonged period of time.
It doesn’t stop there. Sexual assault can lead to post-traumatic stress disorder and/or alcohol and drug abuse; in one survey of women seeking treatment for substance abuse, more than three quarters had reported being the victims of sexual or physical violence.
Without question, any woman who has survived sexual assault knows full well that there is no silver lining. It is a crushing, massively traumatic experience.
That’s why forcing a pregnancy on a woman who has been a victim is literally adding injury to injury. For many women, a pregnancy is indeed something to celebrate. But this is highly unlikely for survivors of rape, who under this legislation could be forced to carry their assailants’ “silver lining” to term.
This is not only cruel, it could also be dangerous. Despite advances in medicine, maternal mortality is actually on the rise in the U.S., including in Missouri. The days of women dying in childbirth are not over. And pregnancy and childbirth can have lasting consequences on a woman’s health. Exposing sexual assault victims to the risks inherent in pregnancy and childbirth is effectively punishing her for her own assault. This is unacceptable.
Women who have been sexually assaulted do not deserve to have their experience diminished by politicians who seemingly ignore the trauma and pain they experience. What they deserve is empathetic care and access to the full range of medical support that they need, including emergency contraception (which could be compromised as a result of this legislation) and abortion (which would certainly be compromised).
We have treated patients who have been the victims of sexual violence, and have seen firsthand the effect that it has on their lives. Given that roughly one in five women will report an attempted or completed rape in their lifetime, it seems likely our elected officials themselves know these women — they are friends, neighbors, and indeed their families.
We stand with rape victims and denounce the notion that rape has a “silver lining.” We ask our Legislature to do the same.
Dr. Octavio Chorino is president of the Missouri Section Advisory Committee of the American Congress of Obstetricians and Gynecologists. Dr. Peter Greenspan is legislative chair.