Pregnancy from rape

Pregnancy is a potential result of heterosexual rape. It has been studied in the context of war, including war crimes such as war rapes, mass forced impregnation as a tool for genocide, as well as the more common concept of rape in non-conflict areas and in the context of statutory rape, incest, and underage pregnancy.

The current scientific consensus is that rape is as likely to lead to pregnancy as consensual sexual intercourse. In some countries in which abortion for rape and incest is illegal, over 90% of pregnancies in children under 14–15 are due to rape by family members. The false belief that pregnancy can almost never result from rape was widespread for centuries. In recent decades, several prominent politicians and organizations who oppose legal abortion in cases of rape have advanced claims that pregnancy very rarely arises from rape, and that the practical relevance of rape exceptions to abortion law is limited as a result.

Statistics and pregnancy rates
Any female capable of ovulation may become pregnant after a rape by a male who has reached puberty. Many of the youngest documented birth mothers in history experienced precocious puberty and were impregnated as a result of rape, including incest. In the youngest documented case, Peruvian Lina Medina was impregnated at age four and had a live birth in 1939 at age five. In the 1992-5 Bosnian war thousands of women were systematically raped and forced to pregnancy by Serbian participants in widespread "rape camps", later found by a criminal court to have been part of a deliberate campaign of genocide and therefore a war crime.

In a three-year longitudinal study of 4,000 American women, physician Melisa Holmes found that pregnancy may result from forced sexual intercourse, producing over 32,000 pregnancies from rape nationally each year. That study found that among victims of reproductive age (defined in the study as ages 12 to 45), the rape-related pregnancy rate was 5% per rape or 6% per victim. Of these pregnancies, 38% led to birth (kept by the mother or put up for adoption); 12% resulted in spontaneous abortion (the medical term for miscarriage), and 50% were terminated through clinical abortion. A study authored by psychologist Mary P. Koss in 1987 also found a 5% pregnancy rate from rape for 18-24 year-old higher education students in the United States.

The rate varies between settings and depends particularly on the extent to which contraceptives are being used. A study of adolescents in Ethiopia found that among those who reported being raped, 17% became pregnant after the rape, a figure which is similar to the 15–18% reported by rape crisis centres in Mexico. Citing Koss, evolutionary psychologists Ethel Tobach and Rachel Reed note that in Lima, Peru, where abortions are illegal, 90% of girls age 12 to 16 who became pregnant through rape carried the child to term.

Authors writing in the context of evolutionary psychology have published conflicting analysis of statistics about rape, ovulation, and pregnancy. Some have stated that conception rates are lower than reported, while others report unusually high rates. In A Natural History of Rape, Randy Thornhill disputed Holmes' statistics based on DNA findings by Holly A. Hammond, which found that 60% of women who became pregnant after rape were impregnated by a consensual mate. Psychologist Robert L. Smith states that some studies have reported "unusually high rates of conception following rape." Smith cites a paper by C.A. Fox and Beatrice Fox where they report that biologist Sir Alan Sterling Parkes speculated via personal correspondence that "there is a high conception rate in rape, where hormonal release, due to fear or anger, could produce reflex ovulation." Smith also cites veterinary scientist Wolfgang Jöchle, who "proposed that rape may induce ovulaton in human females." Literary scholar Jonathan Gottschall and economist Tiffani Gottschall argued in a 2003 Human Nature article that previous studies of rape-pregnancy statistics were not directly comparable to pregnancy rates from consensual intercourse because the comparisons were largely uncorrected for such factors as contraception usage. Adjusting for these factors, they estimated that rapes are about twice as likely to result in pregnancies (7.98%) as "consensual, unprotected penile-vaginal intercourse" (2–4%); the authors discuss a variety of possible explanations and advance the hypothesis that rapists tend to target victims with biological "cues of high fecundity" and/or subtle indications of ovulation. In contrast, psychologists Tara Chavanne and Gordon Gallup Jr., citing unpublished dissertations by Rogel and Morgan, argued that female adaptations reduce the likelihood of rape during fertile periods. Anthropologist Daniel Fessler disputed these findings, stating "analysis of conception rates reveals that the probability of conception following rape does not differ from that following consensual coitus."

Physician Felicia H. Stewart and economist James Trussell examined rape from pregnancy as a preventive medicine and public health issue. They estimated that 333,000 assaults and rapes reported in the United States in 1998 were responsible for about 25,000 pregnancies. They also estimated that up to 22,000 of those pregnancies could be prevented received with prompt medical services, including the option of emergency contraception.

Rape and enforced pregnancy in conflict
Rape and at times sexual enslavement or forced pregnancy have frequently been used in war and armed conflict as means of psychological warfare in order to humiliate the enemy and undermine their morale. War rape often occurs systematically and thoroughly, as well as opportunistically and individually; military leaders have at times strongly encouraged rape.

Rape, sexual slavery, and related actions including forced pregnancy and sexual slavery, are now recognized under the Geneva Convention as crimes against humanity and war crimes; in particular from 1949, Article 27 of the Fourth Geneva Convention, and later also the 1977 Additional Protocols to the 1949 Geneva Conventions, explicitly prohibit wartime rape and enforced prostitution. The Rome Statute Explanatory Memorandum, which defines the jurisdiction of the International Criminal Court, recognises rape, sexual slavery, enforced prostitution, and forced pregnancy among others, as crime against humanity if part of a widespread or systematic practice. The International Criminal Tribunal for Rwanda identified rape as capable of amounting to genocide when used systematically or on a mass scale to destroy a people; later the International Criminal Tribunal for the former Yugoslavia also recognized rape as capable of being a crime against humanity. In 2008 the U.N. Security Council's resolution 1820 identified such acts as capable of being "war crimes, crimes against humanity or ... genocide”. Despite these measures, rape, whether systematic or otherwise, remains widespread in conflict zones.

During the 1992 - 1995 Bosnian war, the existence of deliberately created "rape camps" was reported. The reported aim of these camps was to impregnate Muslim and Croatian women held captive. Women were reported to often be kept in confinement until the late stage of their pregnancy. This occurred in the context of a patrilineal society, in which children inherit their father's ethnicity, hence the "rape camps" aimed at the birth of a new generation of Serb children. According to the Women's Group Tresnjevka more than 35,000 women and children were held in such Serb-run "rape camps". Estimates range from 20,000 to 50,000 victims. Numerous Serbian officers, soldiers and others were convicted of rape as a war crime by the International Criminal Tribunal and the Court of Bosnia and Herzegovina, and the events inspired the Golden Bear winner at the 56th Berlin International Film Festival in 2006, called Grbavica.


 * "[W]omen and children were kept in the gym, where all of the women and girls over ten years old were raped in the first few days.... There are rape camps all over the country. Thousands of women are being raped and killed. Thousands of women are pregnant as a result of rape. Over and over again, everywhere I went in Bosnia-Herzegovina and in Croatian refugee camps, women told me stories of abomination -- of being kept in a room, raped repeatedly and told they would be held until they gave birth to Serbian children."
 * - 1993 report by lawyer and Equality Now board member Feryal Gharahi, into the Bosnian war.

History
Although war rape of women is documented throughout history, laws protecting civilians in armed conflict have tended not to recognize sexual assault on women.

The ancient Greeks considered war rape of women "socially acceptable behaviour well within the rules of warfare" with conquered women being "legitimate booty, useful as wives, concubines, slave labour or battle-camp trophy". Women were included with "property" as spoils of war since in these cultures they were generally considered to be under the lawful ownership of a man, whether a father, husband, or otherwise. In medieval Europe, women were considered as an inferior gender by law. Catholic Church sought to prevent rape during feudal warfare through the institution of Peace and Truce of God which discouraged soldiers from attacking women and civilians in general and through the propagation of a Christianized version of chivalry. After World War I the 1919 War Crimes Commission found substantial evidence of sexual violence and subsequently included rape and forced prostitution among the violations of the laws and customs of war, but efforts to prosecute failed.

In modern times, Amnesty International have stated that rape is now commonly used as deliberate military strategy to conquer territory by expelling the population, destroying affiliations, spreading AIDS, and eliminating cultural and religious traditions. In 2004 Gita Sahgal said that it is a mistake to think such assaults are primarily about "spoils of war" or sexual gratification. She said rape is often used in ethnic conflicts as a way for attackers to perpetuate social control and redraw ethnic boundaries. "Women are seen as the reproducers and carers of the community," she said.

(Gender note: – Although male pregnancy does not occur, rape of men by other men is also common in war. A 2009 study found it documented in conflicts worldwide; for example, 76% of male political prisoners in 1980s El Salvador and 80% of concentration camp inmates in Sarajevo reported being raped or sexually tortured. )

Effects
A recent study lists the physical effects on war rape victims as traumatic injuries, sexually transmitted disease, and pregnancy. Due to conflict location, clinical, contraceptive and other medical services are extremely limited. Long term physical effects can include incontinence and vaginal fistula. Psychological impact includes feelings of fear, helplessness, and desperation, and longer term may include depression, anxiety disorders (including post-traumatic stress syndrome (PTSS)), multiple somatic symptoms, flashbacks, difficulty re-establishing intimate relationships, shame, and persistent fears. In some cultures honor killings are not uncommon as victims are seen as shaming their family, and AIDS related illness and death is not uncommon; children may be left as AIDS orphans.

Statutory rape, incest and underage pregnancy
In 1995–1996, the journal Family Planning Perspectives published a study by the Guttmacher Institute, a sexual health research and policy organization, on statutory rape (sexual intercourse with a minor) and resulting pregnancies, which drew on other research to highlight that "at least half of all babies born to minor women are fathered by adult men", and also that "[a]lthough relatively small proportions of 13–14-year-olds have had intercourse, those who become sexually active at an early age are especially likely to have experienced coercive sex: Seventy-four percent of women who had intercourse before age 14 and 60% of those who had sex before age 15 report having had a forced sexual experience." However due to difficulties in bringing such cases to trial, "data from the period 1975–1978 (gathered for a case argued before the Supreme Court) indicate that, on average, only 413 men were arrested annually for statutory rape in California, even though 50,000 pregnancies occurred among underage women in 1976 alone." In that state, it was found that 2/3 of babies born to school-aged mothers were fathered by adult men, leading then-Governor of California Pete Wilson to announce in 1995 that "One of the most disturbing things about [the] exploding [rate of] teen pregnancy is that so many of the fathers are...men, 26 and 28 years old, having sex with 14-year-old girls[]"

A 2007 paper by Child Trends looked at studies from 2000–2006 to identify links between sexual abuse and teenage pregnancy, starting with Blinn-Pike et al.'s 2002 metastudy of 15 studies since 1989. It found that childhood sexual abuse has a "significant association" with adolescent pregnancy. Direct connections have been shown both by retrospective and prospective studies (looking back at past history of reported pregnancies, and tracking forward the lives of sexual abuse victims over time). Prospective studies "can be helpful for determining [cause and effect]". "The majority" (over 11 studies) point to a link, and "only a few" do not. More severe abuse such as rape and incest are associated with a greater risk. Although some researchers suggest pregnancies could be a choice made to escape a "bad situation", children may also be "a direct result of unwanted intercourse", and this was the case in one study for around 13% of participants in a Texas parenting program. Studies also highlighted an unexpected risk – a stronger risk factor for rape and pregnancy was found related to male victims of sexual abuse who later in their lives raped others, for whom sex had become normalized, distorted, or internalized as "adult-like", and in some cases a psychological means to restore their own sense of lost masculinity.

Outside the United States, in Nicaragua between 2000 and 2010 around 172,000 births were recorded for girls under 14, out of 1.3 million births (13%), attributed to poverty, laws forbidding abortion for rape and incest, poor sex education, lack of access to justice, and normative beliefs in the culture and legal system. A 1992 study in Peru found that 90% of deliveries to mothers aged 12–16 resulted from rape, typically by a father, stepfather or other close relative. In Costa Rica in 1991 the figure for incest-rape was similar, 95% of adolescent mothers under 15.

Treatment protocols
Some who are raped carry the pregnancies to term, while others choose to terminate the pregnancy. Abortion rates for pregnancies due to rape vary significantly by culture and demographics. Peer-reviewed studies have reported a wide range for women who carry the pregnancy to birth: from 38% among American women to 90% among Peruvian adolescents.

Following experimental use of high-dose estrogen pills as a rape treatment protocol in the 1960s, Canadian physician A. Albert Yuzpe and his colleagues began systematic studies in 1972 on the use of ethinyl estradiol and dl-norgestrel as emergency contraception after an assault. This method is now called the Yuzpe regimen.

Children of rape
Both the traumatic effect of the rape and the connection to the rapist through the child can create significant psychological problems for both the mother and child. For instance, in most U.S. states, the rapist maintains parental rights. Research by legal scholar Shauna Prewitt indicates that the continuing contact with the rapist created by this fact is significantly damaging for women who choose to keep their rape-conceived child.

The rate of children of rape who are given up for adoption is higher than that for other children (which is about one percent). One study estimated that six percent of children conceived in rape are given up for adoption, while another puts the number at 26 percent. According to Brian Palmer, psychologists who study the issue suggest that telling the child the truth when they are old enough to comprehend the event is the best course of action.

Historical legal views
In contrast to the modern scientific consensus that rape-induced pregnancies are not unlikely, according to historians such as Vanessa Heggie of the University of Cambridge or Jennifer Tucker of Wesleyan University, beliefs that rape could not lead to pregnancy were widespread in both legal and medical opinions for centuries.

In the medieval British law texts Fleta and Britton, it was asserted that pregnancy could not occur without consent and hence was a legitimate defense against charges of rape. For example, Britton states: "With regard to an appeal of rape, our pleasure is, that every woman, whether virgin or not, shall have a right to sue vengeance for the felony by appeal in the county court within forty days, but after that time she shall lose her suit; in which case, if the defendant confesses the fact, but says that the woman at the same time conceived by him, and can prove it, then our will is that it be adjudged no felony, because no woman can conceive if she does not consent." Medieval literary scholar Corinne Saunders writes, "The volatile legal status of rape appears to have been further complicated by the popular belief that a raped woman could not conceive a child. Although it is difficult to estimate just how widely disseminated such ideas of sexuality and pregnancy were at the time, at least some justices were influenced by them. A case recorded for the Eyre of Kent (1313) dismisses the charge of raptus brought by a certain Joan on the grounds of her pregnancy."

The belief influenced medical as well as legal thinking: Saunders writes, "According to the Galenic theory of conception, for pregnancy to occur as a result of rape was impossible." Similarly, Tucker writes that in the Aristotelian viewpoint of reproduction (further expanded upon in the 12th century by Hildegard of Bingen), female pleasure played a central role in conception. Female reproduction was, in many ways, viewed through the lens of male reproductive processes, with female organs supposedly functioning as "inverted" versions of the male organs (and hence requiring orgasm for conception).

The 1814 British legal text, Elements of Medical Jurisprudence by Samuel Farr, similarly claimed that conception "probably" could not occur without a woman's "enjoyment", "So that if an absolute rape were to be perpetrated, it is not likely she would become pregnant."

Another British legal text, Treatise of Pleas of the Crown, reported in 1795 on a similar belief, but then disparaged both its legal utility and its biological veracity: "Also it hath been said by some to be no rape to force a woman who conceives at the time; for it is said, that if she had not consented, she could not have conceived, but this opinion seems very questionable, not only because the previous violence is no way extenuated by such a subsequent consent, but also because, if it were necessary to shew that the woman did not conceive, the offender could not be tried till such time as it might appear whether she did or did not, and likewise because the philosophy of this notion may very well be doubted of."

In U.S. v. Dickinson, 1 Hempstead Reporter 1 (1820 Ark. Territory), at 2 n.1., a court case dealing with a man pleading innocent to rape charges because the victim became pregnant, the court rejected the argument: "The old notion that if the woman conceive, it could not be a rape, because she must have in such case have consented, is quite exploded. Impregnation, it is well known, does not depend on the consciousness or volition of the female. If the uterine organs be in a condition favorable to impregnation, this may take place as readily as if the intercourse was voluntary."

Historian Ian Talbot has written about how countries with Quran-based Islamic codes on rape and pregnancy use Sura An-Nur, verse 2 as a legal basis: "The law of evidence in all sexual crimes required either self-confession or the testimony of four upright (salah) Muslim males. In the case of a man, self-confession involved a verbal confession. For women however medical examinations and pregnancy arising from rape were admissible as proof of self-guilt."

Lawyer Shauna Prewitt wrote in 2012 that in the United States, 31 states allow rapists to assert custody over children conceived through rape. In those states, "men who father through rape are able to assert the same custody and visitation rights to their children that other fathers enjoy. When no law prohibits a rapist from exercising these rights, a woman may feel forced to bargain away her legal rights to a criminal trial in exchange for the rapist dropping the bid to have access to her child."

Literary views
An essay in the 2002 book Rape in Antiquity argues that, in classical Greek and Roman dramas, rape is merely an "incidental occurrence or convenient plot device." For example, in the play Epitrepontes by Menander in which a pregnancy ensues, "the act of rape that led to pregnancy is not so important as the arrival of a bastard child nine months later."

Religious scholar Betsy Bauman-Martin writes that the 1810 book The Marquise of O by Heinrich von Kleist "fits the form of romantic rape narratives in its confusion between coerced and passively accepted sex, the bewilderment over the results of the sex, in this case, the pregnancy, the ultimate pleasure the Marquise feels from the relationship with the Count, and the Count's dark, powerful heroism."

Berkeley historian Thomas W. Laqueur, in his 1992 book Making Sex, describes an evolution of the popular understanding of rape-pregnancy in two retellings of a story in which a monk forces himself upon a woman in a coma and impregnates her. A 1752 version of the story, reflecting beliefs at the time about conception, assumes that the woman must have experienced some sort of pleasure. On the other hand, an 1836 version of the story uses the incident to demonstrate that female pleasure is not required for conception.

Sociobiological views
Sociobiologists and evolutionary psychologists have hypothesized that causing pregnancy through rape may be a mating strategy in humans. Randy Thornhill and Craig T. Palmer are key popularizers of this hypothesis. They assert that most rape victims are women of childbearing age, and in many cultures rape is treated as a crime against the victim’s husband. They state that rape victims suffer less emotional distress when they are subjected to more violence. They further state that married women and women of childbearing age experience less psychological distress after a rape than do girls, single women or women who are past menopause. Rape-pregnancy rates are of key importance in evaluating these theories of rape adaptations, because a high or low pregnancy rate from rape would determine whether such adaptations are favored or disfavored by natural selection.

Opposition to legal abortion
Pregnancy from rape is an ethical and moral issue in the context of opposition to legal abortion. While some people who oppose legal abortion make exceptions in cases of rape or incest, others do not. In recent decades, reminiscent of historical beliefs, claims of the improbability of rape-induced pregnancy have begun again to play a role in political discourse surrounding abortion regulation in cases of rape.

In a 1972 article, physician Fred Mecklenburg argued that pregnancy from rape is "extremely rare," adding that a woman exposed to the trauma of rape “will not ovulate even if she is 'scheduled' to." Mecklenburg said researchers in Nazi death camps observed this effect by "selecting women who were about to ovulate and sending them to the gas chambers, only to bring them back after their realistic mock-killing, to see what the effect this had on their ovulatory patterns. An extremely high percentage of these women did not ovulate." Journalist Blythe Bernhard stated, "That article has influenced two generations of anti-abortion activists with the hope to build a medical case to ban all abortions without any exception." John C. Willke, a former president of the National Right to Life Committee and a general practitioner with obstetric training, has published similar statements since 1985. In a 2012 interview, he said, "This is a traumatic thing — she’s, shall we say, she’s uptight. She is frightened, tight, and so on. And sperm, if deposited in her vagina, are less likely to be able to fertilize. The tubes are spastic.” These assertions were disputed by a number of gynecology professors. A 1997 book published by the group Human Life International (which opposes legality of abortion in all cases including rape or incest) claims that several studies performed in the 1970s show that only 0.08% of rapes result in pregnancy, and alternatively offers a rough estimate of 0.8% from other published statistical data; the same book dismisses contrary statistics derived from surveys of rape victims or women obtaining abortions, arguing that "the women who obtain abortions for 'rape' are almost always lying". Many claims that rape reduces the chance of pregnancy refer to the established medical fact that chronic stress can reduce a woman's fertility over a long term, but the current scientific consensus is that the acute stress that occurs during rape cannot "shut down ovulation that has already begun".

Several U.S. Republican politicians have advanced claims about the rarity of pregnancy from rape. Pennsylvania state representative Stephen Freind claimed in 1988 that the odds of a pregnancy resulting from rape were “one in millions and millions and millions.” James Leon Holmes published a letter in 1980 stating that "concern for rape victims is a red herring because conceptions from rape occur with approximately the same frequency as snowfall in Miami." Holmes apologized for this remark in 2003 after he was nominated as United States federal judge (and subsequently confirmed in 2004). In 1995, North Carolina House of Representatives member Henry Aldridge remarked during a debate to eliminate a state abortion fund for poor women: "The facts show that people who are raped — who are truly raped — the juices don't flow, the body functions don't work and they don't get pregnant. Medical authorities agree that this is a rarity, if ever." In 1998, Arkansas state senator (and ophthalmologist) Fay Boozman lost a campaign for a US Senate seat after remarking that rape victims were unlikely to become pregnant due to fear-induced hormonal changes; Boozman later apologized and eventually called the claim "a mistake," and in 1999 the controversy was renewed when he was appointed director of the Arkansas Dept. of Health by then-governor Mike Huckabee. During his campaign in the United States Senate election in Missouri, 2012, U.S. Representative Todd Akin commented on abortion exceptions for rape victims: "I understand from doctors, that’s really rare. If it’s a legitimate rape, the female body has ways to try to shut that whole thing down." The comment was widely criticized. Akin apologized, saying he "misspoke." Akin's suggestion that rape might impede pregnancy was defended by some prominent individuals and groups which oppose legal abortion. A SurveyUSA poll one day after Akin's comments reported that 13% of Missouri adults agreed with Akin's statement and 11% were unsure (±3.8%).

Related views have also been expressed by pro-life groups outside the United States. The United Kingdom pro-life group, Society for the Protection of Unborn Children, similarly claims that rape-pregnancy is "extremely rare", in part because the "trauma of being raped makes it difficult for fertilisation or implantation to occur." The Irish pro-life group Youth Defence published claims on its web site that "Trauma from the rape may bring into play some natural defence mechanisms that reduce the likelihood of pregnancy," but removed these statements in 2012 following the Akin controversy, explaining that the group now deemed them "unreliable." The Irish group Precious Life published claims that "the trauma of sexual assault is likely to inhibit ovulation" and "the rate of pregnancy arising from sexual assault is 0.1%". The Australian group Pro-Life Victoria published an online article (written by Carolyn Gerstner, a medical doctor and former chairman of the National Right to Life Committee) concluding that "pregnancy even from untreated rape is rare" because "There is very firm evidence that the severe emotional trauma prevents ovulation (or implantation)," citing the Nazi experiments studied by Mecklenburg as well as alleged suppression of ovulation by nuns and missionaries raped in Congo, while "Pregnancy after correct medical treatment of rape is zero". The Austrian group Youth for Life (Jugend für das Leben) writes that "Pregnancies after rape are extremely rare" because "protective mechanisms" from the stress of rape will "almost always prevent conception." The group Pro-Life Philippines claims that "Pregnancies resulting from rape are so rare as to be virtually non-existent," because "medical research indicates that an extremely high percentage of women exposed to severe emotional trauma will not ovulate."