Why did a 10-year-old child have to leave Ohio to get an abortion? The state's law is unclear.
- Last month, a 10-year-old child traveled from Ohio to Indiana to get an abortion after she was raped.
- Ohio Attorney General Dave Yost said the child didn't have to leave the state for treatment because her age puts her at greater risk.
- But some doctors and attorneys say he may be wrong, given Ohio's abortion ban is vague and a person's age alone wouldn't qualify as an exception.
The story of a 10-year-old girl from Ohio who crossed state lines to Indiana for an abortion has raised questions about whether she qualified for Ohio's legal exemption to prevent irreversible injury or death.
Hours after the U.S. Supreme Court overturned federal abortion protections last month, Ohio's Senate Bill 23 — also known as the heartbeat bill — took effect, banning almost all abortions once fetal cardiac activity can be detected, which is at about six weeks gestation. There are no exemptions for rape or incest.
This week, Republican Ohio Attorney General Dave Yost told Fox News that, in his legal opinion, the child "did not have to leave Ohio to find treatment" because her age puts her at greater risk.
But some Ohio doctors, attorneys and state lawmakers said he may be wrong given there have been some cases of 10-year-old children who have successfully delivered babies.
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What the law says
The law, which had been on judicial hold since Gov. Mike DeWine signed it in 2019, banned almost all abortions once fetal cardiac activity can be detected at about six weeks, before many people know they're pregnant.
Republicans who control the state Legislature didn't include exemptions for rape or incest.
But an abortion after six weeks could be legal if it prevented "the death of a pregnant woman" or "a serious risk of substantial and irreversible impairment of a major bodily function," according to a nonpartisan analysis by the Ohio Legislative Service Commission.
A "serious risk" is defined in statute as conditions including pre-eclampsia, inevitable abortion and premature rupture of the membranes. Those conditions may also include, but are not limited to, diabetes and multiple sclerosis.
The law provides no path to abortion care for those experiencing mental health challenges. Nor does it provide one for minor victims of sexual assault who are more than six weeks pregnant, according to an Ohio Legislative Service Commission email obtained by the Paste BN Network Ohio Bureau.
"Ohio's abortion prohibition applies regardless of the circumstances of conception or the age of the mother," the email states.
Yost's office emphasized that his assessment did not relate to age requirements but to whether the pregnancy would be considered a medical emergency. The office issued a memo Thursday highlighting exemptions to the six-week ban that stated, in part: "Whether these exceptions apply to a particular case depends on the facts of that case."
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Meanwhile, state Rep. Jeff Crossman, a Democrat from Parma, said Republicans are trying to mislead the public about what their law does ahead of the November 2022 election. Crossman, who is running against Yost for attorney general this year, said he was in the House when the heartbeat bill passed and believes that if Republicans wanted an exemption for children this young, they would have written one.
"We begged them to include a rape exemption," Crossman said. "They didn’t intend for any exceptions whatsoever."
Is a mother's age considered a risk?
Doctors say conditions such as ectopic pregnancy and placental abruptions can be easily labeled life threatening but all might not agree that the age of a patient alone is would qualify.
"It’s not clear," said state Rep. Beth Liston, a Democrat from Columbus, who is a pediatrician who worked at Nationwide Children's Hospital. "Pregnancy increases the risk of death in everybody."
Liston, who now teaches clinical internal medicine and pediatrics, said children younger than 15 have increased risks for potentially life-threatening pregnancy complications, but that doesn't mean those conditions will develop.
"Exemptions for the life of the woman in Ohio are grey, and the law is authored by people without medical knowledge to consider all of the situations which can occur in pregnancy," Liston said.
For example, preeclampsia is more likely in children who become pregnant. The condition often starts with elevated blood pressure but can impair liver and kidney function and cause fluid build-up in the lungs before turning fatal.
"I think physicians are going to have a really hard time interpreting the law," she said.
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Legal confusion
That uncertainty highlights a key criticism of Ohio's six-week abortion ban: Doctors are no longer sure what they can legally do in the exam room.
Those who violate the law can be charged with fifth-degree felonies, fined up to $20,000 by the State Medical Board and lose their medical licenses forever.
Opponents say this creates fear that could cause providers to second-guess decisions or err too far on the side of caution.
"It leaves a lot of room for interpretation," said Dr. Jason Sayat, an obstetrician–gynecologist in Columbus. "These restrictions that have been put into place by lawmakers who really have not looked at medical, evidence-based practice that we apply in the real world ... that makes it difficult for us not to be cautious or limiting."
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Dr. Catherine Romanos, a family physician who provides abortions at Women’s Med Center near Dayton, said she would likely tell a 10-year-old who had been raped that it’s unsafe to carry the pregnancy.
But she emphasized each pregnant person's body is different: Have they been through puberty? Do they have a medical condition such as diabetes?
Patients and their doctors should be allowed to discuss options and make decisions based on that situation, Romanos said.
"For a politician to go on TV and question the medical decision-making or anybody’s intent to help this patient through this horrible situation is upsetting ... it’s just not their place," Romanos said. "It’s not the place of a politician to be questioning these complicated decisions. And clearly, this was a complicated case."
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Anna Staver and Haley BeMiller are reporters for the Paste BN Network Ohio Bureau, which serves the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.
