Balthrop told Regina that the closest abortion provider for Ashley would be in Chicago. At first, Regina thought she and Ashley could drive there. But it’s a nine-hour trip, and Regina would have to take off work. She’d have to pay for gas, food, and a place to stay for a couple of nights, not to mention the cost of the abortion itself. “I don’t have the funds for all this,” she says.
Clarksdale is in the Mississippi Delta, a vast stretch of flat, fertile land in the northwest corner of the state, between the Mississippi and Yazoo rivers. The people who live in the Delta are overwhelmingly Black. The poverty rate is high. The region is an epicenter of America’s ongoing Black maternal-health crisis. Mississippi has the second-highest maternal-mortality rate in the country, with
43 deaths per 100,00 live births, and the
Delta has among the worst maternal-healthcare outcomes in the state. Black women in Mississippi are
four times as likely to die from pregnancy-related complications as white women.
Mississippi’s abortion ban is expected to result in thousands of additional births, often to low-income, high-risk mothers. Dr. Daniel Edney, Mississippi’s top health official, tells TIME his department is “actively preparing” for roughly 4,000 additional live births this year alone. Edney says improving maternal-health outcomes is the “No. 1 priority” for the Mississippi health department, which has invested $2 million into its Healthy Moms, Healthy Babies program to provide extra support for new mothers. “There is a sense of following through, and not just as a predominantly pro-life state,” says Edney. “We don’t just care about life in utero. We care about life, period, and that includes the mother’s life and the baby’s life.”
Mississippi’s abortion ban contains narrow exceptions, including for rape victims and to save the life of the mother. As Ashley’s case shows, these exceptions are largely theoretical. Even if a victim files a police report, there appears to be no clear process for granting an exception. (The state Attorney General’s office did not return TIME’s repeated requests to clarify the process for granting exceptions; the Mississippi Board of Medical Licensure and the Mississippi State Medical Association did not reply to TIME’s requests for explanation.) And, of course, there are no abortion providers left in the state. In January, the New York Times reported that since Mississippi’s abortion law went into effect, only two exceptions had been made. Even if the process for obtaining one were clear, it wouldn’t have helped Ashley. Regina didn’t know that Mississippi’s abortion ban had an exception for rape.
Even before Dobbs, it was perilous to become a mother in rural Mississippi. More than half the counties in the state can be classified as maternity-care deserts, according to a 2023 report from the March of Dimes, meaning there are no birthing facilities or obstetric providers. More than 24% of women in Mississippi have no birthing hospital within a 30-minute drive, compared to the national average of roughly 10%. According to Edney, there are just nine ob-gyns serving a region larger than the state of Delaware. Every time another ob-gyn retires, Balthrop gets an influx of new patients. “These patients are having to drive further to get the same care, then they’re having to wait longer,” Balthrop says.
Read More: The Future of Abortion Access After Roe v. Wade.
Those backups can have cascading effects. Balthrop recalls one woman who had to wait four weeks to get an appointment. “That’s unacceptable, because you don’t know if she’s high risk or not until she sees you,” the doctor says says. Her patient “didn’t know she was pregnant. Now the time has lapsed so much that she can’t drive anyplace to terminate even if she chose to.”
Early data suggests the Dobbs decision will make this problem worse. Younger doctors and medical students say they don’t want to move to states with abortion restrictions. When Emory University researcher Ariana Traub surveyed almost 500 third- and fourth-year medical students in 2022, close to 80% said that abortion laws influenced where they planned to apply to residency. Nearly 60% said they were unlikely to apply to any residency programs in states with abortion restrictions. Traub had assumed that abortion would be most important to students studying obstetrics, but was surprised to find that three-quarters of students across all medical specialties said that Dobbs was affecting their residency decisions.
“People often forget that doctors are people and patients too,” Traub says. “And residency is often the time when people are in their mid-30s and thinking of starting a family.” Traub found that medical students weren’t just reluctant to practice in states with abortion bans. They didn’t want to become pregnant there, either.
And so Dobbs has compounded America’s maternal-health crisis: more women are delivering more babies, in areas where there are already not enough doctors to care for them, while abortion bans are making it more difficult to recruit qualified providers to the regions that need them most. “People always ask me: ‘Why do you choose to stay there?’” says Balthrop, who has worked in the Delta for more than 20 years. “I feel like I have no choice at this point.”
The weeks went on, and Ashley entered her second trimester. She wore bigger clothes to hide her bump, until she was so big that Regina took her out of school. They told everyone Ashley needed surgery for a bad ulcer. “We’ve been keeping it quiet, because people judge wrong when they don’t know what’s going on,” Regina says. She’s been trying to keep Ashley away from “nosy people.” For months, Ashley spent most of the day alone, finishing up sixth grade on her laptop. The family still has no plans to tell anybody about the pregnancy. “It’s going to be a little private matter here,” Regina says.
Ashley has ADHD and trouble focusing, and has an Individualized Education Program at school. She had never talked much, but after the rape she went from shy to almost mute. Regina thinks she may have been too traumatized to speak. At first, Regina couldn’t even get Ashley to tell her about the rape at all.
In an interview in a side bedroom, while Ashley watched TV with Peanut in another room, Regina recounted the details of her daughter’s sexual assault, as she understands them. It was a weekend in the fall, shortly after lunchtime, and Ashley, then 12, had been outside their home making TikToks while her uncle and sibling were inside. A man came down the street and into the front yard, grabbed Ashley, and covered her mouth, Regina says. He pulled her around to the side of the house and raped her. Ashley told Regina that her assailant was an adult, and that she didn’t know him. Nobody else witnessed the assault.
Shortly after finding out Ashley was pregnant, Regina filed a complaint with the Clarksdale Police Department. The department’s assistant chief of police, Vincent Ramirez, confirmed to TIME that a police report had been filed in the matter, but refused to share the document because it involved a minor.
Regina says that another family member believed they had identified the rapist through social-media sleuthing. The family says they flagged the man they suspected to the police, but the investigation seemed to go nowhere. Ramirez declined to comment on an ongoing investigation, but an investigator in the department confirmed to TIME that an arrest has not yet been made. With their investigation still incomplete, police have not yet publicly confirmed that they believe Ashley’s pregnancy resulted from sexual assault.
Regina felt the police weren’t taking the case seriously. She says she was told that in order to move the investigation forward, the police needed DNA from the baby after its birth. Experts say this is not unusual. Although it is technically possible to obtain DNA from a fetus, police are often reluctant to initiate an invasive procedure on a pregnant victim, says Phillip Danielson, a professor of forensic genetics at the University of Denver. They typically test DNA only on fetal remains after an abortion, or after a baby is born, he says.
But almost three days after Peanut was born, the police still hadn’t picked up the DNA sample; it was only after inquiries from TIME that officers finally arrived to collect it. Asked at the Clarksdale police station why it had taken so long after Peanut’s birth for crucial evidence to be collected, Ramirez shrugged. “It’s a pretty high priority, as a juvenile,” he says. “Sometimes they slip a little bit because we’ve got a lot going on, but then they come back to it.”
Ashley doesn’t say much when asked how it felt to learn she was pregnant. Her mouth twists into a shy grimace, and she looks away. “Not good,” she says after a long pause. “Not happy.”
