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Rape and Sexual Coercion Related Pregnancy in the United States
Open accessAbstract
Introduction: Sexual violence is a major public health problem in the U.S. that is associated with numerous health impacts, including pregnancy. U.S. population-based estimates (2010–2012) found that three million women experienced a rape-related pregnancy during their lifetimes. The current study presents more recent estimates of rape and sexual coercion-related pregnancy and examines prevalence by demographic characteristics. Methods: Data years 2016/2017 were pooled from the National Intimate Partner and Sexual Violence Survey, a random-digit-dial telephone survey of U.S. non-institutionalized adults 18 years and older. The analysis, conducted in 2023, examined lifetime experience of rape-related pregnancy, sexual coercion-related pregnancy, or both among U.S. women. Authors calculated prevalence estimates with 95% CIs and conducted pairwise chi-square tests (p-value<0.05) to describe experiences by current age, race/ethnicity, and region of residence among U.S. women overall and among victims. Results: One in 20 women in the U.S., or over 5.9 million women, experienced a pregnancy from either rape, sexual coercion, or both during their lifetimes. Non-Hispanic Multiracial women experienced a higher prevalence of all three outcomes compared with non-Hispanic White, non-Hispanic Black, and Hispanic women. Among victims who experienced pregnancy from rape, 28% experienced a sexually transmitted disease, 66% were injured, and over 80% were fearful or concerned for their safety. Conclusions: Pregnancy as a consequence of rape or sexual coercion is experienced by an estimated six million U.S. women. Prevention efforts may include healthcare screenings to identify violence exposure and use of evidence-based prevention approaches to reduce sexual violence.
Overview
CoChat Summary
TL;DR
This study used 2016/2017 National Intimate Partner and Sexual Violence Survey data to estimate lifetime rape- and sexual coercion-related pregnancy among U.S. women. It found that 4.8%, or 5.9 million women, experienced pregnancy from rape, sexual coercion, or both, with higher prevalence among non-Hispanic Multiracial women and substantial co-occurring injury, fear, and STD impacts.
Key findings
- Overall, 4.8% or 5.9 million U.S. women experienced a lifetime pregnancy from either rape, sexual coercion, or both. Separately, 2.7% or 3.4 million women reported rape-related pregnancy, and 3.9% or nearly 4.9 million reported sexual coercion-related pregnancy.
- Among female victims, 16.0% (5.9 million) became pregnant from any of these experiences. Non-Hispanic Multiracial women had higher prevalence across outcomes; for any experience, 12.2% vs 4.8% non-Hispanic White, 5.8% non-Hispanic Black, and 3.1% Hispanic women.
- Among victims who experienced pregnancy from rape, 28.3% contracted an STD, 66.3% were injured, 82.0% were concerned for their safety, and 85.7% felt fearful. For pregnancy from sexual coercion or any experience, 34.8% and 34.5%, respectively, reported an STD.
- Prevalence was significantly lower in the 65+ age group than in all other age categories with stable estimates; there were no differences by U.S. region.
Methods
- Pooled 2016/2017 NISVS data, a random-digit-dial telephone survey of non-institutionalized English- and Spanish-speaking U.S. adults aged 18+. The unweighted sample included 15,152 females; analysis was restricted to female respondents. Response rate was 7.6% and cooperation rate was 58.6%.
- Rape was measured as completed unwanted vaginal penetration by a male with his penis using physical force or alcohol/drug facilitation; sexual coercion was measured as unwanted sexual penetration due to non-physical pressure by a male partner. Outcomes were lifetime rape-related pregnancy, sexual coercion-related pregnancy, or both.
- Weighted prevalence estimates with 95% CIs were calculated using SUDAAN 11.0. Pairwise chi-square tests (p<0.05) examined differences by age, race/ethnicity, and region. Victim analyses excluded 28 sexual coercion-only victims and 23 victims with only female perpetrators; unweighted victim sample sizes were n=2,867 for rape, n=3,569 for sexual coercion, and n=4,627 for any experience.
Limitations
- The paper states that the low response rate may affect representativeness despite a nearly 60% cooperation rate. Injury, fear, and safety concern impacts were collected for rape-related pregnancies but not sexual coercion-related pregnancies, and impacts could not be conclusively linked to the pregnancy-causing incident for victims with multiple victimizations.
- The paper states that Asian or Pacific Islander and American Indian or Alaska Native subgroup samples were insufficient for reliable estimates, and small Multiracial sample sizes produced wide 95% CIs requiring cautious interpretation. Information was unavailable on pregnancy outcome, number of pregnancies per victim, or perpetrator.
- Evident from the text: estimates rely on retrospective self-report, and the paper notes that measuring rape on surveys is difficult and that varying methodologies or question wording can lead to differing estimates.
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Claims the paper makes
0 Valid · 0 Not valid · 6 Not checked · 39 Own results and interpretations
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Non-Hispanic Multiracial women and non-Hispanic White women, as well as non-Hispanic Black women (5.4%, 95% CI: 3.8–7.6), had higher prevalence compared with Hispanic women (2.2%, 95% CI: 1.3–3.6) (Table 2).”
§ Rape and Sexual Coercion Related Pregnancy in the United States > RESULTS
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among all U.S. women, the prevalence of lifetime experiences of pregnancy from rape, sexual coercion, and any experience was significantly lower in the 65+ age group compared to all other age categories with stable estimates (i.e., the 18–24 age group prevalence estimates were unstable for pregnancy from rape) (Table 2).”
§ Rape and Sexual Coercion Related Pregnancy in the United States > RESULTS
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Approximately a quarter of victims who experienced a pregnancy from rape (28.3%) and about one third of victims who experienced a pregnancy from sexual coercion or any experience (34.8% and 34.5%, respectively) also reported contracting an STD from the victimization.”
§ Rape and Sexual Coercion Related Pregnancy in the United States > RESULTS
hedgedstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For example, non-Hispanic Multiracial women had significantly higher prevalence (6.3%, 95% CI: 3.6–10.8) compared with Hispanic women (2.0%, 95% CI: 1.2–3.5) and non-Hispanic Black women (2.3%, 95% CI: 1.5–3.7) (Table 2).”
§ Rape and Sexual Coercion Related Pregnancy in the United States > RESULTS
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For victims who experienced a pregnancy from rape, 66.3% suffered an injury, 82.0% were concerned for their safety, and 85.7% felt fearful because of the violence against them (Table 4).”
§ Rape and Sexual Coercion Related Pregnancy in the United States > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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In the paper
§ Rape and Sexual Coercion Related Pregnancy in the United States > INTRODUCTION
“The current study advances the knowledge about the prevalence of experiencing rape-related pregnancy and sexual coercion-related pregnancy, which has not been examined before, in important ways by building on the recent work of Basile et al.3”
§ Rape and Sexual Coercion Related Pregnancy in the United States > INTRODUCTION
“This is the only publication known to the authors that reported the prevalence of sexual coercion-related pregnancy”
Citations
Cites
Social and Structural Determinants of Health Inequities in Maternal Health
Crear-Perry, J., Correa-de-Araujo, R., Lewis Johnson, T., McLemore, M. R., Neilson, E., & Wallace, M. (2021) · Journal of Women's Health · doi:10.1089/jwh.2020.8882 · Cited by 898
Merrick, M. T., Ford, D. C., Ports, K. A., Guinn, A. S., Chen, J., Klevens, J., Metzler, M., Jones, C. M., Simon, T. R., Daniel, V. M., et al. (2019) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6844e1 · Cited by 694
Self-citationThe impact of intimate partner violence on women's reproductive health and pregnancy outcome
Sarkar, N. N. (2008) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443610802042415 · Cited by 390
Rape-related pregnancy: Estimates and descriptive characteristics from a national sample of women
Holmes, M. M., Resnick, H. S., Kilpatrick, D. G., & Best, C. L. (1996) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(96)70141-2 · Cited by 363
US Preventive Services Task Force, Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., Doubeni, C. A., Epling, J. W., Grossman, D. C., et al. (2018) · JAMA · doi:10.1001/jama.2018.14741 · Cited by 357
Reproductive Coercion: A Systematic Review
Grace, K. T., & Anderson, J. C. (2018) · Trauma, Violence, & Abuse · doi:10.1177/1524838016663935 · Cited by 340
Committee Opinion No. 518: Intimate Partner Violence
(2012) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e318249ff74 · Cited by 274
Connecting the Dots: An Overview of the Links Among Multiple Forms of Violence
Wilkins, N. J., Tsao, B., Hertz, M. F., Davis, R. A. H., & Klevens, J. (2014) · Cited by 263
STOP SV : a technical package to prevent sexual violence
Basile, K. C., DeGue, S. A., Jones, K. M., Freire, K. E., Dills, J., Smith, S. G., & Raiford, J. L. (2016) · Cited by 247
Self-citationThe Effects of Survey Question Wording on Rape Estimates: Evidence From a Quasi-Experimental Design
Fisher, B. S. (2009) · Violence Against Women · doi:10.1177/1077801208329391 · Cited by 175
Cited by
Li, F., Valentine, A. M., Stevens, J. D., Chaikof, J., & Mitra, M. (2025) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2025.04.011 · Cited by 5
Adıgüzel, İ. B., & Cankurtaran, Ö. (2024) · Journal of Social Service Research · doi:10.1080/01488376.2024.2360624 · Cited by 4
Rocha, M., Lipschutz, R. S., Ravi, M., Nugent, N. R., Lathan, E. C., Wallace, S., Arthur, M., Karra, S., Hinrichs, R. C., Stevens, J. S., et al. (2025) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2025.107619 · Cited by 3
Wahyuni, H. I., Setiyawan, R., Budiman, A., & Shoukat, N. (2025) · Indonesian Values and Character Education Journal · doi:10.23887/ivcej.v8i1.94909 · Cited by 3
Noninvasive Prenatal Paternity Testing: A Review on Genetic Markers
Carrara, L., & Hall, D. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26104518 · Cited by 2
Metadata
- Authors
- D'Angelo, D. V., Liu, Y., Basile, K. C., Smith, S. G., Chen, J., Friar, N. W., & Stevens, M.
- Affiliations
- Centers for Disease Control and Prevention (US)
- ORCID
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2024-03
- Volume
- 66
- Issue
- 3
- Pages
- 389-398
- ISSN
- 0749-3797 (ISSN-L)
- PMC
- PMC10951889
- OpenAlex
- W4388378609
- Semantic Scholar
- 8887c5183b303f657847e403e20a651892ed3b54
- Cited by
- 15
- References
- 30
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 4
- FWCI
- 4.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Centers for Disease Control and Prevention
- Topics
- Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
- Social Sciences › Health › Intimate Partner and Family Violence
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- sexual coercion, sexual violence, intimate partner violence, lifetime prevalence, women, racial and ethnic disparities, sexually transmitted infections, injuries, sexual violence prevention
- MeSH terms
- Adult, Coercion, Ethnicity, Female, Humans, Pregnancy, Rape, Sexual Behavior, Sex Offenses, Sexual Partners, United States
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- D'Angelo, D. V., Liu, Y., Basile, K. C., Smith, S. G., Chen, J., Friar, N. W., & Stevens, M. (2024). Rape and Sexual Coercion Related Pregnancy in the United States. American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2023.11.001
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