In April 2023, Iowa Attorney General Brenna Bird announced that the state will no longer pay for any type of emergency contraception or abortion treatment for sexual assault survivors.[1] While not surprising given the Iowa legislature’s aptitude at destroying the rights of its citizens,[2] the removal of emergency contraception for survivors represents another failure by the state to show respect and kindness to those who have been sexually assaulted or are experiencing sexual abuse.

 In June 2022, in Dobbs v. Jackson Women’s Health Organization, the Supreme Court overturned half a century of precedent when it dismantled the constitutional right to an abortion in the United States.[3] In a 6-3 opinion, the majority-conservative court left the fate of abortion access up to the states. In a post-Roe[4] world, it was expected and feared that Republican-majority states would immediately limit access to abortion. Not to be left out of the limelight for long, soon after Dobbs, Iowa Governor Kim Reynolds reintroduced her “fetal heartbeat” bill[5] that would effectively ban abortion after the six-week mark.[6] This bill, House File 732, was originally signed into law in May 2018.[7] While abortion providers challenged this decision, the Iowa Supreme Court simultaneously wrote in a separate challenge that abortion is a fundamental right within Iowa’s constitution.[8] A trial court later applied this ruling to place an injunction on House File 732.[9] Since 2018, Iowa’s six-week abortion ban has sat idle until Dobbs emboldened Governor Reynolds to rear the bill’s ideologically unsound head once more.[10]

Four years later, in 2022, the Iowa Supreme Court overruled its earlier decision that abortion is a fundamental right under the state constitution.[11] In direct response to Dobbs, the State subsequently asked the trial court to dissolve the injunction on House File 732.[12] When the trial court declined to do so, the State appealed to the Iowa Supreme Court.[13] In June 2023, the Iowa Supreme Court chose not to reinstate the fetal heartbeat bill.[14] In the 2023 abortion decision, the Iowa Supreme Court retained the undue burden standard regarding abortion access litigation “with an invitation to litigate the issue further.”[15]

After the Iowa Supreme Court refused to uphold House File 732, persistent on the path of destruction, Governor Reynolds called a special session with the Republican-controlled legislature in July 2023.[16] When the dayslong session concluded, the Iowa Senate passed the fetal heartbeat bill 32-17.[17] In the same month, Polk County District Judge Joseph Seidlin relied on the “undue burden” standard to determine whether the fetal heartbeat bill creates substantial obstacles for those seeking an abortion.[18] Applying the Iowa Supreme Court’s rhetoric in their 2023 abortion decision, Judge Seidlin wrote that “This, perhaps, is the litigation that accepts the invitation.”[19] Under the undue burden standard, Seidlin believed that abortion advocates could argue the fetal heartbeat bill violates Iowans’ constitutional rights.[20] Judge Seidlin’s concern that constitutional rights may be violated facilitated his decision to place a temporary injunction on the bill.[21] Today, House File 732 remains blocked, and Iowa currently allows abortion up to 20 weeks of pregnancy with a required twenty-four-hour waiting period.[22]

While abortion remains legal in Iowa, the Iowa Attorney General’s decision to remove emergency contraception access demonstrates another step taken to decrease the rights of those able to become pregnant. In a statement to the Des Moines Register, Bird’s press secretary, Alyssa Brouillet, announced that the fund was being evaluated to determine whether its payment for emergency contraception is an appropriate use of public funds.[23] The Iowa Attorney General’s statement of “public funds” is misleading and plainly incorrect; funds for the program come directly and solely from fines and penalties paid by convicted individuals.[24] The Iowa Sexual Abuse Examination Payment Program was established in 1979 and since its creation, the program has never held survivors responsible for paying for their examination and any medication received in the aftermath of abuse.[25] Emergency contraception is incredibly important when it comes to treating survivors of sexual abuse.[26] Providing emergency contraception gives survivors an opportunity to reclaim an aspect of their autonomy that has been stolen from them – to not be subject to the pregnancy of a child born of sexual assault.[27]

Despite the state declaring its intentions to increase forced pregnancies and births through House File 732,[28] providing emergency contraception helps survivors avoid unwanted pregnancies and forced births. Forcing a survivor to bear the child born of assault can worsen the psychological and physical symptoms of abuse that the expecting mother experienced prior to her forced pregnancy.[29] Removing emergency contraception for survivors will unmistakably result in a greater number of forced births.[30] This effect is depravingly and depressingly comical in the face of a pro-life legislature and governor who claim to care about the rights of children.

Yet, in the face of this self-proclaimed indignation for upholding children’s rights by being anti-abortion, Iowa is ranked sixth in the nation[31] for the highest number of children in foster care. Iowa’s failure to properly care for the rights of children who currently exist is highlighted by the starvation and subsequent deaths of Natalie Finn[32] of West Des Moines and Sabrina Ray[33] of Perry, and the physical abuse experienced by Krystal Bell[34] of Ankeny and Malayia Knapp[35] in Urbandale all while in foster care. Children born out of sexual assault will suffer alongside their birth mother, as these children often develop poor parent-child relationships because the maternal capacity can be hindered by sexual assault.[36] These circumstances can lead to neglect and abusive parenting.[37] When a child is neglected because they were born out of sexual assault, it is even more likely that they will enter the foster care system where they will continue to be harmed by Iowa’s failure to properly care for its foster youth.[38]

The rights of those with the ability to become pregnant continue to decline in a post-Dobbs world. Forced pregnancies and forced births will rise as the United States faces a landscape in which the right to choose one’s bodily autonomy over government intervention continues to be interpreted as a farce.[39] Taking away a survivor’s choice whether to bear a child while stomping on their autonomy[40] after a sexual assault is cruel, unprecedented, and an embarrassment for the Iowa Attorney General’s Office.

Despite the apathetic message that the Iowa Attorney General’s Office sends its citizens by removing emergency contraception access, the importance of promoting bodily autonomy in the face of sexual assault cannot be undervalued. Bodily autonomy is a simple yet radical notion that individuals have the right to control what happens to their bodies.[41] In the context of sexual assault, bodily autonomy refers to the absence of consent and if applicable, the violative physical intrusion of one’s person.[42] Promoting bodily autonomy has been linked to preventing sexual violence.[43] Consequentially, any action by a state to decrease opportunities for survivors to regain bodily autonomy sends a message to survivors that their own bodies do not belong to themselves. Removing access to emergency contraception for survivors clarifies that bodily autonomy is nonexistent in Iowa; bodily autonomy is now synonymous with a state’s morality code.

The Iowa Attorney General’s Office’s decision to remove access to emergency contraception burns lifesaving bridges of aid and autonomy to survivors of sexual assault. Removing emergency contraception access to survivors will increase forced pregnancies and forced births. While the sweet tooth of the pro-life sponsored legislature and now Attorney General’s Office[44] may be satisfied, these “Iowa Nice” entities will be responsible for the future suffering of children born out of sexual assault who will experience neglect in their own homes and at the hands of the state’s foster care system.


[1] William Morris & Michaela Ramm, Iowa Stops Paying for Rape Victims’ Morning-After Pills and Abortions, Des Moines Reg., (April 7, 2023, 7:45 PM), [].  

[2] This trend includes: House File 732 banning abortions at six weeks or when fetal cardiac activity is detected; Senate File 538, banning gender-affirming care signed into law in March of 2023; Senate Files 391 and 496 banning education on LGBTQ+ topics, requiring schools to forcibly out transgender students, and removing curriculums that teach students about HIV and AIDS signed into law in May of 2023; and now the removal of emergency contraception for sexual assault survivors represents another failure by the state to attempt to show respect and kindness to those who have experienced or are currently experiencing sexual abuse. H.F. 732, 87th Gen. Assemb. (Iowa 2023); S.F., 538, 87th Gen. Assemb. (Iowa 2023); S.F. 391, 87th Gen. Assemb. (Iowa 2023); S.F. 496, 87th Gen. Assemb. (Iowa 2023).

[3] Dobbs v. Jackson Women’s Health Organization, 142 S.Ct. 2228 (2022).

[4] In Roe v. Wade, the Supreme Court held that the right to privacy enumerated in the Fourteenth Amendment protected abortion as a fundamental right. Abortion was legal until viability and as the pregnancy progresses, so would a state’s interest and thus states had greater leeway to regulate or prohibit abortion after the stage of viability. Roe v. Wade, 410 U.S. 113 (1973).

[5] Cara C. Heuser & Christina Han, Antiabortion Heartbeat Bills Are Not Morally, Scientifically or Legally Sound, Sci. Am., (Jan. 23, 2023), [].

6 Governor Reynolds Signs Heartbeat Bill into Law, Iowa, (July 14, 2023) [].

[7] Id.

[8] Roe v. Wade and Supreme Court Abortion Cases, Brennan Ctr. for Just. (September 28, 2022),,on%20the%20stage%20of%20pregnancy. [].

[9] Sharon Bernstein & Julia Harte, Iowa Legislature Passes Six-Week Abortion Ban in Special Session, Reuters (July 12, 2023, 1:39 PM), [].

[10] Id.

[11] Id.

[12] Id.

[13] Id.

[14] Id.

[15] Bernstein & Harte, supra note 9. See Planned Parenthood of the Heartland v. Reynolds, Inc. v. Reynolds ex rel. State, 2023 WL 4635932 (Iowa).

[16] Bernstein & Harte, supra note 9.

[17] Id.

[18] Iowa Judge Temporarily Blocks Enforcement of State’s New ‘Fetal Heartbeat Law’, KCCI Des Moines (July 17, 2023, 10:38 PM), [].

[19] Id.

[20] Id.

[21] Id.

[22] Id.

[23] Morris & Ramm, supra note 1.

[24] Sexual Assault Examination Payment, Iowa Dep’t of Just., [].

[25] Three Year Program Reports, Iowa Dep’t of Just. Att’y Gen.’s Off. Crime Victim Assistance Div., (Dec. 2014), [].

[26] Emergency Contraception is a Simple Part of Post-Rape Care: Why is it Not Routinely Provided?, Sexual Violence Research Initiative, (Jan. 16, 2017, 1:09 PM), [].

[27] Id.

[28] Morris & Ramm, supra note 1.

[29] Penelope K. Trickett, et al., The Impact of Sexual Abuse on Female Development: Lessons From a Multigenerational, Longitudinal Research Study, Nat’l Libr. of Med., [].

[30] ‘Staggering Number’ of Unintended Pregnancies Reveals Failure to Uphold Women’s Rights, United Nations, (March 30, 2022), [].

[31] Facts & Figures, Fams. Helping Fams. of Iowa, Inc., [].

[32] Lee Rood, Four Years After Teen's Starvation Death, Report Says DHS Failed to Heed Earliest Reports of Abuse, Des Moines Reg., (Feb. 18, 2020, 7:40 AM), [].

[33] Tyler J. Davis, Marc Ray Reaches Plea Agreement in Case of Adopted Daughter's Death, Des Moines Reg., (Dec. 22, 2018, 7:11 PM), [].

[34] Lee Rood, After 68 Police Reports, Ankeny Couple Who Adopted 9 Kids Charged with Abuse, Des Moines Reg., (July 28, 2017, 11:41 AM) [].

[35] Lee Rood, Beaten and Locked Up: Another Abuse Case Raises Questions About Iowa's Response, Des Moines Reg., (Jan. 21, 2017, 2:07 PM), [].

[36] Robert T. Muller, Children Born of Rape Face a Painful Legacy, The Trauma & Mental Health Rep., (Jan. 22, 2016), [].

[37] Id.

[38] Elisa van Ee & Rolf J. Kleber, Growing Up Under a Shadow: Key Issues in Research On and Treatment of Children Born of Rape, Ass’n of Child Prot. Pros., [].

[39] High Rates of Unintended Pregnancies Linked to Gaps in Family Planning Services: New WHO Study, World Health Org., (Oct. 25, 2019), [].

[40] Hannah Saunders, Sexual Assault Advocates Speak Out About Loss of Bodily Autonomy Following Roe v. Wade Decision, Bothell-Kenmore Rep., (July 13, 2022, 10:30 AM), [].

[41] Bodily Autonomy: A Framework to Guide Our Future, Positive Women’s Network, [].

[42] Autonomy: Promoting Autonomy Helps Prevent Sexual Violence, NJ Coal. Against Sexual Assault,,respecting%20someone%27s%20choices%20during%20sex [].

[43] Id.

[44] Amanda Rooker, Get the Facts: Fact-Checking the First Campaign Ads in Iowa Attorney General Race, KCCI Des Moines, (Sept. 26, 2022, 6:50 PM), [].

Friday, November 17, 2023