Date of Award

Spring 4-15-2025

Embargo Period

4-28-2025

Document Type

Dissertation - MUSC Only

Degree Name

Doctor of Health Administration

Department

Health Administration

College

College of Health Professions

First Advisor

Kit Simpson

Second Advisor

Jami Jones

Third Advisor

Walter Jones

Abstract

Objective: To assess how often women aged 18–45 in the U.S. who experienced medically documented vaginal rape received prescriptions for abortion pills within 16 weeks of the incident in 2022, using MarketScan® and Medicaid claims data.

Methods: This retrospective cohort study used ICD-10 codes to identify rape survivors in insurance claims data. Researchers tracked prescriptions for abortion pills (mifepristone and misoprostol) within 16 weeks of the incident. Descriptive statistics compared use before and after the overturning of Roe v. Wade.

Results: Among 3,314 identified survivors (508 commercially insured; 2,806 Medicaid), abortion pill use was extremely rare—only 16 women had a prescription paid by their insurer. Emergency contraception was also infrequent, with only 60 women receiving “Plan B” drugs.

Conclusion: Insurance billing data show that most rape survivors do not use insurance to obtain abortion pills or emergency contraception. This suggests a reliance on out-of-pocket care and highlights a significant limitation of using medical claims data to study the intersection of sexual violence and reproductive health choices.

Rights

Copyright is held by the author. All rights reserved.

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