In 2019, Kentucky lawmakers passed the Human Life Protection Act (2019 HB 148), a law designed to take effect if Roe v. Wade were overturned. On June 24, 2022, following the decision in Dobbs v. Jackson Women’s Health Organization, that law went into effect, banning abortion in nearly all circumstances. Today, the only exception permitted is for serious medical risk to the pregnant patient. There are no exceptions for rape or incest.
Since then, Kentucky has revisited aspects of this law. In 2025, legislative updates clarified what constitutes a medical emergency and adjusted language from “good faith” to “reasonable medical judgment,” while maintaining that performing an abortion outside of these narrow criteria remains a Class D felony for physicians. House Bill 90 further demonstrates that lawmakers recognize the need to refine the law by outlining qualifying medical conditions that fit the exemption. Yet notably absent from these revisions is any consideration of pregnancies resulting from rape or incest.
This omission is not a minor oversight; it represents a fundamental gap between the stated goals of “pro-life” policy and the realities faced by some of the most vulnerable patients.
As of April 2026, according to the Kaiser Family Foundation, 20 states have implemented abortion bans or severe restrictions. Of those, 11 include exceptions for rape or incest. Kentucky is one of the states that does not. Even among states with similarly restrictive policies, many still recognize these circumstances as ethically distinct. That Kentucky does not raises an important question: What does it mean to protect life if the conditions under which that life begins are not considered?
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The reality is that incest is not a theoretical issue. In 2024 alone, Kentucky reported 89 cases of incest, according to state police data. This number likely represents only a fraction of actual cases, given the well-documented underreporting of sexual violence. Still, it demonstrates that incest is a real and recurring problem within the state.
Research further shows that incest most often occurs among minors, frequently involving a parent or close family member, with father-daughter relationships among the most reported dynamics. These circumstances create profound barriers to disclosure. Victims may depend on the perpetrator, live in the same household, and experience repeated abuse over time. In these cases, the patient is not only a survivor, but often a child.
When pregnancy results from incest, the consequences are layered and severe. Studies estimate that approximately 7 percent of incest cases result in pregnancy. These patients are more likely to delay seeking care, experience significant emotional and behavioral distress, and face long-term educational and socioeconomic challenges. The expectation that they will navigate legal systems, disclose abuse, recognize pregnancy early, and access care within narrow timeframes is not grounded in reality.
Pregnancy resulting from incest does not affect just one child, but two. From a medical perspective, these pregnancies carry increased risks for the fetus, including a higher likelihood of genetic disorders, structural abnormalities, and long-term developmental challenges. While not every case results in these outcomes, the risks are well established. A policy framework that seeks to protect children must consider both the health of the pregnant patient and the potential long-term well-being of the child.
Under current Kentucky law, however, a minor impregnated through incest has no option for abortion within the state. While resources such as the Kentucky Association of Sexual Assault Programs provide critical support for survivors, access to comprehensive medical care remains inconsistent. At the same time, crisis pregnancy centers, many of which are faith-based, are widespread across the state. Research has shown that these centers can provide misleading information and may delay access to evidence-based medical care, creating additional barriers for patients already in vulnerable situations.
Policies described as “pro-life” aim to protect children. But in cases of incest, the pregnant patient is often a child herself. These circumstances also raise important considerations about long-term quality of life, including the potential for social stigma related to the circumstances of conception and the added challenges that may arise from associated medical or developmental conditions. A commitment to protecting life cannot stop at legislation; it must extend to the realities of those most affected by it.
Improving reproductive health legislation is a complex and ongoing process, one that reflects deeply held values and is unlikely to be resolved quickly. However, addressing the needs of the most vulnerable populations should not be overlooked. Incorporating protections for pregnancies resulting from incest would not resolve every challenge within this broader debate, but it would represent a meaningful step toward aligning policy with patient reality. In a conversation that is far from over, this is one place where progress is both possible and necessary.
Taylor Scott is a medical student.
