The voices of my patients echo in my memory as I write this. Even women who are not seeking abortions find themselves at odds with the growing criminalization of pregnancy.
Recently, a patient shared with me: “I’m scared to even talk about my miscarriage because what if they think I did something wrong?” This fear is the direct result of an unsettling trend in our country.
When I first learned about policies like Project 2025, my heart sank. Isn’t it enough that patients already face enormous barriers to care? Now, they must navigate a system that views pregnancy complications as a legal liability. I can’t stay silent. This issue goes beyond politics into human dignity, autonomy, and justice.
Let’s go deeper into how proposed policies like Project 2025 contribute to the criminalization of pregnancy, its impact on marginalized communities, and real-life consequences for patients and providers. I believe that, together, we can challenge a system that prioritizes punishment over care.
What Is Pregnancy Criminalization?
Pregnancy criminalization refers to the prosecution of people for outcomes or decisions related to their pregnancies. It’s a trend that has grown more alarming after the 2022 Dobbs decision in which the U.S. Supreme Court ended the protections of Roe v. Wade.
According to a 2023 report by Pregnancy Justice, nearly 1,400 cases of pregnancy criminalization have been documented in the U.S. between 2006 and 2022. These cases can involve child endangerment, homicide, or drug use—and disproportionately target Black, Indigenous, and low-income individuals. Pregnant people in marginalized communities face heightened risks of investigation for miscarriages or stillbirths—situations where care should be the priority, not police action.
Project 2025 advocates for heightened surveillance of pregnancies. Bringing back outdated laws only deepens the problem. For instance, lawmakers want to revive the Comstock Act, a relic from 1873 that criminalized the distribution of materials related to contraception and abortion. These measures create a climate where patients are less likely to see a doctor because they’re afraid of being prosecuted, further isolating those already struggling with access to services.
This is becoming a public health crisis. Pregnancy criminalization reinforces historic inequalities and erodes trust in healthcare systems.
How Criminalization Targets Marginalized Communities
The Pregnancy Justice report shows how Black women are disproportionately targeted. In one case, a young Black woman experiencing pregnancy loss was charged with manslaughter. These cases don’t happen in isolation. They reflect a pattern of systemic over-policing and racial inequities that permeate our legal and healthcare systems.
Economic barriers make these inequities worse. Low-income people are less likely to have access to legal representation or supportive healthcare services, leaving them vulnerable to investigation and prosecution.
Real-life Consequences
The criminalization of pregnancy has led to significant real-life consequences for patients and healthcare providers, undermining reproductive justice and bodily autonomy.
In 2023, at least 210 women were charged with pregnancy-related crimes. These cases often involved allegations of child abuse, neglect, or endangerment, with the fetus listed as the victim. Notably, most of these charges did not require proof that the fetus or baby was harmed. For instance, in Alabama, a woman was prosecuted for chemical endangerment after her newborn tested positive for drugs despite the lack of evidence of harm to the child.
Some healthcare professionals are becoming afraid to provide necessary care due to fear of prosecution. Doctors hold back from offering treatments that could be seen as helping a woman have an illegal abortion. This compromises patient care, as providers may delay or withhold treatment for ectopic pregnancies, miscarriages, or other conditions.
Prioritizing Care Over Criminalization
The criminalization of pregnancy is a part of a broader erosion of reproductive justice, one that places punishment above compassion.
The consequences are profound and far-reaching, from patients terrified to seek medical attention to providers forced into ethical and legal dilemmas. Policies like Project 2025 amplify these challenges.
Fear-driven policies fail to protect or uplift individuals and families. Instead, they reinforce cycles of inequity and create a public health crisis. The stories of patients and providers caught in this legal labyrinth remind us this isn’t about politics. It’s about morals.
There is hope. Organizations like Pregnancy Justice, advocates, and healthcare professionals are pushing back against these harmful trends. They’re documenting cases, providing legal support, and educating the public about the urgent need for reform. This work reminds us that change is possible when we choose compassion over criminalization.
We can build a system that values dignity and autonomy, and centers care instead of fear. But it will require all of us to speak out and demand justice.
