In early June, Sasha, who was around 16 weeks pregnant, started to bleed vaginally. She went to the emergency room, where doctors told her she was suffering from a “subchorionic hemorrhage,” diagnosed her with a “threatened miscarriage,” and sent her home.

A couple of weeks later, Sasha (whose name has been changed to protect her privacy) miscarried a tiny, non-viable, 18-week-old fetus in a South Carolina motel room. She later told a county coroner that she didn’t call for help at the time because she “was scared and did not know what to do.”

As it turned out, she was right to be fearful. The day after her miscarriage, Sasha continued to bleed and suffered from severe abdominal pain, so she returned to the hospital. There, her medical providers reported her to the state’s Department of Social Services, whose staff alerted the county sheriff’s office about a possible “child abuse” case, as they complied with South Carolina’s reporting mandates. According to the hospital, failure to report any suspicion of harm to a fetus, viable or not, can result in the provider being criminally liable. The sheriff’s office began an investigation and eventually found the pregnancy remains in a trash receptacle near the motel.

The Mayo Clinic estimates that 10 to 20 percent of known pregnancies end in miscarriage. Nonetheless, Sasha was arrested and jailed for the improper disposal of hers. A local abortion fund that had heard about the arrest on the news provided Sasha’s $10,000 bail.

Sasha’s arrest was not an isolated incident. A report released today by Pregnancy Justice—a research, legal, and advocacy group—shows that between June 2022 and June 2024, at least 412 people across the country have been charged for crimes related to their pregnancies, pregnancy losses, or even live births. Sasha’s case is not included in the report because her arrest occurred a year after the researchers’ 2024 cut-off date, as were at least four criminalization cases Mother Jones has identified. But collectively, experts say, these types of arrests show a concerning pattern: Amid a conservative movement to enshrine rights to fetuses, being pregnant is not just a health status. Sometimes, it’s a criminal liability.

“Four hundred and twelve women were charged with crimes that would not have been crimes if they were not pregnant. That is exactly what happens when we give rights and status to embryos and fetuses.”

“Four hundred and twelve women were charged with crimes that would not have been crimes if they were not pregnant,” says Dana Sussman, senior vice president at Pregnancy Justice. “That is exactly what happens when we give rights and status to embryos and fetuses.”

The pregnancy-related prosecutions tracked by Pregnancy Justice span 16 states, most having taken place where Republican state legislatures or courts have conferred legal rights to eggs, embryos, and fetuses: a conservative movement known as “fetal personhood.”

The 62 prosecutions that took place before Sasha’s in South Carolina followed a 1997 state supreme court decision that held child endangerment charges also applied to fetuses. In Oklahoma—where Pregnancy Justice identified 112 prosecutions—a state appeals court made a similar decision in 2020.

Pregnancy Justice counted 192 pregnancy-related prosecutions in Alabama, which was the first state to enshrine rights to unborn children in its constitution via a 2018 ballot measure. The Alabama state supreme court used this ballot measure to support its 2024 decision that even frozen embryos are considered “extrauterine children” with inalienable rights. (This ruling had vast implications for Alabama fertility clinics, some of which paused IVF services out of fear they’d be held liable for the “wrongful death” of embryos on ice. Facing backlash, Republicans spoke out in support of IVF. Alabama subsequently passed a law shielding fertility providers from liability.)

Roughly 90 percent of the charges catalogued by Pregnancy Justice accuse pregnant women of abuse, neglect, or endangerment—accusations that are bolstered by the conservative perception of fetuses having the same rights as children that result from live births.

Many of the abuse, neglect, and endangerment cases involved allegations of substance use during pregnancy. Evidence of meth and cocaine use was noted in some of the charging documents, according to Pregnancy Justice. So was the presence of marijuana, nicotine, and alcohol. In 68 of the cases, the nonprofit says, the only substance use alleged was marijuana.

Some defendants were charged for pregnancies they did not know existed. This was the case for Catherine, a 31-year-old woman in Alabama, who was arrested in 2023 for a pregnancy-related drug charge.

Catherine, who asked not to be identified by her last name, previously spoke to Mother Jones reporter Madison Pauly about her years-long ordeal. She said what began one day in 2021 as severe stomach pain quickly escalated to an intensity that led her to collapse in her bathroom, where she lay on the floor surrounded by blood and holding a stillborn baby. After calling 911 and being transported to a local hospital, law enforcement confiscated her phone, and the nurses asked for her password. They all were seeking evidence in order to charge her with “chemical endangerment” of her “unborn child.”

For many reasons, Catherine said she was shocked. She never tried to hide that she had a controlled substance in her system. (She admitted to battling drug addiction.) Nor was she trying to hide a pregnancy.

“I never knew that I was pregnant,” she told Mother Jones. “My body never showed signs. I never gained weight. I felt completely normal.”

Generally, most health experts would recommend that individuals battling substance abuse try to avoid becoming pregnant. But in real life, Sussman says, the scenarios are often far more nuanced. Some investigations have arisen from pregnant individuals using medications they had been prescribed; there have even been cases in which mothers who consumed poppy seed bagels were falsely charged with opioid abuse. In circumstances where pregnant women are actively battling addictions to substances like methamphetamines or fentanyl, Sussman argues that criminalization can be more harmful than helpful.

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“Criminalization does not improve health outcomes,” Sussman says. “Ensuring that people can access prenatal care and go to the hospital when they need to, without worrying that they will be charged with a crime—that is the best intervention possible.”

“Criminalization does not improve health outcomes.”

A law Tennessee passed in 2014 illustrates the risks of criminalization. The statute allowed prosecutors to bring aggravated assault charges against women for using illicit narcotic drugs while pregnant, with penalties of potentially up to 15 years in prison.

While the law intended to reduce Neonatal Abstinence Syndrome and other complications, reproductive care advocates such as Pregnancy Justice say it discouraged pregnant people from seeking prenatal care or drug treatment, out of fear of prosecution.

According to a review by the Georgetown Law Journal, there was a “sharp decline in the receipt of prenatal care” around the time the fetal endangerment law was implemented, and fetal deaths increased. The law was also seen as being responsible for having a disproportionate impact on women in poverty and those with more limited access to treatment programs. As a result, the law was sunsetted in 2016.

The Trump administration’s recent amplification of a narrow research study suggesting that acetaminophen use during pregnancy can cause autism gives Pregnancy Justice additional concerns about what else could make pregnant women vulnerable to prosecution in the future. “We are moving into a place, potentially, where pregnant people’s behavior and exposure of their pregnancy to any risk—whether perceived or actual, justified by science or not—can further diminish their rights,” Sussman says.

As seen with both Sasha and Catherine, medical facilities and personnel potentially can play a significant role in the pregnancy criminalization surveillance system. In 264 of the 412 prosecutions Pregnancy Justice tracked between 2022 and 2024, health care providers contributed information to police that eventually was used as evidence against the defendants during their prosecutions.

Brittany Watts is one example. In September 2023, she repeatedly went to her local hospital in Ohio after her water broke prematurely. Her 22-week-old fetus registered a heartbeat, but doctors determined it was nonviable. Despite physician concerns that Watts could contract sepsis, hemorrhage, or even die, staff at the hospital delayed inducing her as they awaited input from the hospital’s ethics board. (Ohio banned abortion at 22 weeks.) Over the course of two days, Watts waited 18 hours at the hospital for an induction that never came. Frustrated by the delays, she went home to be more comfortable.

Less than 48 hours later, she miscarried in the toilet, attempted to flush, and returned to the hospital, where she was treated for dehydration and blood loss. But hospital staff also took it upon themselves to report Watts to the police.

“The nurse comes in and she’s rubbing my back and talking to me and saying, ‘Everything’s going to be OK. You’re going to be OK,'” Watts told CBS News last year in her first sit-down interview. “Little do I know, there’s a police officer who comes into the room a short time later. And I’m wondering, ‘Why is a police officer coming in here? I don’t recall doing anything wrong.’ And little do I know, the nurse comforting me and saying that everything was gonna be OK was the one who called the police.”

As Watts lay in a hospital bed, police searched her home, where they rummaged through her trash and disassembled her toilet to find evidence of the fetal remains, investigatory files obtained through public records requests show.

Photos taken by police as a part of the investigation reveal what anyone who has endured the trauma of a pregnancy loss might expect: blood-stained pants, soiled rags, a drug store receipt for Tylenol, and a discarded hospital bracelet. For the purported crime of experiencing a pregnancy loss in her bathroom, Watts could have faced a year in prison. Instead, a grand jury declined to indict her, leading prosecutors to drop the charges against her.

Amari Marsh risked a much longer sentence for her 2023 home miscarriage. Prosecutors initially charged the South Carolina woman with homicide through child abuse. Police erroneously suspected she had tried to induce an abortion. They also claimed that a proximate cause of death was her not removing the fetus from the toilet fast enough. An autopsy later determined that an infection had caused the pregnancy loss, and a grand jury declined to indict Marsh. Had she been convicted, she could have faced 20 years to life in prison.

Fueling the issue, Sussman argues, is the public’s lack of knowledge around miscarriages: “How common it is, what it looks like, where it happens, how it happens.” Law enforcement might find something suspicious that is, in fact, “completely normal,” she says.

Pregnant women also can be in the dark, Sussman notes: “No one is given a pamphlet in their doctor’s office when they go for their first prenatal appointment that’s like, ‘By the way, if you miscarry, here’s the number to call, here’s the coroner’s office that you’re required to call.'”

Even when charges don’t result in convictions, pregnancy-related prosecutions can have enduring consequences for those accused. In a civil lawsuit Watts recently filed against the city that prosecuted her and the hospital that she went to for medical help, Watts claims to have suffered “deprivation of liberty, reputational harm, public humiliation, distress, pain, and suffering, for which she is entitled to compensatory damages, including damages for mental and emotional distress.”

And in the midst of dealing with legal issues, some women who have been prosecuted for pregnancy-related crimes are also mourning pregnancies they lost. According to her civil suit, Watts’ pregnancy was “very much wanted.” Catherine, who is in remission from drug addiction, says she misses her stillborn daughter every day. Sasha and her lawyer declined to be interviewed while her case is active, but in police records, she asserts that she was taking prenatal vitamins—another indication that she, too, was trying to have a healthy pregnancy.

Contained in these stories, experts say, is a painful irony. Pregnant women who fear becoming the next Watts, Catherine, or Sasha may choose to forgo medical help altogether, risking even worse outcomes for both them and their fetuses. “It’s not surprising,” Sussman says, “that the states that represent a lot of the arrests also have poor infant health outcomes.”

—with reporting by Sheena Samu, Rachel de Leon, and Laura Morel.

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