These prosecutions are taking place in relation to pregnancy, pregnancy loss and birth, according to a report released Tuesday. The group Pregnancy Justice, a non-profit that defends the rights of pregnant people, found that Alabama prosecuted 192 women from June 2022 to July 2024, the first two years after the Supreme Court overturned Roe v. Wade.
Most of the prosecutions were related to drug use, according to the report. Many were concentrated in Etowah County, which in recent years has cracked down on drug use during pregnancy, using a 2006 chemical endangerment law intended to protect children from meth labs. According to the report, at least 412 prosecutions have happened in the two years following the Dobbs decision, most of which involved accusations of drug use during pregnancy. A’Niya Robinson, policy and organizing director of the Alabama American Civil Liberties Union (ACLU), said in an interview Thursday that prosecutors should prove that any drug-related crime was done with the intent to harm a woman’s unborn child before they punish them.
“That’s a really big issue. If you’re going to charge a mother with harming her child, you at least need to be able to prove that that’s what she set out to do,” Robinson said. “They’re not necessarily proving that intent element, or if they are, we’re not really seeing it in the records.” The report found that about 85% of cases did not require proof of harm.
“The fact that someone who maybe does suffer from substance abuse, the fact that that is being met with incarceration and not something that feels a bit more merciful, like treatment, that’s also something that is weighing on me as well,” she said. Robinson said that incarcerated pregnant women are generally not taken care of, including not having time with their child when they are born during the mother’s imprisonment. The ACLU worked on drafting legislation last year to allow a pregnant woman’s imprisonment date to be delayed until 12 weeks after the birth. The bill was never even considered.
White infants account for 69.8% of births in Alabama but make up 44.5% of deaths. Black infants account for 28% of births but 51.4% of deaths, according to the Centers for Disease Control.
In December 2025, a group of Alabama nonprofits and women’s health advocates were planning to launch a programme to improve maternal and infant mortality rates. The Alabama Birth Equity initiative is led by the Yellowhammer Fund and joined by Margins: Women Helping Black Women, Oasis Women’s Health, and Alabama Birth Center.
Jenice Fountain, executive director of the Yellowhammer Fund, said the initiative will help midwives in Alabama pay for their training, which usually costs $4,000-8,000 per semester, and transportation to clinics. “Acknowledging that the Alabama Birth Center has a lot going on outside of being a preceptor, and compensating them so that they can compensate their staff for those trainings,” Fountain said.
Fountain said the initiative’s goal is to have 10 midwives or doulas in Alabama within one year, and to meet any reproductive health needs. “What we’re going to do is make some ground on midwifery policy. One of which being that midwives don’t count as guests when you’re at the hospital,” Fountain said. “The person that might not make the cut might be the person you really needed to make sure you have adequate care.”
Dr. Yashica Robinson, an OB-GYN and founder of Alabama Birth Center in Huntsville, said that access to prenatal care in rural counties makes a major difference in infant mortality. “It doesn’t have to be a huge medical event,” Robinson said of giving birth. “It’s when we’re not properly prepared and properly educated, our moms aren’t healthy and they’re not getting prenatal care early enough. Then we miss the opportunities to intervene and make sure they get off to a good start.” Part of the initiative also includes advocating for policy changes like funding for birth centers, Robinson and Fountain said. Robinson said a lack of support from the state for birth centers has also contributed to maternal and infant mortality rates.
SOURCES: New York Times bestselling author Irin Carmon on her new book, “Unbearable: Five Women and the Perils of Pregnancy in America.” AND: Report: Alabama continues to lead nation in prosecutions of pregnant women, Alabama Reflector, October 2025, AND Nonprofits, women’s health organizations launch Alabama Birth Equity Initiative, by Anna Barrett. 9 December 2025.