Report Counts 902 Pregnancy-Related Prosecutions Since Dobbs

Prosecutors opened at least 902 criminal cases against people over their pregnancies in the three years after the Supreme Court overturned Roe v. Wade, according to a report released this month by the advocacy group Pregnancy Justice. South Carolina accounted for 381 of them, more than any other state, and the organization says nearly all of those cases rested on allegations of drug or alcohol use during pregnancy rather than on abortion.

The count, drawn from court records in 23 states between June 2022 and June 2025, is the second interim release from the Pregnancy Prosecutions Tracking Study, co-led by Wendy A. Bach, Madalyn K. Wasilczuk and Kendra Hutchens. The authors describe 902 as a floor rather than a total: the data stop in mid-2025, cases from the past year are not included, and the researchers say records in many jurisdictions are difficult to retrieve.

What the charges actually alleged

The report documents 955 individual charges across those 902 cases. Of that number, 876 involved allegations of child neglect, endangerment or abuse — the ordinary criminal statutes that predate the abortion debate and carry no requirement that a fetus or an infant was harmed. Pregnancy Justice found that close to 95 percent of the cases relied on statutes of that kind, meaning a prosecutor did not have to establish injury to obtain a conviction.

The three states that dominated the count were South Carolina with 381 cases, Oklahoma with 222 and Alabama with 204. Together they produced the large majority of the total, and the pattern in each reflects a different legal route to the same result.

"These numbers show that the criminalization of pregnancy in this country is not some distant or hypothetical consequence of abortion bans," said Lourdes A. Rivera, president of Pregnancy Justice. "It is already happening."

Why South Carolina leads the country

South Carolina's figure is not a byproduct of its abortion law. The state's cases, as the report and local coverage describe them, are overwhelmingly about what a pregnant person ingested. The Daily Gazette reported that almost every South Carolina case documented by the researchers involved allegations of drug and alcohol abuse during pregnancy, not an attempt to end one.

That distinction matters for anyone working in addiction treatment, because it means the criminal justice system in at least one state is functioning as the primary responder to perinatal substance use disorder. A positive toxicology result at delivery, a disclosure to a prenatal provider or a report from a hospital social worker can begin a case that ends in a neglect charge.

Pregnancy Justice has documented the state's position for years. It has ranked South Carolina near the top of its state-by-state assessments of pregnancy criminalization, and its researchers argue that prosecutors there have used child-endangerment law to reach conduct that legislators never wrote it to cover.

The clinical cost of a charge

The public health concern is straightforward. Buprenorphine and methadone are the recommended treatments for opioid use disorder in pregnancy, and both are far safer for mother and fetus than untreated addiction, which carries elevated risks of preterm birth, low birth weight and maternal overdose. Research published this year in The BMJ found no increase in neurodevelopmental disorders among children exposed to buprenorphine in utero compared with methadone.

But a treatment system that can generate a criminal file is a treatment system people avoid. Clinicians who work with pregnant patients describe the same calculation repeatedly: an expectant mother who fears a report may skip prenatal appointments, decline medication-assisted treatment or deliver without any care at all. The charge arrives after the harm that better care would have prevented. This blog has covered the long-term safety data for buprenorphine in pregnancy that clinicians now weigh against those fears.

That is the argument harm reduction and maternal health groups have made in statehouses for a decade, and the new count gives it a denominator.

Where the numbers go from here

Pregnancy Justice published the interim update alongside a policy blueprint for state legislatures, and its tracking study continues. The organization says the next release will cover the most recent year of cases, which its researchers expect to be larger than any prior period.

What the current data cannot show is how many of the 902 cases ended in conviction, how many defendants were jailed, or how many children were placed in foster care as a result. Those questions sit with individual court systems that do not report them in any consistent form, and the report does not attempt to answer them.

For now the documented fact is narrower and harder to argue with: in the three years after Dobbs, prosecutors in 23 states filed at least 902 cases against people because they were pregnant, and in the state with the most cases, the allegations were about drugs and alcohol.

If you or someone you know is pregnant and struggling with substance use, medication-assisted treatment and prenatal care can be arranged together, and the national maternal mental health hotline at 1-833-TLC-MAMA is available around the clock.