Since the Supreme Court overturned Roe v. Wade on June 24, 2022, the landscape of reproductive healthcare in the United States has shifted dramatically. Nowhere is this more apparent than in the rising number of prosecutions against women following pregnancy loss and the mounting threats to healthcare access, especially in states like Virginia. In the year following Roe’s reversal, at least 210 women across the nation faced prosecution for pregnancy outcomes—many related to allegations of substance use or miscarriage, according to a report by Pregnancy Justice, a nonprofit organization that has tracked these cases for decades.
“Each of these cases is a pregnant person who has been incarcerated or separated from their children, who has experienced a pregnancy loss, or maybe they’ve had law enforcement called on them when they’re seeking health care,” said Michele Ko, project manager at Pregnancy Justice, as reported by AFRO American Newspapers. “These cases can be deeply traumatic experiences that really strip pregnant women of their dignity and their humanity.”
Pregnancy Justice’s data paints a stark picture: the 210 prosecutions recorded in the year after Roe’s fall represent the highest number ever documented in a single year. Of those cases, 133 involved substance use as the sole allegation. Prosecutors have increasingly relied on existing statutes—such as child endangerment, neglect, and abuse laws—applying them beyond their original intent to criminalize pregnancy outcomes. Ko emphasized, “The vast majority of pregnancy related prosecutions involve prosecutors actually using existing laws like child endangerment, neglect and abuse statutes beyond their original intent to criminalize pregnancy.”
This trend is not new. Pregnancy Justice has cataloged over 400 cases from 1973 to 2005, and nearly 1,400 more between 2006 and June 2022, the date of the Dobbs ruling that overturned Roe v. Wade. But the current surge is unprecedented, and the consequences are rippling through communities—especially among Black women and other marginalized groups. Of the 210 women impacted in the past year, 30 were Black. The criminalization of pregnancy has its roots in the 1980s, when unfounded claims about cocaine’s effects on unborn children led to a disproportionate targeting of Black mothers. As substance use trends shifted, prosecutions expanded to poor white communities, but low-income women of all backgrounds remain most vulnerable.
The stories of Brittany Watts and Amari Marsh, both Black women, underscore the human cost of this approach. Watts, from Warren, Ohio, was charged with “abuse of a corpse” in September 2023 after experiencing a miscarriage. Marsh, in Orangeburg County, South Carolina, faced a “homicide by child abuse” charge in early 2023. Both women saw their cases dropped after grand juries declined to indict—Marsh after spending 22 days in jail, and Watts in February 2024. These cases highlight the increasing likelihood that, in states with strict abortion bans, a miscarriage is treated less like a medical event and more like a potential crime scene.
“In states with strict abortion bans, a miscarriage is treated less like a medical event and more like a potential crime scene,” noted Ross Goodman, a criminal defense attorney in Las Vegas, in AFRO American Newspapers. “We’ve seen cases where women have been investigated or even charged for not seeking medical care ‘soon enough’ or simply because the circumstances of the pregnancy loss raised suspicion among people who are not medical professionals.” Goodman added, “We’re watching due process and bodily autonomy being pushed aside. In states with strict abortion bans, the state’s interest in a pregnancy outweighs the rights of the person carrying it. That creates a situation where pregnant women are treated more as vessels under surveillance rather than people experiencing a medical event.”
This chilling environment is deterring pregnant people from seeking care, inevitably worsening maternal health outcomes. Ko argued that a policy shift is urgently needed: “We need to be changing policy and practices to ensure that pregnant women have access to the health care and support they need without fear of criminalization. It’s really going to take all of us to ensure that all people–regardless of pregnancy status or outcome–have the freedom to make decisions about their bodies and experience a life of dignity and respect.”
Meanwhile, in Virginia, the battle over reproductive healthcare has taken on new urgency with the passage of the One Big Beautiful Bill (OBBB). Marketed by its supporters as a landmark achievement that delivers tax cuts and border security, the OBBB also contains provisions that threaten healthcare access for approximately 1.9 million Virginians on Medicaid. The most contentious aspect of the bill is its attempt to block all federal Medicaid funding to Planned Parenthood for one year—a move that would have devastating consequences for low-income and rural populations, especially those already facing barriers to care.
On July 28, 2025, a federal judge issued a preliminary injunction blocking this provision, ensuring that—for now—Medicaid patients can continue to receive care at Planned Parenthood clinics while litigation proceeds. Judge Indira Talwani’s ruling protects all 47 Planned Parenthood affiliates nationwide, following an emergency motion filed by the organization. In her decision, Judge Talwani wrote that Planned Parenthood has a “substantial likelihood of success” in its argument that the provision violates the Constitution.
Despite this temporary reprieve, the impact is already being felt. Since the OBBB was signed into law, at least 32 Planned Parenthood clinics across the country have announced closures. Planned Parenthood Mar Monte, the nation’s largest affiliate, has shut down five clinics and anticipates a $100 million loss in annual revenue. The Virginia League of Planned Parenthood operates five clinics in Greater Richmond and Hampton Roads, offering services like cancer screenings, STI testing, birth control, abortion care, and routine exams. While Medicaid prohibits abortion coverage in nearly all cases, the vast majority of care provided at these clinics is preventive and routine—services that would become even harder to access if federal funding is cut.
Virginia Medicaid Director Cheryl Roberts summed up the uncertainty facing the state: “We do not have [Centers for Medicare and Medicaid Services] guidance for 90% of this. When I say ‘we don’t know’—we really don’t know yet.” In the absence of clear guidance, clinics, hospitals, and patients are left to brace for potentially devastating consequences without knowing exactly how—or when—they’ll arrive.
For abortion seekers in Virginia, financial support often comes from abortion funds like the Blue Ridge Abortion Fund (BRAF), one of only four in the state. These funds provide both financial and logistical assistance to help people access abortion care, especially as clinics close and costs rise. Planned Parenthood has estimated that up to 200 clinics could close nationwide as a result of the funding cuts, worsening access for rural, working-class, and Black and Brown communities.
The OBBB’s Medicaid cuts are not just about funding. As The Dogwood notes, they represent a targeted dismantling of public health infrastructure, carried out under the banner of fiscal responsibility. Even with the injunction in place, the threat of defunding remains, and the future of reproductive healthcare in Virginia—and across the country—hangs in the balance. Advocates argue that upholding liberty, dignity, and real access to healthcare means protecting reproductive care, not legislating it out of reach.
As the legal and political battles continue, the stakes for women, families, and communities could not be higher. The stories emerging from courtrooms and clinics alike are a stark reminder: the fight for reproductive rights and healthcare access is far from over, and the consequences of inaction are all too real.
