Oklahoma prosecutors have initiated at least 222 criminal cases related to individuals' pregnancies and births in a three-year period after the U.S. Supreme Court ended the constitutional right to an abortion in June 2022, according to new data published by the nonprofit Pregnancy Justice.
The advocacy group, which works to defend the rights of pregnant people, has identified at least 902 defendants who faced 955 charges in 23 states from June 2022 to 2025. Madalyn Wasilczuk, a co-principal investigator for the study, said this is an undercount. Data collection is ongoing, and some states don’t have accessible records.
The associate professor of law at the University of South Carolina said Pregnancy Justice has studied pregnancy-related prosecutions over several decades. She said trends remain the same: the majority of cases involved allegations of substance use during pregnancy, and most individuals were charged with some form of child abuse, neglect or endangerment.
Most cases involved live births and low-income individuals. Prosecutors often charged pregnant people under statutes that allow them to obtain convictions without proving that the person harmed the fetus or infant. Approximately 854 of the 955 charges required no proof of harm.
Oklahoma had the second highest number of pregnancy-related prosecutions, trailing behind South Carolina, which had 381 cases, and surpassing Alabama, which had 204.
Wasilczuk said states like this create the conditions for higher rates of pregnancy-related prosecutions through court rulings. In 2020, Oklahoma’s Court of Criminal Appeals ruled in State v. Green that an unborn fetus is protected as a child under the state’s child neglect statute. Pregnant Oklahomans can be charged with child neglect for using drugs during pregnancy.
Oklahoma case documents were also more accessible than in other states. Wasilczuk said this contributed to a better count.
She said the growing frequency of cases related to pregnancy loss is the main thing that’s changed since Roe v. Wade was overturned.
The nonprofit identified 70 cases that involve allegations that a person did something during their pregnancy that caused a miscarriage, stillbirth or newborn death. She said when pregnancies don’t end in a live birth, law enforcement and prosecutors are suspicious and look for someone to blame.
“Even though we know miscarriage is very common and stillbirth is more common than one would wish it to be,” Wasilczuk said. “Those cases really have, I think, been given additional fire by the Supreme Court's decision in Dobbs.”
Researchers have limited insight into how cases originate because that isn’t considered relevant to the case itself, Wasilczuk said. Pregnancy Justice found 700 cases involving the medical system and 468 including the child welfare system.
Wasilczuk said the Oklahoma legislature could decide to treat fetuses as part of the pregnant person and not subject to child neglect laws during a person's pregnancy. She added that medical institutions could reconsider their drug testing policies.
Yale New Haven Health, the largest health system in Connecticut, for example, created criteria for drug testing pregnant patients and is only testing newborns if doing so will inform medical care. The Marshall Project reports that is rare.
“I think we know that the criminal legal system does not solve public health problems, and pregnant people need healthcare, not handcuffs,” Wasilczuk said. “So states need to invest in what actually makes pregnancies and families healthier. We know prosecution does not achieve that, but accessible healthcare, accessible evidence-based substance use treatment, economic support and accessible health coverage and insurance do make a difference.”
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