Anna Claire Vollers, Stateline

After the Trump administration slashed billions in state and local public health funding from the federal Centers for Disease Control and Prevention earlier this year, the eventual impact on states split sharply along political lines.

Democratic-led states that sued to block the cuts kept much of their funding, while Republican-led states lost the bulk of theirs, according to a new analysis from health research organization KFF.

The uneven fallout underscores how politics continues shaping health care in the United States. The nearly 700 CDC grants were worth about $11 billion and had been allocated by Congress during the COVID-19 pandemic. Since then, state and local health departments had spent or planned to spend the money not just on COVID-related efforts, but also on prevention of other infectious diseases, support for mental health and substance use, shoring up aging public health infrastructure, and other needs.

The CDC grant terminations initially affected red and blue states about evenly, according to KFF. California, the District of Columbia, Illinois and Massachusetts — all led by Democrats — had among the largest numbers of terminated grants.

But then nearly two dozen blue states and the District of Columbia sued the Trump administration in April, asking the court to block the grant terminations. They argued the federal government lacked the authority to rescind funding it had already allocated.

“The Trump administration’s illegal and irresponsible decision to claw back life-saving health funding is an attack on the well-being of millions of Americans,” said New York Attorney General Letitia James in an April statement announcing the lawsuit.

“Slashing this funding now will reverse our progress on the opioid crisis, throw our mental health systems into chaos, and leave hospitals struggling to care for patients.”

A federal judge sided with the blue states and blocked the cancellations — but she limited her injunction to the jurisdictions that filed in the lawsuit.

Nearly 80% of the grant cuts have now been restored in blue states, according to the KFF analysis, compared with less than 5% in red states.

Now four of the five states with the most canceled grants are led by Republicans: Georgia, Ohio, Oklahoma and Texas. California, which is dominated by Democrats, kept all of its grants that had been initially terminated.

In the West and Midwest, Democratic-led Colorado — which joined the lawsuit — had 10 of its 11 grant terminations reversed. Its Republican-led neighbors that did not sue, including Kansas, Nebraska, Oklahoma, Utah and Wyoming, lost all of their grants, according to the KFF analysis.

Editor’s note: This story has been updated to correct the photo caption. Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org

In the year after the U.S. Supreme Court dismantled the constitutional right to abortion in June 2022, more than 200 pregnant women faced criminal charges for conduct associated with their pregnancy, pregnancy loss or birth, according to a new report.

The report was produced by Pregnancy Justice, a nonprofit that advocates for the rights of pregnant people, including the right to abortion. Researchers in multiple states documented 210 cases of women being charged for pregnancy-related conduct in 12 states from June 24, 2022, to June 23, 2023, the first year after the U.S. Supreme Court eliminated the constitutional right to an abortion, throwing the issue to the states.

The majority of charges alleged substance use during pregnancy; in two-thirds of cases, it was the only allegation made against the defendant. Six states — Alabama, Mississippi, Ohio, Oklahoma, South Carolina and Texas — accounted for the majority of cases documented by researchers.

The new report utilizes improved data collection, making comparisons with previous versions difficult. But “what we found was even more of an acceleration in pregnancy criminalization as compared to before” the Supreme Court’s ruling, said Lourdes Rivera, president of Pregnancy Justice. Rivera said she thinks that in states with abortion bans or new restrictions, there is more scrutiny of pregnancy loss.

However, almost none of the prosecutions documented by researchers were brought under state abortion laws. Instead, researchers found that law enforcement most often charged pregnant women with crimes such as child neglect or endangerment, interpreting the definition of “child” to include a fetus. In doing so, authorities relied on a legal concept called fetal personhood — the idea that a fetus, embryo or fertilized egg has the same legal rights as a person who has been born.

“If we focus only on abortion laws, we miss a crucial part of the picture in the fact that pregnant individuals are being criminalized for allegedly endangering their own pregnancies, for pregnancy loss and, in some cases, for conduct related to abortion,” Rivera said. “What’s driving pregnancy criminalization is the expansion of fetal personhood.”

Charges of child abuse or endangerment carry stiffer penalties — higher fines and lengthier prison sentences — than the low-level drug charges the women likely would have faced had they not been pregnant.

“Pregnancy-related prosecutions don’t generally charge crimes that, on the face of the criminal statute, have anything whatsoever to do with pregnancy,” said Wendy Bach, a professor at the University of Tennessee College of Law and the report’s principal investigator. “Instead, using the idea of fetal personhood, or more specifically the idea that the fetus can be the victim of a crime perpetrated by the pregnant person, they use that theory to charge general crimes.”

The push for charges

Conservative lawmakers in Alaska, Illinois, Missouri, South Carolina and West Virginia introduced fetal personhood bills in the most recent legislative session, though none made it out of committee. In Nebraska, dueling amendments will appear on the ballot. One would codify the right to abortion until “fetal viability,” about 24 weeks. The other would amend the state constitution to restrict abortion to 12 weeks and protect “unborn children” in the second and third trimesters of pregnancy.

Proponents of charging pregnant women for conduct that could harm a fetus argue that the threat of prosecution incentivizes the women to get care or treatment for substance use disorders.

Jody Willoughby, the Republican district attorney in Etowah County, Alabama, which has long had some of the highest numbers of pregnancy-related arrests in the country, has said publicly that his office prosecutes cases because doing nothing would make his office “an enabler of a deadly addiction, complicit in the abuse of a child, and ultimately lead to the death of a mother,” local news outlet AL.com reported in 2022. Willoughby did not respond to Stateline’s requests for comment.

But critics say the arrests and prosecutions deter people from seeking care for fear they’ll be arrested or lose custody of their children. The majority of defendants identified in the report had low incomes; most were white.

All six of the states that accounted for most of the cases cited in the study have fetal personhood language baked into their laws. Seventeen states have laws with broad fetal personhood language that could apply to all criminal laws, according to an analysis by Pregnancy Justice.

When it comes to prosecuting pregnant women, Alabama leads the nation: The state accounts for nearly half of the prosecutions documented in the report. Alabama has a constitutional amendment, approved by voters in 2018, that explicitly confers personhood on fetuses and affirms the state’s responsibility to protect “the rights of unborn children.” All the cases documented in Alabama were brought under its chemical endangerment law, which the Alabama Supreme Court ruled in 2013 can include fetuses.

Most of Alabama’s cases come from just a few counties. They were long considered outliers, places where a handful of overzealous officials liberally applied the state’s chemical endangerment law to hundreds of pregnant women.

But Brittany VandeBerg, who led the research in Alabama, said that chemical endangerment charges have popped up in a dozen more Alabama counties since the Dobbs ruling.

Conservatives push to declare fetuses as people, with far-reaching consequences

“In each county the district attorney really steers the ship as far as what type of priorities they have in their office for prosecutions,” said VandeBerg, who is associate chair of the department of criminology and criminal justice at the University of Alabama. “I don’t know if the elected district attorneys feel this is what the community wants, or if it’s their own personal feelings. But the system is in place to move those cases forward.”

VandeBerg said Alabama provides relatively meager resources for people struggling with addiction. That leaves law enforcement feeling like they have no options other than to arrest and jail women with substance use disorders, she said.

“There just aren’t enough inpatient treatment facilities to help these women,” VandeBerg told Stateline.

One of the things that stuck out to VandeBerg in reviewing cases was the large share of incidents in which a pregnant woman was charged with chemical endangerment even though her baby exhibited no signs of harm after it was born.

“I found that incredibly shocking,” said VandeBerg, who noted that Alabama’s chemical endangerment law can result in a 10-year prison sentence — much longer than some domestic violence crimes carry. “Here, they’re charging the mother before we know harm has been done.”

Defendant exonerated

In July, an Oklahoma court exonerated a woman who’d been charged with felony child neglect in 2020 after her son tested positive for marijuana at birth. Prosecutors pursued the case even though her baby was born healthy, and she’d had a doctor-approved state license to legally use medical marijuana to treat severe morning sickness during the pregnancy.

Helping a minor travel for an abortion? Some states have made it a crime.

Brian Hermanson, an Oklahoma Republican district attorney who’s prosecuted dozens of women in his district in similar circumstances, used fetal personhood language in his legal argument.

“Marijuana is an illegal drug under Oklahoma law unless the person consuming the marijuana holds a medical marijuana license. Unborn babies cannot hold such a license,” Hermanson wrote in a court filing.

“[The defendant] admitted to smoking marijuana throughout her pregnancy, knowing that her unborn baby was being exposed to the possible harmful effects of the marijuana smoke.”

The Pregnancy Justice report also documented five cases in which allegations specifically mentioned abortion. One was brought under a state abortion statute that has since been repealed. The other four cases were charged as homicide, child neglect or abuse of a corpse. In the two cases in which homicide was charged, the defendants allegedly visited an abortion clinic or took pills and the abortion was successful, Rivera said.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org. Follow Stateline on Facebook and X.

Marilyn Gomez was sitting at her kitchen table in Charlotte, North Carolina, on Feb. 16 when news alerts and friends’ texts began pinging her phone: The all-Republican Alabama Supreme Court had ruled that frozen embryos created through in vitro fertilization were children under state law. That meant providers could be held liable for discarding them, a common part of the IVF process.

As Alabama clinics began suspending IVF services and public outrage mounted, politicians on both sides scrambled to distance themselves.

In Gomez’s quiet kitchen, it all felt deeply personal.

“I remember thinking, this is the only way I was able to become a mother,” Gomez told Stateline. She and her husband went through years of fertility treatments and multiple rounds of IVF before the birth of their daughter in 2016. Without freezing her embryos and going through IVF, she said, “I would not be a mom. My 8-year-old would not be here.”

Gomez owns a small business, called Infertile Tees, where she designs and sells shirts and accessories aimed at people experiencing infertility. Less than two hours after hearing about the Alabama court ruling, Gomez, who describes her political views as Democratic-leaning, had created a new set of T-shirt designs featuring the slogan “Protect IVF.”

In the wake of the Alabama ruling, potential threats to IVF access have become an election-year issue, pushing many political novices toward involvement and activism. Reproductive rights groups say they’ve seen unprecedented interest in protecting IVF access, and Democrats hope it will motivate voters in the swing states that will decide the election, including North Carolina.

At least 19 states — either through state law, criminal statutes or case law — have declared that fetuses at some stage of pregnancy are people, according to a 2023 report by Pregnancy Justice, a nonprofit that conducts research and advocates for the rights of pregnant people, including the right to abortion. Such statutes could, in theory, be used to restrict or ban IVF by classifying the destruction of embryos as causing the death of a child. The Alabama high court cited so-called fetal personhood language in the state constitution when it issued its decision.

Marilyn Gomez and her husband, Manny, struggled for years with infertility before conceiving their daughter through in vitro fertilization. Gomez’s experience led her to launch an apparel company called Infertile Tees and to get involved in advocating for legislation that protects and promotes access to IVF treatment for others. Nicole Bertrand Photography/Courtesy of Marilyn Gomez

North Carolina isn’t one of those 19 states, but conservatives there have been testing the waters.

A bill proposed last year by three Republican state representatives would have banned abortion from the moment of fertilization, and last year an appeals court judge terminated a woman’s parental rights for conduct during her pregnancy because “life begins at conception,” though the opinion was later withdrawn.

Michigan, Pennsylvania and Wisconsin, all swing states, do have laws that include references to “unborn children.” And in Georgia, another contested state, the state’s abortion ban defines a person as “any human being including an unborn child.”

Democrats are eager to highlight the issue. The newly minted Democratic vice presidential candidate, Minnesota Gov. Tim Walz, has been outspoken about the seven years of fertility treatments he and his wife, Gwen, went through before conceiving.

“This is very personal for my wife and I,” Walz told a crowd in Eau Claire, Wisconsin, last week. “I remember each night praying that the call was going to come, and it was going to be good news. The phone would ring, tenseness in my stomach, and then the agony when you heard the treatments hadn’t worked.”

Republicans say the idea that IVF is under threat is overblown, and dismiss Democratic warnings as scare tactics.

Conservatives push to declare fetuses as people, with far-reaching consequences

“There is no concerted Republican, conservative, pro-life effort mounting against IVF,” said Cole Muzio, executive director of Frontline Policy Action, a Georgia organization that lobbies for abortion restrictions and other conservative policies.

“I think this is something the left largely has tried to use as a wedge issue, but I don’t think most people are buying it as something that’s a real threat,” he said.

But Muzio acknowledged that some anti-abortion advocates have asked his organization to talk more publicly about IVF. And he predicted that eventually, more conservative lawmakers will turn their attention to the issue.

“Long term, we believe in the value of human life, and that’s my concern with IVF, that it results in the discarding of human life,” he said. “Now that Roe has been overturned and we’re able to have legislative conversations and think about where life begins, it’s an important conversation to have.”

Following public backlash over the Alabama court decision, lawmakers in a dozen states, including Alabama, introduced bills to protect IVF, according to the Guttmacher Institute, a research organization that supports abortion rights.

But so far, only Alabama has enacted a law. In March, Alabama’s Republican-majority legislature hastily passed a measure shielding IVF providers from criminal and civil liability. The only other bill that gained traction was one in Louisiana, where both legislative chambers approved it. However, it was scuttled in May after the state’s powerful anti-abortion lobby opposed the removal of fetal personhood language that would have left IVF providers open to criminal prosecution and civil lawsuits.

Far-reaching consequences

For many people, the IVF issue illustrates how fetal personhood laws can have consequences far beyond abortion. And it has energized them.

The National Infertility Association, which goes by the name Resolve, has held a national advocacy day annually for more than two decades. This year, after the Alabama Supreme Court decision, more than a thousand people attended the event virtually, twice the number that attended last year, said Barbara Collura, CEO of Resolve.

“We ended up with our largest advocacy day ever,” she said. “More than half of the people attending were brand new to the event. We feel very much that what happened in Alabama motivated people to figure out a way for themselves to get involved.”

In North Carolina, Gomez sold out her “Protect IVF” T-shirts within 24 hours. She launched a new batch a week later, and sold out again. Since then, she’s continued selling new “Protect IVF” designs, donating a portion of her proceeds to Resolve.

Before getting involved in IVF advocacy, Gomez said she barely paid attention to politics. Now, she’s been active in supporting pro-IVF legislation and contacting her state lawmakers. And she often fields Instagram messages from customers in other states who are scared, she said, and want to know what they can do.

“People are saying to me they didn’t know IVF was on the line, that they were surprised it wasn’t protected in every state,” said Gomez, who sends them links to sites where they can learn more about the state of IVF access where they live. “Customers are saying their parents and grandparents are having these conversations in their social circles, saying they wouldn’t be grandparents without IVF.”

She added: “I think we forget how much power we have. Regardless of what happens with the presidency, we have so much control over what happens in our state.”

‘New territory’

Less than two weeks after the Alabama court decision, Jamie and Dontez Heard stood at one end of a long hallway on the fourth floor of the Alabama State House, staring nervously at all the doors of state lawmakers’ offices. They considered turning around and going back home.

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“It was intimidating, and it was scary, not knowing what to say, thinking, ‘I’m going to stumble over my words,’” Jamie said. “What if I say the wrong thing? Neither one of us has ever been in any type of advocacy role, so this was new territory.”

The couple had driven down to Montgomery that morning from their home in Birmingham, anxious but determined to defend their chance at having another baby by convincing their legislators to save in vitro fertilization.

The court decision had landed just two days after the couple met with a specialist in Birmingham to begin a new round of IVF. They’d conceived their son, Legend, now 2, through IVF in 2022 after years of struggling through infertility. They’d hoped to add another child to their family this year.

“It was devastating,” said Jamie. “We didn’t understand what it meant for us and our family.” But a few days after the ruling, she saw a social media post that her fertility clinic had shared about a gathering of IVF families and supporters at the state Capitol.

“I knew then that we needed to be there,” she said. “We couldn’t afford to sit on the couch and wait and see how this plays out.”

Since speaking to Alabama lawmakers, Heard has testified before Congress and traveled to other states to advocate for federal and state laws that would protect access to IVF.

Jamie Heard of Birmingham, Ala., speaks in front of the U.S. Capitol in Washington, D.C., in March to encourage Congress to pass a bill protecting access to IVF treatments. Courtesy of Jamie Heard

Next door in the battleground state of Georgia, one of the biggest reproductive justice advocacy organizations in the Southeast recently launched its first-ever Black (in)Fertility Awareness Week. SisterSong, which is focused on reproductive rights for women of color, hosted a panel, documentary screening, online discussions and a raffle of $40,000 in fertility services for Black Georgia families.

Leah Jones, director of maternal health and birth equity at SisterSong, said the new initiative had been in the works for a while, but the Alabama ruling highlighted for people how IVF access is connected to other reproductive health issues, from preconception through pregnancy to postpartum.

“What we realized when we started this conversation around infertility in Black communities and listening to their stories, these are the same people talking about maternal health, abortion, mental health, birth justice,” said Jones. “Once you make the connection that this is part of an attack on overall bodily autonomy, I think that’s when it clicks for people.”

Even in Minnesota

As Minnesota’s governor, Walz in 2023 signed a law confirming the right to abortion and other reproductive health care in Minnesota.

Miraya Gran and her husband, Andy, conceived their daughter, Isla, through IVF. The Grans now advocate for state legislation in Minnesota that would require insurers to cover fertility treatments. Courtesy of Miraya Gran

And yet Minnesotans like Miraya Gran felt the shockwaves from the Alabama court decision. Gran and her husband struggled for years with infertility before finally conceiving their daughter Isla, now 3, through IVF.

Gran advocates for a Minnesota law that would require health insurers to cover fertility treatments.

“We saw some great momentum after the Alabama decision,” said Gran. “It didn’t really matter which political party you were a part of. If you believed in access to IVF, you joined our group.”

Gran said she considers Minnesota a “safe state” for IVF access and other reproductive rights, at least for now. “But we look to our neighbors in Iowa, where they introduced some personhood bills recently. It’s terrifying. It’s too close to home.”

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org. Follow Stateline on Facebook and X.

When Missourians head to the polls in November, they may get to vote on whether to overturn their state’s near-total abortion ban and legalize abortions up to the point of fetal viability.

But one lawmaker says the results of that vote may not matter if his colleagues approve his bill declaring that fetuses are people.

Missouri state Rep. Brian Seitz, a Republican, plans to reintroduce a bill in January that would grant “unborn children” the same rights as newborns, building on a similar Missouri law that has been on the books since the 1980s.

Seitz said the bill would provide protections for embryos and fetuses “regardless of that vote in November.”

Absolute abortion bans remain unpopular, even in conservative-led states and among Republican women. So during this legislative session, many GOP state lawmakers pivoted to protecting the rights of fertilized eggs, embryos and fetuses. And when the national Republican Party released its official platform in July, it made no mention of a federal abortion ban. Instead, the GOP affirmed states’ prerogative to pass laws protecting life under the Constitution’s 14th Amendment, which has been used in legal arguments to support fetal personhood.

Fetal personhood, a longtime cornerstone of the anti-abortion movement, is the idea that a fetus, embryo or fertilized egg has the same legal rights as a person who has been born. If the law considers fetuses to be people, the thinking goes, then abortion would legally be considered murder.

At least 19 states — either through state law, criminal statutes or case law — have declared that fetuses at some stage of pregnancy are people, according to a 2023 report from Pregnancy Justice, a nonprofit that conducts research and advocates for the rights of pregnant people, including the right to abortion.

Missouri is one of several Republican-led states where lawmakers have taken a renewed interest in fetal personhood legislation in the two years since the U.S. Supreme Court’s Dobbs decision overturned Roe v. Wade and dismantled the federal constitutional right to abortion.

“If you elevate a fetus to the status of a person and grant it citizenship rights equal to that of a pregnant person, then now you have a clash of rights,” said Rebecca Kluchin, a history professor at California State University, Sacramento, who is writing a book on the history of efforts to establish fetal personhood in the United States.

Kluchin said one goal of the recent fetal personhood bills is to get a case before the U.S. Supreme Court. The Dobbs decision, and the conservative bent of the current court, have created an environment where lawmakers are saying, “Let’s try it,” she said. “If one of them gets it right, then others can pass identical laws.”

Seitz thinks his bill could fulfill that purpose.

“If it does get to the Supreme Court, due to the makeup of the court right now, I think they would see this commonsense legislation is, in fact, truth,” he said.

Critics, meanwhile, warn of legal chaos. The possible implications of fetal personhood bills extend far beyond abortion — to fertility treatments, birth control and even child tax credits. In states that have enacted such laws, pregnant women have faced criminal charges for actions that might harm their pregnancies.

“When a pregnant person’s rights conflict with fetal rights,” Kluchin said, “fetal rights tend to trump them.”

IVF’s chilling effect

Seitz’s bill didn’t make it out of committee before Missouri’s legislative session ended in May.

He attributed that failure to the GOP’s reluctance to push an anti-abortion bill in an election year, a concern that might have been justified: Missouri abortion rights supporters gathered more than double the number of signatures needed to get their constitutional amendment on the ballot. As of press time, the ballot petition signatures were still being reviewed by local and state officials.

But Seitz said the bill will be the first he introduces when the legislature returns in January. With election season behind them, he said, “I think it will be very easy for my Republican colleagues to come on board and support this.”

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Conservative lawmakers in Alaska, Illinois, South Carolina and West Virginia introduced similar fetal personhood bills in their most recent legislative sessions, though none made it out of committee.

Then in February, the Alabama Supreme Court ruled that embryos created through in vitro fertilization are children under state law, and that people can be held liable for destroying them. The court cited Alabama’s constitutional amendment, passed by voters in 2018, that confers personhood on fetuses and affirms the state’s responsibility to protect “the rights of unborn children.”

The court’s decision generated a national uproar, ignited bipartisan ire and halted fertility treatments statewide until Alabama’s Republican supermajority legislature hastily passed a law protecting fertility service providers.

The backlash underscored how many lawmakers hadn’t fully considered the far-reaching implications and legal bedlam that can be created by fetal personhood laws.

And it had a chilling effect on fetal personhood bills.

In February, a Florida Republican state senator sidelined her bill that would have covered fetuses under wrongful death lawsuits after some lawmakers worried it would hurt IVF providers.

In March, the Iowa House passed a bill to criminalize “the death of an unborn person,” but Republicans in the Senate declined to take up the bill over concerns it could criminalize IVF.

Similarly, the Kentucky House refused to hear a bill that the Senate passed that would have granted the right to retroactively collect child support for costs incurred during pregnancy.

Through the back door

Last year, Arizona Republican state Rep. Matt Gress introduced five pregnancy-related bills that he said were inspired by his experience growing up in a family headed by a single mother.

“I’m the youngest of four and raised by a single mom in a single-wide trailer house in rural Oklahoma. We grew up very poor,” Gress said in an interview with Stateline. “These bills, to me, represented a policy approach that helps women and families.”

One of the bills would have allowed families to retroactively claim child tax credits in the year before a baby is born; another would have allowed pregnant women to drive alone in a highway car pool lane, their fetus counting as a separate passenger.

Yet another bill would have allowed a woman, after having a baby, to collect child support backdated to the date of her positive pregnancy test.

Arizona’s Democratic state legislators accused Gress of taking a back-door approach to inserting fetal personhood language into state law. But Gress denies that codifying fetal personhood was his intent.

“That didn’t even cross my mind,” he said. “The way I read the bills, there were no rights being afforded to anybody besides women and families.”

Gress noted that he was the first Republican, and one of the few, who supported Democratic state legislators’ bid to repeal Arizona’s near-total abortion ban, which dated to 1864. The repeal effort eventually succeeded in early May.

Arizona’s legislature passed two of Gress’ pregnancy bills, but Democratic Gov. Katie Hobbs vetoed both. Gress said he doesn’t intend to reintroduce the bills unless a new governor is elected who might support them.

Republican and Democratic lawmakers in Alabama, Kansas, Kentucky, Mississippi and Missouri tried but failed to pass similar fetal child support laws this year. Georgia’s 2019 “heartbeat law,” which went into effect in 2022, grants child support benefits for fetuses.

Republican U.S. Rep. Mike Johnson of Louisiana, now the speaker of the House, introduced a similar bill in Congress in 2022, and was explicit about its purpose. In a statement, he called it a “first step” toward updating federal laws to reflect that “life begins at conception.”

Beyond abortion

Fetal personhood laws, like abortion bans, end up having broader effects on all pregnant people and pregnancy-related care, said Dr. Daniel Grossman, an OB-GYN and the director of Advancing New Standards in Reproductive Health, a research program at the University of California, San Francisco, which focuses on abortion and reproductive health.

Grossman points to cases in which pregnant patients experiencing obstetric emergencies had to be airlifted out of states with strict abortion bans, such as Idaho, because doctors were afraid of violating the law.

In states such as Florida, North Carolina and Texas, pregnant women who weren’t seeking abortions but who experienced possible miscarriages or other emergencies have been turned away from hospitals. Stories of pregnant women being turned away from emergency rooms spiked after Roe was overturned, a recent Associated Press investigation found.

Fetal personhood has implications for birth control, too.

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Hormonal contraceptive methods such as IUDs and birth control pills typically work by preventing an egg from being fertilized, but there’s a small chance that some forms can also prevent a fertilized egg from being implanted in the uterus, said Grossman. So, if state law considers a fertilized egg a person, that could create a legal basis for banning any contraception that could possibly prevent implantation.

Grossman also worries about increased scrutiny these laws create for people who experience miscarriage or stillbirth.

“Before Dobbs, people were arrested and criminally prosecuted for allegedly trying to end a pregnancy on their own,” he said. “I’m already concerned that’s going to become more common, especially in places with fetal personhood laws.”

The laws also have resulted in women being criminally charged for actions that might harm their pregnancies, said Lourdes Rivera, president of Pregnancy Justice.

Rivera’s organization documented nearly 1,400 instances of pregnant women being charged, often for substance use, in the 16 years leading up to the June 2022 Dobbs decision. Most of the cases occurred in a handful of Southern states — including Alabama, South Carolina and Tennessee — that have expanded their definitions of child abuse to include fetuses, fertilized eggs and embryos.

Nearly 85% of pregnancy criminalization cases in the Pregnancy Justice report involved charges against a pregnant person who was legally indigent, and the laws were disproportionately applied to poor women and women of color, Rivera said.

“These laws are forcing pregnant people to give up their bodily autonomy, their health and well-being,” she said, “and to be surveilled and criminalized for actions that would not be criminal if they were done by people who were not pregnant.”

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org. Follow Stateline on Facebook and X.