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County-Level Pregnancy Criminalization Rates and Prenatal Care Initiation and Utilization in Alabama, 2014-2022.

Taylor Riley1, Jaquelyn L Jahn2, Maeve E Wallace3

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Women'S Health Issues : Official Publication of the Jacobs Institute of Women'S Health
|April 17, 2026
PubMed
Summary
This summary is machine-generated.

Higher rates of pregnancy-related arrests correlate with delayed and inadequate prenatal care, particularly for white and Hispanic women. This criminalization impacts maternal health access, necessitating policy changes for reproductive autonomy.

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Area of Science:

  • Public Health
  • Sociology of Health & Illness
  • Reproductive Health Policy

Background:

  • Pregnancy criminalization is a growing concern, especially post-Dobbs.
  • Limited research exists on the association between county-level pregnancy-related arrests and prenatal care access.

Purpose of the Study:

  • To investigate the association between county-level pregnancy-related arrests and delayed/inadequate prenatal care in Alabama (2014-2022).
  • To examine racial and ethnic disparities in this association.

Main Methods:

  • Utilized restricted-use natality data (National Center for Health Statistics) and county-level arrest data (Pregnancy Justice).
  • Employed log Poisson generalized estimating equation models with cluster robust standard errors.
  • Stratified analyses by race and ethnicity, adjusting for individual and county-level confounders.

Main Results:

  • Higher pregnancy criminalization rates were associated with a moderate increase in delayed prenatal care initiation (RR 1.11, 95% CI [1.08, 1.14]).
  • Higher criminalization rates were also linked to inadequate prenatal care (RR 1.05, 95% CI [1.03, 1.06]).
  • Positive associations were observed for non-Hispanic white and Latina/Hispanic women; null or protective associations were found for non-Hispanic Black women.

Conclusions:

  • Pregnancy criminalization appears to have a chilling effect on prenatal healthcare access.
  • Evidence-based policies are needed to support maternal health and reproductive autonomy amidst rising pregnancy surveillance and criminalization.