Pregnancy Criminalization in Alabama: Brooke Shoemaker, Fetal Personhood, and Post-Dobbs Prosecutions

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2026/01/23

Karen Thompson is a national advocate with/legal director of Pregnancy Justice, a U.S. legal and policy organization working to end the criminalization of pregnancy and advance reproductive justice. Her work sits where medicine, law, and human rights collide, challenging prosecutions that treat miscarriage, stillbirth, or alleged substance exposure as criminal acts. Thompson emphasizes due process, credible medical evidence, and the principle that rights belong to the pregnant person, not to a pregnancy itself. She collaborates with attorneys, researchers, and advocates to track post-Roe prosecutions and press for laws that protect health care and dignity. Her focus is preventing convictions and harsh sentencing.

Scott Douglas Jacobsen speaks with Karen Thompson and Zenovia Earle of Pregnancy Justice about the case of Brooke Shoemaker, an Alabama woman who served five years after a stillbirth before her conviction was vacated. Thompson argues the prosecution criminalized a pregnancy outcome, not abortion, and relied on weak medical inference despite evidence of a severe uterine infection. They describe Alabama’s outsized role in pregnancy criminalization, driven by fetal personhood logic and broad statutes like chemical endangerment. Earle notes data challenges but sees rising prosecutions pre- and post-Dobbs, plus growing scrutiny of mental-health and common medications during pregnancy. With alarming momentum.

Scott Douglas Jacobsen: There have been many concerning trends involving regression in women’s reproductive rights, specifically abortion rights, in the United States. As Human Rights Watch and others have noted, abortion is first and foremost a human right, and in a contemporary context, standard health care should be considered standard health care. Unfortunately, the United States has areas where this is not respected. In this particular case, an Alabama woman, Brooke Shoemaker, served five years after experiencing a stillbirth. Is Alabama the worst legal context for this type of imposition, or are there worse cases in other U.S. states now that we are in a post-Roe era?

Karen Thompson: There are several questions in there, and I am going to try to separate them because they merit different answers. The first issue is that while abortion is undoubtedly a question of reproductive justice, our cases at Pregnancy Justice very rarely involve abortion. As is clear in Brooke Shoemaker’s case, what is being criminalized is a pregnancy outcome: someone who was pregnant had a stillbirth and then faced criminal charges because of that fact.

I also want to clarify that she had served five years of her sentence, but she was actually sentenced to 18 years on a charge that could have carried a life sentence. As a matter of sentencing, this is one of the longest sentences we have ever seen in a pregnancy criminalization case.

Alabama leads the country in pregnancy criminalization cases. One reason for this is that, long before Roe, Alabama embraced the idea that fetuses and embryos are entitled to legal rights equal to those enjoyed by people. We believe that rights belong to the pregnant person, not to the pregnancy itself, but that is not the case in Alabama. This is why nearly 70% of pregnancy criminalization cases come out of that state.

What is notable about Miss Shoemaker’s case is that we were able to present information to the judge that the medical examiner had already identified. From the beginning, it was clear that she had suffered a severe uterine infection that affected the placenta. At that initial stage of the prosecution, the medical examiner could not say that drugs were involved or that it was a homicide. All they could say was that there was fetal death and signs of infection.

The inability to classify the death as a homicide was something the judge recognized at trial, and it remained a thread throughout the trial and the appeal. Although we are relieved that Miss Shoemaker’s conviction has been overturned, one of our arguments was that there was ineffective assistance of counsel. Her lawyer should have raised the clear medical basis for the pregnancy loss, which had nothing to do with drugs.

More broadly, even if drugs were involved, people should not be jailed or imprisoned for drug use during pregnancy. They should receive the help they need and want. Handcuffs are never the answer.

Jacobsen: When the medical examiner cannot identify a specific cause of death and homicide is not established, she still spent five years in prison.

Thompson: One hundred percent. We believe she was wrongfully convicted of that charge. This is why we are so relieved that the judge agreed there was something very wrong with the presentation of the evidence—so much so that a new trial is warranted. We hope that, on appeal, the higher court will affirm the trial judge’s decision.

Jacobsen: Do you think that, particularly in the contemporary American context, the emotionally charged nature of issues around fetuses, babies, and religious convictions played a significant role in how this case unfolded, resulting in at least five years of injustice that she endured?

Thompson: What I heard you saying is that religious and political influences tend to permeate these kinds of cases.

Jacobsen: Yes, and also the emotionally charged presuppositions people have—religious convictions and politically charged language around abortion. Was that a significant influence on how her case of injustice played out?

Thompson: While there is undoubtedly a real push around abortion issues, that is not what was happening here. What I do think is at play, and where there is legal and political influence, is the question of what pregnant people—particularly pregnant women—are doing during their pregnancies, and the idea that the state gets to control their behaviour from the moment they become pregnant until they give birth, especially in Alabama.

A patriarchal surveillance and control issue is being surfaced here. These issues are coextensive with reproductive justice, which we define as the ability of all people to choose whether to parent, whether not to parent, and whether to raise their children in safety and health. To the extent that people believe those choices belong to the church or to the legislature, that is indeed happening through fetal personhood laws in Alabama.

However, we still live in a world of science and reason. Regardless of how people feel about this case, the facts are that Miss Shoemaker had a severe infection, and that infection led to the end of her pregnancy.

Jacobsen: What would justice look like in her case?

Thompson: Justice would mean that the conviction, which has now been vacated, remains vacated, and that the state decides not to retry her on these facts. There is no viable basis for any of these charges, and certainly nothing that could justify an 18-year prison sentence.

Jacobsen: With respect to Alabama, Supreme Court justices cited 192 cases in the first two years after the Dobbs decision. Are you seeing a rapid uptick since then? And with the most recent administration coming into power following Dobbs, do you see this as two waves—first post-Dobbs, and then a second surge driven by more forceful political language and enforcement?

Zenovia Earle: This is an interesting question. First and foremost, we have been tracking these cases even before the loss of Roe, including when we were named national advocates for pregnant women. We do have data, and it does show fewer cases during the years when Roe was still in effect. However, we are not comfortable doing a strict year-by-year analysis—for example, comparing the year before the loss of Roe to the year immediately after.

The reason for that is that we now have far more resources and are part of an academic partnership with institutions such as the University of Tennessee, the University of Texas, and others through the post-Roe pregnancy prosecutions tracking project. Because of that, it would not be a fair comparison. The process of collecting these cases is incredibly labour-intensive. Each state has a different system. You may have to submit records requests, go to county clerks, and navigate local procedures. Because of that variability, we cannot say anything definitively.

Anecdotally, however, we do see an increase year over year—pre-Dobbs and post-Dobbs, yes, there is an increase. When it comes to the Trump administration specifically, that is harder for us to assess. I would not attribute everything directly to him, although he has publicly bragged about ending Roe. This is much bigger than Trump himself. There has been a long-term plan, and those advancing it have been very effective at playing the long game. What we are seeing now is the result of a gradual buildup.

The final point I would make regarding the current administration is that we are seeing other troubling developments, such as the demonization of antidepressant use during pregnancy. There was a panel suggesting that taking antidepressants during pregnancy is unacceptable, despite evidence to the contrary. I believe the data were opioid-related—I can send the link—but substance-use-related deaths among pregnant and postpartum women increased during a specific period. Depression, mental health issues, and substance use are closely connected.

It is very dangerous to tell people they cannot use medications because of perceived harm to a fetus. We have seen the demonization of Tylenol, which is widely considered safe during pregnancy. All of this is profoundly troubling and indicative of where we may be headed.

Telling people that valid avenues of care and medication are being shut off, effectively instructing women to suffer, plays directly into all of this.

Thompson: To build on everything Zenovia just said, and to return to your question about the influence of politics and the Bible—or conservative or orthodox religious beliefs—the fundamental issue driving all of this is fetal personhood. If you believe that someone should suffer through a mental health crisis during pregnancy, or that they should not take Tylenol for a fever because everything must be sacrificed for the fetus, that belief system has consequences.

It begins with cases like Miss Shoemaker’s, but as we have seen in New York, it also extends to holding boyfriends and partners legally responsible for controlling a pregnant person’s behaviour. If they fail to do so, they face state repercussions. In one amicus case, we saw a father subjected to family separation proceedings because the state determined he did not adequately control his partner’s behaviour during pregnancy.

In Kansas, there is now a law requiring male partners to pay child support for a fetus. This issue does not remain limited. It expands and justifies increasing levels of state intervention and surveillance. When people talk about states’ rights and small government, fetal personhood provides a justification not for limited government, but for total control over people’s lives and choices.

Jacobsen: There are two areas I want to get your expertise on. Karen, there is junk science and junk inference. What safeguards could be implemented in future cases—particularly in Alabama—to prevent junk science and junk inference from leading to wrongful convictions? Or, if a sentence is somehow justified, to ensure that sentencing is not as punitive as 18 years?

Thompson: Sadly, I do not think it will matter, and here is why. What Alabama is doing is using bills and statutes meant for one purpose and applying them in contexts for which they were never intended. In Miss Shoemaker’s case, it was the chemical endangerment charge she faced, which was initially meant to protect children exposed to meth cook houses. The intent was to prevent bringing a living, breathing child into a space where toxic chemicals could seriously harm them.

What is happening now is that, because of the belief that a fetus has rights superior to the pregnant person, the law is being applied to someone’s own body. All that is required is proof of exposure to a drug, which does not carry the same meaning, evidence, or factual basis as bringing a child into a meth lab. We are using laws that do not require proof of harm or evidence that one thing caused another.

That puts us in a nearly lawless space, where the charge is effectively built on a prosecutor’s animus toward the defendant. What would actually help is legislation that is much clearer about how these charges are supposed to be used and why, and that prevents them from being applied so vaguely that they pull countless people into court and under government scrutiny simply because officials disapprove of their behaviour.

Jacobsen: These kinds of policy pushes usually require advocates. Are there particular American political or legal figures—well-known at the state level—who have been driving this?

Thompson: What I would say is this: the day after Roe was decided, a group of people committed themselves to overturning it. That plan has been in place for five decades.

Almost immediately, some challenges chipped away at Roe’s protections. In the broadest sense, this has been under attack for a very long time. What has changed recently is the volume and intensity of legislation being passed in states like Alabama, South Carolina, and Oklahoma—legislation that enshrines principles even further than those that existed when Roe was decided.

For example, South Carolina has introduced bills that would classify abortion as homicide. That would mean that if someone has an abortion—whether self-managed or otherwise—it could be treated as a death-eligible offence. Most of these bills do not include exceptions for the life of the mother. Abortion, in any context, would be treated as a capital crime. That does not make sense.

Jacobsen: Right—especially given that the body self-aborts quite often.

Thompson: Exactly. This is where it intersects with criminalization. Beyond criminalizing what we believe is a right, the question becomes: who decides whether a pregnancy loss was intentional or illegal? How are those determinations made, especially in cases like Brooke’s, where prosecutors claimed that drug use caused the end of her pregnancy?

If the state decides that drug use led to the pregnancy loss and then charges that as a murderous act, we are going to see more people imprisoned on increasingly severe charges, facing harsher sentences, up to and including the death penalty. We are in a gruesome moment right now.

Pregnancy Justice has been working on these cases for a long time, so we are familiar with how ugly this can be. But the pressure, the legislative activity, and the sideways ways these policies are emerging are deeply alarming.

I was saying to one of our attorneys today that I used to think there was about a 60% chance this administration would issue an executive order declaring fetal personhood to be the law of the land. I am now closer to 90%. If that happens, we will see a federal moment where fetal personhood is declared through executive order, and everyone is required to interpret existing law to conform to it.

That would mean that regardless of where you live, and regardless of what your state laws say, fetal personhood would become the law of the land for everyone. This is a sideways attempt to strip people of their reproductive rights and freedoms.

Let me bring this back to men, because this is important. Some men have been deeply abusive—I am not excusing their behaviour—but there was a case in Texas where a man spiked his girlfriend’s drink with mifepristone, an abortion medication. She lost her pregnancy, and he is being charged with first-degree murder.

That is not the correct charge. He should be charged with assault. The behaviour that should be punished is his abuse of his partner, not the pregnancy loss itself. What is happening here is that these laws are not only stripping rights from pregnant people but also expanding punishment outward to others under the banner of fetal personhood. That expansion should concern everyone.

Jacobsen: This is vague in my memory, so you may have to help me here. There was a news case reporting that the United States government was attempting to define human rights, but stipulating things that, if you look at the UN Charter or the Universal Declaration of Human Rights, are not there, or in some cases are the opposite. It felt a bit like the “Gulf of Mexico versus America” situation, where definitions are being reshaped for political expediency. Have you noticed a trend of redefining rights within the U.S. legal context—whether at the state or federal level—or is it more an infusion of religious concepts into political and legal frameworks, such as fetal personhood or expanded notions of parental rights?

Thompson: Yes, one hundred percent. I strongly encourage you to read the LaPage decision out of Alabama, which equated frozen embryos with living children. The language in that case is genuinely shocking. We all recognize that people hold different beliefs, but it is startling to see a judge effectively deliver a sermon and issue a decision that is almost entirely grounded in biblical principles.

I absolutely think a redefinition is happening, but it is not new. The United States was founded through the seizure of land under claims of divine authority and the enslavement of millions under religious justifications drawn from biblical narratives. This pattern is longstanding, but we are seeing a renewed regression.

Recently, one of our policy experts travelled to Geneva to testify before the United Nations about the erosion of reproductive justice rights. The United States was supposed to send a representative to address these concerns, but it did not. What we are seeing is both a reframing of rights and an abdication of engagement with international human rights processes. This mirrors what we saw with the withdrawal of USAID—an abdication of the U.S. role in contributing to a just and safe global order.

And let me add one more thing. It is not as though the United States has ever been strong on maternal or fetal health. We have consistently lagged behind Canada, Europe, and many other countries with more robust healthcare systems. We have always been far behind on these measures. Alabama, for example, has one of the worst maternal mortality rates in the United States and globally. There is nothing new here, but there is now a disturbing normalization and justification of these failures.

Earle: Thank you so much.

Jacobsen: Thank you. I appreciate that.

Thompson: I really appreciate you covering this.

—

For further information:

1. Overdose deaths increased in pregnant and postpartum women from early 2018 to late 2021 | National Institutes of Health
2. Our op-ed on the Texas case Karen mentioned: The Abortion Prosecution No One Is Talking About

Pregnancy Justice Senior Policy Counsel Kulsoom Ijaz’s remarks in Geneva: USA_NHLC_statement.pdf, and more context

Last updated May 3, 2025. These terms govern all In-Sight Publishing content—past, present, and future—and supersede any prior notices.  In-Sight Publishing by Scott  Douglas  Jacobsen is licensed under a Creative Commons BY‑NC‑ND 4.0; © In-Sight Publishing by Scott  Douglas  Jacobsen 2012–Present. All trademarks, performances, databases & branding are owned by their rights holders; no use without permission. Unauthorized copying, modification, framing or public communication is prohibited. External links are not endorsed. Cookies & tracking require consent, and data processing complies with PIPEDA & GDPR; no data from children < 13 (COPPA). Content meets WCAG 2.1 AA under the Accessible Canada Act & is preserved in open archival formats with backups. Excerpts & links require full credit & hyperlink; limited quoting under fair-dealing & fair-use. All content is informational; no liability for errors or omissions: Feedback welcome, and verified errors corrected promptly. For permissions or DMCA notices, email: scott.jacobsen2025@gmail.com. Site use is governed by BC laws; content is “as‑is,” liability limited, users indemnify us; moral, performers’ & database sui generis rights reserved.