Fetal mortality rates in the United States have been on an overall decline since the 1990s,^[1] but data demonstrates that there is a stillbirth crisis across the nation.^[2] Yale School of Medicine found that 20% of all pregnancies across the United States end in loss.^[3] Of those losses, 1 in 175 pregnancies end in stillbirth (loss after 20 weeks)^[4] and 15–20% of pregnancies end in miscarriage (loss before 20 weeks).^[5] According to researchers and pregnancy advocacy groups, many stillbirths are preventable: people with public insurance are more likely to experience stillbirths, and preventable stillbirths largely stem from medical conditions such as placental insufficiency, substance use disorder, or multiple pregnancy (e.g., twins).^[6] Despite the potential preventability of some stillbirths, many pregnant people live in regions dubbed “maternity care deserts,” which are areas that lack obstetric or other maternal health care providers.[7]

Although these troubling statistics indicate a systemic failure to provide adequate maternal health care, individual prosecutions against people who have experienced pregnancy loss are on the rise.^[8]  Scholars and advocates have attributed the rise in prosecutions to the increased promotion of fetal personhood arguments by anti-abortion advocates, which are the basis for various criminal statutes that punish stillbirths on the presumption that stillbirths are caused by child abuse, substance abuse, and child endangerment.^[9]

For example, in December 2025, a judge vacated the 18-year sentence against Brooke Shoemaker, an Alabama woman who had a stillbirth at home.^[10] Despite the fact that Shoemaker’s placenta had shown signs of infection, because she disclosed to hospital staff that she took methamphetamine during her pregnancy, she was charged with felony chemical endangerment of a minor and ultimately served five years before her sentence was vacated.^[11]

Shoemaker’s case illustrates the ways in which the criminal justice system targets pregnancy outcomes, which, like stillbirths, disproportionately impact people with fewer health care resources. Low-income people and people of color, rural and southern women,^[12] Black women, and Native Hawaiian/Pacific Islander women all experience the nation’s highest rates of stillbirths and are thus most vulnerable to being targeted by criminal prosecutions if they experience pregnancy loss.^[13]

Many stillbirth prosecutions occur in cases similar to Shoemaker’s (i.e., a person experiences stillbirth at home and fails to report it). Many of the statutes related to handling the remains from a pregnancy loss are for hospitals and health centers. However, prosecutors are using child abuse and neglect statutes to cover the improper disposal of fetal remains, essentially to establish that improper disposal is proof of purposeful or willful killing.^[14] When fetal remains are found in unusual locations, law enforcement use a technology known as Forensic Investigative Genetic Genealogy (FIGG) to conduct “Baby Doe” investigations aimed at discovering the identity of the parent and then prosecuting them.^[15]

 

FIGG’s Role in “Baby Doe” Prosecutions

FIGG is a multistep genetic process that has been employed by law enforcement since the 1980s, mainly to investigate sexual assault and homicide cases.^[16] Various genetic information companies collaborate with law enforcement to create large databases and training models for the DNA process involved in FIGG.^[17] Although all other investigative methods should be used before FIGG, Baby Doe investigations now primarily rely on the technology.^[18] Previously, Baby Doe investigations would use the long-discredited lung float test, which supposedly proved that a baby was born alive when its lungs would float in water.^[19] According to ProPublica, the test was used to prosecute 11 women after 2013, but has since been superseded by genetic testing.^[20] Using FIGG, scientists use DNA collected from crime scenes or unidentified remains to create and upload genetic profiles to DNA databases owned by companies like GEDmatch—one of the nation’s top genetic databases for law enforcement.^[21] These databases then find profiles of people who share significant DNA segments with those in the sample, and from there, investigators search through relatives to find their person of interest.^[22] This form of criminalization has been well-documented, particularly when a pregnancy loss was presumed to have resulted from substance use or abuse.^[23]

Some Baby Doe prosecutions occur decades after pregnancy loss, as the investigations tend to be years-long cold cases. In 2023, FIGG was used to track down the source of fetal remains found on a country road in Medina, Texas in 2004.^[24] Maricela Frausto had not known she was pregnant until she went into labor, after which she believed the fetus was stillborn because she did not hear any breathing or crying.^[25] In a state of shock, she placed the fetal remains in her closet, and then after two days, placed them in brush alongside a remote road.^[26] Twenty years later, Frausto was charged with capital murder, took a plea, and was sentenced to serve 18 years in prison.^[27]

Stillbirth cases are typically prosecuted as homicides, despite the fact that many pregnancies ending in stillbirths do not present risk factors that would have prompted medical intervention prior to the stillbirth.^[28] These investigations and subsequent prosecutions turn stillbirths into spectacles, with law enforcement officials lamenting the impacts these cases have had on unrelated individuals (such as those running campaigns to find the fetus’ parents), yet rarely giving the same consideration to those who experienced loss and were unable to cope with the trauma. Two women even took their own lives as a result of being investigated for their stillbirths.^[29]

The criminalization of stillbirths through FIGG has become more understood in the post-Dobbs political landscape; in the years following the 2022 Dobbs decision, there were at least 200 pregnancy-related prosecutions throughout the United States.^[30] In 2024, Pregnancy Justice released a report finding that over 400 prosecutions were initiated, and nearly 75% of those prosecuted were low-income.^[31]

 

Maternity Care Deserts and Impacts on Low-Income Communities

Like Frausto, many women prosecuted for stillbirths had no knowledge they were pregnant prior to the stillbirth, and many gave birth outside of a hospital.^[32] Statistics have found that stillbirths are most common in Southern states; in 2022, Mississippi was the state with the highest rate of stillbirths, at nearly double the national rate.^[33] Sixteen states have initiated stillbirth prosecutions, with Alabama prosecuting the highest number of stillbirth cases.^[34]

Additionally, the further a pregnant person has to travel for care, the higher the risk of adverse pregnancy outcomes.^[35] Prior to the passage of the One Big Beautiful Bill Act, over two million women were at high risk of negative pregnancy outcomes due to living in maternity care deserts,^[36] and since the bill was made law, several hospitals in rural areas have been forced to close their maternity and obstetric wards.^[37] This poor access to perinatal health care means that many pregnant people may not begin receiving health care until the fifth month of pregnancy or later, which means their fetuses are at a higher risk of being born before 37 weeks.^[38]

A doula in Moses Lake, Washington explained that because of the lack of health care infrastructure, many providers in the state’s rural areas are overworked, seeing patients who have to drive at least 30 minutes to the closest health care provider.^[39] In Moses Lake, for example, only one provider speaks Spanish, and there is only one pelvic floor physical therapist.^[40] Because providers often do not take insurance, the lack of alternatives means that many residents on Medicaid are unable to access necessary care.^[41]

Pregnancy loss can be one of the most devastating moments of an expecting parent’s life. Instead of resources to guide parents through pregnancy loss, law enforcement probes parents, accusing them of abuse and murder for their responses to an extremely traumatic event. Baby Doe prosecutions often do not serve justice, nor do they seek to address the various systemic problems that create the conditions for loss or that leave millions of Americans with little to no access to medical attention post-stillbirth. FIGG investigations also raise questions about surveillance and privacy, particularly because oftentimes people who use ancestry tests may not know that their DNA could easily end up in a criminal investigation.^[42] Although some genetic information websites prohibit the use of FIGG for identifying stillborn babies and fetal remains,^[43] Baby Doe prosecutions are still occurring and there is not currently a method of ensuring a fair criminal process for many of these families. FIGG enables law enforcement’s hyperfocus on the criminalization of pregnancy loss and obscures the lack of available options within a deeply fractured health care system.

 

 

^[1] Elizabeth C.W. Gregory et al., Fetal Mortality: United States, 2021, Nat’l Vital Stat. Rep. Ctr. For Disease Control (July 23, 2023), https://www.cdc.gov/nchs/data/nvsr/nvsr72/nvsr72-08.pdf [https://perma.cc/76KP-9LAV].

^[2] Data and Statistics on Stillbirth, Ctr. For Disease Control. (Aug. 26, 2025), https://www.cdc.gov/stillbirth/data-research/index.html [https://perma.cc/7GDA-F9AW] (reporting that rates of fetal deaths have remained relatively stagnant since the mid-2010s).

^[3] Jenny Blair, Why pregnancies fail, Yale Sch. Of Med. (Mar. 20, 2024), https://medicine.yale.edu/news/yale-medicine-magazine/article/why-pregnancies-fail/ [https://perma.cc/XBA8-MREJ].

^[4] Data and Statistics on Stillbirth, supra note 2.

^[5] Id.; Miscarriage, Harv. Health Publ’g. (Sept. 19, 2024), https://www.health.harvard.edu/womens-health/miscarriage-a-to-z [https://perma.cc/C5QF-JQFX].

^[6] Michael W. Wong, Pregnant Mothers Need Better Access to Healthcare, Physician-Patient All. for Health & Safety, https://ppahs.org/2024/09/pregnant-mothers-need-better-access-to-healthcare/ [https://perma.cc/C3WB-ECVZ]; Jessica M. Page et al., Potentially Preventable Stillbirth in a Diverse U.S. Cohort, obstetrics & gynecology (Feb. 1, 2018), doi: 10.1097/AOG.0000000000002421.

[7] March of Dimes, Nowhere to Go: Maternity Care Deserts Across the US 8 (2024),  https://www.marchofdimes.org/peristats/assets/s3/reports/2024-Maternity-Care-Report.pdf [https://perma.cc/EB48-EET7] [hereinafter Nowhere to Go].

^[8] Cary Aspinwall, Some States Are Turning Miscarriages and Stillbirths Into Criminal Cases Against Women, The Marshall Project (Oct. 31, 2024), https://www.themarshallproject.org/2024/10/31/stillbirth-oklahoma-arkansas-women-investigated [https://perma.cc/C99E-C3PZ].

^[9] Id.

^[10] Press Release, Pregnancy Justice, Alabama Woman’s Conviction and 18-Year Sentence for a Stillbirth is Vacated, (Dec. 29, 2025), https://www.pregnancyjusticeus.org/press/brooke-shoemaker-alabama-stillbirth-conviction-vacated/ [https://perma.cc/S6GU-3WBZ].

^[11] Id.

^[12] Maya Brownstein, Stillbirths in the U.S. higher than previously reported, often occur with no clinical risk factors, Harv. Sch. Of Pub. Health, (Oct. 27, 2025), https://hsph.harvard.edu/news/stillbirths-in-the-u-s-higher-than-previously-reported-often-occur-with-no-clinical-risk-factors/ [https://perma.cc/2SBL-PD5M].

^[13] Id.

^[14] Aspinwall, supra note 8.

^[15] Nat’l Acad. Law Enforcement Use of Probabilistic Genotyping, Forensic DNA Phenotyping, and Forensic Investigative Genetic Genealogy Technologies: Proceedings of a Workshop 23 (2024) [hereinafter Law Enf’t]. https://www.nationalacademies.org/read/27887/chapter/3 [https://perma.cc/S4HZ-J65N].

^[16] Id. at 24.

^[17] Some websites, such as DNA Solves, request community donations of money or DNA to fund investigations using FIGG. See e.g., “You Can Help Solve a Case,” Dna Solves, https://dnasolves.com/ [https://perma.cc/E468-7CTP].

^[18] Law Enf’t, supra note 15 at 24.

^[19] Duaa Eldeib, A Lab Test That Experts Liken to a Witch Trial Is Helping Send Women to Prison for Murder, ProPublica, (Oct. 7, 2023), https://www.propublica.org/article/is-lung-float-test-reliable-stillbirth-medical-examiners-murder [https://perma.cc/5Q9J-UUDK].

^[20] Id.

^[21] Law Enf’t, supra note 15, at 24.

^[22] Id.

^[23] As was the case with Marshae Jones, a Black woman from Alabama who was blamed for the death of her unborn child when she was shot during an argument. See Annie Blackman, Criminalizing Pregnancy Loss, The Regul. Rev., (Feb. 8, 2022), https://www.theregreview.org/2022/02/08/blackman-criminalizing-pregnancy-loss/ [https://perma.cc/8PQR-UV86].

^[24] Isabelle Taft, A Lab Test That Experts Liken to a Witch Trial Is Helping Send Women to Prison for Murder, N.Y. Times, (June 3, 2025), https://www.nytimes.com/2025/06/03/us/forensic-genetic-geneology-dna-babies.html; Luke Whitney, Mother of ‘Baby Hope Medina’ accepts plea deal 20 years after body found abandoned on side of road, Kens5, (Nov. 25, 2024),

https://www.kens5.com/article/news/crime/mother-baby-hope-medina-accepts-plea-deal-20-years-after-body-found-abandoned-road/273-2130e5e2-6203-4fc7-8c79-972bfd835704 [https://perma.cc/A8DC-5PUW].

^[25] Taft, supra note 24.

^[26] Id.

^[27] Id.

^[28] Brownstein, supra note 12; see also Valena E. Beety & Jennifer D. Olivia, Policing Pregnancy “Crimes,” 98 N.Y.U. L. Rev. 29 (Mar. 2023), https://nyulawreview.org/wp-content/uploads/2023/03/NYULawReview-Volume98-OlivaBeety.pdf.

^[29] Taft, supra note 24.

^[30] Post-Dobbs Pregnancy Criminal Cases, Pregnancy Just., https://www.pregnancyjusticeus.org/post-dobbs-pregnancy-criminalization/ [https://perma.cc/9VYX-Y82A].

^[31] Id.

^[32] Taft, supra note 24.

^[33] Isabelle Taft, Mississippi moms suffer another grim statistic: The nation’s highest rate of stillbirths, Miss. Today  (Aug. 5, 2022), https://mississippitoday.org/2022/08/05/mississippi-stillbirth-rates/.

^[34] Wong, supra note 6; see also Cary Aspinwall et al., They Lost Their Pregnancies. Then Prosecutors Sent Them to Prison, The Marshall Project (Sep. 1, 2022), https://www.themarshallproject.org/2022/09/01/they-lost-their-pregnancies-then-prosecutors-sent-them-to-prison [https://perma.cc/T79F-XBHG]; Post-Dobbs Pregnancy Criminal Cases, supra note 30.

^[35] Nowhere to Go, supra note 7; Dr. Baker’s Story, March of Dimes, https://www.marchofdimes.org/find-support/community/stories/bakers-story [https://perma.cc/6GF6-M2U4].

^[36] Nowhere to Go, supra note 7, at 3.

^[37] Eli Y. Adashi, et al., Maternity Care Deserts: Key Drivers of the National Maternal Health Crisis, 12 J. Am. Bd. Fam. Med. 165 (2024); see Jazmin Orozco Rodriguez, ‘One Big Beautiful Bill’ Would Batter Rural Hospital Finances, Researchers Say, Kff Health News (June 12, 2025), https://kffhealthnews.org/news/article/rural-hospitals-battered-by-big-beautiful-bill-researchers/ [https://perma.cc/2Z8B-JT4N]; Rolonda Donelson et al., Republican’s New Health Care Law Will Impact Over 130 Rural Labor and Delivery Units, Nat’l P’ship For Women and Fam. (June 2025), https://nationalpartnership.org/report/republican-budget-bill-could-close-over-140-rural-labor-and-delivery-units/ [https://perma.cc/3427-JW82].

^[38] Wong, supra note 6.

^[39] Washington State Women’s Committee, Your Stories: Maternal Health Deserts, YouTube (Dec. 23, 2025), https://www.youtube.com/watch?v=pNtx9E5hSQQ [https://perma.cc/MG4M-EN5E].

^[40] Id.

^[41] Id.

^[42] Taylor Galgano, She took a DNA test for fun. Police used it to charge her grandmother with murder in a cold case, Cnn (Dec. 12, 2024), https://www.cnn.com/2024/12/12/us/baby-garnet-cold-case-michigan [https://perma.cc/V9BX-8LU9].

^[43] Law Enf’t, supra note 15, at 24; Corey Kilgannon, Cold Case Inquiries Hampered After Genealogy Site Revisits Terms of Use, N.Y. Times (Dec. 7, 2025), https://www.nytimes.com/2025/12/07/nyregion/ancestry-dna-police.html [https://perma.cc/H8PV-WSZU].