Journal article
County-Level Pregnancy Criminalization Rates and Prenatal Care Initiation and Utilization in Alabama, 2014-2022
Women's health issues, Forthcoming
16 Apr 2026
PMID: 41997831
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Abstract
We investigated whether higher rates of county-level pregnancy-related arrests were associated with delayed and inadequate prenatal care among births in Alabama (2014-2022).
We used restricted-use natality data from the National Center for Health Statistics and data on annual pregnancy-related arrests by county from Pregnancy Justice. We fit log Poisson generalized estimating equation models with cluster robust standard errors to estimate the relative risk and 95% confidence intervals (CIs), stratified by race and ethnicity, and adjusted for individual- and county-level confounders.
Fully adjusted models suggest individuals living in counties with higher pregnancy criminalization rates were moderately more likely to delay prenatal care initiation (1.11, 95% CI [1.08, 1.14]) and receive inadequate prenatal care (1.05, 95% CI [1.03, 1.06]) compared with those living in a county with no arrests. We found positive associations among non-Hispanic white and Latina/Hispanic women, and null or slightly protective associations among non-Hispanic Black women.
These findings suggest pregnancy criminalization has an indirect chilling impact on prenatal health care access. The rise in the criminalization and surveillance of pregnancy, particularly in a post-Dobbs context, requires evidence-based policy responses that support maternal health and reproductive autonomy.
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Details
- Title
- County-Level Pregnancy Criminalization Rates and Prenatal Care Initiation and Utilization in Alabama, 2014-2022
- Creators
- Taylor Riley (Corresponding Author) - University of North Carolina at Chapel HillJaquelyn L Jahn - Drexel UniversityMaeve E Wallace - University of Arizona
- Publication Details
- Women's health issues, Forthcoming
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Other Identifier
- 991022173650904721