At least 61 people were criminalized for alleged self-managed abortions between 2000 and 2020.

If you are looking to end your own pregnancy, your own doctor may be your downfall. 

Between 2000 and 2020, law enforcement in 26 states investigated or arrested at least 61 people for allegedly aborting their own pregnancy or helping someone else do so, according to a report released earlier this week by the legal advocacy group group If/When/How. And in 45 percent of those cases, it was healthcare providers or social workers who tipped off police.

In another 26 percent of the cases, people “entrusted with information”—like partners, parents, and friends—reported their ostensible loved one to police.

“The research really clearly confirms that the biggest threat to the privacy of abortion seekers is other people,” said Laura Huss, senior researcher for If/When/How. “That breakdown of trust and ethics and the patient-doctor relationship is really alarming.”

The report, which examined the criminalization of self-managed abortions while Roe v. Wade was still the law of the land, offers a stunning glimpse at how people who get abortions in this post-Roe era may be targeted and threatened by law enforcement. Although abortion opponents often insist that they do not want to punish pregnant people for abortions, abortion rights supporters have long pointed out that pregnant people have already faced criminal consequences—and there’s no way to ensure they’ll be kept out of an anti-abortion dragnet.

Indeed, that future is already coming to pass: Earlier this week, Nebraska law enforcement charged a 17-year-old and her mother with a litany of misdemeanors and felonies after they allegedly sought to end the 17-year-old’s pregnancy through a medication abortion. 

Currently, just three states have laws on the books that explicitly target self-managed abortions. But if prosecutors want to pursue charges, abortion rights experts say they’ll find a way to do so. In the Nebraska case, both individuals are facing charges that apparently refer to the 17-year-old’s fetus as a “dead human body”—language that elevates the fetus to the status of personhood, suggesting that it deserves the same rights and protections as people who can get pregnant.

In 43 percent of the cases uncovered in the If/When/How report, law enforcement weighed applying homicide or murder charges to people who sought to end their pregnancies or helped others of so. People of color were twice as likely as white people to face the possibility of those charges.

Out of the 61 cases, 43 continued through the criminal court process. Of those, 4 ended with a guilty verdict after a trial, 19 ended with a guilty plea, and 23 were dismissed or dropped. But just because someone may have avoided jail doesn’t mean that they walked away without consequences.

“In several cases, people lost custody of their existing children temporarily or permanently,” the report found. “In one case in which local authorities declined to prosecute after acknowledging the self-managed abortion was not unlawful, the woman was still turned over to immigration authorities for deportation.”

Most of those 43 cases also involved people living in poverty.

Throughout Roe’s slow collapse and ultimate overturn, reporting has often focused on how data from tech companies and, in particular, period tracking apps may be used to surveil people looking to end their pregnancies. But Huss said that, in all 61 cases, If/When/How found zero examples of authorities using data from period tracking apps.

People’s electronic records are, however, far from safe. In some cases, Huss said, police would get tipped off to a potential self-managed abortion and then then use someone’s texts and search history to build a case against them. (In the Nebraska case, Facebook turned over private chats.) 

If/When/How is not aware of a single law that requires health care providers to alert police to self-managed abortions, according to Lauren Paulk, who studies this issue as If/When/How’s senior research counsel. In fact, Paulk said, revealing a patient’s potential self-managed abortion may violate that patient’s privacy rights. 

Sometimes, providers get confused about their legal obligations, since they’re subject to other mandatory reporting requirements. But, Paulk added, “There have been cases where health care providers were anti-abortion and so reported the patient to law enforcement.”

Paulk is convinced that that, as abortion foes consider avenues to further limit the procedure in the wake of Roe’s devastation, they will try to change health care providers’ obligations to include reporting people for abortions.

“It’s clear that they either actively want to criminalize pregnant folks or don’t care that they are criminalized,” Paulk said. “I don’t put anything past them. They’ve really tried everything.”