Roe Reckonings: The Criminalisation of Help, Care and Choice

Laws carry more weight than their mere wording – they signal what actions a society will allow, penalise or stigmatise. In the US today, abortion bans and restrictions are pushing us toward a disturbing trajectory: prosecuting not only those who perform reproductive care but those who support, assist, or even facilitate it. In effect, we are witnessing the criminalisation of help, care and choice.

A stark example: Texas has recently charged eight people over their links to a midwife accused of illegal abortions. State Attorney General Ken Paxton described the case as uncovering “a cabal of abortion-loving radicals” allegedly practising medicine without a licence. (The Guardian, Oct 2025)

This case is not merely about legal technicalities, it’s about denying agency, autonomy and compassion in a country that once guaranteed reproductive rights. It reflects a broader movement toward policing care itself.

The Texas Case: How Help Becomes a Crime

To understand what’s unfolding, let’s unpack the Texan charges, and then reflect on the wider implications.

What the charges allege

In what reproductive rights advocates call a test case for Texas’s abortion ban, Houston midwife Maria Margarita Rojas and eight others have been indicted under laws that criminalise reproductive care.

Rojas and an employee were first charged in March 2025, among the earliest prosecutions under the ban (Texas Tribune).
By September, the case had expanded: Rojas now faces 15 felony counts, and eight others were charged with practising medicine without licences, allegedly under her supervision (Houston Chronicle, Houston Chronicle).
Texas Attorney General Ken Paxton’s office has framed the prosecutions as protecting “life,” using language intended to demonise providers and deter others from offering care

Rojas’s lawyers argue the case is political, not legal. Possession of abortion pills — specifically misoprostol, a safe, common medication also used in miscarriage and obstetric care — does not prove abortion, they say. The investigation was flawed and overreaching, part of a broader push to intimidate providers and restrict reproductive healthcareacross Texas and practising medicine without a licence. (Houston Chronicle, Sep 2025)

What this signals

Expanded liability: beyond the direct provider
The charges reach beyond the person alleged to perform abortions. They ensnare assistants, clinic staff and support networks. That sends a clear warning: anyone involved in reproductive work may be vulnerable.
Licensing as a tool of control
Accusations of “practising without a licence” become a blunt instrument. Because reproductive and maternal care often operate in overlapping spheres – midwifery, telehealth, community health – the legal net can be cast broadly.
Chilling across professions
Clinicians, midwives, doulas and counsellors may withdraw services, refuse certain clients, or abandon reproductive work altogether to shield themselves from legal risk.
Stigma weaponised
Language such as “fake doctors” or “radicals” frames care as inherently suspect. That discourages others from stepping forward whether they are patients, supporters, or providers.

What This Means for Individuals

For care providers and helpers

Legal jeopardy: Providers may be charged with serious felonies for what was once considered standard reproductive or maternal care.
Self-censorship: Professionals may refuse clients whose cases seem legally risky or avoid reproductive health altogether.
Institutional abandonment: Medical boards, liability insurers and hospitals may distance themselves from controversial care.
Emotional burden: The moral and psychological strain on providers forced to stop care or risk prosecution is profound.

For patients

Shrinking access: Clinics may close, providers may flee the field, and travel or cost barriers will escalate.
Health risks: Delays, unsafe alternatives, or lack of care may endanger lives.
Legal exposure: In certain jurisdictions, patients or those assisting (friends, family) may face legal or civil consequences.
Inequitable harm: Marginalised groups – low income, rural, BIPOC – will be worst hit by shrinking access.

What It Means for the US

Erosion of bodily autonomy

When the state can punish those who help you make medical decisions, your autonomy becomes conditional. Care becomes a political privilege, not a medical necessity.

Expansion of the carceral state into health

Historically, criminal law remained separate from legitimate medical practice. Now care, especially reproductive care, is being policed. Every health worker becomes a potential target.

Inequality baked in

Wealthier individuals will find ways around restrictions – travel, private networks, clandestine resources. Others will be locked out. The law becomes an added barrier for those already marginalised.

Legal chaos and instability

State and federal rulings will clash. Litigation, unpredictable enforcement, shifting definitions of what is legal will make the landscape volatile. Providers and patients may be uncertain until it’s too late.

Innovation under threat

Telehealth, mail-order medication, community-based care models are all vulnerable. The very approaches that improved access may be criminalised or constrained.

Paths of Resistance & Resilience

If this is the trajectory, how do we fight back?

Legal defence infrastructure: Bolster legal funds, pro bono representation, safe provider networks.
Decriminalisation advocacy: Push for laws that explicitly protect reproductive care; create safe harbour statutes for providers and assistants.
Best practices, protocols, documentation: Providers should work with clarity, keep thorough records, consult legal counsel proactively.
Narrative and stigma work: Share stories of patients, families and providers. Reframe abortion care from “controversial” to essential healthcare.
Movement building: Support clinic access, transportation funds, cross-state networks, abortion funds, community care systems.

🇬🇧 Why We Should Be Paying Attention

The Texas case is not an isolated incident, it sits at the intersection of a broader, dangerous trend: that reproductive care, assistance, and choice can be prosecuted. This isn’t simply about one midwife or eight workers. It’s about the message these prosecutions send: that care can be illegal, compassion can be suspect, and choice can be punishable.

And this matters far beyond the US. 🌍

Here in Britain, as of July 2025 pregnant people can no longer be prosecuted for ending their own pregnancies outside the criteria of the 1967 Act – thanks to a recent amendment in Parliament. But abortion is still governed by criminal law for anyone who provides or assists with care outside that framework. Medical professionals, nurses, midwives, pharmacists all remain vulnerable to prosecution if they act beyond the strict legal parameters.

The criminalisation of help, care and choice is not a distant political skirmish — it is a calculated dismantling of trust, safety and bodily autonomy. Each prosecution sends a message that compassion is dangerous and care can make you a criminal. In the US, where rights once protected by Roe are being unravelled case by case, the cost is measured in fear, silence, and lives put at risk. This is not just about laws; it is about who gets to decide if people live with dignity, or under the shadow of punishment for seeking or offering care.

Reproductive rights don’t disappear overnight — they are chipped away, case by case, prosecution by prosecution. What we’re seeing in the US today should set alarm bells ringing here in Britain. 🔔