In rural Appalachia, abortion pill offers reproductive choice and privacy − but police may see a crime

A 35-year-old Kentucky woman was arrested in late 2025, accused of taking abortion pills that she ordered online. The gestational age and status of the pregnancy is unknown. But Kentucky, like the majority of Southern states that contain Appalachian counties, has a complete abortion ban. Mifepristone is a medication approved by the Food and Drug Administration for self-administered abortion care through 10 weeks’ gestation, and research suggests it is safe and effective up to 16 weeks. Mifepristone can still be ordered into states with abortion bans after the Supreme Court weighed in on the matter on May 4, 2026. Abortion is illegal in Kentucky, however, and the police viewed the woman’s actions as criminal. A grand jury supported bringing charges, including fetal homicide, “abuse of a corpse” and tampering with physical evidence. Her distressed mugshot was plastered all over regional news sites. As a social work researcher who studies access to reproductive healthcare in underserved Appalachian communities, I have worked with clients in similar circumstances. I have observed that many decisions to end pregnancies are motivated by intense barriers to accessing healthcare – not by criminal intent. It can be extremely difficult for women in this region to get healthcare,…

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