In September 2015, according to reports, pregnant 31-year-old Anna Yocca lay down in a tub of water and inserted a coat hanger into her cervix. She panicked over the amount of blood she saw in the bathtub and called her boyfriend to take her to the hospital. Despite her repeated requests to the hospital personnel to end her pregnancy, doctors instead delivered a one and a half pound baby. She was 24 weeks pregnant, before the fetus was likely to be viable outside the uterus.

Three months later, on December 16, she was arrested for her attempted coat-hanger abortion. The police report claimed that the infant sustained damage that will cause lifelong effects, without mentioning the alleged damages are also common effects of extremely premature birth. Her cries for help to hospital staff are being used as testimony against her. She is being shamed publicly by the hospital staff via the police for being concerned about her own health and safety. Anna Yocca is being charged with attempted first-degree murder.

Anna Yocca is being held at the Rutherford County Adult Detention Center on $200,000 bond. Since she said she cannot afford a lawyer, the court has appointed her a public defender. She is due back in court again on February 29, and her lawyer has said he will be seeking a mental health evaluation. She has pled not guilty.

Numerous people have asked what her motives were, if she had attempted to access an abortion legally, if she is mentally ill and so on. Questions like these only matter as in so far as they allow us to evaluate the quality of abortion access in the state of Tennessee.

What does it take to have an abortion in Tennessee?

Tennessee has seven clinics in four cities. As of 2011, 63 percent of Tennessee women live in counties without a provider. The provider closest to Murfreesboro, where Anna Yocca lives, is about 40 miles away. Despite abortion technically being legal up to 24 weeks in Tennessee, the existing clinics in the state only perform abortions up to 16 weeks.

As a woman seeking an abortion, you would need to travel to a clinic where a doctor would read you a list of benefits and risks of pregnancy and abortion, what services are available and then tell you abortion is a major surgical procedure. You would have to come back 48 hours after the day of your visit to sign an “informed consent” form before being able to move forward. Depending on the stage of your pregnancy, it would cost between $500 and $1500 for the procedure. (Imagine needing to have that much money available very quickly before the cost rose or the procedure was no longer possible.) Since the state also bans health plans under the Affordable Care Act from covering abortion, all of this expenses would be out of pocket.

Why a coat hanger?

We may never know why Anna Yocca chose the gruesome, historically resonant coat hanger in her attempt to self-abort. But what we do know is that self-aborting is becoming an increasingly common occurrence. The hurdles women are forced to jump through in order to access abortion are becoming higher every year. So many are taking the matter into their own hands.

Women have been taking action to end unwanted pregnancies for thousands of years. But today, when the science and technology to safely end pregnancy is well-understood, it is outrageous that women are once again resorting to self-abortion. In areas where it is too difficult to access clinics, women have been conducting abortions at home. Whether trying herbs, ordering pills from other countries or other methods, this is a growing trend. But it should not be. Women should be able to access a trusted provider, in their area, as a covered procedure. All these restrictions, which are intended to make it harder for women to control their own bodies, are an incredible burden. They need to be overturned. All of them.

What is fetal homicide?

So-called fetal homicide is illegal in 38 states, including Tennessee. The original idea was to bring double charges against people who assaulted or murdered pregnant women. Most states include an exemption for women who have a legal abortion (meaning with a physician), although the promotion of such laws has been seen by the anti-abortion movement as a legal wedge to eventually be used against legal abortion. Tennessee passed legislation in 2012 that expanded the definition to include all embryos and fetuses at any stage of gestation as possible victims.

It is currently uncommon for a woman to be arrested and charged for fetal homicide, but Yocca’s case is not only one in which a woman has been charged for killing, harming or endangering her own fetus. Tennessee is just one of the states that charges women with assault if they were addicted to drugs during pregnancy and the baby was born with drugs in their system. The only defense is completion of a court-approved drug treatment program before the baby’s birth. For many women, the problem is finding and getting into an appropriate treatment program. Attempted suicides while pregnant have also led to criminal charges and convictions. Just last spring in Indiana, Purvi Patel was sentenced to 20 years for feticide and child neglect when she miscarried and, in a panic, got rid of the dead fetus.

What are these women guilty of? They were pregnant women in need of medical care and services. Women who have miscarried need medical care. Women with mental health issues, with addiction, or who commit self-destructive acts need treatment. Women carrying an unwanted pregnancy need appropriate medical treatment. These women need support, not criminalization and incarceration. Because what happens is that rather than seek help, women will risk their health.

What is needed is to make birth control, abortion, and pre-/post-natal care available for all women. What is needed is to end the idea that prison is the way to deal with women’s health problems.

That is why we say: Drop the charges against Anna Yocca! Health care not incarceration!