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After the Supreme Court ruling in Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade in 2022, the state of Alabama is leading the nation in the use of chemical endangerment charges to prosecute women who use illegal substances while pregnant. Within the state, most of these charges are filed in rural counties where women face challenges posed by maternity care desserts and a lack of access to substance use treatment. This study explores police filings, court documents, access to health care, and media coverage collected from the Alabama state court system and in conjunction with Pregnancy Justice and the Appalachian Research Center, to better understand how the chemical endangerment movement is being framed and operationalized in rural counties across Alabama post-Dobbs.