In 2006, Mississippi teenager Rennie Gibbs gave birth to a little girl, Samiya. She was a month premature and arrived with an umbilical cord around her neck, stillborn. Shortly thereafter, Gibbs was indicted for murder—“depraved heart murder,” to be exact—and has spent the past seven years fighting for her freedom. This is all because a highly controversial medical examiner named Steven Hayne discovered traces of a cocaine byproduct called benzoylecgonine in Samiya’s blood and decided that it must have been the cause of death. (No actual cocaine was found in Samiya’s body.) Nina Martin of ProPublica reports on the case, putting it in context with the larger nationwide push to hold women, especially young women of color, criminally accountable for failing to produce a live baby when they give birth.

There’s no doubt that Gibbs took cocaine during her pregnancy. But, as Martin reports, the case against Gibbs for “unlawfully, willfully, and feloniously” killing her baby—as the indictment reads—appears to be more political than scientific. The defense has hired a number of expert witnesses who say that the likeliest cause of death is “umbilical cord compression,” with one forensic pathologist concluding, “It is impossible to conclude from the very small amount of benzoylecgonine that the stillbirth was caused by cocaine toxicity.” In addition, the defense argued, in motions to dismiss the case, that there is no evidence linking cocaine use during pregnancy with “serious fetal harms, birth defects, or serious long-term physical or developmental impairments,” much less directly causing stillbirth. (This comes from research by Deborah A. Frank, a pediatrician and researcher at Boston University School of Medicine.) Using cocaine during pregnancy can cause placental disruption, but it didn’t in this case.

Then there’s Hayne, the medical examiner. Despite never having completed his certification test for the American Board of Pathology, according to Martin, Hayne has been repeatedly hired by Mississippi and other states to do autopsies anyway. During that time, he’s built up a track record of helping convict people and then seeing those convictions overturned. From Martin:

In litigation (much of it by the Mississippi Innocence Project) and news reports (many of them by Radley Balko, now of the Washington Post), defense lawyers and other medical examiners have accused Hayne of being sloppy, exaggerating his credentials, and leaping to conclusions that sometimes had no basis in science. At least four murder convictions based on Hayne’s evidence — one involving an innocent man sentenced to death for the killing of a three-year-old girl — have been overturned since 2007.

Using cocaine during pregnancy is not a good idea, of course. Even if it doesn’t directly affect the fetus, it does impact a woman’s sleep and nutrition, and it puts all sorts of stresses on her body that are bad for her and the baby. However, it’s a huge leap from advising against risky behavior during pregnancy to accusing someone of murdering her baby. And yet, it keeps happening, over and over again, and as Martin explains, the women accused are “disproportionately young, low-income and African American.” In other words, women who have the least amount of power to fight back.

The situation speaks to a gross cultural hypocrisy in Mississippi. The state has the highest infant mortality rate in the country, comparable to that of Sri Lanka and Botswana. Elizabeth Landau of CNN explains the reasons: Poor nutrition, poverty, and inferior education are all major contributing factors. Lack of health insurance is another biggie, as is teen pregnancy. Sex education is nonexistent in most of the state. It is no coincidence that Mississippi tops all sorts of nationwide lists on poverty, teenage pregnancy, and high school dropout rates.

The conservative leadership in Mississippi shows zero interest in taking any real measures to save infants from dying in their first year of life. Rather than expanding access to health care for the most at-risk, the Republican-led state government rejected the Medicaid expansion. While Rennie Gibbs could face life in prison for failing to give birth to a live baby, political leadership in Mississippi continues to support policies that lead to 9.4 babies out of every 1,000 in the state (compared to a national rate of 6 out of 1,000) dying before their first birthday, all without ever having to fear being led away in cuffs because of it.