An Indiana judge on Monday sentenced a 33-year-old woman, Purvi Patel, to 20 years in prison on charges of feticide and neglect of a dependent.

Patel is the first woman in Indiana to be convicted under the state’s feticide law. Activists say the case highlights the way that prosecutors across the U.S. are increasingly using laws designed to protect expecting mothers to criminalize women for terminating a pregnancy or allegedly harming an unborn child.

In 2013, Patel was arrested after seeking help in an emergency room for excessive bleeding, with an umbilical cord protruding from her vagina. She first told staff she hadn’t been pregnant but then revealed that she had given birth at her home in Granger, Indiana, according to court documents.

Patel told an investigator that she thought the fetus wasn’t alive and that she left it in a plastic bag in a dumpster outside her family home.

A police investigation recovered the fetus and charged Patel with killing her baby.

"I assumed because the baby was dead there was nothing to do," the South Bend Tribune, a local newspaper, reported she said in a police interview that was performed just hours after she was admitted to the hospital.

"I've never been in this situation. I've never been pregnant before," she allegedly told the police from the hospital while recovering from sedation and blood loss, before she had legal counsel.

Reproductive rights advocates say Patel’s case isn’t the first instance in which a woman has been accused under fetal homicide laws.

Although the laws were intended to deal with crimes against pregnant women and to target illegal abortion providers, they are increasingly used to prosecute women who miscarry, have stillbirths, try to terminate their own pregnancies or are accused of harming a fetus by taking drugs, according to Sara Ainsworth, legal director of National Advocates for Pregnant Women (NAPW).

“We are gravely concerned that this case represents a trend in punishing pregnant women for their pregnancy outcomes and demonstrates that women will be targeted for terminating their pregnancies, even though abortion opponents routinely claim that if abortion were re-criminalized in the U.S., no pregnant woman would be punished,” she said.

Lynn Paltrow, NAPW's executive director, also notes that the charges in Patel's case seem contradictory. “It’s confusing why a prosecutor would be allowed to bring such contradictory charges,” Paltrow told ThinkProgress. “How can you both have caused a pregnancy to terminate and given birth to a baby whom you neglect?”

A study by NAPW and Fordham University, which documents the arrests of pregnant women in the U.S. since 1973, found that black women and economically disadvantaged women are disproportionately targeted by feticide laws.

Indiana's feticide law had only been invoked once before, also a case brought against a woman of color, an immigrant from China. In that case, the woman tried to commit suicide while she was pregnant. She survived, but the baby died, and the woman was charged with feticide. She pled guilty to criminal recklessness after spending more than a year in jail.

Patel's case was also controversial for other reasons — the pathologist who determined that Patel’s fetus was alive used an outdated medical method that involves dipping the lungs in water and seeing whether they float, Slate reported. If they surface, it is taken as proof that the fetus was born alive.

Patel told investigators in the hospital interview that she was excited about being pregnant, but text messages and search engine records later showed a jury that she had looked online for abortion-inducing drugs — misoprostol and mifepristone — and texted a friend about terminating her pregnancy, the the South Bend Tribune reported.

She said she had purchased two drugs from a website in Hong Kong and began taking them in July 2013, according to court documents.

A toxicology report, however, revealed no traces of the drugs in Patel’s blood. And Patel's attorney said, according to the South Bend Tribune, that police could find no evidence that the drugs had actually been purchased.

Patel’s lawyers said she was afraid to disclose her pregnancy to her parents, who disapproved of extra-marital sex, ThinkProgress reported. Patel’s defense is expected to file an appeal.