FRANKFORT, Ky. — A new report demonstrates the divide between states that prioritize reproductive health and those that do not - and Kentucky is among of the latter.

The Population Institute's annual report card on reproductive health and rights gave 19 states, including the Commonwealth, a failing grade. The findings are not a surprise to Marcie Crim, executive director at the Kentucky Health Justice Network.

"Kentucky is a birth-control desert, meaning that our publicly funded clinics are not offering all forms of contraception. That's a problem,” Crim said. “And 76 out of our 120 counties don't even have an OB-Gyn. So we're just a mess in Kentucky in terms of reproductive health."

Kentucky scored poorly for mandating abstinence as part of the sexual education in public schools, while not requiring contraception or HIV education. The state also has no laws affirming a woman's right to emergency contraception in an emergency room.

Overall, the country received a "D-minus," with the research noting declining overall reproductive health and rights, and increasing disparity between states. Twenty-two states received a "B-minus" or higher, while the other 27 received a "D" or lower.

Kentucky fared well in the report for its teen pregnancy rate, the number of unintended pregnancies, and for allowing minors to consent to contraceptive services. However, Crim pointed out that just because it's permitted, that doesn't mean it's accessible.

"This person was 19, 20 years old, went to go see their family doctor to get on birth control and the family doctor refused to give them a prescription because the doctor said, 'You're not married, and it's against my beliefs to give you birth control,’” Crim said. “And so that's obviously a huge problem."

Abortion access is another problem area, with the report showing that about 3-in-4 women live in a county without an abortion clinic. Kentucky also has several laws that make it unnecessarily difficult to obtain an abortion, and Crim said lawmakers are trying to pass more.

"It feels like there's an overall wish to dominate Kentuckians' bodies without actually doing the research into how you would bring down numbers of abortions through access to sex education and contraception,” she said. “It is to just stop abortions and damn the consequences."

The report added a "minus" to Kentucky's failing grade because the state's "Choose Life" license plates fund anti-choice organizations.


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A majority of South Dakotans have voted to maintain a strict abortion ban but other factors are shifting the landscape for reproductive care in the state.

Of the 10 states voting on abortion during the 2024 election, South Dakota was one of three to keep a ban in place.

Kim Floren, director of the Justice through Empowerment Network, which provides financial assistance to people seeking abortions, said the state's view on the issue is not new but concern is growing over how the federal government may affect reproductive rights.

"I'm feeling the panic from people who are in areas that maybe haven't experienced what we've experienced as far as barriers go," Floren noted. "The reality is that we as a community can figure out how to take care of one another."

The Justice through Empowerment Network provides assistance with travel and transportation, child care, lodging, interpreters, birth control and medical procedure funding. Floren pointed out the organization supports 30 to 40 people per month. The final tally for Amendment G, which would have established a right to abortion in the state's constitution, was 41% for and 59% against.

South Dakotans voted in 2006 and 2008 against near-total abortion bans but Floren stressed since then, President-elect Donald Trump's first term made people feel "emboldened to be more vocal." Still, she acknowledged his second term will begin in a different context than his first.

"Before Dobbs, we did not have all of these reliable, safe websites where you can order abortion pills from and have them sent to your house for extremely cheap," Floren observed. "In some ways, access here has gotten better."

Floren added Gov. Tim Walz of Minnesota will return to his post after running for vice president on the Democratic ticket. Walz in 2023 signed a bill protecting patients who travel to Minnesota for abortion care and their providers from legal penalties in other states.


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It is now up to Wisconsin Supreme Court justices to decide the fate of an abortion law from the mid-1800s.

A circuit court determined last year an 1849 law does not apply to "medically consented" abortions in Wisconsin. The high court heard arguments Monday about whether a 1985 state law overrides the older one, allowing abortions before the point at which a fetus could survive outside the womb.

Jenny Higgins, professor of obstetrics and gynecology at the University of Wisconsin-Madison, said while the impact of this case is critically important, even if the 1849 law is determined to be unenforceable, returning to the status quo would mean a dire landscape for abortion access.

"Even though abortion is technically available at clinics in Wisconsin right now, it's heavily restricted," Higgins explained. "Because of insurance and Medicaid prohibitions, people have to pay out-of-pocket for a service that should be covered by insurance."

The 1849 law, which was brought to light after Roe v. Wade was overturned by the U.S. Supreme Court, prompted a statewide freeze on abortion services for more than a year. Higgins noted if Wisconsin's high court rules the law still applies today, the state would be looking at another abortion freeze.

Abortion access disproportionately affects those who are already the most marginalized, Higgins pointed out. She noted while people from all walks of life may find themselves needing abortion care, factors like poverty and racism make it much harder for some to achieve reproductive autonomy, compared to those with more economic and social resources.

"Those effects make it much harder for folks to be able to access contraceptive care, be in relationships that are stable and healthy and communicative, to be able to see past the end of the day into one's future if you are, again, mostly focused on your own economic scarcity or figuring out how to feed your kids, or figuring out how not to get evicted," Higgins outlined.

The 1976 Hyde Amendment, established three years after Roe v. Wade, prohibits the use of federal funds for abortion. Higgins hopes federal lawmakers will focus more on this amendment when considering the barriers to abortion care.


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Strong reactions are pouring in from both sides as Missouri voters made history by adding abortion rights to the state constitution.

The decision to pass Amendment 3, the "Right to Reproductive Freedom Initiative," makes Missouri the first state to overturn a near-total statewide abortion ban. Advocates and opponents are now gearing up for future battles.

Jamie Morris, executive director and general counsel of the Missouri Catholic Conference in Jefferson City, said he is disappointed with the passage of the amendment but emphasized his organization's pride in the conference's efforts, despite limited resources, and vowed the fight is not over.

"From the church's perspective, win or lose, we were going to continue to advocate for policy to help address the needs of women to help them choose life to begin with," Morris explained. "So that not only you're dealing with, necessarily, the supply of abortion, but also the demand."

In addition to abortion rights, Amendment 3 protects access to contraception and reproductive health services.

Meanwhile, pro-choice advocates in Missouri including Planned Parenthood and the ACLU are celebrating the passage of the amendment, while filing a lawsuit to block some restrictions, including parental consent for minors and continued regulatory oversight of abortion services.

Maggie Olivia, senior policy manager for the advocacy group Abortion Action Missouri, applauded the vote.

"I could not be more proud of the first steps that we are taking together as Missourians to dismantle the decades of political infringements on our access to abortion and, frankly, all reproductive care," Olivia stressed.

Missouri was among nine states with abortion rights measures on the 2024 general election ballot. Amendment 3 takes effect Dec. 5.


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