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 ruling from the U.S. Supreme Court Thursday will allow for abortions in emergency situations in Idaho - for now.
The justices said they were dismissing an appeal, reestablishing a lower court decision allowing hospitals to perform abortions in emergency cases, despite the state's restrictive abortion laws.
Molly Meegan, chief legal officer for the American College of Obstetricians and Gynecologists, said the organization is glad to see temporary relief in this case but added it is far from a complete solution.
"The way these laws are set up in Idaho and elsewhere are that there are limits on what care can be provided," Meegan explained. "Those limits are not clearly defined, and they're not committed to the discretion, the judgment, the expertise and the training of the physician that's facing a particular patient."
The protection for emergency abortions stems from a federal law known as the Emergency Medical Treatment and Labor Act. The law requires Medicare-funded hospitals to perform abortions in emergency situations. The three dissenting justices in Thursday's case called the Act's ability to preempt Idaho's restrictive abortion laws "plainly unsound."
Dr. Stella Dentas, president of the American College of Obstetricians and Gynecologists, said there is still a lack of clarity around the law in Idaho and OB/GYNs are leaving the state as a result. She noted when doctors face the prospect of jail over restrictive laws like Idaho's, it makes their job more difficult in emergency situations.
"It's already hard enough to make these critical decisions in the moment," Dentas emphasized. "If you're stuck on, 'OK, I can go down path A, but I'm not allowed to go down path B,' that is very confusing for both clinicians and the patients and the shared decision-making that we do."
Meegan added legislators should not be determining what care is available to patients.
"These questions need to be decided by science, by evidence, by the individual case in front of you," Meegan contended. "The idea that you can have black and white worlds being created by people without the expertise, training or experiencing the emergencies is really fundamentally dangerous."
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A groundbreaking report from a team of Wayne State University researchers revealed fathers pass down more than genetics to their children. They are also sharing toxins.
The study found when adult male mice are exposed to a mix of old and new PFAS chemicals, it alters their sperm and affects the genes in their offspring's liver and fat. The substances have been widely used since the 1940s in consumer projects and industry.
Dr. Michael Petriello, toxicologist and assistant professor of environmental health sciences and pharmacology at Wayne State, worked on the study and said the results have been surprising.
"It was a such an interesting collaboration that I didn't know what to expect, because I had never done anything looking at paternal exposures," Petriello observed. "Every time that we expose these male mice, we see something - whether it's in the male themselves, or their offspring."
Studies show PFAS exposure also causes less testosterone in male rats and more estradiol, a female sex hormone. PFAS are a large group of synthetic chemicals resistant to oil, water and heat, giving them the nickname "forever chemicals."
Dr. Richard Pilsner, OB/GYN and professor of human growth and development at Wayne State, who co-authored the report, said while women often focus on their health before trying to become pregnant, planning is important for men too, and the three months before conception are most critical.
"During that period, it's very good to try and avoid environmental exposures and reduce your exposure to different factors that may negatively influence those sperm epigenetic patterns," Pilsner recommended.
DruAnne Maxwell, a doctoral student at Wayne State and co-author of the report, said she is grateful to Professors Pilsner and Petriello for what she called a revolutionary opportunity.
"PFAS, there's not a lot known about it, especially when it comes to reproductive science," Maxwell pointed out. "There's not a lot of emphasis on male contribution, and so we're trying to, like, turn the tides and show people that men do matter."
The team said more research is needed to understand how PFAS exposure before conception affects future generations.
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The Illinois General Assembly has just passed a $53 billion state budget which includes a boost in funding for Planned Parenthood.
Reproductive rights may be in limbo across the country, but it is not the primary focus of the funding increase.
Katie Stanczykiewicz, director of government relations for Planned Parenthood Illinois Action, an independent advocacy arm of Planned Parenthood of Illinois, said reproductive health issues disproportionately affect people of color, and state lawmakers are paying attention.
"I think the additional funding that happened this year that's brand new, dealing with the Black maternal health crisis, is something that Planned Parenthood of Illinois cares deeply about," Stanczykiewicz pointed out. "It's very exciting to see not only the same amount of funding we've received for years before, but additional funding to address the maternal mortality rate that is plaguing our country."
According to a 2023 Illinois report, what's known as "extreme maternal morbidity" is most common among Black women, at a rate of 150 per 10,000 births, more than twice the rate among white women.
Abortion and reproductive rights remain high-profile issues in this election year, with legal actions nationwide to challenge or uphold a person's right to end a pregnancy. But Stanczykiewicz noted Planned Parenthood is committed to keeping all health centers open for patients in Illinois, and pointed out the clinics provide a range of services.
"Continuing to receive funds to not only help with our navigational services that we provide, to people who are coming to Illinois or coming within Illinois to receive abortion care, but also our gender-affirming care and our family planning services," Stanczykiewicz outlined.
She added clinic staffers still face harassment and threats, and some fear for their safety. A 2021 study reported an 80% increase in bomb threats and a 163% rise in devices or suspicious packages left at clinics providing abortion services.
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