As maternal death rates go up, states are considering whether to extend postpartum coverage through Medicaid. Supporters in Iowa hope lawmakers take advantage of federal incentives and join the list.

Under the American Rescue Plan, states have the option to seek matching funds allowing 12 months of postpartum Medicaid coverage. The current requirement is 60 days.

Dr. Lena Rydberg Freese, internal medicine specialist at the Iowa Clinic and an American Heart Association board member, said she often sees new mothers after they have given birth. She feels yearlong coverage would address common lingering health effects tied to a pregnancy.

"That's going to do a lot better job of getting hypertension levels back to normal and getting their risk factors under a little bit better control," Rydberg Freese recommended. "So that they are better able to prevent the long-term health consequences of not treating this."

The American Heart Association said other risk factors for new mothers include blood clots and stroke.

Currently, four out of every 10 births in Iowa are covered by Medicaid. Nationally, cost barriers result in an unmet medical need for one in five uninsured new moms. There is a proposed extension in the Iowa Senate, but an added provision dealing with pregnancy counseling and avoiding abortions has seen pushback.

Meanwhile, the Centers for Disease Control and Prevention noted the maternal death rate in the United States has steadily increased, going from 17 per 100,000 births in 2018 to 23 in 2020. The rates are much higher for Black women.

Rydberg Freese pointed out those disparities exist in Iowa.

"It has not been, I think, as well recognized as a problem in the Midwest as it has in some of our coastal regions," Rydberg Freese observed. "But we see that magnitude is, is a little bit greater."

The federal incentives for the extended coverage, which begin Friday, sunset after five years. Nearly 30 states have either adopted extensions or are considering it.

Rydberg Freese added if Iowa were to move ahead, it would help families feel like they are supported here.

"I want my young moms to be in good health, because that helps them do all the things that they need to do for their families, for their communities," Rydberg Freese asserted.

The Heart Association is encouraging those who want a coverage extension to speak up through the group's You're the Cure platform.

Voters in Arizona overwhelmingly supported and approved Proposition 139 last week, which enshrines abortion rights into the state's constitution.

The measure will allow abortions up to fetal viability, which is about 24 weeks.

But Fatima Goss Graves - president and CEO of the National Women's Law Center - said while ballot measures expanding access to abortion won in seven of the ten states this election, she contended there are still countless ways to restrict and upend abortion access even further, including nationwide.

"There is a long list of ways to target birth control, to target fertility treatments, to target our ability to control our own bodies, and to be fully equal in this society," said Graves. "We know that road will be long and hard."

Over the weekend Arizona was officially called for former President Donald Trump, awarding him the state's 11 electoral college votes.

Graves said Trump has promised to veto a national abortion ban, and to distance himself from the conservative playbook Project 2025.

She said reproductive rights advocates, like herself, expect the next administration to deliver on those campaign promises.

The state has a number of abortion restrictions and laws that directly conflict with Prop 139.

Until the election results are officially certified by Gov. Katie Hobbs later this month, pro-choice advocates say they'll likely file legal challenges to deem those current restrictions unconstitutional.

In a statement, the It Goes Too Far Campaign - a group opposing the measure - says "the fight against extreme abortion laws will continue."

Monica Simpson is the executive director of the SisterSong Women of Color Reproductive Justice Collective.

She said while all eyes need to stay on the Trump administration, advocates must also continue to lift up "powerful programs."

"I want us to be able to find a balance in doing that," said Simpson, "and work together as the organizations and entities that we are, to be able to make sure that we give ourselves the power and the fuel that we need over these next four years."

Simpson said while it is crucial to keep an eye out at the policy level, advocacy will also be a key part of the fight moving forward.

Support for this reporting was provided by the Carnegie Corporation of New York.

Oregon has the third highest percent of women in city government, according to a new report from Rutgers University.

It may be proof of the success of organizations working to support and encourage women to run.

Groups like Emerge Oregon and Vote Run Lead Action train women and nonbinary people to run for office - and win.

Emerge Oregon alums currently hold more than 100 elected positions on city councils, school boards and in the legislature.

Beyond campaigning and fundraising, women receive support to overcome gender-based barriers.

The group's outgoing director, Annie Ellison, noted that the political system wasn't designed with women - particularly women of color - in mind.

"This is a system that was built - like, pretty immaculately - to keep women and women of color out, even if it's not the intention now," said Ellison. "When do we have city council meetings? You know, most of these city council meetings are unpaid, and they're at 7:00 at night. If you're a caregiver, that's bedtime."

But research shows that female elected officials bring more money back to their districts, pass more bipartisan legislation, and get more done overall.

State Director of Vote Run Lead Action, Becca Phelps, said the challenge isn't just getting more women into office - it's keeping them there.

She said in the past few years, several women in the Oregon Legislature have had to leave prematurely or not run again, citing the low pay and added responsibilities of daily life.

This is where organizations can step in to fill these gaps - advocating for higher pay, helping with childcare and transportation costs, even providing emotional support.

"Sometimes," said Phelps, "it's that personal care of having a friend check in on you to see how you're doing when you're an elected leader."

After Tuesday's election, 15 graduates of Emerge Oregon programs may be in the Oregon House and four may hold seats in the Senate.

Ellison added that the biggest barrier women face in running for office is confidence.

"If he can do it, you can do it," said Ellison. "And here's how you're going to do it, and we're going to help you."




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A federal nutrition program for low-income moms and babies now includes canned fish and beans, whole grains such as quinoa and cornmeal, and more money for fruits and vegetables.

Theda Simpson, a former participant in the Special Supplemental Nutrition Assistance Program for Women, Infants and Children from Metcalfe County, said she relied on the funds for extra help paying for supplemental formula for her daughter and sons, who had milk allergies as infants. She found out about the program through her local health department and stressed it was a lifesaver for preventing her children from going hungry.

"I hope that every mother finds out about it, knows about the program, is able to access and get the help that they need to be able to feed their children," Simpson emphasized.

Under the new changes, children ages 1-4 will now receive $24 per month, pregnant and postpartum women will now receive $43 per month and breastfeeding women will now receive $47 per month, under recent USDA updates.

Research has shown the WIC program helps improve pregnancy outcomes, including lower incidences of premature births, infant mortality and low-birthweight babies.

Karena Cash, data and research director for Kentucky Youth Advocates, said WIC is not reaching every available mom or mom-to-be in the state, although advocates have been doing work to reach more households, especially in Latino communities and among kinship caregivers. The data show two of every eligible five families are not participating in the program.

"About 96% of infants in Kentucky are enrolled, whereas only about 60% of women and 51% of eligible children one to five," Cash reported. "We see some pretty big discrepancies."

Tanya Torp, executive director of the nonprofit Step By Step in Lexington serving young, single mothers and their babies, said a major barrier is a lack of understanding among grocery stores about how WIC works and what products are covered under the program.

"For us, being able to work with some of the stores is going to be really important," Torp explained. "To train the employees at the stores so that they will be able to help when someone comes in and asks questions about WIC."

Advocacy groups have developed an online toolkit for local communities and leaders, and professionals who serve young children to help get the word out about the WIC program. Nationwide, more than 6 million women and children rely on WIC each month.


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