A new report found care provided in community birth settings, whether at home or in what are known as birth centers, can improve maternal health outcomes, especially for Black, brown and Indigenous women.

The U.S. has a far higher maternal mortality rate than other high-income nations, and Black and Indigenous women are two to three times more likely to die from pregnancy-related causes than their white peers.

Carol Sakala, director for maternal health at the National Partnership for Women and Families and co-author of the report, said community births often lead to better outcomes around preterm birth, Caesarean birth and breastfeeding.

"These models are especially powerful when they are community based and led," Sakala contended. "And they have the potential to do an incredible job of meeting the needs of birthing people of color, and mitigating effects of racism and trauma."

She noted a bill before the General Court would create a system for licensing Certified Professional Midwives (CPMs), who can attend to out-of-hospital births. It also would reimburse CPMs through MassHealth, the state's Medicaid program.

Currently, many families who opt for community births have to pay for care out-of-pocket.

Sakala added hospital care has received a lot of publicity for its shortcomings during the pandemic, which has increased demand for community births.

"That was greatly magnified when the pandemic set in," Sakala asserted. "We're asking healthy people to go into hospitals and potentially be exposed to the virus, and also to be separated from their loved ones and their support networks and often from their newborns as well if there were certain issues or concerns. "

The report added community births are cost-effective, and there are a number of steps to help increase access, from ensuring midwives and birth centers are covered by insurance, to supporting schools and programs trying to get more midwives into the workforce and expanding into underserved areas.

It also recommended increasing funding for community birth care and including midwifery as an eligible profession for loan forgiveness.

Abortion bans and restrictions limit women's participation in the workforce, according to a new analysis that quantifies the negative impacts on state economies.

South Dakota saw an average loss in GDP of nearly 1% per year between 2021 and 2023, due to a drop in labor force participation by people who became pregnant and didn't have access to abortion care, according to data from the Institute for Women's Policy Research. That adds up to nearly $641 million in economic losses to the state.

Jamila Taylor, president and CEO of the Institute for Women's Policy Research, said the 16 states with abortion bans or extreme restrictions, including South Dakota, are costing the national economy $68 billion annually.

"Not only do these restrictions and bans have a clear impact on the health and well being of people with the ability to get pregnant, they also have an impact on their productivity and their economic position in life," Taylor said.

Taylor added abortion access not only helps family finances, but also allows women ages 15 to 44 to engage more broadly in society -- in local communities or politics, for example.

Despite restrictions, abortion numbers are rising. The first full calendar year after the Dobbs decision overturned Roe v. Wade saw an 11% increase in abortions since 2020 - or over one million abortions in the formal health care system in 2023, according to The Guttmacher Institute.

If voters pass South Dakota's constitutional Amendment G in November, it will enshrine protections to abortion.

Hannah Haksgaard, University of South Dakota law professor, said even if it passes, people seeking an in-state abortion would likely see a lag time before services become available.

"There would still likely be state legislation that would try to restrict abortion in certain ways, and then the question would become whether those restrictions violated the new constitutional amendment," she said.

Haksgaard added that could make providers move slowly on offering abortion services in the state, until the legal issues are settled.


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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.