With the Dobbs ruling allowing states to restrict abortion access, health care practitioners have been forced to innovate in order to deliver care.

Planned Parenthood of the St Louis Region and Southwest Missouri announced last week it will provide reproductive health care via a mobile clinic parked in southern Illinois. They converted a 37-foot recreational vehicle into a mobile health care center, which will be able to conduct medication abortion for patients up to 11 weeks' gestation.

Dr. Colleen McNicholas, chief medical officer for the regional group, said the plan is to eventually expand services.

"Once we iron out the operational work of delivering medication abortion, we will be quickly looking to pivot to expanding that service line to include first-trimester procedural care as well," McNicholas explained.

Before the Dobbs decision, medication abortion accounted for more than half of all abortions. The clinic is expected to be able to see patients by the end of the year.

Demand for reproductive health services has increased dramatically in the wake of the Dobbs decision. At its Fairview Heights, Illinois, clinic, 20 miles from the Missouri border, Planned Parenthood reports there has been a 30% increase in abortion patients, with appointment wait times increasing from four days to two and a half weeks.

McNicholas noted their locations in Illinois give them perspective on the distances people will travel for care.

"As one of only two abortion providers in southern Illinois, we've seen the distances that people are being forced to travel for abortion care," McNicholas observed. "We're adapting our service lines to provide the same quality care that we do in our health centers, but now in a mobile unit."

The mobile care center is equipped with a lab and two exam rooms. The initial goal is to be able to serve 30 patients per day.

About one in eight new mothers report having symptoms of postpartum depression and the rate of women diagnosed at delivery was seven times higher in 2015 than in 2000, according to the Centers for Disease Control and Prevention.

Dr. Elizabeth Ottman, OB/GYN at Ohio County Healthcare, said many rural Kentucky women lack the resources and support needed to address perinatal mental health disorders.

"I started in 2019 really getting into treating perinatal mental health," Ottman explained. "The program at Ohio County was for Zulresso infusion and it was the first drug approved by the FDA for postpartum depression."

Ottman noted the drug is now available in a pill form. Symptoms of postpartum depression may include feeling persistently angry or sad, having trouble bonding with your baby, insomnia and loss of appetite.

Dr. Donna O'Shea, OB/GYN and chief medical officer for population health at UnitedHealthcare, said risk factors include any woman with a history of anxiety or mood disorders and a family history of depression. She added women from under-resourced communities are also at risk.

"There are some women who have little or no social support," O'Shea pointed out. "If someone has a history or is currently using substances like drugs or alcohol, that they will face higher risks with the pregnancy and after a pregnancy."

Carole Johnson, administrator of the U.S. Health Resources and Services Administration, said the Biden administration has launched a new maternal health mental health hotline to help new parents, noting data show new moms fare better when they get help at the onset of symptoms.

"We have trained counselors who are available to help just be a safe space for new parents, pregnant women," Johnson emphasized. "To have a conversation about what they're experiencing and get the support that they need. "

Call 1-833-TLC-MAMA to speak to hotline counselors 24 hours a day, seven days a week.

Women and health care providers testified before the Human Rights Subcommittee, chaired by Sen. Jon Ossoff, D-Ga., in Atlanta this week, detailing the dangerous effects of Georgia's six-week abortion ban.

Nearly two years after the law went into effect, women are recounting how they were forced to continue high-risk pregnancies or seek critical medical care out of state.

Mackenzie Kulik, who lives in Atlanta, said complications in her second trimester did not qualify for an exemption under the law, leaving her with no choice but to leave Georgia to receive the care she needed.

"If I had not been able to travel out of state, I would have been forced to carry a nonviable pregnancy until the baby died in utero," Kulik explained. "Or I would have developed an infection that threatened my health enough to qualify for an intervention. Or I would have had to deliver a baby, only to watch her suffer."

The hearing brought attention to how Georgia's abortion restrictions have limited medical options for people facing pregnancies with severe complications.

Yasmein Ziyad, a resident of Morrow, testified about her experience. After being denied care during a miscarriage, Ziyad said she experienced severe pain and complications. She told the committee her doctor feared the legal consequences of performing an abortion.

"I didn't have to go through this," Ziyad emphasized. "These laws created so much fear and confusion that I couldn't get the care I needed, that would have spared me so much pain and suffering. As a result of what I went through, we have given up on hopes of ever being pregnant again."

Medical professionals, including OB/GYNs, echoed the concerns, warning the ban is increasing maternal mortality rates and putting people's health at risk.

The hearing comes as the story of Amber Nicole Thurman gains national attention. She died two years ago after delays in care due to the state's restrictive laws. Her death was later ruled preventable by 10 doctors.


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A bill to bolster protections for in vitro fertilization treatments failed in the U.S. Senate Tuesday and as the political debate plays out, a Minnesota mother hopes her experience opens more eyes to the challenges some people face in expanding their families.

For the second time this year, Senate Republicans blocked efforts to put in place a nationwide right to IVF. The outcome is likely to get more attention on the campaign trail this fall.

Miraya Gran, an infertility advocate and IVF mom from Bloomington, said she and her husband were both diagnosed with infertility. They are now proud parents of a daughter through IVF but there were many hoops to jump through.

"Infertility is a disease and like any other disease, it is emotionally and physically exhausting," Gran pointed out. "When your disease is not covered by insurance, there's a financial component added on top of it, which is equally exhausting."

She noted the couple underwent many tests, took out a second mortgage and relied on crowdfunding to pay for the IVF. Gran is now an advocate of guaranteed health coverage for IVF treatments in Minnesota.

In Congress, Senate Republicans said they support IVF but accused Democrats of a "political stunt" by bringing it to a vote. Democrats contended the outcome aligns with conservative ideals in curtailing reproductive freedoms.

The issue received renewed focus when Republican presidential nominee Donald Trump expressed his support for IVF, even though some of his voter base objects because of religious beliefs.

Gran acknowledged people have their right to their opinions about an issue but those beliefs should not come at the expense of access to reproductive care.

"It's isolating," Gran explained. "Our society has created a taboo around it for so long."

Although the U.S. Senate vote failed, Gran noted it is encouraging to see policymakers debate the topic openly. Minnesota Gov. and Democratic vice-presidential nominee Tim Walz has frequently called for expanded access to IVF, citing his family's struggle with infertility. A Minnesota bill stalled earlier this year amid debate over costs. It is expected to see another push in 2025.


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