Nebraska physicians and their patients have been dealing with the state's 12-week abortion ban since it went into effect just over a year ago.
It replaced the 2010 law which prohibited abortions past the 20th week of pregnancy and was considered one of the country's most extreme abortion laws at the time.
Dr. Emily Patel, a maternal-fetal medicine specialist, said many things can go wrong after the first trimester.
"We are really punishing women who end up having pregnancy complications or fetal anomalies or genetic conditions that are discovered after 12 weeks," Patel contended. "Saying to them, 'Well, I'm sorry, you don't have access to the same care you could have gotten if you were within that first trimester, or if you were out of our state receiving your prenatal care there.'"
When it comes to potential complications, Patel pointed out the first diagnostic test cannot be done until the 10th through the 12th week of pregnancy, and definitive genetic testing on the fetus itself cannot be done until the 16th week, well into the second trimester.
Patel noted the 12-week ban has already had short-term effects, including requiring Nebraska women to go out of state to receive their care, and she fully expects it will have long-term effects as well.
"I think it's really important that people understand that this has reduced access to care in our state," Patel asserted. "It's going to continue to further reduce access to care, especially in smaller communities, just due to the simple fact that it's going to be really hard to recruit providers."
In 2022, a March of Dimes report labeled nearly 52% of Nebraska counties "maternity care deserts," compared with around 31% of counties nationwide.
Patel admitted the current political atmosphere can make her role challenging, but she is glad she is still able to discuss patients' options with them. Some states now prohibit doctors from doing so. She emphasized the best thing she can hope for as a provider is for voters to really consider what is at stake and vote to protect the rights of patients and the doctors who care for them in November.
She stressed the current 12-week ban has implications for every woman living in Nebraska who becomes pregnant.
"Until somebody is faced with that decision, they wouldn't know that they would need access to it, or maybe even be thinking about it," Patel explained. "In a way, this can affect really anybody at any time, and we just want to be able to offer the same level of care to every patient."
Nebraska voters may have up to four abortion-related initiatives to choose from in November. Only one of them, the "Nebraska Right to Abortion Initiative," backed by the Protect Our Rights coalition, would allow abortions past the first trimester.
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The Missouri Foundation for Health is partnering with The Marshall Project on the launch of a St. Louis nonprofit newsroom highlighting the legal system's effect on health, especially in marginalized communities.
The Marshall Project focuses on investigative, data-driven journalism to explain the justice system, especially to those affected by it. With the foundation's support, its St. Louis newsroom will cover topics like the death penalty, juvenile justice, health care in prison conditions and reentry challenges.
Molly Crisp, senior communications strategist at the foundation, shared the goals of the new partnership.
"We recognize that the criminal justice system disproportionately harms certain populations and that exacerbates health inequities," Crisp explained. "We're hoping through this partnership that we're bringing to light some of the issues that are rampant in the legal system and that we can address those issues."
Statistics show low-income marginalized communities face higher pollution, increasing asthma risk, along with other health problems, and incarcerated individuals often endure long waits for medical care and face barriers to mental health treatment due to staff shortages and limited resources.
Katie Moore, a reporter for the Marshall Project, said its goal is to investigate such issues both locally and statewide.
"We have been talking with different groups, individuals who are connected to the criminal justice system in some way," Moore noted. "To see what their concerns are, what they see as being missing in the media landscape in St. Louis in terms of coverage of some of these more in-depth investigative issues."
With an increasing number of older people who are incarcerated, Missouri prisons face growing health care demands, including the need for geriatric care and hospice services.
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Ohioans are seeing changes in their water infrastructure as cities work to replace lead service lines, a requirement under federal regulations.
But concerns have risen over the materials being used for replacements.
Teresa McGrath, chief research officer with the group Habitable, said while lead exposure poses significant health risks, she cautions against replacing these pipes with polyvinyl chloride due to its environmental and health implications.
"It's important to get those lead pipes out. Let's prioritize that," said McGrath. "But let's not make a regrettable substitution while we do that."
PVC production involves hazardous chemicals, including vinyl chloride, a known human carcinogen. However, PVC remains a popular choice because of its lower cost and ease of installation.
Environmental health advocate Yvette Jordan - the chair emeritus of the Newark Education Workers Caucus, and a steering committee member at Lead Free NJ - underscores the importance for Ohioans to be well informed about their environments.
"What is in their home?" said Jordan. "If they have a service line, is it plastic? Copper? What exactly is it and how does that affect their health, their community, and most importantly their families and children who are most affected by this?"
McGrath highlighted specific concerns about PVC and alternative materials that could be safer.
"The best available water pipe that we have evaluated for use inside a home is copper pipes," said McGrath, "and we will be the first ones to tell you that copper pipes are not perfect, but it is the best available."
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March is National Nutrition Month and rising grocery costs, and food recalls have consumers revisiting the idea of growing their own healthier and more affordable food. Research from gardening site, Gardenp.com shows the average garden produces $600 worth of produce. Indiana farmer's markets attract large numbers of Hoosiers who want fresh, farm-grown fruits, vegetables, and other staples at reasonable prices.
Philip Hartman, president of InstaFarm, which creates countertop food gardens, said foods grown in the healthiest chemical-free soil will produce optimum crops.
"So your food that you buy at the grocery store, your produce, has typically lost up to around 50% of its nutritional value by the time it gets to the store. Also, you don't know how it was grown. So the quality of your produce is linked to the quality of your soil," he said.
Lower costs, convenience, and fewer pesticides make garden-to-table food even more appealing. Hartman advises beginner gardeners to use healthy, nutrient-rich soil because it improves the nutritional value of fruits and vegetables. Gardens use a large amount of soil nutrients and when soil is depleted of these necessary nutrients, the crops are affected too.
Hartman works with students from kindergarten through high school and is passionate about helping children understand where their food comes from. He notes children don't get to see a farm or where their food is grown until they are well into their late teens.
"It's amazing, you know, children that don't usually like vegetables, when they engage in the growing process, all of a sudden, they're inspired to eat this and it's a great way to train them about what's good for them and how to recognize healthy foods," he added.
Gardenpals.com says millennials make up 29% of gardener demographics. Indiana is home to over 60,000 farms covering over 19 million acres. The state ranks in the top five for growing corn, soybeans, blueberries, tomatoes and melons, according to the Indiana Department of Agriculture.
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