The Commonwealth has the second-highest maternal mortality rate in the nation, and within the state maternal deaths are twice as high among Black women.

Tamara Wieder, Kentucky state director for Planned Parenthood Alliance Advocates, said the lack of OBGYN's in the state is part of the problem. Wieder is one of the recipients of this year's Healthy Kentucky Champions Award, given by the Foundation for a Healthy Kentucky, and says legislative efforts such as the Momnibus Bill passed earlier this year will make a huge difference in improving women's outcomes.

"These are nonpartisan bills that we can find common ground on in a state that lacks equitable access to care. We can really have a dialog that brings everybody to the table, and that is something that's really important to me," she said.

The Momnibus Bill adds pregnancy to the list of qualifying life events for health coverage, increasing the odds of women receiving prenatal care; and expands programs that provide free lactation counseling, telehealth assistance, and mental health support for new moms. According to the CDC, more than 80% of maternal deaths are preventable.

Dr. Elizabeth Ottman, an obstetrician-gynecologist with Ohio County Healthcare, said perinatal mental health disorders are the most common complication of pregnancy. Several years ago she launched an innovative program to treat women suffering from postpartum depression with the first FDA-approved drug for the condition. She said the state's efforts to expand broadband access have helped more rural women get help.

"It's allowed us to do more and more telehealth and do meetings with patients to make access easier for them, because it's very difficult when you're depressed to pick up the phone and make an appointment and drive to the doctor. It is super difficult when you're a rural community and you have to drive miles to the doctor with a new baby," she continued.

According to federal data, 76 of Kentucky's 120 counties lack an OBGYN doctor.

Evanston Regional Hospital is discontinuing its labor and delivery services next week, citing a "steady decline of demand."

It is the fourth Wyoming facility to end services since 2016. The change will add to the state's list of "maternity care deserts," which included five counties last year, according to the March of Dimes.

Gov. Mark Gordon requested about $2.4 million in supplemental budget funding to better reimburse hospitals for Medicaid births, which make up about one-third of all births in the state.

Rebekah Hazelton, director of the Wyoming Women's Foundation, called it a "really positive thing."

"Labor and delivery services in Wyoming are not paying for themselves, even at the market rates," Hazelton pointed out. "That's part of the problem why they're closing, is because there are relatively few births in Wyoming and the birth rate has gone down."

Declining birth rates also mean providers are getting less practice in birthing rooms, which Hazelton noted could affect the quality of care. With ongoing abortion litigation and an expected slew of legislation, Hazelton added physicians are leaving the state because the laws are "vague enough," some fear providing care could bring legal consequences.

Maternal health access has been a priority for Gordon, whose Health Task Force includes an OB Subcommittee. The topic was also high on the Labor, Health and Social Services Interim Committee's agenda but Hazelton noted many seats turned over on Election Day.

"A lot of the legislators that are new won't have benefited from that interim study," Hazelton acknowledged. "We'll be kind of starting over to educate them about the problem, in terms of advocates for moms and babies in Wyoming."

She added both groups are working on various solutions. So far, no 2025 bills have been drafted on the subject.


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Birth doulas across Arkansas have formed a new organization to improve maternal health care across the state and help pass legislation they hope will make doula services accessible to more families.

Doulas are members of a birthing team providing emotional, physical and educational support to expectant mothers.

Cora Crain, cofounder and board vice president of the Doula Alliance of Arkansas, said research shows doula services can reduce cesarean sections, premature deliveries and length of labor.

"We have people reaching out to us. This is their first time they don't know what they don't know," Crain explained. "It's all very overwhelming. There's definitely a certain amount of fear that a lot of people are bringing to the birth experience and then of course if you had a doula in your previous birth then you usually continue."

Doulas provide services during pregnancy, childbirth and postpartum.

Members of the alliance are supporting a bill before state legislators next year mandating insurance companies and Medicaid to cover doula costs. Crain noted if passed, the legislation will make services available to more expectant mothers.

"Doula services can be so important in getting healthier outcomes and also just more positive experiences that lead to more positive postpartum times," Crain emphasized. "But it's just not as accessible to so many women that can't afford that out-of-pocket expense. "

Arkansas has one of the highest maternal mortality rates in the nation.


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Wisconsin law bans telemedicine abortion care, yet new data show an increasing number of Wisconsinites have been getting abortion pills through shield law providers.

An 1800s Wisconsin law caused a temporary statewide ban on abortion services after Roe v. Wade was overturned in 2022.

Jenny Higgins, professor of obstetrics and gynecology at the University of Wisconsin-Madison and director of the UW Collaborative for Reproductive Equity, said even after the ban was lifted in 2023, demand for abortion pills in Wisconsin remained high.

"Suggesting that even when brick-and-mortar facilities are offering abortion care in our state, telehealth abortion still is a really important service that many people in our state are taking advantage of through these shield laws," Higgins explained.

There have been about 130 orders for abortion pills per month made through shield law providers since July 2023, according to WeCount data. There have also been reports of stockpiling nationwide since the election. In a recent interview, President-elect Donald Trump said he would "probably" not restrict medication abortion pills during his second term.

With only four abortion clinics statewide, 96% of Wisconsin counties do not have an abortion provider and about 70% of Wisconsinites of reproductive age live in a county without an abortion clinic.

Higgins noted while shield law clinicians provide critical and affordable care to Wisconsinites who grapple with numerous restrictions to abortion, attempts to criminalize both providers and patients are expected, with Black and brown patients at the highest risk.

"We know historically that Black and brown women are the most likely to be criminalized during pregnancy, whether that pregnancy is ending in abortion or birth," Higgins pointed out. "I think we need to pay great attention to the ways in which some of the pregnant people with the least social power could be putting themselves at risk."

She added barriers to care must also be recognized, including distance to brick-and-mortar facilities, state insurance prohibitions affecting affordability and negative past health care experiences.

Another 1800s law could come into play under the new administration, although about 70% of Americans have never heard of it. Project 2025 directs the use of portions of the Comstock Act to criminalize abortion, while some state attorneys general have already asked courts to make mailing abortion pills illegal under the act.


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