Next week, Kentucky lawmakers are expected to consider a bill that would lift legal red tape that backers say makes it difficult to open up freestanding birth centers.

The Commonwealth is among 10 states with no independent nurse midwife-run facilities that provide prenatal and birth services and postpartum care. So, many people travel to Indiana or Tennessee to give birth, said Trimble County resident Paige Thompson, who went out of state to give birth in 2021. She said her friends have made similar trips, but she worries about those in other rural counties who have no options for a natural birth in a home-like environment.

"They offer the freedom to move around during labor," she said. "They offer the option to eat and drink whenever you're hungry or thirsty. And there's also the option to birth in the water."

Senate Bill 17 would exempt freestanding birth centers from the state's certificate-of-need requirements, rules that regulate health-care facilities. The Kentucky Hospital Association opposes freestanding birth centers, arguing that hospitals are better equipped to handle unpredictable medical complications.

The bill's sponsor, state Sen. Shelley Funke Frommeyer, R-Alexandria, said people should have access to the prenatal and delivery care they feel is best for them, noting there are around 800 home births in Kentucky each year.

"I want to recognize that we are not trying to do anything so complicated, other than remove barriers to wellness," she said, "and we believe that this is a very important barrier to remove."

Thompson said more than one in three Kentuckians give birth by cesarean-section, a rate among the highest in the nation.

"I think that people are waking up to the truth that midwives and midwifery care are safer, and produce better outcomes for low-risk pregnancy, in women who want a natural vaginal delivery," she said.

Data show access to birth centers is linked to fewer medical interventions and lower cesarean rates than in hospitals, and can reduce racial disparities, including fewer low birthweight babies for Black women.

Gov. Gretchen Whitmer recently signed landmark legislation to expand access to essential OB/GYN services across Michigan.

Between 2018 and 2022, about 19 mothers per 100,000 live births in Michigan died from pregnancy-related issues, mostly in marginalized communities. The new legislation aims to expand maternal and prenatal care.

Rep. Julie Rogers, D-Kalamazoo, a former health policy chair, sponsored several bills in the package, including one to reduce government red tape for breast milk donors.

"That required HIV testing for breast milk donors every 90 days, and to contrast that with the rest of the United States, we're the only state that requires that," Rogers pointed out. "Forty-nine other states do a one-and-done test at the onset of donations."

Data from 2022 showed white mothers having the highest number of maternal transfusions, followed by Black mothers.

A new report from the American College of Obstetricians and Gynecologists revealed a startling statistic: More than 60% of pregnancy-related deaths could have been prevented with improved quality and safety in the maternal care system.

Rogers noted the new law mandates insurance companies to provide support for people without health coverage or access to care.

"Often times people that are not able to access primary care or obstetrics care," Rogers observed. "This would require insurance coverage for blood pressure monitors, so mothers can check their blood pressure at home."

Rogers stressed the legislation expands access to postpartum mental health screenings. She added most bills in the package received strong bipartisan support in the Legislature.


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There are growing concerns about the prevalence of Christian Nationalism, an ideology that seeks to establish a theocracy rooted in Christian principles. Research indicates that about one-in-three Pennsylvanians support Christian Nationalist views, which opponents argue challenge the American ideal of separation of church and state.

Rachel Tabachnick, an independent researcher and former political research associate fellow, said the rise of Christian Nationalism, seen during the 2024 elections, threatens reproductive healthcare access.

"This is supposed to be a bottom-up theocracy based on biblical law being enforced at the family,
church and local civil government level. So, in order for this to work, women must stay in their God given roles, which is to have children and raise her family," she said.

On a recent episode of the "(In)Accessible" podcast, Tabachnick spoke about the history of Christian Nationalism, and how Theocratic Libertarianism advocates for laws based on biblical principles.

Tabachnick said that movement seeks minimal federal government and governance based on biblical law, aiming to dismantle institutions like the IRS and Department of Education.

Rebecca Susman, communications and development director with Keystone Progress, added that Project 2025, a 900-page guide by the Heritage Foundation, is intended as a blueprint for another Trump administration. The guide covers numerous issues, which Susman argues pose threats to basic rights and freedoms, particularly reproductive rights. She added that aspects of the plan were proposed last year.

"Conservatives have already begun implementing it, with one example being the addition of an anti-trans health care rider in a military spending act that was right out of the Project 2025 playbook, and it passed out of committee," Susman explained.

Tabachnick pointed out that in the 1970s and 1980s, the founders of Christian Reconstructionism wrote thousands of pages detailing how to reshape society and government under Old Testament law. Decades later, these blueprints remain relevant, as they were designed for a long-term transformation. Like Project 2025, most Americans reject these ideas, but they still need greater exposure and scrutiny.

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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