FRANKFORT, Ky. — A new report demonstrates the divide between states that prioritize reproductive health and those that do not - and Kentucky is among of the latter.

The Population Institute's annual report card on reproductive health and rights gave 19 states, including the Commonwealth, a failing grade. The findings are not a surprise to Marcie Crim, executive director at the Kentucky Health Justice Network.

"Kentucky is a birth-control desert, meaning that our publicly funded clinics are not offering all forms of contraception. That's a problem,” Crim said. “And 76 out of our 120 counties don't even have an OB-Gyn. So we're just a mess in Kentucky in terms of reproductive health."

Kentucky scored poorly for mandating abstinence as part of the sexual education in public schools, while not requiring contraception or HIV education. The state also has no laws affirming a woman's right to emergency contraception in an emergency room.

Overall, the country received a "D-minus," with the research noting declining overall reproductive health and rights, and increasing disparity between states. Twenty-two states received a "B-minus" or higher, while the other 27 received a "D" or lower.

Kentucky fared well in the report for its teen pregnancy rate, the number of unintended pregnancies, and for allowing minors to consent to contraceptive services. However, Crim pointed out that just because it's permitted, that doesn't mean it's accessible.

"This person was 19, 20 years old, went to go see their family doctor to get on birth control and the family doctor refused to give them a prescription because the doctor said, 'You're not married, and it's against my beliefs to give you birth control,’” Crim said. “And so that's obviously a huge problem."

Abortion access is another problem area, with the report showing that about 3-in-4 women live in a county without an abortion clinic. Kentucky also has several laws that make it unnecessarily difficult to obtain an abortion, and Crim said lawmakers are trying to pass more.

"It feels like there's an overall wish to dominate Kentuckians' bodies without actually doing the research into how you would bring down numbers of abortions through access to sex education and contraception,” she said. “It is to just stop abortions and damn the consequences."

The report added a "minus" to Kentucky's failing grade because the state's "Choose Life" license plates fund anti-choice organizations.


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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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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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