AUSTIN, Texas -- When it comes to maternity care, many women are on their own during and after pregnancy due to increasing swaths of the country becoming areas with limited or no access to obstetrics care.

Maternity-care deserts are much like food deserts; in this case counties with limited access, either through lack of services or barriers to a woman's ability to access that care.

According to March of Dimes President Stacey Stewart, Texas women and babies, especially those of color, are very vulnerable and have become more so due to the pandemic.

"Texas is really struggling," Stewart commented. "About 70% of all the counties in Texas are either considered a maternity-care desert or have very limited access to care."

Stewart said unprecedented financial declines reported by maternity-care centers due to COVID-19 are likely to make the problem worse without intervention from policymakers at all levels.

She noted without access to routine, quality health care, moms and babies have an increased chance of maternal and infant mortality and morbidity, including low birth weight and preterm birth.

March of Dimes data show more than two million American women of childbearing age live in counties without access to maternity care. Stewart said in addition to Texas, Midwest and southern states report the vast majority of maternity-care deserts.

"Obviously those are a lot of rural areas," she explained. "And we know that there again have been a lot of hospital closures, there are a lot of gaps in terms of the availability of care."

March of Dimes has launched a campaign called BlanketChange, demanding equity, access and prevention to improve the health of moms and babies across the U.S.


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In the final days of the legislative session, Kentucky Senate lawmakers could consider the "Momnibus" bill, which would increase access to critical prenatal and post-birth care for new moms and babies.

House Bill 10 would extend the state's voluntary home-visitation program for expectant parents to when a child reachs age three, and would include lactation assistance and telehealth.

Bonnie Logsdon, a board-certified lactation consultant and birth doula, said many women have to return to work a few weeks after giving birth and often lack the tools or knowledge to have a positive lactation experience.

"They need access to those quality supplies," she stressed, "and they need someone who can teach them how to use the pump, which is again where that lactation support would come into play."

The Momnibus bill would add pregnancy to the list of qualifying life events, so pregnant people could get health-insurance coverage and begin prenatal care visits.

Kentucky has the second-highest maternal mortality rate in the nation, according to the Centers for Disease Control and Prevention.

The bill would also expand mental-health counseling through the Lifeline for Moms Psychiatry Access Program.

In Letcher County, Courtney Rhoades said she's had a complex pregnancy, and has struggled to cope with stress and maintaining her physical health. She noted it's critical that first-time moms like herself have a place to turn for support, where they don't feel judged.

"Then to be finding out we're having twins," Rhoades said, "I am really excited to know that there's these programs available that otherwise I didn't know about."

Renee Basham, executive director of Hope's Embrace, said communities increasingly are aware of the role doulas can play in pre- and post-natal care. She added many of her clients need assistance.

"A lot of the clients that we work with, some of them have support, a lot of them don't," said Basham. "Doulas are extra important in that role, because if we weren't there, they wouldn't have anybody with them as they gave birth."

House Bill 10 would open the door to more research on the role of doulas in the birth experience, and how their expertise is being used for care and to reduce disparities in the Commonwealth.


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Advocates for women veterans, who've experienced sexual trauma while serving in the military, are asking state lawmakers for much-needed funding.

Previous legislation backed the creation of two sexual trauma liaisons at community-based organizations in the state, but funding never came to fruition.

Executive Director of the Augusta-based Sisters-in-Arms Center, Rebecca Cornell du Houx, said lawmakers have a chance to help veteran survivors rebuild their lives.

"To have a consistent clinician there to provide that trauma treatment to the woman veteran in a place that they're safe," said Cornell du Houx, "I think, can really, really support their recovery."

Cornell du Houx said one in three women soldiers experience some form of sexual trauma while in the military but many incidents go unreported.

There are more than 10,000 women veterans currently living in Maine.

Women veterans are one of the fastest-growing sectors of the homeless population, and are four times more likely to become homeless than their male peers.

Researchers also now identify military sexual trauma as the biggest factor driving a more than 60% increase in suicide rates among women veterans since 2001.

Cornell du Houx said while group therapy is available to these veterans, state funding would provide for more formalized treatment - especially for those coming off active-duty.

"I think if people knew the stories of what had happened to these women while they were in the service, just really disheartening stories of assault," said Cornell du Houx, "I think that they wouldn't hesitate to fund a position so that they could get help."

Cornell du Houx said sexual trauma is most prevalent among lower-ranking seventeen and eighteen-year-olds, who are influenced to think that reporting an incident is a betrayal of a fellow soldier.

She said it's important to support those who have come forward, to advocate for themselves and others, and who took an oath to serve their country.





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New research shows more than six in 10 abortions in the U.S. last year were medically induced, and U.S. Sen. Catherine Cortez Masto - D-NV - is sounding the alarm over the Supreme Court's decision to hear a case that could restrict access to the abortion pill mifepristone.

It is the first major case related to women's reproductive rights since the Court overturned Roe v. Wade in 2022.

On Tuesday, after hearing oral arguments, the Court seemed likely to preserve access to the medication.

Cortez Masto said the country has witnessed what she calls "the tragic consequences of abortion restrictions," which started with the country's highest court.

"This just goes to show you," said Cortez Masto, "far-right extremists are going to stop at nothing to restrict women's rights when it comes to their reproductive freedom - that is why we can't give up."

Cortez Masto contended mifepristone is safe and effective and is also critical for miscarriage care.

But the case presented to the Supreme Court by anti-abortion doctors claim the Food and Drug Administration acted too quickly in removing restrictions on the drug.

If the court rules in favor of the plaintiffs, mifepristone access could stop immediately in all states - including those where abortion is legal such as Nevada.

Critics of the drug say it carries significant side effects, include bacterial infections and prolonged, heavy menstrual bleeding.

While mifepristone may not be prohibited all together, restrictions on the pill could be reinstated.

Cortez Masto argued conservative groups never planned to stop with just repealing Roe v. Wade, but adds they are aiming to roll back women's rights all together.

"That is why we can't give up," said Cortez Masto. "We have to continue to use our voices and be advocates to fight for women's rights."

The Supreme Court could make a decision on the case in June.

In the Silver State, a coalition is working to get an amendment on the ballot this November to enshrine abortion rights in the Silver State's constitution.