ST. LOUIS, Mo. -- Black women in Missouri are four times as likely to die during childbirth than white women, and during Black Maternal Health Week, reproductive-rights advocates want people to know many pregnancy-related deaths are preventable.

April Mickens Jolly, vice president of health equity and culture for Planned Parenthood of the St. Louis Region and Southwest Missouri, said reasons for the racial disparities range from lack of access to high-quality medical care in many communities of color, to implicit bias and racism within the medical system.

She argued Black women need to have the same access to social, economic and environmental resources necessary to build strong families.

"Factors that can make sure that Black women have the freedom to raise their children in safe and healthy places, both before, beyond birth and during the postpartum period," Mickens Jolly contended.

She noted in Missouri, four in five pregnancy-related deaths are preventable.

Public health experts urge health-care providers, as well as friends, family and partners, to listen to the concerns of pregnant people if they say something doesn't feel right, and find ways to adequately address those concerns.

Mickens Jolly emphasized expanding Medicaid, which Missouri voters approved last year, but lawmakers are resisting funding, could make a big difference.

She pointed to research which shows states that have fully implemented Medicaid expansion have also reduced rates of both infant and maternal mortality, and in some cases, begun to reduce racial disparities.

"Because of discriminatory and racist public policies, women of color and certainly Black women rely on publicly funded programs like Medicaid, more than white women do," Mickens Jolly stated.

In Congress, the Black Maternal Health Caucus has introduced what it calls a "Momnibus" package.

The bills range from investing in social determinants of maternal health such as housing, transportation and nutrition to growing and diversifying maternity-support systems. It also would improve data collection, support moms with substance-abuse issues or who are incarcerated, and invest in initiatives to reduce climate-change-related risks for pregnancy.

Women and health care providers testified before the Human Rights Subcommittee, chaired by Sen. Jon Ossoff, D-Ga., in Atlanta this week, detailing the dangerous effects of Georgia's six-week abortion ban.

Nearly two years after the law went into effect, women are recounting how they were forced to continue high-risk pregnancies or seek critical medical care out of state.

Mackenzie Kulik, who lives in Atlanta, said complications in her second trimester did not qualify for an exemption under the law, leaving her with no choice but to leave Georgia to receive the care she needed.

"If I had not been able to travel out of state, I would have been forced to carry a nonviable pregnancy until the baby died in utero," Kulik explained. "Or I would have developed an infection that threatened my health enough to qualify for an intervention. Or I would have had to deliver a baby, only to watch her suffer."

The hearing brought attention to how Georgia's abortion restrictions have limited medical options for people facing pregnancies with severe complications.

Yasmein Ziyad, a resident of Morrow, testified about her experience. After being denied care during a miscarriage, Ziyad said she experienced severe pain and complications. She told the committee her doctor feared the legal consequences of performing an abortion.

"I didn't have to go through this," Ziyad emphasized. "These laws created so much fear and confusion that I couldn't get the care I needed, that would have spared me so much pain and suffering. As a result of what I went through, we have given up on hopes of ever being pregnant again."

Medical professionals, including OB/GYNs, echoed the concerns, warning the ban is increasing maternal mortality rates and putting people's health at risk.

The hearing comes as the story of Amber Nicole Thurman gains national attention. She died two years ago after delays in care due to the state's restrictive laws. Her death was later ruled preventable by 10 doctors.


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A bill to bolster protections for in vitro fertilization treatments failed in the U.S. Senate Tuesday and as the political debate plays out, a Minnesota mother hopes her experience opens more eyes to the challenges some people face in expanding their families.

For the second time this year, Senate Republicans blocked efforts to put in place a nationwide right to IVF. The outcome is likely to get more attention on the campaign trail this fall.

Miraya Gran, an infertility advocate and IVF mom from Bloomington, said she and her husband were both diagnosed with infertility. They are now proud parents of a daughter through IVF but there were many hoops to jump through.

"Infertility is a disease and like any other disease, it is emotionally and physically exhausting," Gran pointed out. "When your disease is not covered by insurance, there's a financial component added on top of it, which is equally exhausting."

She noted the couple underwent many tests, took out a second mortgage and relied on crowdfunding to pay for the IVF. Gran is now an advocate of guaranteed health coverage for IVF treatments in Minnesota.

In Congress, Senate Republicans said they support IVF but accused Democrats of a "political stunt" by bringing it to a vote. Democrats contended the outcome aligns with conservative ideals in curtailing reproductive freedoms.

The issue received renewed focus when Republican presidential nominee Donald Trump expressed his support for IVF, even though some of his voter base objects because of religious beliefs.

Gran acknowledged people have their right to their opinions about an issue but those beliefs should not come at the expense of access to reproductive care.

"It's isolating," Gran explained. "Our society has created a taboo around it for so long."

Although the U.S. Senate vote failed, Gran noted it is encouraging to see policymakers debate the topic openly. Minnesota Gov. and Democratic vice-presidential nominee Tim Walz has frequently called for expanded access to IVF, citing his family's struggle with infertility. A Minnesota bill stalled earlier this year amid debate over costs. It is expected to see another push in 2025.


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Abortion care restrictions in North Dakota are expected to be lifted in the near future, following a court ruling on Thursday.

A state judge said North Dakota's ban on the procedure violates the state Constitution. It's been part of a wave of abortion laws stemming from the U.S. Supreme Court's ruling in the Dobbs case.

Prior to this week's decision, the state's lone abortion provider moved its clinic just across the border to Minnesota.

Dr. Ana Tobiasz, an obstetrician and gynecologist in Bismarck, said physicians in hospital settings had been weighed down by uncertainties about what to do in cases of medical exceptions under the law.

"We have been made to choose between saving a patient's life and possibly facing jail time," Tobiasz explained.

Tobiasz, a plaintiff in the case, said while there are no more abortion clinics in North Dakota, hospitals can at least step in during pregnancy complications without legal ramifications. Advocates said some procedural steps are needed before the ruling goes into effect. North Dakota's attorney general criticized the opinion, vowing to file an appeal.

Groups behind the legal challenge to North Dakota's ban say while Thursday's outcome provides hope, it would be hard to quickly build up a system of abortion care within state boundaries.

Meetra Mehdizadeh, staff attorney at the Center for Reproductive Rights, said in the meantime, women around the state at least have some peace of mind about their reproductive care needs.

"The court has reaffirmed the fundamental right to make personal and private health care decisions without interference from the government," Mehdizadeh asserted.

The Republican-led Legislature reconvenes early next year, and depending on what happens with the expected appeal, the plaintiffs have urged lawmakers to let this week's decision stand. The group North Dakota Right to Life said the judge in this case unilaterally issued a ruling which, in their words, "dismantles critical protections for the unborn and vulnerable women across our state."


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