September brings attention to an unfortunate and painful issue: infant deaths in the United States.

This month is Infant Mortality Awareness Month. The rate in Washington state is about 4.3 infant deaths per 1,000 births, lower than the national average of 5.5. However, racial disparities are prevalent across the nation.

Rokea Jones, community engagement specialist for Open Arms Perinatal Services in Seattle, said infant mortality is closely linked to maternal mortality, which is also higher than the average for people of color.

"For Washington state, Black and Indigenous infants are two to three times more likely to die than their white counterparts," Jones reported.

Jones noted many of factors contribute to racial disparities but they must be tackled systemically.

She pointed out barriers within the hospital system itself also contribute to infant mortality rates and racial disparities.

"We're talking about hospitals that are understaffed, meaning nurses that are overworked," Jones explained. "Even the way a hospital is designed could have a huge effect on how much care one person in Room 2 that maybe is close to the nursing desk gets, versus another person down in Room 14."

Open Arms provides doula services, which gained a big boost when the Washington state Legislature passed a bill allowing for state certification of doula services. Jones contended it will benefit birthing services in the state.

"I think programs like Open Arms are providing community health workers that naturally stand in the gaps," Jones emphasized.


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A lawsuit has been filed against the Alabama Attorney General over what plaintiffs call "threats to criminalize" those who aid individuals who go out-of-state to get an abortion.

Jenice Fountain, the executive director of the Yellowhammer Fund, stated that their organization has been forced to halt some operations due to fear of prosecution following Attorney General Steve Marshall's remarks. Despite this setback, they are still able to provide safer-sex kits, comprehensive sex education materials, pregnancy tests, referrals for low-cost medical services, contraceptive options, and hormone therapies for trans patients.

Fountain pointed out the need for her group's assistance has only increased since the fall of Roe v. Wade.

"It's important to take a stand, because not everyone is able to vocalize their disdain or organize around it, and we are," Fountain explained. "I think it's important for folks to know there are people out here advocating for us having autonomy over our bodies. And it's not something that we can just lay down and say, 'Oh, this is fine.'"

The lawsuit claims the Attorney General's threats violate constitutional rights to freedom of expression, association, travel and due process. And Fountain contended they also impinge on the rights of states where abortion is legal. Marshall has argued in a court filing he has the authority to prosecute anyone who helps with out-of-state abortion access, suggesting those who do so could face charges of criminal conspiracy.

According to state data, almost 2,000 people traveled elsewhere for abortion care even before Alabama's ban. Fountain noted the ban creates hardships to receiving care, which disproportionately affect communities of color. She added increasing criminalization is an equally damaging side effect.

"I just want everybody to really be cognizant event of the way that they're going to use this abortion ban as a way to incarcerate people," Fountain emphasized. "Because we're heavily surveilled and there are still going to be people that are going to try to self-manage, and all they're going to have to go to for medical care is, like, whatever the state offers - and that's really going to put them at risk."

Two women's health care clinic owners have also filed lawsuits against the attorney general.

A new study finds that people of color often experience different treatment during and after their pregnancy than do their white counterparts in encounters with a health-care provider.

Almost one-third of Black or Hispanic patients reported incidents such as receiving no response to requests for help, being shouted at or scolded, or not having their physical privacy protected. Some reported being threatened with withholding treatment or made to accept unwanted treatment.

Unfortunately, said Lauren Lancaster, maternal child health manager at the Indiana Minority Health Coalition, these reports are nothing new.

"It has been happening for years - for generations, honestly," she said. "I would say that because of the increased awareness that is going on, there is more of a presence of reporting these issues and getting them out into the limelight."

Lancaster said the coalition has a "three-doula" program in northern Indiana. The doulas work primarily with minority patients, through birth as well as postpartum, as a source of emotional and educational support. The Centers for Disease Control and Prevention suggested that health-care systems make it a priority to support care that's respectful and considerate of the patient's values, needs and desires.

Mistreatment is part of a pattern of inequality in medical care that can have a troubling outcome on pregnancies. In the most recent report for Indiana, in 2020, the maternal mortality ratio for Black women was 208 per 100,000 live births, compared with 108 for white women and 71 for Latina women.

Lancaster noted that there is something a patient can do if she believes she isn't receiving proper assistance and guidance during pregnancy.

"At the end of the day, you are the patient," she said. "So, if you feel that you are not being heard, or you're being mistreated, please report that. You have the ability or capability. Please, find a provider that best suits you - that listens to you - so you can get the help that you need."

The IU Public Policy Institute report included data from Indiana's Maternal Mortality Review Committee, which found that discrimination contributes to 8% of pregnancy-related deaths in the state.


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One in four Missourians either doesn't believe or doesn't know that using birth control pills is legal in the state.

The Right Time, an initiative of the Missouri Foundation for Health that has said it's committed to expanding access to contraception, surveyed 1,000 Missourians this spring. More than half the people surveyed didn't know that emergency contraception is legal.

Michelle Trupiano, executive director of the Missouri Family Health Council, said many Missourians are concerned that elected officials will enact laws to restrict people from using the birth-control method they want.

"We see this, really, as a fallout from the Dobbs decision, and just a lot of the conversation that is happening around reproductive health," she said, "and that the extreme misinformation is leading people to inaccurately believe that they cannot access some forms of contraception and emergency contraception."

She said correcting that misinformation is one of the council's primary goals, with its newly launched "Free EC" contraceptive access project. Free EC kits can be picked up at more than 40 locations throughout the state, or requested by mail at MFHC.org/EC.

Lucia Obergoenner, a nurse practitioner at East Missouri Action Agency Women's Health Center, said she sees too many patients coming into the facility with incorrect information. She said she'll never forget a particular patient who walked in with tears in her eyes.

"She said, 'Lucia, you can't give me this Depo injection because you may go to jail.' And my heart just dropped, and I said, 'Well, let's talk about this.' So, she calmed down and we talked about her birth-control method, and what it is and how it works," Obergoenner said, "and how it's not abortion - and that I am not going to go to jail, and neither will she."

In the survey, more than 70% of respondents - no matter their political views - said they think the Missouri Legislature should pass policies to make birth control more affordable and accessible. More than 80% supported people ages 18 to 35 having access to all forms of birth control.