Maternal mortality, or death from pregnancy-related issues, nearly doubled in the U.S. between 2018 and 2021 - and a person who is Black is three times more likely to die from these issues than one who is white. Nebraska ranked 17th
for maternal mortality, with a higher rate than the national average during those years.

Ashlei Spivey, executive director of the organization "I Be Black Girl," which works in Nebraska for reproductive justice, said data show some practitioners take Black patients' complaints of pain less seriously, with some erroneously believing Black people have a higher pain tolerance.

"How can we make sure medical practitioners - no matter if they're the OB or the phlebotomists - are getting cultural awareness training, that they're being in tune to the experiences of all the different types of patients that they're seeing, especially their Black patients,?" she said.

Awareness-raising events during this Black Maternal Health Month will culminate with a Reproductive Justice Summit on October 27th. Spivey said the speakers and breakout sessions will cover a number of issues that affect "reproductive well-being," including housing, transportation and wages. The keynote speaker will be renowned activist, author and professor Angela Davis. Registration closes after today.

Spivey said one of the steps they're taking is working with partner agencies to increase the number of doula-friendly
hospitals in the state.

"They're a trained companion that can help, and know that pregnant person more intimately," she explained. "And so they know this is this person's birth plan, how can we make sure that it's honored, and help that person have power and choice when working with their medical team - to address some of the things around not being heard."

Research shows doulas have a positive impact for both mothers and babies, and several states now include Medicaid coverage for doula care.

Spivey sees the "transactional" nature of U.S. healthcare - factors like insurance billing, what's covered and what isn't, and how many patients a practitioner is expected to see in a day - as contributing to the risks for patients.

"I think we need to remove that as transactional and really spend time with people, understanding what they're needing, and also making sure people feel empowered to hold doctors accountable. You know, people feel like they're the experts - they don't want to question," she continued.

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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In an unusual set of circumstances, the Nebraska Supreme Court will hear arguments in three lawsuits about the two abortion-related ballot initiatives, each of which had successful petition drives for the November ballot.

The first two lawsuits ask the Nebraska Supreme Court to rule to keep "Protect our Rights," which would legalize abortions until fetal viability, off the ballot. They claim it violates the state's "single subject" rule.

The third suit was filed in response to these on behalf of 29 Nebraska physicians who support Protect Our Rights.

Joshua Livingston, an attorney at the Koenig Dunne law firm in Omaha, which filed the lawsuit, said there are two types of access at stake.

"These physicians spend their days working with Nebraska patients, and they understand what Nebraskans need and what Nebraskans are asking for," Livingston explained. "Over 200,000 Nebraskans signed this petition asking for their voices to be heard. So the goal is access to health care and access to the ballot."

Livingston maintained the only fair outcome would require both initiatives to remain on the ballot or both to be removed. The "Protect Women and Children" initiative would prohibit abortions after the first trimester. The Nebraska legislature passed a 12-week abortion ban in 2023.

Livingston noted their position is that the "single-subject" rule would allow both initiatives to remain on the ballot.

"What we're really seeing is that the opponents to Protect Our Rights, the activist opponents, are scared of what the outcome is going to be," Livingston contended. "They're scared that if Nebraskans have the opportunity to expand abortion health care, they're going to vote in favor of that."

Livingston stressed Nebraska voters' right to be heard is really what is at stake here. He added they hope the Nebraska Supreme Court will rule before the Sept. 13 deadline for Nebraska ballots to be finalized.

Since the U.S. Supreme Court overturned Roe v. Wade in 2022, voters in six states have passed constitutional amendments to protect abortion rights.


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The Commonwealth has the second-highest maternal mortality rate in the nation, and within the state maternal deaths are twice as high among Black women.

Tamara Wieder, Kentucky state director for Planned Parenthood Alliance Advocates, said the lack of OBGYN's in the state is part of the problem. Wieder is one of the recipients of this year's Healthy Kentucky Champions Award, given by the Foundation for a Healthy Kentucky, and says legislative efforts such as the Momnibus Bill passed earlier this year will make a huge difference in improving women's outcomes.

"These are nonpartisan bills that we can find common ground on in a state that lacks equitable access to care. We can really have a dialog that brings everybody to the table, and that is something that's really important to me," she said.

The Momnibus Bill adds pregnancy to the list of qualifying life events for health coverage, increasing the odds of women receiving prenatal care; and expands programs that provide free lactation counseling, telehealth assistance, and mental health support for new moms. According to the CDC, more than 80% of maternal deaths are preventable.

Dr. Elizabeth Ottman, an obstetrician-gynecologist with Ohio County Healthcare, said perinatal mental health disorders are the most common complication of pregnancy. Several years ago she launched an innovative program to treat women suffering from postpartum depression with the first FDA-approved drug for the condition. She said the state's efforts to expand broadband access have helped more rural women get help.

"It's allowed us to do more and more telehealth and do meetings with patients to make access easier for them, because it's very difficult when you're depressed to pick up the phone and make an appointment and drive to the doctor. It is super difficult when you're a rural community and you have to drive miles to the doctor with a new baby," she continued.

According to federal data, 76 of Kentucky's 120 counties lack an OBGYN doctor.