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.

Voters across the country approved a majority of measures in November to affirm abortion rights and supporters of an initiative to legalize abortion in Idaho said they are feeling momentum.

Voters approved seven of 10 state abortion-rights measures, including in Montana. A Florida measure received a majority of votes but did not reach the state's 60% threshold for passage.

In Idaho, pro-choice advocates are waiting for approval to collect signatures on a 2026 measure which would allow access to abortion until viability of the fetus.

Melanie Folwell, executive director of Idahoans United for Women and Families, is leading the effort.

"If there's anything that was very clear in November's election, it's that abortion amendments and abortion laws -- laws that expand access to reproductive options -- do well at the ballot, even in very 'red' states," Folwell asserted.

Idaho is one of six states with a near-total abortion ban. Folwell noted her organization is awaiting approval from the attorney general's office and could start collecting signatures by the end of January.

However, unlike many other states allowing voter initiatives to amend the state constitution, Idaho does not. If approved for the ballot, the abortion access measure would mean passing legislation, which in turn means legislators could repeal it. Folwell argued it is unfortunate, when people have been telling lawmakers since Roe v. Wade was overturned about the negative effects of banning abortion.

"They've heard from doctors, they've heard from health care systems, they've heard from patients themselves -- from women who have suffered needlessly as a result of these laws -- and they've done nothing," Folwell observed. "They've had two legislative sessions to do something. They've done nothing. And we think there's an imperative to just take this question to the people."

If the measure is approved to collect signatures, it would need 6% of signatures from registered voters from at least 18 of the state's 35 legislative districts, a total of about 70,000 signatures before April 30, 2026.


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Health clinics in New England and elsewhere are coping with a sharp uptick in requests for long-acting contraceptives in the wake of the election.

Planned Parenthood centers in New Hampshire, Maine, and Vermont report more than double their weekly average appointment inquiries for intrauterine devices - or IUD's - and the birth control implant.

Planned Parenthood of Northern New England CEO Nicole Clegg said the organization had exceeded its monthly average for vasectomy consultations by mid-November.

"There's a lot of anxiety," said Clegg, "that people have around whether or not they're going to have access to their preferred birth control choice."

Clegg said patients are also calling with concerns about the availability of gender-affirming care.

She said the increase mirrors what the organization experienced after President-elect Donald Trump's first win in 2016, and the eventual overturning of Roe v. Wade in 2022.

In New Hampshire, abortion remains accessible up to twenty-four weeks of pregnancy, but health care advocates note that state law does not expressly protect abortion rights and that anything could change under the new Republican trifecta at the statehouse.

Clegg said New Englanders are already showing a heightened interest in volunteering at health centers to ensure patients can get the care they need.

"We've had these intense fights before," said Clegg, "and time and time again the American public has stood up for Planned Parenthood and our rights. We think they'll do the same again this time."

Clegg said a loss of federal funds would reduce peoples' access to vital, preventative health care services.

The co-leaders of Trump's new Department of Government Efficiency have already vowed to cut $300 million earmarked for groups like Planned Parenthood, which they claim pursue a progressive agenda.





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A majority of South Dakotans have voted to maintain a strict abortion ban but other factors are shifting the landscape for reproductive care in the state.

Of the 10 states voting on abortion during the 2024 election, South Dakota was one of three to keep a ban in place.

Kim Floren, director of the Justice through Empowerment Network, which provides financial assistance to people seeking abortions, said the state's view on the issue is not new but concern is growing over how the federal government may affect reproductive rights.

"I'm feeling the panic from people who are in areas that maybe haven't experienced what we've experienced as far as barriers go," Floren noted. "The reality is that we as a community can figure out how to take care of one another."

The Justice through Empowerment Network provides assistance with travel and transportation, child care, lodging, interpreters, birth control and medical procedure funding. Floren pointed out the organization supports 30 to 40 people per month. The final tally for Amendment G, which would have established a right to abortion in the state's constitution, was 41% for and 59% against.

South Dakotans voted in 2006 and 2008 against near-total abortion bans but Floren stressed since then, President-elect Donald Trump's first term made people feel "emboldened to be more vocal." Still, she acknowledged his second term will begin in a different context than his first.

"Before Dobbs, we did not have all of these reliable, safe websites where you can order abortion pills from and have them sent to your house for extremely cheap," Floren observed. "In some ways, access here has gotten better."

Floren added Gov. Tim Walz of Minnesota will return to his post after running for vice president on the Democratic ticket. Walz in 2023 signed a bill protecting patients who travel to Minnesota for abortion care and their providers from legal penalties in other states.


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