The Illinois General Assembly has just passed a $53 billion state budget which includes a boost in funding for Planned Parenthood.
Reproductive rights may be in limbo across the country, but it is not the primary focus of the funding increase.
Katie Stanczykiewicz, director of government relations for Planned Parenthood Illinois Action, an independent advocacy arm of Planned Parenthood of Illinois, said reproductive health issues disproportionately affect people of color, and state lawmakers are paying attention.
"I think the additional funding that happened this year that's brand new, dealing with the Black maternal health crisis, is something that Planned Parenthood of Illinois cares deeply about," Stanczykiewicz pointed out. "It's very exciting to see not only the same amount of funding we've received for years before, but additional funding to address the maternal mortality rate that is plaguing our country."
According to a 2023 Illinois report, what's known as "extreme maternal morbidity" is most common among Black women, at a rate of 150 per 10,000 births, more than twice the rate among white women.
Abortion and reproductive rights remain high-profile issues in this election year, with legal actions nationwide to challenge or uphold a person's right to end a pregnancy. But Stanczykiewicz noted Planned Parenthood is committed to keeping all health centers open for patients in Illinois, and pointed out the clinics provide a range of services.
"Continuing to receive funds to not only help with our navigational services that we provide, to people who are coming to Illinois or coming within Illinois to receive abortion care, but also our gender-affirming care and our family planning services," Stanczykiewicz outlined.
She added clinic staffers still face harassment and threats, and some fear for their safety. A 2021 study reported an 80% increase in bomb threats and a 163% rise in devices or suspicious packages left at clinics providing abortion services.
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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.
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Legal disputes still surround North Dakota's abortion ban.
Underneath the court activity is the influence of "crisis pregnancy centers" and debate over the state's role in supporting them. The facilities have become controversial in recent years. Opponents said they pose as a non-biased resource with services such as peer counseling and infant supplies but instead have a mission to steer women toward keeping their pregnancy. North Dakota is one of several states with abortion restrictions to set aside funding for these centers.
Kali Bauer, executive coordinator of the Minot Women's Network, said it is troubling.
"This state funding is allowing them to continue a lot of these practices that are not evidence based and do not adhere to the same medical standards that traditional clinics have to abide by," Bauer pointed out.
Bauer added the centers are often staffed by untrained and unlicensed individuals. North Dakota is currently providing $1 million to fund its "Alternative to Abortions" program. Opponents want lawmakers to revisit the issue next session and establish accountability measures. A Republican sponsor has vowed to block such efforts, arguing the initiative is not harmful to clients.
After the U.S. Supreme Court overturned federal abortion protections, North Dakota joined the wave of conservative-led states to enact bans. In response, other states, such as neighboring Minnesota, have expanded access to assist patients living under restrictions elsewhere.
Sen. Janne Myrdal, R-Edinburg, contended North Dakota's program is trying to help women with an unwanted pregnancy succeed.
"Women that find themselves in crisis pregnancy need the support from volunteerism, from the local communities," Myrdal contended. "But also we stepped in as a state and said, 'We're going to fund these places because they affirm life, like our law said.'"
Because of other budget priorities, Myrdal does not anticipate pushing for increased funding for the centers, but she feels they are transparent and no additional oversight is needed.
Bauer suggested the descriptions of crisis centers leave out practices she feels are dangerous.
"Even providing medically inaccurate information, such as information on how to reverse a medical abortion," Bauer noted.
Meanwhile, a judge recently announced he would decide whether to dismiss a legal challenge to North Dakota's abortion ban. The request blocked a trial in the case from getting underway last month.
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