By Sarah Varney for KFF Health News.
Broadcast version by Brett Peveto for Maryland News Connection reporting for the KFF Health News-Public News Service Collaboration

In the two counties around nurse practitioner Samantha Marsee's clinic in rural northeastern Maryland, there's not a single clinic that provides abortions. And until recently, Marsee herself wasn't trained to treat patients who wanted to end a pregnancy.

"I didn't really have a lot of knowledge about abortion care," she said.

After Roe v. Wade was overturned, she watched state after state ban abortion, and Marsee decided to take part in the first class of a new training program offered by the University of Maryland School of Medicine and the University of Maryland-Baltimore.

Marsee learned how to administer medication abortion pills, procedural abortions, and highly effective birth control methods, including hormonal implants and intrauterine devices.

She cares for patients with all sorts of everyday ailments and health conditions, including pregnancy. "I do have patients who come in for confirmation of pregnancies and then disclose they don't want to continue with the pregnancy for whatever reason," Marsee said.

Now, with her new training, she can help.

Expanding the pool of health care providers with reproductive health care skills outside of the state's urban centers is vital, said Mary Jo Bondy, associate dean of the School of Graduate Studies at the University of Maryland-Baltimore. She helped create the new training program.

In 2022, Maryland lawmakers passed the Abortion Care Access Act, expanding the type of medical care nurse practitioners, physician assistants, and certified nurse-midwives could offer, including abortion, and the training program "prioritized that group," Bondy said.

Those types of professionals have long provided abortions to rural patients in other states, Bondy said, and "we have proof that receiving this care from an advanced practice clinician is safe."

As many as 120 health care providers will be trained over the next two years. Some participants have said they are returning to communities that are hostile to abortion rights.

On Nov. 5, voters approved a ballot measure to protect reproductive rights in the Maryland Constitution, by an overwhelming margin, preliminary results show. The state is widely considered a safe haven for patients who live in states with abortion bans. The number of abortions in Maryland increased 29% from 2019 to 2023, driven largely by out-of-state residents. But one training participant, a family physician from the Eastern Shore, said providing abortions makes her concerned for her physical safety and asked not to be identified.

"The rural catchment and politics really drive it either out or at least into the quiet," she said of abortion availability where she lives. She worries that her employer will question the prescriptions she writes for medication abortion pills and said pharmacists often refuse to give the medication to her patients.

Even in Maryland, pharmacists are allowed to refuse to dispense medication abortion pills.

As more health care providers are trained in abortion care, they need help from the state's medical schools and health officials to overcome these barriers, the family physician said. She wants help with "access to medication and pushing in some ways the hand of our employers, or normalizing, 'This is just health care.'"

For Marsee, the next step is to figure out how to let her patients know she can provide abortions. She plans to tell her current patients and hopes they'll tell others.

"I'm working on a way to let people know that I'm here and can provide it," Marsee said. "This is a conservative area, so it's walking that line. I want people to know I'm here, but I don't want to cause too much outrage and attention."


Sarah Varney wrote this story for KFF Health News.


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A new study from Michigan State University researchers revealed lasting PFAS effects in a Michigan community's drinking water near an old paper mill landfill.

PFAS are "forever chemicals" which enter the body and do not break down easily, often found in products like nonstick pans and waterproof gear.

The study focused on a southwest Michigan city where PFAS contamination in drinking water was first identified in 2018. It is the first study to examine PFAS in both tap water and blood in a community exposed to the chemicals.

Courtney Carignan, assistant professor of food science and human nutrition at Michigan State University and the study's lead author, shared key findings from the study.

"The levels that we see in blood, being elevated and for some people were above what the national academies have recommended in terms of where you would start to need additional medical screening for certain PFAS related health effects," Carignan explained. "It's good that this community got that intervention."

The study found PFAS compounds lingered in the body, even three years after switching to clean water. The findings give a starting point for understanding PFAS risks and how well intervention strategies work.

Study participants who drank contaminated water were divided into two groups: those with high exposure from city water and those with lower exposure from private wells. Blood PFAS levels rose with each year of exposure for both groups. Women in the low-exposure group had lower levels than men, likely due to biological factors. Carignan noted a separate study identified key sources of PFAS contamination.

"We found that closer proximity to airports, military fire training cites, wastewater treatment plants, were more likely to have PFAS contamination in those public water systems," Carignan pointed out.

Research shows PFAS compounds are found in the blood of most Americans. Those with the highest levels were people exposed at work or via contaminated drinking water.


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At least two people have tested positive for measles in Illinois and public health officials are working to combat misinformation surrounding vaccines in an effort to curb the spread.

Health officials said the measles virus is highly infectious and especially concerning for babies and young children, as well as people who are pregnant or have compromised immune systems. It can cause pneumonia, brain damage and even be fatal in some cases.

Dr. Kiran Joshi, interim chief operating officer at the Cook County Department of Public Health, said it is also preventable through vaccination, with two doses of measles-mumps-rubella vaccine providing nearly 100% lifelong protection.

"Ninety-seven percent of people who got measles this year happened to be unvaccinated," Joshi pointed out. "Vaccination is incredibly protective."

Joshi added over the past 50 years, the measles vaccine has saved more than 150 million lives across the world. He noted the department has launched a campaign to counter some of the misinformation that is circulating.

Public health officials are focusing campaign efforts on unvaccinated people. Joshi explained it includes having multiple conversations with hesitant patients and providing evidence-backed information. He stressed misinformation about preventive measures like taking vitamin A is concerning and not scientifically proven.

"There are a lot of myths out there, such as 'vaccines can cause autism,'" Joshi pointed out. "I want to state categorically that is incorrect, that there's no credible evidence to support that, yet these myths continue to perpetuate."

Joshi added the myths have potentially contributed to more than 900 measles cases reported across the country.

"When you look at the research, when you look at the evidence, all of that has been subjected to pretty rigorous standards," Joshi outlined. "We also go to the nature of science, that you have to be able to repeat studies. You have to look at the research as a whole, instead of sort of cherry-picking."

He advised anyone with questions to speak with their primary care provider about their vaccine records and ensure they are getting any health information from reputable sources.

May is American Stroke Month and the American Heart Association wants Missourians to know the signs and take action.

Stroke is the sixth leading cause of death in the state, and across the U.S., nearly 800,000 people suffer from one each year. In 2021, heart disease and stroke took more lives in the U.S. than all types of cancer and chronic lung diseases combined.

Lana Wilhelm, a registered nurse and caregiver advocate, was named the 2025 Caregiver Hero by the American Stroke Association after helping her husband recover from a stroke. She shared tips on how people can manage their risk.

"If you're diabetic, making sure that you are well-managed and you're following your physician's orders," Wilhelm outlined. "High blood pressure: Are you taking your medicine? Are you watching your diet? Are you making sure that you're checking your blood pressure on a regular basis? Exercise, good nutrition."

The Heart Association said to remember the "FAST" acronym when looking for warning signs: face drooping, arm weakness, speech trouble, and "time to call 911." According to the American Stroke Association, about one in four people who survive a stroke end up having another one.

Wilhelm stressed entire families are affected when a loved one suffers a stroke. She urged caregivers of stroke survivors to seek out support groups and other resources to help them navigate those challenges.

"Sometimes as a caregiver, you just want to throw in the towel," Wilhelm acknowledged. "You're exhausted, you're tired, you're worried, and it's just nice to be able to talk to other men and women that get it, and can kind of help you through that whole process."

Data from the American Stroke Association show more than 53 million Americans serve as caregivers, including those caring for stroke survivors.