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This collection examines issues related to reproductive health, including the legality of reproductive services (reproductive rights), access to those services (reproductive health), and how societal factors such as race or social status impact access to and decisions about reproductive health (reproductive justice). This includes everything from contraception and comprehensive sex education, to abortion and pre-natal and pregnancy care, as well as other issues that inform a person’s full reproductive autonomy. This special collection brings together knowledge and insights from organizations addressing reproductive health related issues and explores the impact foundations and nonprofits are having on this work.

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Featured

Birth in a Burning World: The Intersecting Extreme Heat and Maternal Health Crises in Sindh Province, Pakistan

November 1, 2023

Extreme heat worsened by climate change is deepening a maternal health crisis inPakistan already marked by high rates of maternal and newborn deaths even whencompared to most neighboring and other low-income countries.This report provides a window into a major problem that evidence suggests is global: growing extreme heat—and the growing climate crisis more broadly—is having myriad deleterious impacts on maternal and newborn health and well-being with potentially lifelong consequences. Governments need to take urgent action to curb greenhouse gas emissions. While much can be done to reduce the harms of extreme heat including on pregnant people, there is no clear way for low-income communities to adapt their way out of burgeoning heat set to worsen without action.This report is based on interviews with 16 women in Shikarpur District, Sindh Province, Pakistan, who were either pregnant or recently postpartum during the 2022 heatwave. We also interviewed five health providers or officials in the district. In addition, we consulted epidemiologists, doctors, and other experts in maternal health and the climate crisis, especially regarding extreme heat exposure. We also looked at epidemiological studies and other scientific findings showing links between poor maternal and newborn health and extreme heat.

Featured

Increasing Financial Access to Contraception for Low-Income Americans

June 27, 2023

Access to contraception is fundamental to reproductive autonomy and economic mobility for parents and their children. Today in the U.S., the cost of contraception severely limits access for those without health insurance. Although the Affordable Care Act eliminated cost-sharing for contraception for those with health insurance, substantial cost-sharing remains for uninsured individuals who seek care through Title X—a national family planning program that offers patient-centered, subsidized contraception and reproductive health services to low-income individuals. I propose two changes to Title X to increase the affordability of contraception for uninsured Americans: (1) make contraceptives free for low-income clients through a change to the guidelines issued by the Office of Population Affairs and Health and Human Services and (2) increase congressional  appropriations for the Title X program to fund this change in guidelines. Similar to the Affordable Care Act's elimination of cost-sharing for contraception for Americans with health insurance, this proposal eliminates cost-sharing requirements for contraception for uninsured, low-income Americans through the Title X program. This policy proposal is supported by highly relevant evidence from a randomized control trial conducted at Title X providers. Eliminating costsharing for contraception through Title X would increase use of preferred contraceptive methods; reduce pregnancies that are mistimed or not desired, including those ending in abortion; and generate substantial enough savings in other government spending that the program would more than pay for itself.

Featured

The Benefits of Licensed Midwifery and Community Birth in New Mexico, Among BIPOC Birthing People

May 1, 2023

Black, Indigenous and people of color (BIPOC) families comprise a disproportionately low percentage of home and freestanding birth center births in New Mexico, despite NM Medicaid coverage of care by Licensed Midwives (LMs) in these settings. This research explored why low income BIPOC seek out and benefit from care by LMs, as well as the factors that facilitate and obstruct access.

Featured

Birth Equity Funders’ Summit: 2022 Report

April 1, 2023

Maternal morbidity and mortality, preterm birth, and infant mortality rates in the United States are among the worst in the developed world, with rates particularly high among Black and Indigenous people. To date, we've seen growing rates of disparities across the U.S., and these are expected to worsen with the reversal of Roe v. Wade. While significant public and private dollars have been committed to maternal and child health across the U.S., there have been limited gains and growing disparities. There is an urgent need for funders to examine the funding needs of clinical care systems, the community support continuum, and social drivers of poor outcomes – and the interaction of all three to provide culturally congruent experiences and improved outcomes for birthing people. It is critical to reconsider what is being funded, how it is being funded, and who is getting support.The Birth Equity Funders Summit was hosted in partnership with the Mom and Baby Action Network's (M-BAN) 2022 Summit. M-BAN's Summit aimed to amplify best practices from practitioners focused on developing, implementing, and evaluating maternal and infant health programs, policy, and advocacy. The Summit attracted practitioners from CBOs, birth workers, government actors, corporate partners, students, and more. The rich agenda provided fertile ground for funders to learn about the vast quantity of important work taking place across the country and was a critical foundation for the discussion at the Birth Equity Funders Summit.

Communities Need Clinics: The Abortion Care Ecosystem Depends on Independent Clinics

December 5, 2023

This annual overview of the abortion access landscape in the United States details the little-known yet critical role that independent community clinics play in keeping abortion care accessible. 

Maternal Suicide in the U.S.: Opportunities for Improved Data Collection and Health Care System Change Issue Brief (Updated Sept 2023)

November 29, 2023

Maternal suicide is a leading cause of maternal mortality in the US. While maternal mortality has rightfully garnered increasing attention in recent years, maternal suicide has been historically overlooked as a cause of maternal mortality because national maternal mortality rates previously excluded suicides as pregnancy-related deaths, instead classifying maternal suicides deaths as incidental or accidental deaths. According to the provisional data from the Centers for Disease Control & Prevention (CDC) there was a record high number of deaths in 2022 from suicide for the general US population. It is important to continue to address suicide prevention efforts for the general and maternal population.

Report: U.S. Counties with the Highest Maternal Mental Health Risk and Lowest Resources Revealed

November 29, 2023

The risk factors contributing to maternal mental health (MMH) disorders are complex and known to disproportionately impact communities of color, rural communities, and other groups facing systemic inequities. However, until recently, little has been known regarding the geographic county-level distribution of risk nor the available MMH provider resources.Earlier this year, with financial support from Plum Organics, the Policy Center released the first-of-its kind interactive map to track MMH risk and providers by county. The map uncovered an immense need for increased access to MMH providers and programs.The report illustrates where, in the U.S., mothers are at the greatest risk for suffering from maternal mental health disorders and where the greatest need for providers are. An estimated 62 million birthing-age, American women, or 96% of the potential perinatal population live in maternal mental health professional shortage areas. 13,885 providers are needed across the United States to fill these shortage gaps.

Fact Sheet: Maternal Mental Health

November 29, 2023

This fact sheet explores the prevalence and range of disorders associated with maternal mental health disorders. 

Maternal Mental Health Overview

November 1, 2023

This fact sheet provides information about maternal mental health conditions.

Cost-related barriers to sexual and reproductive health care: Results from a longitudinal qualitative study in Arizona

November 1, 2023

Financial barriers can inhibit reproductive autonomy. This study examines the role of financial barriers on Arizona individuals' experiences accessing sexual and reproductive health (SRH) care. We recruited individuals who may have experienced barriers when accessing SRH care in 2019 to participate in three interviews at six-to-nine-month intervals beginning in the summer of 2020. Our analyses focused on respondent strategies to mitigate cost barriers, at times linked to the changing family planning policy landscape or the role of insurance coverage in accessing SRH care. Respondents' experiences of care seeking over time demonstrated that respondents often postpone or forgo SRH care when experiencing cost barriers, and respondents also switch care sites to access affordable care despite sometimes not having preferred providers or care sites as a result. Our findings highlight how burdensome or surprising costs can have enduring effects on whether, when, and where to seek future care.

Self-Care, Criminalized: The Criminalization of Self-Managed Abortion from 2000 to 2020

October 30, 2023

Self-Care, Criminalized: The Criminalization of Self-Managed Abortion from 2000 to 2020 aims to reduce the criminalization of self-managed abortion in the absence of Roe by examining and identifying trends in the criminalization that occurred in the presence of its protections.This report details the criminalization of 61 cases of people criminally investigated or arrested for allegedly ending their own pregnancy or helping someone else do so. The report explores cases between 2000 and 2020 that occurred across 26 states with the greatest concentration in Texas, followed by Ohio, Arkansas, South Carolina, and Virginia.A follow-up to Self-Care, Criminalized: Preliminary Findings, released in 2022, this full report builds on the initial findings to show how people can interrupt and stop abortion criminalization. We share even more quantitative data about case progression as well as a thorough mixed methods analysis, including de-identified case narratives, related to how cases came to the attention of law enforcement, how law has been misapplied to prosecute people, use of technology in the cases, scrutiny of a pregnant person including their abortion and pregnancy loss history, and the lasting harm and negative consequences from this criminalization.From this research, we know more about who has been criminalized for self-managing an abortion, how these cases made their way into and through the criminal system, the laws and practices that enable criminalization, and what is at stake for the accused.

Reproductive Rights and Justice Movement Leaders Respond to ‘Big Tech’ Suppression of Accurate Abortion Information

October 26, 2023

Content suppression was, and remains, a deeply problematic issue in a world increasingly hostile to abortion, and big tech is part of the problem. While organizations and individuals in the abortion rights space are finding ways around the confusing maze of suppression to make sure their content is seen – like spelling it "aborti0n" – this raises questions as to how many are actually getting the information they need and how many are missing vital information to make decisions when posts are incorrectly removed and reinstated. Because abortion is a time-sensitive medical procedure, there is no time to waste, and tech companies should have had a plan for the post-Roe world long ago. We demand they catch up.Our report details the data collected on online anti-abortion disinformation, digital suppression and removal of accurate abortion content, and demands of the reproductive health, rights, and justice community to improve the online space for abortion seekers and health care communicators.