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Most abortion restrictive US states provide the least support for pregnant women
New research shows that states that have the most severe restrictions on abortion may also have the poorest reproductive health care and support infrastructure.
The United States Supreme Court’s ruling on the Dobbs v Jackson Women’s Health Organization case in June 2024 revoked constitutionally guaranteed access to abortion for women.
Since the ruling, 14 US states have placed a complete ban on abortions, while others have banned abortion during the 6 to 18 weeks gestation period.
In the US, minoritised people and people of low socioeconomic status suffer from disproportionately low access to safe abortions — a situation made worse by the geographical barriers created by post-Dobbs abortion restriction policies. However, people who support post-Dobbs restrictions insist that the policies can help protect children, women and families.
In a recent study published in the American Journal of Public Health, Dr. Nigel Madden and colleagues from Northwestern University Feinberg School of Medicine examined the relationship between state policies or legislation around abortion and programs designed to support children, women and families.
They found that states adopting the most restrictive abortion policies after the Dobbs ruling also lacked the most public infrastructure to support access to reproductive health care and family social services.
The findings suggest an interesting contradiction between the stated goals of states with restrictive post-Dobbs abortion policies and their willingness to ensure the welfare of children, women and families through medical or social programs.
“In our analysis, states with the most severe abortion restrictions have the least comprehensive and least inclusive public infrastructure to support access to reproductive health care and family social services,” notes Dr. Madden, the lead author of the study.
“It would seem in these states that the abortion opponent, pro-life attitude not only begins at conception but ends there as well.”
The researchers divided the US states into three groups based on the severity of abortion restrictions, assessed through publicly available data published by nonpartisan organizations as well as the states themselves.
Analysis of insurance data revealed that states with the most restrictive abortion policies have the lowest median percentage of women insured by Medicaid and the highest median percentage of uninsured women.
Additionally, data collected by researchers also showed that states with severe abortion restrictions have more significant limitations on access to reproductive health care and state-sponsored support programs.
“In general, states with more severe abortion restrictions are more likely to have limitations on access to reproductive health care, are less likely to implement policies that support families, have lower enrollment in state-funded assistance programs, and require that women and families be poorer to qualify for these programs compared with the least restrictive state group” explains Madden.
“The most restrictive states are also less likely to have policies that allow pharmacists to prescribe contraception, another barrier to access to general reproductive health care and reproductive autonomy.”
Counties that lack hospitals offering obstetric care, birth centers, obstetricians, gynecologists or certified nurse midwives are designated as “maternity care deserts.” These areas offer minimal medical assistance to expectant mothers.
The researchers found that in states with the most restrictive abortion policies, 9.8 per cent of the population of reproductive age lives in a maternity care desert, compared to just 0.3 per cent in the least restrictive group.
Moreover, the study also revealed that states with the most severe post-Dobbs abortion restrictions are highly restrictive in providing paid parental leave after childbirth.
“Notably, the United States is one of the only high-income countries without a national paid family caregiving or medical leave policy and, as of the writing of this essay, only 14 states have passed state-mandated paid family and medical leave policies. Of these 14 states, 11 (78 per cent) are in the least restrictive state group. Of the states with the most restrictive abortion bans, none has a mandatory paid family and medical leave policy,” Dr. Madden notes.
The lack of access to reproductive health care and support programs for pregnant women, new mothers and families affects disadvantaged populations the most. Combined with a lack of access to safe abortions, inadequate medical and social support after pregnancy can further impact the health of minoritized people and people of low socioeconomic status.
“Although it may not be surprising that the most politically conservative states with the most restrictive post-Dobbs abortion policies are also the most socially and financially conservative with regards to reproductive health, the degree to which these states fail to support their most disadvantaged populations warrants immediate attention and action,” Dr. Madden concludes.
We are excited to reveal the winners of the third annual Femtech World Awards.
The winners were announced at a virtual event this afternoon attended by shortlisted companies, along with sponsors and judges.
The event welcomed guests from the UK, Europe, Asia, Africa and North America.
Thank you to all 174 entries, as well as the sponsors for making the event possible.
See you in 2027!
Femtech World Awards 2026 Winners
Winner:
Shortlisted:
IVI RMA x Juno Genetics
Natural Cycles
Winner:
Highly commended:
U-Ploid
Shortlisted:
Hello Inside
Winner:
WISE HF, led by Prof. Mary Ryder
Highly commended:
Cardiac College for Women
Shortlisted:
Hyvelle Ferguson-Davis
CognitiveCare
Winner:
Highly commended:
Youterus
Shortlisted:
ŌURA
Winner:
Shortlisted:
LeanShield by ParrotPal Group
Perigen
Winner:
Shortlisted:
Body Moody
Looop
Winner:
Shortlisted:
Owning Your Menopause
Womeno
Winner:
Shortlisted:
The Blue Box
Celbrea
Winner:
Shortlisted:
HealCycle
Mor
Winner:
Shortlisted:
HRC Fertility
Mira
Pregnant women’s expectations about postpartum sleep may predict sleep quality after birth, outweighing prior sleep and psychiatric history, a study suggests.
The findings suggest attitudes and beliefs about sleep during pregnancy could be a modifiable risk factor for postpartum sleep concerns.
They also indicate that, among women expecting the poorest sleep, higher postpartum anxiety may further worsen sleep quality.
Sammy Dhaliwal, lead author is clinical health psychologist and research fellow in the department of obstetrics and gynaecology at the Perelman School of Medicine at the University of Pennsylvania.
Dhaliwal said: “Most pregnant women in our sample anticipated poor postpartum sleep before it occurred, and it was striking that those expectations predicted worse sleep outcomes even after accounting for factors such as prior sleep disorders, psychiatric history, and number of previous births.
“This suggests that attitudes and beliefs about sleep during pregnancy may represent a modifiable target for early intervention before postpartum sleep problems emerge.”
Sleep disturbance affects an estimated 60 to 80 per cent of postpartum women and is linked to a higher risk of depression and anxiety.
Researchers said it is often regarded as an expected part of life after childbirth rather than a health issue that may be addressed earlier.
The study enrolled 432 pregnant women at about 24 weeks of gestation, meaning around 24 weeks into pregnancy.
Participants completed measures of their expectations about postpartum sleep, current sleep quality using the Pittsburgh Sleep Quality Index, and mood using validated depression and anxiety scales.
Assessments were repeated at six, 12 and 24 weeks postpartum.
A subset of 49 women also wore wrist actigraphy devices at six to eight weeks postpartum.
Actigraphy uses a wearable device, similar to a watch, to estimate sleep and wake patterns based on movement.
The results showed that 70 per cent of pregnant women, or 301 of 432 participants, expected poor sleep in the postpartum period.
Researchers found that predicted sleep disruption during pregnancy was a significant predictor of postpartum sleep concerns.
Among first-time pregnant women without prior health concerns, those who expected greater sleep disturbance had significantly more disrupted sleep after birth, measured by both actigraphy and self-report.
Among women who expected the worst sleep quality, higher postpartum anxiety significantly worsened both measured sleep and self-reported sleep, independent of anxiety levels during pregnancy.
Dhaliwal said the findings point to two possible areas for intervention: addressing sleep-related beliefs during pregnancy and treating postpartum anxiety.
Dhaliwal said: “Postpartum sleep disruption is often treated only after problems develop, but our findings suggest there may be an opportunity to intervene earlier during pregnancy.
“Addressing sleep-related beliefs and postpartum anxiety during prenatal and postpartum care may help improve sleep and emotional well-being in new mothers.”
A weight loss jab may improve fertility outcomes in women with PMOS, early findings from an ongoing clinical trial suggest.
The proof-of-concept analysis found that injectable semaglutide may offer reproductive benefits while also addressing obesity and metabolic dysfunction.
It is the first report to examine how injectable semaglutide may improve reproductive outcomes in women with PMOS while also addressing obesity and metabolic dysfunction.
The work forms part of the ongoing RESTORE clinical trial.
Melanie Cree, professor at CU Anschutz and first author of the report, said: “Women with PMOS frequently face a frustrating choice between treatments that target reproductive symptoms and those that address metabolic health.
“Our early findings suggest injectable semaglutide may have the potential to improve both, offering a more comprehensive approach to care.
“This medication is incredibly promising when someone responds with 10 per cent weight loss.”
The trial is examining whether semaglutide can restore ovulation and improve reproductive health in adolescents and adults with polyendocrine metabolic ovarian syndrome, known as PMOS.
PMOS, formerly known as polycystic ovary syndrome or PCOS, is a hormone and metabolic condition linked to irregular periods, raised testosterone levels, infertility risk, obesity and increased cardiometabolic disease.
Cardiometabolic disease refers to conditions linked to the heart and metabolism, such as heart disease, high blood pressure and type 2 diabetes.
Existing treatments, including metformin and hormonal contraceptives, often do not fully address reproductive and metabolic complications at the same time.
The analysis focused on participants aged 12 to 35 who lost at least 10 per cent of their body weight during treatment.
Researchers said reproductive improvements appeared earlier than expected, prompting them to report preliminary findings while the wider study continues.
Cree is also a paediatric endocrinologist at Children’s Hospital Colorado.
Endocrinologists are doctors who specialise in hormones and hormone-related conditions.
Cree said: “What makes this work particularly important is that it focuses specifically on women with PMOS receiving injectable semaglutide.
“Although GLP-1 medications have transformed obesity treatment, there remains a significant need for rigorous data examining how these therapies affect fertility and reproductive function in this population.”
The RESTORE study is evaluating semaglutide treatment in girls and women with PMOS and obesity.
Its broader aim is to determine whether weight loss and metabolic improvements can restore ovulation and improve reproductive outcomes.
Ovulation is the release of an egg from the ovary, a key part of the menstrual cycle and fertility.
The authors said the findings are from an early proof-of-concept analysis and that larger, longer-term studies will be needed to confirm whether the reproductive benefits last.
The findings suggest injectable semaglutide may become a treatment option for women with PMOS seeking improvements in both metabolic and reproductive health, if future studies confirm the results.
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