Tonight: the Trump administration wants to eliminate the Teen Pregnancy Prevention program while conservatives complain teen birth rates are falling, what the UK just admitted about how medicine treats women, and more.

— Meghan McCarthy

THEY ACTUALLY WANT MORE TEEN PREGNANCIES // The Trump administration has moved to eliminate the Teen Pregnancy Prevention Program — which it called "radical indoctrination" last year — at the same time conservatives are publicly complaining that teen birth rates are declining. On Fox News, analyst Marc Siegel called it a "problem" that teens are having fewer babies. Katie Miller, wife of Stephen Miller, tweeted that hormonal birth control is "poison" and that women's "biological destiny is to have babies — not slave behind desks chasing careers while our civilization dies." Clinicians told the National Memo that anti-contraception disinformation is already reshaping what patients say in exam rooms.

THE UK NAMED "MEDICAL MISOGYNY" A POLICY PROBLEM // The British government renewed its Women's Health Strategy this week with explicit language about eliminating long-standing patterns of women being dismissed or ignored by the health system — and said providers could have funding withheld based on patient feedback. The strategy also commits to streamlining gynecology care to cut wait times for conditions like endometriosis, which now takes an average of nine years and four months to diagnose in England. New pain relief standards for invasive procedures like IUD fittings and hysteroscopies are also included, addressing what the Health Secretary said was decades of inadequate care.

THE PANDEMIC MATERNAL MORTALITY SPIKE DIDN'T END EQUALLY // A study in Obstetrics & Gynecology tracked 8,298 pregnancy-related deaths from 2018 to 2024 and found that while overall rates have largely returned to pre-pandemic levels, they remain significantly elevated for Black mothers. Maternal deaths rose more than 60% during the pandemic peak, from around 20 deaths per 100,000 live births in 2019 to 33 in 2021. Later postpartum deaths (those occurring beyond six weeks after delivery) are also still elevated across groups, a pattern researchers say warrants urgent policy attention.

YOUR REPRODUCTIVE HISTORY MAY SHAPE HOW YOUR BRAIN AGES // A large study published in Menopause using more than 30 years of data from over 14,000 women found that a longer reproductive lifespan, i.e. the years between first period and menopause, was associated with slower cognitive decline in later life. The finding adds to evidence that cumulative estrogen exposure may matter for brain health. One notable counterpoint in the same data: hormone therapy use, including within 10 years of menopause, was not associated with cognitive benefit in this analysis, which the authors say supports current guidelines against using HRT specifically to prevent dementia.

MALE AND FEMALE BRAINS EXPRESS GENES DIFFERENTLY AND IT MAY MATTER FOR DISEASE // NIH researchers analyzed gene activity in each cell in six certain areas of the brain in 30 adults. They found that biological sex explains only a small fraction of overall gene expression variation, but more than 3,000 genes showed some degree of sex-biased activity in at least one region. And many of those genes overlap with genetic variants linked to ADHD, schizophrenia, depression, and Alzheimer's. The authors are careful to note that some of these differences may reflect socialization and experience rather than biology alone, but the findings suggest that sex-specific patterns in brain gene expression could help explain why psychiatric and neurological conditions affect men and women differently.

Tonight: what the largest-ever genetic study of severe pregnancy nausea found, why women's immune systems age differently than men's, what happens when doulas stop getting paid, and more below.

— Meghan McCarthy

MORNING SICKNESS HAS GENES — AND NOW WE KNOW MORE OF THEM // A large genetic study of hyperemesis gravidarum (HG) — the severe, sometimes dangerous form of pregnancy nausea — analyzed DNA from roughly 11,000 patients and 450,000 controls and identified 10 associated genes, including several not previously linked to the condition. The findings, published in Nature Genetics, reinforce that HG has a biological basis, not a psychological one — a shift that’s been building for years but still matters for how patients are treated. One gene flagged, TCF7L2, is also tied to type 2 diabetes and GLP-1 pathways; researchers are now exploring whether drugs like metformin could play a role in prevention or treatment, though that work is early.

WOMEN’S IMMUNE SYSTEMS AGE DIFFERENTLY// A Nature Aging study using data from nearly 1,000 people found that immune aging differs in men and women. Women showed stronger inflammatory changes over time — a potential clue to why autoimmune diseases disproportionately affect them — while men were more likely to develop precursor changes linked to blood cancers. The takeaway isn’t that one ages “faster,” but that the biology diverges in ways medicine doesn’t consistently account for yet.

BLACK MATERNAL HEALTH WEEK TURNS TEN. THE GAP IS STILL THERE. // Black Maternal Health Week marks its 10th year, with a theme centered on justice and joy. The data hasn’t moved much: Black women in the U.S. remain about two to three times more likely to die from pregnancy-related causes than white women, a disparity that persists across income levels. Thanks to the advocates behind Black Maternal Health Week, awareness has grown. Outcomes haven’t kept pace.

THE DOULA WAS ABOUT TO GET PAID. THEN THE FUNDING DISAPPEARED. // Montana approved Medicaid reimbursement for doulas — up to about $1,600 per pregnancy — but reversed course this spring amid budget concerns tied to potential federal cuts. The rollback hits a state where large areas lack maternity care altogether. On the Northern Cheyenne Reservation, where the nearest hospital delivering babies is roughly 100 miles away, doulas are continuing to work, often unpaid, filling gaps the system still doesn’t cover.

ALZHEIMER’S TESTING MAY MISS WOMEN, EVEN WHEN THE DISEASE IS THERE // Women make up about two-thirds of Alzheimer’s cases, and a study in Brain Communications suggests part of the gap may be diagnostic. Standard cognitive tests can appear normal in early stages because women’s brains may compensate by recruiting additional regions — masking decline. The implication: current screening tools may under-detect disease in women, not that women are less affected.

Here are the most interesting items we saw this week in women's health:

📊 The U.S. birthrate fell again - but the story is more complicated than that. Demographers say women aren't opting out of motherhood, they're postponing it: today's 45-year-olds are actually more likely to be mothers than their counterparts 20 years ago.

🔬 Most cancer patients never got the test that could change their treatment. A study of around 63,000 patients with advanced cancers found most never received genomic tumor testing, even though those tests can point doctors to targeted therapies. Among metastatic breast cancer patients, only about a third were tested after diagnosis. The gaps tracked by income, coverage type, and race.

💊 The federal family planning program no longer mentions contraception - except to call it overprescribed. The Trump administration issued new guidance for Title X that promotes "natural family planning" methods like period tracking apps, which have higher failure rates than hormonal birth control. It’s another attempt to get Planned Parenthood out of the program.

TOP CLICKED STORIES THIS WEEK

Women in Their 20s May Not Be Having Babies, but by 45 Most Probably Will // The New York Times

Trends and Disparities in the Use of Next-Generation Sequencing in Patients With Cancer in the United States // JAMA Network Open

Women with diabetes less likely to receive preventive care and some screenings // UCLA Health

As Florida restricted abortion, state's maternal mortality committee went dark // WLRN

Doctors Couldn't Help Them. They Rolled the Dice With A.I. // New York Times

Patients’ Bill of Rights To Lower Health Care Costs // Center for American Progress

Tonight: we all know the US fertility rate has hit record lows, but there are reasons it’s more complicated than it sounds. Plus nearly 30 maternity wards closed since last summer, what women with cancer aren't being told, and more.

THE U.S. BIRTHRATE KEEPS FALLING. IT MAY NOT MEAN WHAT YOU THINK. // The U.S. fertility rate hit a new low last year, but demographers say the headline number obscures something more interesting: women aren't opting out of motherhood, they're postponing it. Today's 45-year-olds are more likely to be mothers than their counterparts two decades ago: 88 percent vs. 84 percent. Women in their 20s are simply having children later, a pattern demographers call a "postponement transition" that happened in Europe in the 1990s and largely rebounded. The harder question is whether that's true for everyone. Women with less education and lower incomes are delaying childbearing too, often because the economic conditions that would make them feel ready — a stable income, a home, a long-term partner — keep receding. "I worry we get to a point where there are the fertility haves and have-nots," one sociologist told the New York Times.

NIH IS BUILDING A VIRTUAL MODEL OF THE FEMALE HORMONAL SYSTEM // The NIH Office of Research on Women's Health launched an initiative to fund models of how hormones actually work in women across our lifespans, covering puberty, the menstrual cycle, pregnancy, and menopause. The goal is to understand why women respond differently to the same drugs that work in men: sex hormones interact with nearly every system in the body and existing models were largely built on male biology. Researchers are being invited to use tools like AI and digital twins to simulate hormonal complexity that clinical trials haven't been able to capture.

DEM GROUP’S NEW PLAN TO FIX HEALTH CARE COSTS // The Center for American Progress released a new plan that aims to bring down health care costs, including capping annual premium increases, limiting outlier hospital prices, and replacing prior authorization with independent clinical review. They project that could cut average employer deductibles roughly in half and lower family premiums by around $1,300 per year by 2032. It’s just a plan for now, but Democratic legislators take CAP seriously.

NEARLY 30 MATERNITY WARDS HAVE CLOSED SINCE LAST SUMMER // A report tracking the fallout from Trump’s Medicaid and ACA cuts finds that nearly 30 maternity wards have shuttered since Republicans’ “One Big Beautiful Bill” passed last year. On top of that, more than 800 hospitals, nursing homes, and other health facilities have closed, cut services, or are at risk. Medicaid pays for more than 40 percent of all US births — and the biggest cuts haven't kicked in yet, because they were timed to hit after the midterms.

MOST CANCER PATIENTS AREN'T GETTING THE TEST THAT COULD CHANGE THEIR TREATMENT // A study of around 63,000 patients with advanced breast, lung, colorectal, pancreatic, and prostate cancers found that most never received genomic tumor testing, even though those tests can identify mutations that point doctors to targeted therapies. Among metastatic breast cancer patients, only about a third were tested after diagnosis. The gaps tracked predictably: lower income, Medicare or Medicaid coverage, and Black or Hispanic race or ethnicity all meant waiting significantly longer. "The fact that you're still seeing half of patients not getting genomic testing is extremely concerning," one oncologist told STAT.

Tonight: the Trump administration rewrites what "family planning" means, Florida hides data on why its mothers are dying, what happens when women with complex chronic illnesses turn to AI, and more.

TITLE X, BUT MAKE IT PRETEND BIRTH CONTROL // The Trump administration took its another formal step to eliminate federal funding for contraception last week, issuing new guidance that could kick providers like Planned Parenthood out of the program (again). Politico reports that in the nearly 70-page document there is “no mention of contraception other than an assertion that it is overprescribed, has negative side effects, and is part of a broader ‘overreliance on pharmaceutical and surgical treatments.’ The guidance instead promotes ‘natural family planning methods,’ such as period tracking apps and other forms of fertility awareness that have higher failure rates than hormonal birth control.”

FLORIDA SAT ON MATERNAL DEATH REPORTS // Florida Department of Health quietly posted years of delayed maternal mortality reports only after a reporter from the Florida Trib began asking questions. The state’s Maternal Mortality Review Committee—tasked with analyzing pregnancy-related deaths—had not publicly released findings since 2020. The committee operates with limited transparency (no regular public meetings or agendas), and when asked whether it would assess the impact of Florida’s six-week abortion ban, a spokesperson said policy analysis is “not in the purview” of the group. Black women in Florida remain more than twice as likely to die from pregnancy-related causes as white women.

ABORTION BANS ARE PUSHING OUT TRAINEES // We covered this when the study came out in March, but Stateline has a good deep dive on how applications to residency programs (once again) dropped more sharply in states with abortion bans—down about 4% in the 2023–2024 cycle versus <1% in states where abortion remains legal, per the Association of American Medical Colleges. In Idaho, roughly a third of obstetric providers have left since 2022. Reporting from Stateline captures why: trainees describe being unable to provide standard miscarriage or ectopic pregnancy care under current laws—and not wanting to practice where legal risk is part of the job. Many of these same states were already short on maternity care.

WOMEN WITH DIABETES ARE MISSING BASIC CARE // A University of California, Los Angeles-led review in the Journal of General Internal Medicine finds women with diabetes are less likely to receive routine preventive care, such as contraceptive counseling, preconception counseling, and cancer screenings, than women without diabetes. The preconception gap is especially stark across studies, with very low counseling rates overall. Researchers point to siloed care: diabetes visits crowd out broader women’s health needs.

WHEN MEDICINE FAILS, WOMEN TRY AI // A New York Times investigation finds some women with complex chronic illness are turning to tools like ChatGPT and Claude after years of missed or delayed diagnoses. In several cases, patients used chatbots to surface conditions later confirmed by doctors—but the pattern is messy. AI tools hallucinate, can reinforce bad information, and perform inconsistently, especially without expert prompting. It’s not that AI (always) works, it’s that patients feel they’ve run out of other options.

Tonight, a women’s health dataset that needs to be used, a congresswoman who passed out from period pain is doing something about it, and how menopause may quietly rewire breast tissue for cancer — and more.

CLOSING THE DATA GAP ON WOMEN'S HEALTH // A new paper makes the case for using data from the All of Us Research Program, which has which has enrolled more than 500,000 participants (including a large cohort of women) for nearly a decade, to close gaps in women's health research. To prove its value, researchers ran three use cases, with meaningful results: 1) hyperthyroidism is strongly linked to osteoporosis development; 2) women face specific barriers to getting health care, including cost, transportation, and caregiving; and 3) anemia, preeclampsia, obesity, placental abruption, and placenta previa as significant risk factors for postpartum hemorrhage. The point is less the individual findings than the argument: this dataset exists, it's inclusive, and researchers should be using it.

CONGRESSWOMAN PASSES OUT FROM PERIOD PAIN, INTRODUCES LEGISLATION // Arizona Rep. Yassamin Ansari has an op-ed in Time explaining legislation she's introducing to give workers up to 12 paid days off a year for reproductive health issues, covering period pain, endometriosis flare-ups, menopause symptoms, IVF, and miscarriage. She describes her own experience with debilitating period pain, which included passing out on the floor of a New York bodega at 23 years old. The legislation would also cover men recovering from vasectomies or undergoing fertility treatments.

HOSPITAL GROUP: POSTPARTUM HEMORRHAGES MORE PREVENTABLE // Postpartum hemorrhage is responsible for about 14% of maternal deaths in the United States, yet it is considered one of the most preventable causes. The American Hospital Association launched a nationwide effort to help care teams get better identify and respond to it, using digital tools already built into electronic health records. The gaps they're targeting: visual estimates consistently undercount blood loss, risk assessment often isn't continuous, and teams aren't coordinating quickly enough when a hemorrhage unfolds.

MENOPAUSE REWIRES THE BREAST FOR CANCER // Cambridge researchers published what they say is the most detailed map to date of how breast tissue changes with age, covering more than 3 million cells analyzed from over 500 women. They found the most dramatic changes occur at menopause, including immune cells that identify and kill cancer cells decreasing while cell types associated with inflammation increase. About four out of five breast cancer cases occur in women over 50, and this research starts to explain why at the cellular level.

POSTPARTUM CLOTHING ADS VS. REALITY // Julia Wertz has a comic strip in the New Yorker highlighting the gap between what postpartum wear is marketed as and what it actually looks like in practice. My favorite: a cute nursing-friendly dress that is ultimately replaced with an old t-shirt with a stretched-out neck. (And there are many other examples to enjoy!)

Tonight, a rethink on ovarian cancer detection, pregnant women in ICE custody arriving in emergency condition, and a new woman leading one of the country’s most powerful cardiology groups.

EARLY OVARIAN CANCER DIAGNOSIS HELPS // Earlier data suggested catching ovarian cancer sooner didn’t improve survival, which cut interest in better diagnostics. But a JAMA Network Open study finds a “wait time paradox”: the sickest patients are diagnosed fastest and die sooner, which can make early detection look ineffective—unless you account for how advanced the disease was at diagnosis. And once you do, researchers found earlier detection does matter for survival.

BAN STATES ARE ALSO FAILING PREGNANT WOMEN IN ICE CUSTODY // The Department of Homeland Security detained and deported 363 pregnant, postpartum, and/or nursing immigrants between January 2025 and February 2026, including 16 women who had miscarriages. According to the researchers, one woman bled for days inside a facility with no treatment; another was deported with an untreated missed miscarriage and required immediate hospitalization upon arrival. The 19th covers the full report.

WOMAN LEADING TOP CARDIOLOGY GROUP// Dr. Roxana Mehran was named President of the American College of Cardiology this week, making her one of the few women to lead the organization in its 75-year history. Mehran also leads the Lancet Commission on Women's Cardiovascular Diseases, and founded a nonprofit dedicated to advancing women in medicine. The ACC has nearly 60,000 members and sets cardiology standards nationwide. TLDR: the person now steering that ship has spent her career documenting the ways those standards have failed women — and heart disease is the number one cause of death for women.

OP-ED: THE PERIMENOPAUSE INDUSTRY IS MEDICALIZING NORMAL AGING // Patricia Bencivenga and Adriane Fugh-Berman at Georgetown University’s “PharmedOut” project argue in STAT News that blaming perimenopause is the same old story of women being ruled by their hormones — now with merchandise. As they write: “If we accept the laundry list of 100 symptoms attributed to perimenopause, and that this phase begins sometime in our 30s and lasts until menopause at the average age of 52, then we accept the idea that women are the helpless victims of erratic, all-powerful hormones for most or all of our adult lives. This narrative certainly helps the bottom line of hormone and supplement manufacturers, compounders, and distributors...” (PharmedOut aims to educate health care professionals about “pharmaceutical and medical device marketing practices.”)

RENTERS LEAVING ABORTION BAN STATES? // An NBER working paper shows lower rents and higher vacancies in states that banned abortions after the Supreme Court ended Roe vs. Wade, compared to those states that did not. That movement can signal people leaving or not moving in. The authors tried to control for new construction by looking at permit data. The study was adapted from a Center for Reproductive Rights paper.

Here are the most interesting items we saw this week in women's health:

🤰 Nearly half of all serious pregnancy complications happen before labor begins or after the mother goes home. A McMaster University study found the obstetric care system is concentrated on the birth itself, leaving the moments that are actually killing women largely unmonitored.

⚖️ A Georgia woman charged with murder for taking abortion medication at home was released on a $1 bond after a judge called the case "extremely problematic." The county coroner didn't rule the death a homicide, and if prosecutors pursue it, it would be among the first murder cases brought against a woman for ending her own pregnancy under Georgia's six-week ban.

🏙️ Philadelphia passed a law requiring employers to accommodate workers whose menstrual or menopause symptoms interfere with their ability to do their jobs. A Villanova law professor argues it should be a national model, especially for retail and service workers who can't just log off when a hot flash hits.

TOP CLICKED STORIES THIS WEEK

Georgia murder charge gets a $1 bond and a skeptical judge // AP

Nearly half of severe pregnancy complications happen before labour or after birth and are not monitored // McMaster University / CMAJ

Philadelphia's menstruation and menopause workplace law should be a model for the country // The Conversation

Built for the wrong body: 50 years of male crash test dummies // NYT

Abortion numbers held flat in 2025 despite bans // Guttmacher Institute

13 states under federal investigation for requiring abortion insurance coverage // AP

Tonight: a Georgia woman is charged with murder over a self-managed abortion and there are (of course) early cracks in the case, plus what’s actually worth paying attention to on midlife exercise and COVID shots in pregnancy.

p.s. We unfortunately had some broken links in Tuesday’s edition! Below are links that actually work.

NYT: Buckle Up, Women. Cars Still Aren’t Built for You.

McMaster University: Nearly half of severe pregnancy complications happen before labour or after birth and are not monitored

GEORGIA MURDER CHARGE GETS A $1 BOND AND A SKEPTICAL JUDGE // Alexia Moore, a Georgia woman charged with murder by local police after taking abortion medication at home, was granted a $1 bond this week by a judge who called the charge "extremely problematic" and said it would be "a hard charge to convict upon." Moore said she didn't know how far along she was and the county coroner did not rule the death a homicide. If prosecutors pursue it, it would be among the first murder cases brought against a woman for ending her own pregnancy under Georgia's six-week ban.

STAYING ACTIVE IN MIDLIFE CUTS PREMATURE DEATH RISK IN HALF // A study of more than 11,000 Australian women found those who consistently met exercise guidelines across midlife had about half the risk of dying prematurely compared to those who stayed inactive. Researchers followed participants for over two decades, surveying them nine times. The association appeared similar for cardiovascular and cancer deaths, though those findings were less conclusive.

YOUR COVID SHOT DURING PREGNANCY STILL PROTECTS YOUR BABY // A study more than 140,000 infants in Norway found COVID vaccination during pregnancy was linked to about half the risk of COVID hospitalization in the first two months of life. Protection waned by about six months, around when babies become eligible for vaccination themselves. The study also found no increased risk of other infections in exposed infants, undercutting claims made by Robert Malone, an RFK Jr. appointee leading CDC vaccine policy.

SENATE VOTES TO KEEP THE VA ABORTION BAN // Senate Republicans on Wednesday blocked a Democratic effort to restore abortion access for veterans and their dependents at VA facilities. The ban was reimposed by the Trump administration earlier this year. Advocates noted the result means women veterans now have less access to abortion than people in federal prisons or on Medicaid.

Tonight: how crash test dummies built for men have left women more likely to die in a car accident for 50 years, exactly where women are dying during pregnancy, 13 states targeted by Trump for requiring insurers offer abortion coverage, and more.

— Meghan McCarthy

PHILLY SAID "HOLD MY WEIGHTED VEST" // A Villanova law professor argues that a Philadelphia city ordinance prohibiting discrimination based on menstruation, perimenopause, and menopause should be a model for the rest of the country. The law requires employers to provide reasonable accommodations to workers whose symptoms substantially interfere with their ability to do their jobs. Accommodations might include flexible bathroom breaks, breathable uniforms, or temperature control, modest asks that could make a real difference for retail and service workers who don't have the luxury of working from home when a hot flash hits.

BUILT FOR THE WRONG BODY // For more than 50 years, federal car safety standards have been designed around a male body, and women are paying for it with their lives. While a new female crash dummy was announced by a federal agency at the end of last year, Eve Van Dyke has a great op-ed video in the New York Times diving into the history of how we got here and why Congress must pass legislation to force the actual use of female crash test dummies.

13 STATES, ONE FEDERAL INVESTIGATION // The Trump administration has launched investigations into the 13 states that require health insurers to cover abortion. It says those states are violating the Weldon Amendment, a law that says health entities don’t have to cover abortion. The Biden administration interpreted the law as applying to health care providers, not employers and insurers. But the Trump administration reversed that position this year. Legal scholars say the question hasn't been resolved in court.

THE COMPLICATIONS NOBODY SEES COMING // Nearly 45% of severe pregnancy complications occur outside the delivery room, either before labor begins or after discharge, according to research from McMaster University. The finding challenges a model of obstetric care that concentrates largely on the birth itself and raises the question of whether prenatal and postpartum monitoring gets enough attention to catch what's actually killing pregnant women.

ABORTION NUMBERS HELD IN 2025 // Despite bans and restrictions in more than a dozen states, the total number of abortions in the U.S. remained essentially flat in 2025, according to the Guttmacher Institute. The data shows that while women traveling out of state for care dropped from 2024 to 2025, medication abortion via telehealth increased to make up for that gap (and then some.)