Tonight: Congress finally puts menopause on the calendar, signs of maternity units closing, and more.

— Meghan McCarthy

CONGRESS HAS NEVER HELD A HEARING ON MENOPAUSE. THAT ENDS WEDNESDAY.

The Senate Special Committee on Aging holds the first congressional hearing ever on menopause tomorrow, entitled “Half the Country, Zero Hearings." Nine of the 13 members of the committee are men. Sen. Kirsten Gillibrand (D-NY) said it was "absolutely disgraceful" that the committee has never held a hearing specifically focused on menopause, and she is asking for increased research funding and physician training. More than half of states have introduced or passed menopause legislation in the past two years, but nothing has been seriously considered on the federal level beyond research funding.

THE MATERNITY UNITS STILL OPEN LOOK A LOT LIKE THE ONES THAT CLOSED

Among the US hospitals that still delivered babies in 2023, 41% had high-risk factors for losing that service, according to a study that analyzed 3,108 hospitals from 2010. Low birth volume predicted closures everywhere, but the financial picture split along rural and urban lines. Being unprofitable raised a rural hospital’s predicted risk of closing its maternity unit by 12 percentage points, while in urban areas it was more strongly tied to the entire hospital closing. For-profit ownership also carried a much larger risk of maternity-unit closure in rural communities, leading researchers to argue the two need different policy responses.

58% OF MEDICAL TEXTBOOKS DON’T REALLY COVER MENOPAUSE

A white paper from Calla Lily Clinical Care and ABIG Health makes the economic case for teaching menopause in medical school. The numbers are bleak: 58% of medical textbooks worldwide don’t adequately cover menopause, and in a study of 20 US residency programs, more than 20% of residents got no menopause training at all and just under 7% felt prepared to treat it. Menopause symptoms account for roughly $25 billion a year in direct medical costs among US women aged 45 to 60, with the cost of treating cardiovascular disease in postmenopausal women on track to top $200 billion a year.

A PROVEN C-SECTION ANTIBIOTIC FINALLY CAUGHT ON. INFECTIONS DROPPED.

Doctors used the antibiotic azithromycin in just over 2% of unscheduled c-sections before a 2016 trial showed that it prevents infections. In 2024, the drug was used in nearly 60% of cases. As doctors adopted the drug, postpartum infections after c-sections fell from around 9% to 8%, even as they rose among vaginal births. Researchers analyzed around 1.7 million US deliveries from 2013 to 2024. Doctors perform more c-sections than any other surgery in the country, and the procedure poses the greatest risk for infection after childbirth. But even eight years after the trial, four in 10 unscheduled c-sections still did not include the drug.

AMERICAN DOCTORS MAKE ONE KIND OF CUT. IT'S THE ONE LINKED TO WORSE TEARING.

More than one in five of the 5,277 US women who delivered babies with forceps or a vacuum suffered a severe tear. An episiotomy, a surgical cut used to widen the vaginal opening, generally increased the odds of this injury, but the direction of the cut made a crucial difference. Midline episiotomies, which accounted for more than three quarters of those performed, raised the odds of severe tears during vacuum deliveries. Episiotomies that angle away from the anus lowered the odds for women who had never delivered vaginally, whether doctors used forceps or a vacuum. The observational study cannot prove that either cut caused the outcomes, but it points to a group that may benefit from the less commonly used approach.

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

⚠️ Almost 200 women died from ectopic pregnancies from 2020–2025 — double the previous six years — with steeper increases in abortion ban states.

💊 After nearly a year of silence, the FDA now acknowledges the estrogen patch shortage, blaming demand — not supply — while almost 20 formulations remain affected.

🏛️HHS cancelled $38M in postpartum and minority health grants and redirected some of the money to erectile dysfunction and sperm count research.

TOP CLICKED STORIES THIS WEEK

Lilly's GLP-1 Windfall to Fund Investments in Women's Health // Bloomberg 

Doctors told women to use this medicine for menopause. Pharmacies can't keep it in stock // USA Today

Healthy Moms, Healthy Babies America pledges $100M to cut US maternal mortality rate in half // AP News 

HHS Cancels Infant Mortality, Postpartum Grants to Focus on Sperm Counts, ED // Notus

Prospective Grant of an Exclusive Patent License: Development and Commercialization of Mifepristone… // Federal Register 

Prime Healthcare 'unable' to provide answers on cuts to OB/GYN units at hospitals // NBC Chicago

Tonight: ectopic pregnancies are killing twice as many women as it used to, the FDA's explanation for why you can't find an estrogen patch, and more.

— Meghan McCarthy

TWICE AS MANY WOMEN ARE DYING FROM A CONDITION THAT SHOULDN'T KILL ANYONE

Almost 200 women died after an ectopic pregnancy from 2020 to 2025, compared with about 100 in the previous six years, a ProPublica analysis of CDC data found. The rise happened nationwide but climbed much more steeply in states with strict abortion bans, reaching just over 13 deaths per million live births in 2023-2025 against just over 7 in states without one. Maternal health experts cautioned that bans alone can't explain the increase, but were blunt about the baseline: "A death related to ectopic pregnancy should really be a never event," said Dr. Alice Abernathy, an OB-GYN in Philadelphia.

THE FDA LIFTED THE WARNING. NOW IT SAYS THE SHORTAGE IS WOMEN'S FAULT.

After nearly a year of telling women there was no estrogen patch shortage, the FDA now acknowledges the low supply and is working with six manufacturers to increase it, but it won't formally declare a shortage. Its explanation is demand: the agency removed the black box warning last fall, more women sought estrogen, and manufacturers weren't ready. The pharmacists' association counts almost 20 affected patch formulations, double the number earlier this year, and Jennifer Weiss-Wolf, who met with FDA leadership in April, said it took four months to issue what amounts to a lukewarm statement.

$100 MILLION TO CUT US MATERNAL DEATH RATE IN HALF

Philanthropists Olivia and Tom Walton launched Healthy Moms, Healthy Babies America, pledging $100 million over five years to cut the US maternal mortality rate in half by 2031. The CDC counted 688 deaths during or shortly after pregnancy in 2024, and the rate rose to 19 per 100,000 live births from 18.6 the year before. One of the campaign's own pillars is getting hospitals to report deaths faster: the most recent state-level maternal mortality data is still from 2022.

ELI LILLY IS SPENDING ITS GLP-1 MONEY ON ENDOMETRIOSIS

Eli Lilly is using some of the windfall from GLP-1 drugs to build a women's health business, recruiting scientists in osteoporosis and preeclampsia, and investing in outside companies working on endometriosis. In May the company hired reproductive medicine researcher Kelle Moley to lead women's health and early clinical development. Women and girls are nearly half the world's population; women's health has drawn about 6% of private healthcare investment.

AN AMERICAN ENDOMETRIOSIS TEST IS AVAILABLE IN ENGLAND. NOT IN AMERICA.

Endometriosis patients can wait ten years or more after symptoms begin to get a diagnosis for a condition that affects about 1 in 10 women worldwide. Two non-surgical tests exist: EndoSure, a half-hour test from a Maryland company that reads electrical signals in the gut through sensor pads on the abdomen, and Endotest, a French saliva test that looks for microRNAs. UK draft guidance recommends the NHS use both for three years while evidence accumulates, but neither is FDA-approved. EndoSure's founder says his company is still in the process of submitting its application.

September 8, 2026

Tonight: the senator who spent 25 years delivering babies and then sued hundreds of the women he treated, why federal money for postpartum visits is now going to erectile dysfunction instead, and more.

— Meghan McCarthy

POSTPARTUM VISITS OUT. ERECTILE DYSFUNCTION IN.

HHS cancelled 16 grants worth $38 million from its Office of Minority Health, more than half the office's portfolio, ending postpartum home visits for minority women, maternal and infant mortality prevention, cancer screenings and hypertension monitoring. The money is being redirected to what the agency calls the “root causes” of infertility, a list that includes endometriosis and uterine fibroids but also low sperm count, low testosterone and erectile dysfunction. "It is shocking that OMH under any leadership would prioritize erectile dysfunction over the health and wellbeing of infants and new mothers," Rep. Diana DeGette wrote.

A SENATOR DELIVERED THE BABIES. THEN HE SUED THE MOTHERS (HIS CONSTITUENTS).

Sen. Roger Marshall of Kansas sued more than 700 patients over unpaid bills during 25 years as an obstetrician, and 81 of them were arrested after missing court dates. He charged 18% annual interest under a contract patients signed, garnished paychecks and bank accounts, and pursued debts as small as $101. One woman was arrested three times over a C-section bill, the first time while eight months pregnant. Despite his own record as a doctor, Marshall introduced a bill to bar hospitals from suing patients in 2025 if they don't post their prices.

CHICAGO LOSES THREE MATERNITY UNITS AT ONCE

Prime Healthcare is suspending obstetrics at three Chicago-area hospitals, Saint Joseph's in Joliet, Mercy Medical Center in Aurora, and Resurrection Medical Center in Chicago, citing financial distress and fewer than one delivery a day. Rep. Lauren Underwood, a nurse who founded the Illinois Black Maternal Health Caucus, said the company made no plans to help the mothers who will now have to travel. "This is not how a company with nothing to hide operates," she said.

THE MIFEPRISTONE NOBODY IS FIGHTING ABOUT

While the FDA conducts a “safety” review of mifepristone in abortion care, the National Institute of Diabetes and Digestive and Kidney Diseases is considering granting a French company an exclusive patent license to develop mifepristone and related drugs for insulin-resistance disorders caused by excess cortisol. Mifepristone has been approved since 2012 as a daily 300 mg treatment for high blood sugar in some patients with Cushing’s syndrome—a dose higher than the single 200 mg tablet used in medication abortion and one that is taken repeatedly rather than once. Yet that version of the drug is not subject to the special prescribing restrictions imposed on mifepristone for abortion care.

STUDY: THE MENOPAUSE BRAIN DOESN'T SHRINK LIKE THE OTHERS

Puberty and pregnancy both accelerate reductions in the brain’s gray-matter volume. But menopause doesn’t, according to longitudinal imaging of 120 women who went through menopause and more than 700 women in comparison groups. It was the first study to compare whole-brain structural changes across all three transitions using the same analytical approach. In other words, menopause isn’t simply puberty or pregnancy in reverse—the brain responds differently to each hormonal transition.

Tonight: Gloria Steinem's origin story, Texas delays its maternal death count, and more.

— Meghan McCarthy

TEXAS WILL TELL YOU HOW MANY MOTHERS DIED. IN DECEMBER.

Texas’s report on maternal mortality in the state was due September 1, but state officials moved it to December 1, after the midterm elections. Why? The official line is that the committee was asked “to strengthen the report by further describing its work around preventability, better defining the sources of its recommendations, and making clearer connections between the underlying data, findings, and recommendations.” The Texas House Women's Health Caucus says they want the recommendations by October 1 so they can prepare before the state’s legislative session. Texas has had several women die due to lack of care while miscarrying under the state’s all-out abortion ban.

GESTATIONAL DIABETES MOVES THE CLOCK UP THIRTEEN YEARS

Women who had gestational diabetes were more likely to develop type 2 diabetes at a younger age, around 43 years old, than women who did not, who were around 56 years old. Among women who had gestational diabetes, 40% developed type 2 diabetes before age 40, compared with only 6% of women who had not had gestational diabetes. Researchers also noted that women with gestational diabetes “more frequently require insulin therapy at the time of diabetes diagnosis. This pattern suggests a more severe form of type 2 diabetes and an elevated risk of subsequent complications.”

YOUR CHART DOESN'T KNOW YOU'RE IN MENOPAUSE

An analysis found that menopause status is rarely captured as structured data in electronic health records and is instead inferred from things like age or a billing code. Researchers say that makes it harder to track symptoms over time, which in turn makes clinical decisions more difficult. They call for a standardized way to track menopause and its symptoms to make scalable menopause research possible.

A 1930s MAP IS STILL DECIDING WHO GETS A MAMMOGRAM

Breast cancer screening rates were more than four percentage points lower in neighborhoods that received the government’s worst redlining grade in the 1930s than in those rated the best. Researchers examined 1,152 census tracts in Kansas and Missouri and found that poverty explained nearly half of the association, while lower educational attainment explained another quarter. Overall, 84% of the areas studied fell short of the federal screening target of just over 80%.

GLORIA STEINEM TURNED A SECRET ABORTION INTO A LIFETIME OF ACTIVISM

Gloria Steinem died Wednesday at age 92. At 22, years before Roe, she traveled to London for an illegal abortion and promised the doctor who helped her that she would never reveal his name. Twelve years later, hearing women publicly share their abortion stories launched her historic path into activism for women’s rights. She went on to make reproductive freedom central to the modern women’s movement—and dedicated a memoir to the unnamed doctor who made her life as she knew it possible.

September 1, 2026

Tonight: Medicaid cuts coming for women (and men), preeclampsia in the blood, and more.

— Meghan McCarthy

WOMEN MORE LIKELY TO LOSE MEDICAID NEXT YEAR

Next year adults covered through Medicaid expansion will have to document 80 hours of work or other qualifying activities each month. Pregnant and postpartum enrollees are exempt — an important carveout in a program that pays for over 40% of U.S. births. But a new analysis found that nearly one in five working adults could still fall short because their hours hover near the threshold or change from week to week. Women were 22% more likely than men to be at risk of losing coverage.

THE ABORTION PILL CASE IS PAUSED, NOT GONE

A federal judge in Texas paused a case seeking to revoke the FDA's 2000 approval of the abortion pill until December 1 or until the FDA finishes its own review of the drug, whichever comes first. That review is expected to take about six months. The states are invoking the Comstock Act, an 1873 anti-vice law, to try to stop abortion pills from moving through the mail. The Trump administration has reportedly delayed the FDA review until after the midterm elections, because banning the abortion pill would be politically unpopular.

MAHA MET THE MENOPAUSE STARTUPS

Wired has a deep dive that finds the hormone-therapy revival has produced an unusual alliance of menopause specialists, venture-backed telehealth companies and MAHA officials increasingly pitching estrogen as a longevity intervention. The movement accelerated after the FDA removed boxed warnings last fall. At the announcement, ARPA-H Director Alicia Jackson — who founded menopause telehealth company Evernow — said hormone therapy could add “up to a decade of healthy years” to women’s lives. Traffic to four leading menopause startups rose 490% between 2023 and 2026. But experts warn that the evidence supports hormones for treating menopause symptoms, not prescribing them broadly to prevent aging or explain nearly every discomfort of midlife.

TWELVE WEEKS IN, ONE PROTEIN TALKS

Researchers screening nearly 3,000 proteins found that low levels of a placental protein called isthmin-2 around week 12 were strongly associated with later preeclampsia or fetal growth restriction. The finding came from a study nested within a cohort of over 4,500 first-time mothers, and the protein distinguished affected pregnancies better than five measurements currently used in first-trimester risk screening. Lab experiments offered a possible explanation: reducing the protein made placental cells less able to invade surrounding tissue.

IT'S NOT THE TRANSITION. IT'S THE CALENDAR.

A study of over 7,600 women covering nearly 14 years found a hormone that signals potential thyroid problems rose steadily with age, with no sharp increase at menopause. The rates of underactive and overactive thyroid climbed on the same aging curve. Clinical attention, the authors write, "should be focused on the age-related progression of thyroid abnormalities, independent of menopausal status."

Here’s what we found most interesting this week in women’s health:

🏥 Perinatal mental health conditions affect 1 in 5 women during or after pregnancy, yet screening remains far from universal — partly because mental health was never included in the 30-year-old bundled payment model obstetric providers get paid under. The Lindsay Clancy trial has brought new attention to the issue.

🚑 KFF found the median drive between rural maternity hospitals is 43 minutes, more than three times the 13-minute urban median. And Republicans’ looming Medicaid cuts could make those distances longer.

☕ An active-duty soldier and her husband paid $10,000 out of pocket for IVF because military health insurance generally doesn't cover it. So, the husband got a job at Starbucks, which does have fertility benefits.

TOP CLICKED STORIES THIS WEEK

Maternal mental health is making headlines. Experts say it's long overdue // CNN

Out-of-State Travel for Abortion Care Before and After the Dobbs v Jackson Decision // JAMA Network Open

Availability of Rural Hospitals Providing Inpatient Maternity Care in Medicaid // KFF

ACS report reveals Native Hawaiian women in U.S. have highest breast cancer incidence // American Cancer Society

Missouri military family needed IVF. Starbucks offered better coverage than the Army. // Missouri Independent

From Silence to Systems Change: Connecticut Moves Menopause Equity Forward // UConn

August 27, 2026

Tonight: cervical screening is falling as vaccination rises, Starbucks out-covers the Army on IVF, and more.

— Meghan McCarthy

ALMOST A THIRD OF WOMEN IN THEIR TWENTIES HAVE NEVER BEEN SCREENED

A JAMA Network Open analysis of around 106,000 women across nine editions of a national health survey found the share of women aged 21 to 29 who have never had a cervical cancer screening rose from just above 12% in 2005 to nearly 32% in 2023. Among women 30 to 65 it nearly tripled, to nearly 15%, or roughly 9 million people. The good news? At the same time, HPV vaccination climbed from 6% to 54%.

FORTY-THREE MINUTES TO THE DELIVERY ROOM

KFF counted 943 rural hospitals still providing inpatient maternity care to Medicaid enrollees, then measured how far apart they sit: a median 43-minute drive to the next one, against 13 minutes for urban hospitals. One in four rural hospitals is at least an hour from another maternity unit, and in 14 states an hour travel time is typical. The 2025 reconciliation law's cuts to hospital payments could thin the map further.

STARBUCKS COVERS IVF. THE ARMY DOESN'T.

An active-duty couple at Fort Leonard Wood paid more than $10,000 out of pocket for IVF because most military members’ health insurance doesn’t cover fertility drugs or procedures, the Missouri Independent reports. In this story the husband put college on hold for a job at Starbucks, because the company covers fertility treatments. Despite past support, all 14 Republicans on the Senate Armed Services Committee voted in July to strip IVF coverage from the defense bill.

SPAIN’S MENOPAUSE GUIDE WAS BASED ON STUDIES OF MEN

Spain’s food safety agency based parts of its menopause nutrition guidance—including recommendations on iron and vitamin C—on research conducted exclusively in men. After women scientists raised the alarm, the agency sent the report back to its scientific committee for review. Equality Minister Ana Redondo said it was time for the male body to stop being “the universal reference point for everything.”

NATIVE HAWAIIAN WOMEN HAVE THE COUNTRY’S HIGHEST BREAST CANCER RATE
American Cancer Society researchers separated cancer registry data that typically groups Asian American, Native Hawaiian and Pacific Islander populations together—and uncovered stark differences. Native Hawaiian women had the country’s highest breast cancer incidence: 27% higher than white women and 57% higher than the combined group. Across the 11 populations studied, overall cancer rates varied more than twofold, showing how aggregation can bury both the highest and lowest risks inside a single data point.

August 25, 2026

Tonight: maternal mental health never made it into the bundle, Alabama sent 1,208 women to North Carolina, and more.

— Meghan McCarthy

MATERNAL MENTAL HEALTH: NATIONAL STAGE, STILL LEFT OUT
Perinatal mental health conditions affect as many as 1 in 5 women during pregnancy or the year after birth, making them more common than gestational diabetes. Yet screening remains far from universal. One reason may be structural: Obstetric providers are generally paid a single bundled rate for care from pregnancy through six weeks postpartum. Joy Burkhard, CEO of the advocacy group Policy Center for Maternal Mental Health, argues that the 30-year-old payment model discourages providers from addressing mental health because it was never included in the original bundle. The Lindsay Clancy trial and the death of Hayden Panettiere, who spoke publicly about postpartum depression, have pushed maternal mental health into the national conversation.

ALABAMA SENT FIVE WOMEN TO NORTH CAROLINA. THEN IT SENT 1,208.
North Carolina providers performed an average of nearly 38 more abortions for out-of-state patients each day in the year after Dobbs than in the year before it, while the number provided to state residents barely changed. A JAMA Network Open analysis covered all 79,433 abortions provided in the state during those two years. The number of patients arriving from Georgia jumped from 127 to 6,513; from Alabama, 5 to 1,208; and from Tennessee, 218 to 1,644. Out-of-state patients also traveled farther — an average of 258 miles, up from 156 — and arrived at a median of eight weeks’ gestation instead of seven. The timing of abortions among North Carolina residents didn’t change.

CONNECTICUT PUTS MENOPAUSE IN EMPLOYMENT LAW
Two new Connecticut laws treat menopause as both a workplace issue and a health care issue. One explicitly adds menopause-related impairment to the state’s workplace accommodation protections, requires employers to notify workers of those rights and directs the Commission on Human Rights and Opportunities to develop model policies. The other directs the state to create a clinician toolkit covering menopause diagnosis and both hormonal and nonhormonal treatments. A UConn initiative helped shape the laws with residents’ accounts of navigating menopause at work and in the health care system.

WOMEN’S HEALTH VENTURE FUNDING FELL BY MORE THAN A THIRD
Venture funding for women’s health companies dropped from $3.2 billion in 2024 to roughly $2 billion in 2025, while the companies’ share of all health care venture deals slid from 7.4% to 5.7%, according to a Silicon Valley Bank report. Biopharma startups were hit hardest, with funding falling from $1.3 billion to $610 million. SVB’s Megan Scheffel describes it as a higher bar rather than a disappearance of capital: “Progress that used to be the province of Series A is now required to raise a Seed round.” Some founders are also broadening their pitches beyond conditions exclusive to women to include depression, obesity and heart disease — conditions that affect both sexes but may affect women differently.

DIABETES CAN SET WOMEN AND MEN ON DIFFERENT PATHS
After a type 2 diabetes diagnosis, women were more likely than men to be diagnosed with anxiety, depression or a somatoform disorder — 8.1% versus 5.3% — while men were more likely to develop cardiovascular disease or kidney failure, 8.4% versus 5.3%. A PLOS Medicine study tracked 28,720 UK adults for a median of nearly seven years and found that younger women had the greatest probability of developing a mental health condition. The researchers recommend making routine mental health screening part of diabetes care, particularly for younger women.

💰 TREATING MENOPAUSE COULD BE CHEAPER THAN NOT TREATING IT — A cost-effectiveness model found that putting 10,000 fifty-year-old women with hot flashes on five years of transdermal estrogen could save roughly $135 million and prevent 647 deaths, largely from cardiovascular disease. The model projected 87 additional breast cancer cases — but also 259 fewer cases of heart disease and 181 fewer hip fractures.

💊 FDA WANTS OPINIONS ON TESTOSTERONE FOR WOMEN — Off-label use of testosterone for menopausal women has climbed for a decade, so the FDA's Office of Women's Health is convening a public workshop on the topic with comments open through October 19. Beyond 24 months of use, the agency says safety data is limited — "particularly regarding cardiovascular and breast cancer risks."

👶🏽 DOULAS WORK, REVIEW FINDS — A review of 30 studies found doula support was associated with lower rates of preterm birth and C-sections, better birth experiences, and higher attendance at the 6-week postpartum check-up. The benefits held — and sometimes were strongest — among people facing racial, income, insurance, or incarceration-related disparities.

TOP CLICKED THIS WEEK

The Anti-Abortion Movement's Next Target: Surrogacy // Texas Tribune

Testosterone for Women Workshopping // Federal Register

Women Are Nearly 70% of the Health Workforce, and the Lowest Paid // Institution for Health Metrics and Evaluation

Wall Street Bets on Fertility Benefits // CNBC

I’m a Psychiatrist. I’m Hearing Something New From Young Women. // New York Times

Interpol Isn't Coming for Abortion Pills // The 19th