Tonight: the NC personhood bill's IUD problem, Washington on menopause at work, and more.

— Meghan McCarthy

NORTH CAROLINA'S PERSONHOOD BILL HAS AN IUD PROBLEM

North Carolina Republicans filed a constitutional amendment in May that would define life from the moment of fertilization and grant anyone the right to use “deadly force” in defense of human life. A labor and delivery nurse's viral video — 193,000 likes — argued that IUDs, which prevent implantation rather than fertilization, could expose users to criminal liability under the bill. The backlash was significant enough that one of the two primary sponsors removed his name; Rep. Keith Kidwell of Beaufort is now the sole sponsor.

WASHINGTON GOVERNOR ORDERS STATE AGENCIES TO ACCOMMODATE MENOPAUSE SYMPTOMS

Washington is the latest state to require agencies to accommodate employees with menopause symptoms, including considerations like flexible scheduling, temperature control, and access to cold water among the measures. A state commission has a year to develop guidance for both state agencies and private employers; a progress report is due to the governor by April 2027. Rhode Island enacted a broader mandate in 2025 covering all employers statewide.

TWO IN THREE PREGNANT WOMEN TAKE TYLENOL. OB SPECIALISTS SAY KEEP TAKING IT.

After Trump and RFK Jr. warned earlier this year against acetaminophen in pregnancy without strong evidence, the Society for Maternal-Fetal Medicine reaffirmed June 1 that it remains the first-line treatment for pain and fever. SMFM's review found no causal link between prenatal acetaminophen and autism or ADHD; RFK Jr. has since walked back to calling the evidence merely "suggestive." Two in three pregnant women use the drug at some point; untreated first-trimester fever is linked to birth defects and miscarriage.

SOME HIGH-RISK BREAST CANCER PATIENTS MAY NOT NEED CHEMO AFTER ALL

A trial for over 4,000 women found that 68% of those classified as clinically high-risk for early breast cancer had low genomic scores and could safely skip chemotherapy, doing well on hormone therapy alone. Results were presented at the ASCO annual meeting, and the trial offers the strongest evidence yet that women may be pushed toward chemotherapy their tumor biology doesn't require.

FOUR IN TEN ABORTION PATIENTS HIT A CATASTROPHIC SPENDING THRESHOLD

Out-of-pocket abortion costs vary so widely that 42% of patients exceed what researchers classify as the “catastrophic spending threshold,” i.e. more than 40% of household income after basic needs. The analysis tracked direct care costs plus travel, childcare, and lost wages. For patients who crossed state lines, 65% hit the catastrophic mark.

Tonight: the preventive care panel RFK is messing around with, giving money to pregnant women helps babies, and more.

— Meghan McCarthy

THE TASK FORCE THAT MAKES YOUR MAMMOGRAM FREE HASN'T MET IN THREE MONTHS

RFK Jr. fired both vice chairs of the U.S. Preventive Services Task Force last week, an independent panel that determines what preventive care health insurance must cover at no cost under the ACA. That includes everything from mammograms, breast and cervical cancer screenings, birth control, and depression screenings. The task force has not convened since March and has no meetings scheduled. Even worse, former members said the administration suppressed a completed recommendation endorsing at-home HPV self-testing as an alternative to the Pap smear.

THE U.S. JUST ADDED A PAID-LEAVE SCORE FOR NEW MOMS. IT'S AN F.

The Policy Center for Maternal Mental Health at George Washington University graded all 50 states on their maternal mental health infrastructure for the fourth consecutive year, adding a "parental support" domain in 2026 that immediately dragged the national grade to an F. Paid leave and childcare access were absent or inadequate in 31 states, which scored less than one star out of five; Maine led with 3.5 stars. One in five new mothers in the U.S. experiences a maternal mental health condition; untreated, these disorders have lasting effects on women's well-being, family stability, and child development.

IN THE WORLD'S LARGEST BREAST CANCER DATASET, ONE PATIENT IS NATIVE AMERICAN

The Cancer Genome Atlas is the world's largest breast cancer database with more than a thousand patients. But only one of them is Native American, which means today's targeted treatments were calibrated on data from other populations. A team at Notre Dame compared 17 Native American tumor samples to nearly 700 from white women and found differences at every level studied: which genes mutated, how tumors evaded immune defenses, how DNA was organized. Native American women have lower breast cancer incidence than white women but higher mortality rates — the researchers say these biological differences may help explain why.

TURNS OUT, GIVING PREGNANT WOMEN CASH WORKS

Flint, Michigan's Rx Kids program gave pregnant women $1,500 mid-pregnancy and $500 a month through the baby's first year, with no restrictions on how families spent it. The results showed a cut in NICU admissions by 29% and low birthweight rates dropped by over 4 percentage points. The study tracked about 4,500 births across similar Michigan cities. The program also reduced evictions, increased prenatal care visits, and drove a 32% drop in child maltreatment allegations. The results offer the most comprehensive real-world evidence yet that unconditional cash in the perinatal period outperforms most targeted interventions.

TRUMP'S HEALTH AGENDA DOESN’T DELIVER (YET) FOR ABORTION HATERS

Anti-abortion groups that helped elect Trump are now openly breaking with his administration, frustrated that MAHA pet projects like food dyes, dietary guidelines, and vaccine recommendations have crowded out moves to restrict mifepristone. The FDA recently approved a new mifepristone generic rather than rolling back access; the agency's top two officials, both targets of sustained anti-abortion pressure, departed in the past month. The White House's response to the movement so far is Moms.gov, a directory of crisis pregnancy centers.

Tonight: denied lifesaving care in Arkansas, the postpartum cliff, and more.

— Meghan McCarthy

SHE CALLED THE GOVERNOR'S OFFICE. ARKANSAS STILL WOULDN'T HELP.

ProPublica's Kavitha Surana documents how Emily Waldorf, a 38-year-old physical therapist at the Arkansas hospital where she had worked for six years, spent five days being denied care for an inevitable miscarriage. During that time her cervix was open to a potentially deadly infection, and despite meeting with the hospital CEO, calling the governor's office, and retaining a lawyer, she was refused care in her home state. She had to be transferred by ambulance to Kansas, she nearly died when her placenta failed to detach and she lost a liter of blood. The investigation surfaces a new gap: unlike Texas, Arkansas has issued no guidance telling doctors they can legally induce miscarriages without waiting for sepsis to set in.

THE BABY GETS SEVEN CHECKUPS. THE MOTHER GETS ONE.

In an essay in the New York Times, Sejal Hathi, director of the Oregon Health Authority and a Stanford physician, describes assembling her own postpartum care after a third-degree tear and separated abdominal muscles that made lifting her infant difficult. Her specialist OB discharged her at six weeks, her clinic had too booked for new postpartum patients, and her primary care physician said recovery was outside her scope. As Hathi put it: “Beyond the first few weeks after delivery, no single clinician owns accountability for the mother’s recovery and well-being. Her baby will see a pediatrician seven or more times in the first year of life. Whether the mother sees a doctor will depend largely on whether something goes wrong.”

TRUMP PROMISED TO COVER IVF. DON'T WAIT FOR IT.

Last week, the Trump administration proposed a rule letting employers voluntarily offer standalone IVF benefits with a $120,000 lifetime cap — no mandate, no financial incentive for employers to sign on. Experts are unconvinced: "Do not delay your treatment thinking there's going to be a benefit from this policy anytime soon," said Sean Tipton of the American Society for Reproductive Medicine. A single IVF cycle runs $25,000 to $35,000; only 30 percent of employers currently cover it; Trump's 2024 campaign had promised the government would pay.

THE PERIMENOPAUSE CONTENT BOOM HAS A SIDE EFFECT: UNINTENDED PREGNANCIES.

Experts interviewed by the Guardian warn that perimenopause content on social media is sending some women in their 30s and 40s to demand HRT for insomnia while stopping contraception, a combination producing unintended pregnancies. "I work in an abortion service and we're seeing more women over 35 now who believe themselves to be menopausal and are gobsmacked when they become pregnant," said Dr. Paula Briggs, a sexual and reproductive health consultant. The British Menopause Society's chair is direct: if you're still having regular periods, you're not perimenopausal, and contraception is needed until menopause is confirmed or age 55.

WHAT HAPPENS TO THE FEMALE BRAIN WHEN ESTROGEN DISAPPEARS

A Northwestern Medicine preclinical study is the first to show that estrogen loss after menopause alters the extracellular matrix (molecular scaffold between certain brain cells) in women but not in men. The ECM makes up about 20 percent of brain volume and helps cells communicate; its breakdown in aging females may help explain why two-thirds of Alzheimer's patients are women. "Once memory is gone, it's gone," said Serdar Bulun, the study's senior author and chair of obstetrics and gynecology at Northwestern Feinberg.

Tonight: a weight loss drug just posted numbers associated with bariatric surgery, what 198 proteins in your blood have to do with your period, and more.

— Meghan McCarthy

WOMEN'S HEALTH GETS 20 CENTS ON THE RESEARCH DOLLAR

Only 20% of program funding across the ten conditions analyzed by the World Economic Forum targets women specifically, and 59% of that goes to just two: ovarian cancer and menopause. For conditions that hit women harder or differently, including heart disease and anxiety, fewer than 3% of clinical trials carry any women-specific focus. Anxiety disorders illustrate the translation gap: 112 pipeline programs identified, four products launched in the past decade.

THE NEXT WEIGHT LOSS DRUG JUST HIT NUMBERS ASSOCIATED WITH BARIATRIC SURGERY

Eli Lilly's retatrutide — a GLP-1 that also hits two additional receptors — posted results showing over 45% of participants reached at least 30% weight loss, a threshold long associated with bariatric surgery. Participants who took the drug for two years lost an average of 85 pounds. Women already use GLP-1 drugs at roughly twice the rate of men which makes the results particularly consequential for women's health.

THE MENSTRUAL CYCLE LEAVES A PROTEIN FINGERPRINT IN YOUR BLOOD

A Nature Medicine study analyzed blood plasma from around 2,800 women and identified 198 proteins that rise and fall in distinct patterns across the menstrual cycle — extending well beyond reproductive hormones into immune, vascular, and metabolic pathways. Several of those proteins overlap with endometriosis, fibroids, and abnormal uterine bleeding. Researchers also developed a 75-protein score capable of predicting menstrual cycle phase from a single blood draw, with potential implications for how clinical trials account for cycle timing and how these common, chronically underdiagnosed disorders get identified earlier.

CREATINE IS THE MENOPAUSE SUPPLEMENT OF THE MOMENT. DOCTORS ARE LESS SURE.

Creatine has become the supplement of the moment for women in perimenopause and menopause, with influencers claiming it fights muscle loss and brain fog. The New York Times found that most creatine research has been done in men and a 2025 meta-analysis couldn't draw conclusions on its effects in middle age due to insufficient data. The Cleveland Clinic's medical director for women's comprehensive health described the evidence in women as "quite weak." Most physicians interviewed won't recommend it but won't fight a patient who wants to try: it's safe, inexpensive, and — per the experts — has to be paired with resistance training to do anything for muscle mass at all.

BIRTH CONTROL IS OTC NOW. YOUNG WOMEN STILL DON'T KNOW HOW IT WORKS.

Since 2024, birth control pills are available over the counter in the U.S. — no prescription needed. A University of Mississippi School of Pharmacy survey of women aged 16 to 24 found they have only moderate knowledge about how pills prevent pregnancy and what the side effects are, with rural women faring worse due to pharmacy closures and fewer OBGYNs. The study's author flags AI chatbots and platforms like ChatGPT as an unreliable substitute for a provider conversation — at a moment when that's exactly where many young women are going for answers.

Tonight: abortion bans are changing miscarriage care, how biology might play a role in PMDD and psychiatric conditions, and more.

— Meghan McCarthy

WHAT ABORTION BANS ARE DOING TO MISCARRIAGE CARE

States with abortion bans at or before six weeks have also changed how miscarriages get treated, a JAMA study of tens of thousands of privately insured patients found. Women in ban states were less likely to receive the gold standard mifepristone-misoprostol regimen and 14 points more likely to be given misoprostol alone, a less effective option with greater side effects. The study, the first national look at this connection, excludes Medicaid patients, which means the actual scope is likely larger. The broader point: abortion bans are no longer just shaping abortion access; they’re reshaping routine pregnancy care for women who very much wanted to stay pregnant.

YOUR PMDD AND YOUR ANXIETY ARE DRIVING EACH OTHER

Women with premenstrual disorders face roughly double the lifetime risk of developing depression, anxiety, ADHD, or bipolar disorder, and the relationship runs both ways: prior psychiatric diagnoses roughly double the risk of later developing PMDD or PMS, a JAMA Network Open analysis of 3.6 million Swedish women found. Researchers tracked records from 2001 to 2022. The two-way pattern suggests the conditions share underlying biology rather than merely co-occurring by chance. The bigger implication is that PMDD still gets treated culturally as “bad PMS” when the data increasingly points to it being deeply intertwined with serious psychiatric and neurodevelopmental conditions.

THE MENOPAUSE SLEEP SYMPTOM THAT MISSES SCREENING

A nationally representative survey of 1,200 U.S. women, presented at the ACOG annual meeting, found that 75 percent of those with menopausal symptoms reported sleep problems, compared with about half of women without symptoms. Sleep disorders rarely come up at menopause appointments, even though untreated sleep disruption compounds other menopausal health risks, including cardiovascular disease and depression.

FOR THE HIGHEST-RISK C-SECTIONS, A DRUG THAT CUTS HEMORRHAGE RATES

A multicenter Chinese randomized trial of around 1,700 women with placenta previa found that giving tranexamic acid at the time of cesarean delivery cut postpartum hemorrhage rates from 35 to 30 percent, a statistically significant though modest reduction, per the BMJ study. Placenta previa, in which the placenta partially or fully covers the cervix, puts women at elevated hemorrhage risk; postpartum hemorrhage is the leading cause of maternal death worldwide.

THE FDA DOOR NOW WIDE OPEN FOR ABORTION OPPONENTS

Anti-abortion groups spent months calling for FDA Commissioner Marty Makary's firing over his slow-walking a mifepristone “safety” review, and his exit this week gives them a new shot at a successor willing to restrict the drug's telehealth approval. His departure is also a loss for menopause advocates. Makary championed expanded hormone therapy access, and the FDA removed black box warnings from estrogen treatments during his tenure.

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

🩺 The Supreme Court let the abortion pill stay on telehealth — for now (again). The court ruled Thursday that mifepristone can continue being prescribed via telehealth while a Louisiana challenge moves through lower courts. Two conservative justices dissented, calling the result a "perpetration of a scheme" against the court's decision to allow states to ban abortion.

💊 Postpartum depression peaks around two weeks after birth. A Lancet Psychiatry meta-analysis of around 2 million women across 90 countries found the highest prevalence of major depressive disorder comes earlier than most standard screening starts.

🔬 PCOS is officially being renamed PMOS. A global group of 56 organizations and The Lancet agreed to rename polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome, finally reflecting the metabolic and hormonal disease it actually is. The "cysts" were never cysts. They're arrested follicles.

TOP CLICKED STORIES THIS WEEK

Healthy Moms, Healthy Babies America Launches National Campaign to Cut U.S. Maternal Mortality in Half Within Five Years — Heartland Forward

New Gov't Website Will Help CPCs Collect Data On Pregnant Women — Abortion, Every Day

The Men Who Want Women to Be Quiet — The Atlantic

Cardiovascular Health Characterization Using Life's Essential 8 Score in Perimenopausal Women: An Analysis of the National Health and Nutritional Examination Survey — Journal of the American Heart Association

How to Improve Your Bone Health — Vogue

The global prevalence of major depressive disorder during the peripartum period: a systematic review and meta-regression — The Lancet Psychiatry

Risk of congenital anomalies among infants of patients with endometriosis: a population-based cohort study — CMAJ

Tonight: PCOS gets a new official name, the lates on the Supreme Court, and more.

— Meghan McCarthy

SCOTUS SAYS ABORTION PILL TELEHEALTH PRESCRIBING CAN CONTINUE…FOR NOW (AGAIN)

The Supreme Court ruled Thursday that the abortion pill, known as mifepristone, could continue being prescribed via telehealth appointments while a case brought by Louisiana moves through lower courts. Two conservative justices dissented in the decision, saying it was a “perpetration of a scheme” against the Supreme Court’s decision to allow states to outright ban abortion. (How do they feel about states like Missouri, whose residents voted for abortion access, yet they still don’t fully have it? One will never know…)

PCOS WAS NEVER THE RIGHT NAME

A global group of 56 organizations using more than 22,000 patient survey responses reached a consensus and The Lancet made it official: polycystic ovary syndrome or PCOS will now be called polyendocrine metabolic ovarian syndrome, or PMOS. The change reflects what doctors have long known: the “cysts” seen on ultrasound aren’t actually cysts. They’re arrested follicles, and the old name obscured the metabolic and hormonal problems at the heart of the condition. The new name keeps “ovarian” but adds “polyendocrine” for the multiple hormonal disturbances and “metabolic” for the insulin resistance, type 2 diabetes, and cardiovascular risks that come with it. Lead author Helena Teede framed the rename as a chance to finally treat PMOS as the multisystem condition it actually is, not a fertility problem.

THE MEN WHO WANT WOMEN QUIET

The Atlantic’s Helen Lewis argues that “masculinism” has become the single most important force holding together the American right, profiling Doug Wilson, Nick Fuentes, Scott Yenor of Heritage, and others openly working to remove women’s right to vote, work, and divorce. Wilson, the pastor Pete Hegseth invited to lead the Pentagon worship service, told Lewis he favors household-only voting and the eventual repeal of the 19th Amendment (“maybe 200 years’ time”). The piece walks through how the “longhouse thesis,” anti-empathy rhetoric, and Heritage’s “family wage” policy proposals all fit together.

THE HEART HEALTH WARNING NOBODY (IN THEIR 40s) KNOWS

Perimenopausal women are twice as likely to have a low cardiovascular health score compared to women with regular cycles, according to a Journal of the American Heart Association analysis of nationwide U.S. data published Wednesday. The gap was driven by higher cholesterol and blood sugar levels, and the authors argue clinicians should start screening for blood pressure, cholesterol, and type 2 diabetes earlier in the perimenopausal transition. In other words, the window for prevention is open right when most women aren’t being told to look.

ENDOMETRIOSIS DOESN’T END AT FERTILITY

A population study of roughly 1.5 million Ontario births found that infants born to women with endometriosis had a 16% higher rate of congenital anomalies, including cleft palate, hypospadias, and pulmonary artery stenosis. IVF and ICSI accounted for only 11% of the excess risk, suggesting endometriosis itself drives the pattern, not the fertility treatments.

Tonight: a Supreme Court ruling on telemedicine abortion access is (once again) days away, a Mother’s Day website that’s actually a government data pipeline, and more.

— Meghan McCarthy

THE MIFEPRISTONE RULING IS DAYS AWAY

Justice Alito on Monday extended his stay to continue telemedicine access to mifepristone, pushing the deadline three more days while the full court deliberates. Around one in four US abortions now happen via telemedicine. The Trump administration’s FDA declined the court’s request for a brief; former FDA leaders filed one anyway, arguing the appeals court decision “would upend FDA’s gold-standard, science-based drug approval system.”

GOVERNORS CROSS AISLE ON MATERNAL MORTALITY

Gov. Wes Moore (D-MD) and Gov. Sarah Huckabee Sanders (R-AR) launched “Healthy Moms, Healthy Babies America”, an effort founded by Olivia Walton that has a five-year goal of cutting U.S. maternal mortality in half. They say they are targeting state-led policy reform by gathering employers, health systems, and policymakers around a single measurable target. Maternal deaths cost the U.S. economy an estimated $165 billion a year; more than 80% are preventable.

MOMS.GOV IS A DATA PIPELINE

The Trump administration launched moms.gov on Mother’s Day, along with a goal of eventually letting employers offer stand-alone IVF and fertility insurance plans. But the government site funnels users to an antiabortion organization’s “Option Line”, a data-collection tool that has gathered names, addresses, marital status, and menstruation dates from millions of women under terms allowing the data to be used “for any and all purposes.” Republican Sen. Katie Britt, who twice introduced bills to build a federal “crisis” pregnancy center site under different names, stood behind Trump at the launch.

OSTEOPENIA IS HAVING A MOMENT

Vogue reports that bone-density loss is sliding from AARP territory to wellness-influencer world, partly driven by GLP-1s (rapid weight loss can accelerate bone loss). Reporter Alice Gregory became osteopenic at age 37 and learned that a USPSTF still doesn’t recommend a baseline DEXA scan until 65—a cutoff her endocrinologist calls “terrible.” Twenty-one percent of older women who fracture a hip die within a year.

POSTPARTUM DEPRESSION PEAKS BEFORE WE SCREEN FOR IT

A Lancet Psychiatry meta-analysis of 780 studies covering around 2 million women across 90 countries found the most women (around 8%) with major depressive disorder peaks around two weeks after childbirth. They also noted that standard symptom scales overestimate prevalence by up to 122% versus diagnostic interview, but the timing finding still holds. Prevalence stays elevated through the rest of the first postpartum year.

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

📊 Half of American women fear medical bills more than cancer. A Cleveland Clinic survey found nearly 50% are more worried about affording care than developing cancer, heart disease, or Alzheimer's.

💊 The Supreme Court's reprieve on a mifepristone telehealth ban lifts Monday. Justice Alito's temporary order keeping the pill available by mail expires May 11, just as once-loyal anti-abortion leaders publicly turn on Trump for letting it keep flowing.

🩺 A small upside to PCOS, finally. Women with the condition reach menopause later and report 32% fewer symptoms, including 41% fewer hot flashes, than women without it.

TOP CLICKED STORIES THIS WEEK

Using over-the-counter drugs to treat menopause symptoms? Think again, doctor advises — CNN

As the estrogen patch shortage continues, these women are meeting with the FDA — USA Today

AI can detect breast cancer risk before humans. Why it may take hospitals a while to adopt the tech — WBUR

ACOG 2026: New Study Shows Preventive Care Use Low After Hypertensive Disorders of Pregnancy — Patient Care Online

Study: New preeclampsia treatment may safely extend pregnancy — EurekAlert / Cedars-Sinai

Maria Shriver highlights new survey on women's health, financial strain — WTHR

PCOS Linked to Later Menopause and Fewer Symptoms — Medscape

Tonight: women fear a healthcare bill more than a potentially deadly diagnosis, the estrogen patch shortage just landed at the FDA's doorstep, and more.

— Meghan McCarthy

WOMEN ARE MORE AFRAID OF THE BILL THAN THE DIAGNOSIS

A Cleveland Clinic survey found nearly half of US women are more worried about affording healthcare than they are about getting cancer, heart disease, or Alzheimer's. Maria Shriver presented the findings Thursday at the Cleveland Clinic Global Women's Health + WAM Forum. (If you click on the link, scroll down to see this specific story.)

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ONE IN TEN WOMEN JUST QUIT HRT BECAUSE OF A SHORTAGE

Almost half of women on hormone replacement therapy say they can't reliably fill their estrogen patch prescriptions, and one in ten have stopped treatment entirely, per an 8,000-woman Midi Health (informal) survey across 49 states. Patches have been short since January. Midi's CMO and a group of patients met with the FDA on Wednesday to push for action and pointed at the manufacturers, not demand, as the cause: Bayer stopped producing patches in 2023, and Sandoz says the patches are unusually complex to make.

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MEET THE COURT THAT KEEPS GETTING REVERSED

The appeals court that gutted telehealth access to mifepristone last week is the most-reversed appeals court in the country, with the Supreme Court overturning 10 of 13 of its decisions last term. Trump appointee Judge Kyle Duncan wrote the opinion, arguing Louisiana has standing to sue because it once paid Medicaid for two abortion-pill complications. Legal observers note that's an even thinner claim than the doctors' standing argument SCOTUS unanimously rejected in 2024.

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MAMMOGRAM AI WORKS. INSURANCE DOESN'T COVER IT.

AI tools that read mammograms can flag breast cancer risk years before doctors notice it. A UMass Memorial pilot using MIT's Mirai algorithm caught six already-existing cancers in 145 high-risk women on its own. The National Comprehensive Cancer Network added AI risk assessment to its 2026 screening guidelines, but most insurance plans don't cover the follow-up MRIs (around $1,400) or out-of-pocket scans (around $200), leaving the technology mostly in well-resourced hospitals.

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PCOS HAS ONE LATE BENEFIT

In a Finnish birth-cohort study of women at age 46, just 3.1% of those with polycystic ovary syndrome had reached late perimenopause or menopause, compared with 18.4% of women without PCOS. The PCOS group also reported fewer hot flashes and less disrupted sleep. Researchers think prolonged exposure to natural estrogens may explain the gap and may carry some long-term health benefits for a condition more often discussed in terms of its costs.