July 30, 2026

Tonight: Louisiana locks up a hemorrhage drug, the operation that prevents most ovarian cancer, and more.

— Meghan McCarthy

REMOVING THE FALLOPIAN TUBES CUTS OVARIAN CANCER RISK BY NEARLY 80%

Nearly all fatal "ovarian" cancers actually begin in the fallopian tubes, and taking the tubes out during any abdominal surgery, from a hysterectomy to a gallbladder operation, lowers the risk by almost 80%, the New York Times reports. The five-minute procedure is now backed by the American Cancer Society, which is planning a national awareness campaign. Ovarian cancer kills most of the 20,000 U.S. women diagnosed each year because no screening test catches it early.

LOUISIANA LOCKED UP THE DRUG THAT STOPS POSTPARTUM BLEEDING

A 2024 state law that reclassified misoprostol and mifepristone as controlled substances has pushed Louisiana hospitals to pull misoprostol off the mobile carts used to treat postpartum hemorrhage and store it in a locked room instead. Doctors told KFF Health News and Verite News the extra steps cost minutes when a hemorrhage can turn fatal fast. Misoprostol is cheap, shelf-stable, and a frontline treatment for one of the most common childbirth complications.

HORMONE THERAPY USE HAS NEARLY DOUBLED

Menopausal hormone therapy use among women in outpatient care rose from 1.7% to 3.6% between 2017 and 2026, and nearly tripled among women aged 45 to 54, according to an Epic Research analysis of more than 163 million women. Use stayed flat until 2023, then accelerated after further analysis softened the perceived risks and the FDA moved to strip the decades-old black-box warning off estrogen products last November. Patches and gels grew fastest of all.

…AND THE PATCHES TO MEET THAT DEMAND KEEP RUNNING OUT

That surge is colliding with supply. Pittsburgh-area pharmacies report estradiol patch shortages that have dragged on for six to eight months, with some patients driving 40 minutes to fill a prescription and pharmacies paying double when stock appears, the Pittsburgh Post-Gazette found. The FDA says patches haven't met its threshold for a national shortage and that all six manufacturers are running at full capacity. Patients are being switched to gels and alternate doses in the meantime.

PREGNANCY HIGH BLOOD PRESSURE HAS JUMPED 73% SINCE 2016

The share of U.S. births complicated by gestational hypertension rose from 6% in 2016 to 10.4% in 2024, and CDC data shows the rate climbed in all 50 states. Axios reports the roughly 73% jump cuts across age groups and races. High blood pressure in pregnancy raises the odds of preeclampsia, stroke, preterm birth, and lasting heart disease, and it's one of the clearest early warnings clinicians have.

July 28, 2026

Tonight: a new anti-abortion weapon, drinking in pregnancy climbs, and the 716-page Medicare rule pricing women's health.

— Meghan McCarthy

THE 716-PAGE RULE THAT DECIDES WHAT WOMEN'S HEALTH IS WORTH

Medicare's proposed 2027 physician pay rule is 716 pages of policy proposals so dense, almost no one will ever read it (except those who are paid to). But thankfully we have a 51& analysis that reads the rule through a women's health lens…and finds the words "menopause," "hormone," "osteoporosis," and "postpartum" appear zero times. Buried in the same pages: the biggest maternity-coding overhaul in decades, Medicare's first lactation-payment codes, and an 86% cut to the pelvic-exam supply pack. Valuation is the quiet mechanism that decides whose care the system pays for, and the public comment window to fix the omissions closes September 14. Check out more in our interview with 51& founder Jodi Neuhauser.

p.s. have something newsy you want to talk about in women’s health? email me at [email protected]

ANTI-ABORTION GROUPS ARE NOW “TESTING” THE WATER

Students for Life spent two years sampling wastewater and this week released a study claiming "significant levels" of mifepristone in the water systems of Austin, Blacksburg, Virginia, and Carbondale, Illinois. But the researchers never actually tested for mifepristone: as Jessica Valenti reported, their method only detects whether something is blocking progesterone, which could just as easily be sunscreen, an insecticide, or a flame retardant. The paper ran in a journal published by the anti-abortion group that once sued the FDA over mifepristone, and its authors are not water scientists. Even if the drug were present, you'd have to drink roughly 5 million liters, about two Olympic pools, to swallow the equivalent of a single clinical dose. The campaign is a response to Biden-era rules allowing abortion pills by mail; in 2025 lawmakers in seven states filed nine bills tying medication abortion to water pollution, and 25 members of Congress asked the EPA to start monitoring.

A RURAL MATERNITY EXPERIMENT SERVED 8,600 WOMEN

A federal program funded three rural maternal-health networks in Minnesota, Missouri, and West Virginia, and a new HRSA report says they reached more than 8,600 women between 2021 and 2025. Leaning on telehealth, remote monitoring, patient navigation, group prenatal care, and doulas, the networks reported gains in first-trimester prenatal care, postpartum visit rates, and infant outcomes. The strategies were built to route around the provider shortages and transportation gaps that make rural pregnancy so dangerous, exactly the kind of care that keeps disappearing as rural hospitals close.

HEAVY DRINKING IN PREGNANCY HAS NEARLY TRIPLED

The share of pregnant women who report drinking rose from 9% in 2011 to about 15% by 2023, a 59% jump, according to a Columbia analysis of CDC survey data covering nearly 34,000 pregnancies. Binge drinking climbed 77% over the same stretch and heavy drinking 166%. But the biggest increase was in tobacco use: among pregnant women who drank at all, 68% of those who also smoked reported binge or heavy drinking, versus 31% of those who didn't.

MATERNAL-HEALTH STARTUPS RAISED $978M. FEW TOOK MEDICAID.

Investors put $977.5 million into 172 venture-backed maternal-health startups between 2014 and 2022. A University of Pennsylvania team found the single biggest slice, $520 million, went to maternal and fetal diagnostics, and the most common company was virtual or hybrid "wraparound" pregnancy care. But few of the startups mentioned maternal mortality and few accepted Medicaid, which pays for more than 40% of US births. The gaps the market is rushing to fill, the authors note, are mostly not the ones killing women.

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

🏥 THREE MATERNITY WARDS CLOSED IN THREE WEEKS

Hospitals in Kentucky, Indiana, and Iowa all moved to shutter or shrink labor-and-delivery services in a three-week stretch. That comes on top of 29 closures in the last year, as hospitals face financial losses, staffing shortages, and falling birth rates. What's different is the pace. For most rural patients, the nearest delivery room keeps getting farther away.

💊 THE MEDICAID GAP IN MENOPAUSE CARE IS AN ACCESS PROBLEM, NOT A PREFERENCE PROBLEM

Women on Medicaid are about half as likely to use menopausal hormone therapy as privately insured women, even after controlling for age and health, according to a JAMA Network Open analysis. Hormone therapy is the most effective treatment for hot flashes and night sweats, and the gap mirrors documented racial disparities in menopause care. Researchers concluded coverage — not preference — is what's shaping who gets treated.

❤️ PMOS CAN SIGNAL HEART PROBLEMS. MOST WOMEN DON'T KNOW THEY HAVE IT.

Women with PMOS — the condition formerly called PCOS, renamed in May — are about 2.5 times more likely to have a heart attack or stroke and nearly four times as likely to develop peripheral artery disease, according to the largest US study on the question so far, which covered more than 2 million patients. The risk held after adjusting for smoking, obesity, cholesterol, and diabetes. Around 10 to 13% of reproductive-age women have PMOS, and roughly 70% are undiagnosed.

TOP CLICKED STORIES THIS WEEK

Feds Have a New Teen-Pregnancy Prevention Plan. Fertility and Reproductive Goals. // Stateline

New Report Shows Coverage Gains for New Mothers — But Progress Has Stalled With New Threats on the Horizon // Georgetown Center for Children and Families

National Strategy to Close the Women's Health Gap // Society for Women's Health Research

The Menopause Gold Rush Is Failing Women // Bloomberg 

PMOS, Formerly PCOS, Raises Risk of Atherosclerotic Cardiovascular Disease, Heart Attacks, Strokes // Newswise

Insurance Type and Menopausal Hormone Therapy Use Among US Women // JAMA Network Open

July 23, 2026

Tonight: the federal teen-pregnancy plan that skips birth control, a coverage cliff for new mothers, and more.

— Meghan McCarthy

THE BIRTH-CONTROL CLUE HIDING IN SEMAGLUTIDE PRESCRIPTIONS?

Women who used hormonal contraception were more likely to later start a semaglutide, the drug behind Ozempic and Wegovy, than women who didn't, according to a study comparing nearly 23,000 first-time semaglutide users with matched controls. The association was strongest among women who had used multiple contraceptive types. The researchers stress this is an association, not proof that birth control causes weight gain, but say contraceptive history may help identify women more likely to seek pharmacologic weight management.

COVERAGE FOR NEW MOTHERS CLIMBED, THEN HIT A WALL

Forty-six states and DC now guarantee a full year of Medicaid coverage after pregnancy, up from almost none four years ago. But a Georgetown and Urban Institute analysis found progress has stalled. Expiring enhanced marketplace subsidies and new limits on how states finance Medicaid are expected to push coverage back down, and more than 100,000 pregnant and postpartum women are enrolled through pathways now at risk. Roughly a third of pregnancy-related deaths happen after the first postpartum week, when losing coverage means losing follow-up care.

THREE MATERNITY WARDS CLOSED IN THREE WEEKS

Over the span of three weeks, hospitals in Kentucky, Indiana, and Iowa moved to shut or shrink labor-and-delivery services, according to Becker’s Hospital Review, on top of 29 maternity closures last year. Financial losses, staffing shortages, and falling birth rates keep driving the math, pushing rural patients hours from the nearest delivery room. A few systems are going the other way: AdventHealth just restored obstetric care to a rural Kansas hospital that had gone without.

THE MENOPAUSE MARKET BOOM AND MISDIAGNOSES

Menopause is a booming market, yet only 1.7% of American women over 40 were on hormone therapy in 2023, and the country has a little over 5,000 menopause-certified clinicians for the 1.3 million women who reach menopause each year, Bloomberg Businessweek reported. Into that gap came telehealth start-ups and supplement brands. When a reporter ran her own symptoms through four of them, two diagnosed perimenopause off an intake form and prescribed hormones she didn't need, blaming weight gain and night sweats that actually traced to stress-baking and too many blankets. As one OB-GYN asked, have women gone "from being dismissed and ignored to being preyed upon?"

THE FEDERAL TEEN-PREGNANCY PLAN THAT DISCOURAGES BIRTH CONTROL

The Trump administration is redirecting federal teen-pregnancy-prevention money toward groups that teach "fertility awareness", i.e. tracking cervical mucus and body temperature, while steering teens away from contraception, according to reporting from Stateline. The language could, of course, route funds to anti-abortion pregnancy centers. Congress created the program in 2010 and has renewed it on a bipartisan basis for 16 years, including in the 2026 budget, even as decades of research tie abstinence-focused sex ed to higher teen birth rates, not lower.

July 21, 2026

Tonight: a $20 billion moonshot plan for women's health, nurses hold their own on abortion care, and more.

— Meghan McCarthy

THE $20 BILLION MOONSHOT PLAN TO CLOSE THE WOMEN'S HEALTH GAP

A coalition led by ACOG and the Society for Women's Health Research is calling on Congress to spend $20 billion over 10 years to close the women's health gap, with a national strategy endorsed by 37 medical organizations spanning cardiology, neurology, and OB-GYNs. The framework sets measurable targets across research funding, public-awareness campaigns, and getting findings into the clinic. Congress might be divided, but this hands advocates a concrete yardstick.

ON MEDICAID? HALF AS LIKELY TO GET MENOPAUSE HORMONES

Women on Medicaid are about half as likely to use menopausal hormone therapy as privately insured women, even accounting for age and health, according to a JAMA Network Open analysis of around 1,700 women aged 45 to 64. Hormone therapy is the most effective treatment for hot flashes and night sweats, and the gap mirrors long-documented racial disparities in menopause care. Coverage, not just preference, appears to shape who gets treated.

NURSES AND MIDWIVES PRESCRIBE ABORTION PILLS AS SAFELY AS DOCTORS

Medication abortions provided by nurse practitioners, midwives, and physician associates were as effective and as safe as those from physicians in a review of more than 59,000 abortions at Planned Parenthood clinics across Southern California. Completion rates ran 92.9% for advanced-practice clinicians versus 90.1% for doctors, with serious complications under 0.1% for both. The finding matters because 26 states bar these clinicians from prescribing abortion pills, restrictions the authors say the data don't support. Loosening them could widen access where doctors are scarce.

STUDY: PCOS ALSO BRINGS CARDIOVASCULAR RISK

Women with polyendocrine metabolic ovarian syndrome (PMOS) — the condition the WHO and Endocrine Society renamed from PCOS in May — are about 2.5 times more likely to have a heart attack or stroke than women without it. They are also nearly four times as likely to develop peripheral artery disease, according to a study of more than 2 million patients. The risk held even after adjusting for smoking, obesity, cholesterol, and diabetes, suggesting the condition drives cardiovascular disease on its own. It's the largest US study on the question so far, and the stakes are big: 10 to 13% of reproductive-age women have PMOS, and roughly 70% don't know it.

THE GOVERNMENT DOUBTS ITS OWN NEW FERTILITY BENEFIT

The Trump administration's proposed rule letting employers offer standalone fertility coverage, capped at $120,000 per person, comes with an unusual caveat: the government isn't sure it will work. In the rule's own preamble, regulators warn that because mostly people already worried about infertility would be the most likely to buy the voluntary, largely employee-paid coverage, the risk pool could tip into adverse selection and push premiums high enough to make the products unprofitable. They even concede it might lead some people to delay trying to conceive and admit they don't know how many insurers would offer it at all. It would take effect in 2027 if finalized.

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

🧬ENDOMETRIOSIS ISN'T ONE DISEASE. RESEARCHERS NOW THINK IT COULD BE FOUR. A study mining the All of Us database of more than 22,000 women identified four distinct symptom clusters — going well beyond pelvic pain to include gastrointestinal issues, migraines, anxiety, and depression. The condition still takes four to eleven years to diagnose and affects one in ten women of reproductive age. Sorting patients into subtypes could be the first real step toward treating endometriosis as more than a catch-all diagnosis.

💓PREGNANCY IS A STRESS TEST FOR THE HEART — EVEN WHEN IT GOES SMOOTHLY. Rutgers researchers tracked women's cardiovascular health during and after pregnancy and found that within seven years, 40% had developed a cardiometabolic condition like high blood pressure or diabetes. Lower cardiovascular health scores during pregnancy predicted an earlier diagnosis, and the pattern held even in women whose pregnancies were uncomplicated. The authors argue pregnancy is an underused window to catch heart risk early.

💊THE ACTING AG WANTS THE ABORTION PILL OUT OF THE MAIL. Acting Attorney General Todd Blanche told Republican senators he would prioritize stopping mifepristone from being mailed if confirmed as the nation's top lawyer — though he declined to say how. Medication abortion is now the most common way pregnancies are ended in the U.S., which is exactly why it has become the movement's central target.

TOP CLICKED LINKS THIS WEEK

Endometriosis presents symptom patterns that go beyond pain // EurekAlert

How OB-GYNs Get Paid Is Changing for the First Time Since the '90s // Axios

Pregnancy may flag future heart and metabolic risk, even without major complications // EurekAlert

Texas Bets $100 Million on Abortion "Reversal" Clinics // Houston Chronicle

Many women still confused about perimenopause // EurekAlert

Wisconsin Was the Second-to-Last State to Extend Postpartum Medicaid for New Moms // Wisconsin Independent

July 17, 2026

Tonight: The sad conclusion to the Trump administration’s $10 million contraceptive saga, the acting AG comes for the abortion pill, and more.

— Meghan McCarthy

p.s. More predictions await your wise responses…we’ll share the top answers on Sunday.

p.p.s. Due to an email glitch, this is coming on a Friday. TGIF!

INSIDE THE PLAN TO DESTROY $10 MILLION IN CONTRACEPTIVES

Internal State Department emails, released after a Freedom of Information Act suit by the Center for Reproductive Rights, show diplomats scrambling as the Trump administration moved to destroy $9.7 million in USAID contraceptives and HIV-prevention drugs sitting in a Belgian warehouse and bound for some of the world's poorest countries. "There is no one here that knows definitively what is in the warehouse," one embassy official wrote to Washington. The majority of goods were “not stored in a temperature-controlled environment, they were no longer considered safe for use by health care authorities. The U.S. government has spent more than $400,000 on the storage and transportation of the goods, the inspector general estimated.”

THE ACTING AG WANTS THE ABORTION PILL OUT OF THE MAIL

Acting Attorney General Todd Blanche told Republican senators on Wednesday that he would prioritize stopping mifepristone from being sent through the mail if confirmed to be the nation’s top lawyer, though he declined to say how. The Trump administration opposes the Biden-era rule allowing the abortion pill to be mailed, and Blanche suggested the Justice Department could review it. Medication abortion is now the most common way pregnancies are ended in the U.S., which is exactly why it has become the movement's central target.

ENDOMETRIOSIS ISN'T ONE DISEASE. IT COULD BE FOUR.

Researchers mining the All of Us database of more than 22,000 women with endometriosis identified four distinct symptom clusters that reach well beyond pelvic pain. They include gastrointestinal issues, migraines, anxiety, and depression. The condition affects roughly one in ten women of reproductive age and still takes four to eleven years to diagnose. Women who also had adenomyosis showed markedly more severe disease. Sorting patients into subtypes could be the first real step toward treating endometriosis as something other than a single catch-all diagnosis.

ONE IN THREE WOMEN CAN'T TELL IF THEY'RE IN PERIMENOPAUSE

A survey of more than 7,600 U.S. women found that 34% weren't sure whether they had entered perimenopause, a share that climbed to 42% among women aged 40 to 44, according to a study in Menopause. The confusion is structural: there is no lab test for perimenopause, the symptoms shift over years, and they overlap with everything from thyroid disease to depression. This is one of the largest surveys conducted on this topic, finding once again that women lack adequate education. Roughly two million American women enter the transition each year and stay in it for four to eight years, often without a name for what's happening to them.

WOMEN'S HEALTH JUST HAD ITS BIGGEST FUNDING YEAR EVER

Women's health companies raised a record $1.55 billion in equity across 164 rounds in 2025, with 85 companies closing deals, the highest single-year count on record, per a W Group report. The more telling shift is that the money stopped pooling at the very top, spreading across 15 categories and more than 30 countries. The catch is a Series A bottleneck leaving promising seed-stage startups stranded, which the report calls the ecosystem's highest-leverage problem to fix in 2026.

July 14, 2026

Tonight: Texas funds an abortion "reversal" doctors call dangerous, Wisconsin finally extends postpartum coverage, and more.

— Meghan McCarthy

p.s. forget trivia (tonight), we want your predictions 🔮 

TEXAS BETS $100 MILLION ON ABORTION "REVERSAL" CLINICS

As abortion pills became the only real way to end a pregnancy in Texas, crisis pregnancy centers are pushing an unscientific counter-intervention: take progesterone within 72 hours of the first abortion pill to try to stop it. The Houston Chronicle found the state has poured nearly $100 million into the centers offering it, even though the one OB-GYN who tried to formally study reversal halted his trial after three of twelve women landed in the ER with severe bleeding. No one in Texas tracks how often reversal is done, or how often it goes wrong.

WISCONSIN WAS THE SECOND-TO-LAST STATE TO EXTEND POSTPARTUM MEDICAID FOR NEW MOMS

A new Wisconsin law took effect this month, stretching Medicaid coverage from 60 days after birth to a full year, leaving Arkansas as the last holdout. State officials expect about 16,000 women a year to gain coverage. It matters most where the danger lingers: the leading cause of pregnancy-related death in Wisconsin is mental health conditions and overdose, and overdose risk peaks between seven and twelve months postpartum, long past the old 60-day cutoff.

HOW OB-GYNS GET PAID IS CHANGING FOR THE FIRST TIME SINCE THE '90S

Starting in January, OB-GYNs will be able to bill insurers for each service they provide instead of the lump-sum "bundled payment" that has covered prenatal care, delivery, and postpartum since the 1990s. Axios reports the new American Medical Association codes are meant to reward tailored care, like extra postpartum visits for higher-risk patients, when more than half of pregnancy-related deaths happen within a year of birth. Critics warn unbundling could just turn every visit and scan into a fresh billing opportunity.

WOMEN WAIT 14 YEARS FOR A BLEEDING-DISORDER DIAGNOSIS. MEN WAIT TWO.

A Lancet Haematology Commission on global female health warns that women wait an average of 14 to 16 years to be diagnosed with a bleeding disorder, versus about two years for men. Heavy menstrual bleeding affects up to one in three women and is often the first sign of an inherited disorder, yet it's routinely waved off as normal. The group behind the report, led by a Cleveland Clinic hematologist and presenting this week in Paris, wants universal screening for heavy bleeding and iron deficiency, and aims to get women to under a two year wait by 2035.

PREGNANCY IS A STRESS TEST FOR THE HEART, EVEN WHEN IT GOES SMOOTHLY

Rutgers researchers scored women's cardiovascular health during pregnancy and tracked them afterward, finding that within seven years 40% had developed a cardiometabolic condition like high blood pressure or diabetes. Lower pregnancy scores predicted an earlier diagnosis, and the pattern held even in women whose pregnancies were uncomplicated. The JAMA Network Open analysis shows association, not cause, but the authors argue pregnancy is an underused window to catch heart risk early, especially now that more women keep coverage past the first months.

Here are the most interesting things we found this week in women’s health:

🏥WHO'S WATCHING WHETHER THE ER TURNED YOU AWAY? SOON, MAYBE A PRIVATE FIRM.

Buried in Medicare's proposed 2027 outpatient payment rule, CMS wants to hand off part of EMTALA enforcement to private accrediting organizations — the same ones paid by the hospitals themselves. One of those duties is maintaining ER logs, which document women sent home mid-miscarriage or ectopic pregnancy. Under this structure, those records could also be exempt from public disclosure rules. Comments are open through August 31.

🔥 THE MENOPAUSE SYMPTOM MEDICINE HAS NO NAME FOR

Hot flashes, brain fog, sleep loss — those are in the guidelines. Rage isn't. In a TIME essay, OB-GYN Dr. Sarah Berg argues that perimenopausal rage gets folded into depression and anxiety clusters, studied just enough to confirm it's real and no further. A federally funded UNC trial has started looking at perimenopausal irritability specifically, but rage as a distinct clinical entity has no diagnostic name, no treatment protocol, and no guideline. That gap has professional consequences — different ones depending on who you are.

 🔬 THE PILL CAN WORK AS WELL AS AN IUD — WITH THE RIGHT SUPPORT

A University of Utah study of 4,000 women found that when patients got same-day access, reliable refills, and care built around their own priorities, failure rates were similarly low across nearly every contraceptive method: about one pregnancy per 100 women a year, whether using an IUD or the pill.
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TOP CLICKED STORIES THIS WEEK

Ovary identity shift after menopause may contribute to inflammation // New Scientist

How a conversation about affordability led to menopause legislation // 19th News 

The Menopause Conversation Still Has One Major Blind Spot // Time

At-Home Transvaginal Pelvic Ultrasonography and Image Quality in Premenopausal Women // JAMA Network Open 

Medicare Program: …Deeming for Emergency Medical Treatment and Labor Act (EMTALA)// Federal Register

Texas Hospital Discharged Woman With Doomed Pregnancy, Breaking Law // NBC News

July 9, 2026

Tonight: a quiet rule change on ER oversight (does it matter?), maternity wards still closing, ovarian cancer caught too late, and more.

— Meghan McCarthy

p.s. Tonight’s trivia: What’s actually killing most women?

WHO CHECKS WHETHER THE ER TURNED YOU AWAY? SOON, MAYBE A PRIVATE FIRM.

Buried in Medicare's 2027 outpatient payment rule, CMS proposes letting private accrediting organizations verify compliance with parts of EMTALA, the law that requires all hospitals to stabilize patients in need, even if they don’t have health insurance. One of those duties is keeping a log of everyone who arrives at the ER, and that’s important for documenting women sent home mid-miscarriage or ectopic pregnancy because the hospital refused to provide an abortion. (See the horror story of Kayleigh Thurman.) CMS used to check on the record-keeping function, but here they are trying to hand it off to accreditation bodies paid by the hospitals themselves. It also means the records could be largely exempt from public-disclosure rules that cover state inspections. Comments run through August 31.

A YEAR AFTER THE MEGABILL, MATERNITY WARDS KEEP CLOSING

One year after Republicans' “big beautiful bill” took effect, maternity units around the country are closing, scaling back, or shelving expansion plans, according to a report from Democratic Rep. Frank Pallone and Sen. Ron Wyden. The law's cuts to Medicaid payments, which many rural hospitals rely on to keep labor and delivery open, don't formally take effect until 2027. But the report says providers are already cutting services as they budget for the losses. Rural maternity deserts predate the bill, but the direction it describes is well documented and amplified after this legislation passed. Pallone calls it the largest closure of labor and delivery services the country has seen.

TWO IN FIVE OVARIAN CANCERS ARE CAUGHT ONLY IN THE ER

Forty percent of women with ovarian cancer in England were diagnosed only after an emergency hospital admission, and those women were four times more likely to die within two months than women diagnosed through other routes, a University of Surrey team found in an analysis of more than 28,000 cases in BMJ Oncology. One-year survival for the emergency-diagnosis group was 50%, versus 83% for everyone else, largely because their cancer was caught later. The pattern was worst for the youngest and oldest patients, and in poorer areas. Ovarian cancer has vague symptoms and no screening program, which researchers say clinicians and patients need to be more vigilant about the symptoms.

THE PILL CAN MATCH AN IUD, GIVEN THE RIGHT SUPPORT

The idea that IUDs and implants are far more effective than the pill or the ring may have less to do with the methods than with the access around them. In the HER Salt Lake initiative, more than 4,000 low-income women got contraceptive counseling built around their own priorities, including starting on the day they visited the clinic and dependable refills. With that approach University of Utah researchers reported in JAMA Network Open that failure rates were similarly low across nearly every method. About one pregnancy per 100 women a year, whether using an IUD or the pill. That's a striking break from a much-cited 2012 study that put the pill, patch, and ring at roughly 20 times the failure rate of long-acting methods. The authors argue that support closes the everyday gaps usually blamed on the patient: the missed refill, the skipped appointment, the out-of-pocket cost.

MENOPAUSE'S MISSING SYMPTOM ISN'T IRRITABILITY. IT'S RAGE.

In an essay for TIME, OB-GYN Dr. Sarah Berg argues the public menopause conversation has focused on symptoms that are easiest to name, including hot flashes, sleep loss, and brain fog. But it has skipped the one doing the most professional damage: rage. The science is thin, she writes, as perimenopausal mood gets studied as depression or folded into an anxiety cluster, with no guideline or diagnostic name for rage itself. A federally funded UNC trial has started examining perimenopausal irritability, but rage on its own remains studied just enough to confirm it's real and no further. Berg founded Selfority, which sells menopause education to employers, so she has a stake in the workplace case she's making, but the clinical gap she describes is real.