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.