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.