Advocates gather outside the Hippodrome Theater in Richmond, Virginia, this summer to protest Medicaid cuts. Medicaid covers nearly two-thirds of Black babies’ births in the U.S., federal data shows, and congressional cuts to the program are already limiting reproductive health care in Black and low-income communities. (Photo by Bert Shepherd/Courtesy of Protect Our Care PAC)

At least 90% of Black people surveyed for a new poll said Medicaid is important to them or their families, and more than half either have public insurance or a family member who relies on the program. 

“Medicaid is critical for so many things with regards to making sure that we’re healthy and addressing health disparities. By losing it or weakening it, it is just going to disproportionately harm our communities,” said Regina Davis Moss, the president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda. 

Davis Moss’ organization commissioned the 10-state poll, which includes views from California, Florida, Georgia, Michigan, North Carolina, New Jersey, Nevada, Ohio, Pennsylvania and Virginia. Nonpartisan research firm PerryUndem conducted the survey between May and June and interviewed 500 Black adults in each state. 

The findings, shared exclusively with States Newsroom, show a significant number of Black people who want children are not yet planning to have them due to cost and health care concerns. 

Results were released just as several Planned Parenthood clinics that served Black patients with low incomes closed after a law took effect blocking certain reproductive health clinics affiliated with abortion providers from receiving Medicaid reimbursements until July 2026.

Louisiana’s Planned Parenthood clinics, which never offered abortions in their decades of service, closed on Sept. 30. Sixty percent of the Baton Rouge and New Orleans patients were Black and most have Medicaid insurance, States Newsroom reported. One of two Planned Parenthood locations in Memphis, where more than 60% of the population is Black, temporarily closed its doors during the first week of October due to Medicaid cuts, Tennessee Lookout reported. 

“Proximity is important, and the fact that these clinics have to close means that individuals needing their services will go without,” said Danielle Atkinson, executive director of Mothering Justice, a national advocacy group based in Michigan. 

Four Planned Parenthood clinics closed in her state this spring after the Trump administration cut millions of Title X family-planning funding, Michigan Advance reported.  

“They’ll go without STI testing. They’ll go without cancer screening. They’ll go without counseling,” Atkinson said. 

The ban on Medicaid for some reproductive health providers was part of a larger reconciliation package that is also set to slash nearly $1 trillion from Medicaid more broadly over the next decade. 

“Medicaid is a lifeline for Black women, girls and gender-expansive people,” Davis Moss said. The state and federal program covers nearly two-thirds of Black births, according to the U.S. Centers for Disease Control and Prevention, and almost half of all births nationwide. 

Maternal health advocates are bracing for the impact of Medicaid cuts on labor and delivery units, which have already been closing at a rapid pace over the last 10 years, especially in rural communities. A maternity ward in northeast Georgia, one of the states included in the poll, will close at the end of the month partially due to Medicaid cuts, Georgia Recorder reported in September. 

Findings from the In Our Own Voice poll also show that Black people of reproductive age — 18 to 44 in this case — want children but are not planning to have them, citing high costs of living. 

California had the biggest disparity of 28 percentage points: 56% want children but only 28% plan to have them. 

“I believe some of the reasons they said are not new issues that we are grappling with, but it’s deeply concerning because they are being exacerbated in this current administration,” Davis Moss said. 

At least 69% of Black people polled in each of the 10 states said they worry about being able to take care of children or more children than they already have, while at least 67% cited housing costs and 57% pointed to child care expenses. 

“In a lot of these states, the cost of child care is more expensive than a year of tuition, which is such a barrier for people to be able to: one, go into the workforce, two, have that early intervention and early education that really sets their children up for success, and three, give individuals and families the opportunity to go and explore careers and learning opportunities,” Atkinson said. 

Abortion restrictions played a factor in family planning, too, though in smaller numbers. At least 45% said they don’t want children because they or their loved one could die from pregnancy, while 43% worry about miscarriage care and 30% said abortion bans are stopping them from growing their families. 

Three of the states included in the poll — Florida, Georgia and North Carolina — have abortion bans stricter than 20 weeks. Voters in California, Michigan and Ohio approved reproductive rights amendments in recent years that secured the right to an abortion up to fetal viability, while Nevada and Virginia may have similar safeguards in place after the midterms. 

A majority of voters in each of the 10 states say abortion should be legal in all or most cases and at least 78% say Black women should make the decisions about pregnancy that’s best for them. 

Overall, at least half of Black adults polled are struggling with economic security. Black women of reproductive age were more likely to expect less safety and security throughout the rest of Republican President Donald Trump’s second term than Black men. 

“We’re getting ready to celebrate our 250 years, and all the things that we have fought for and all these things that we have gained in terms of civil rights and human rights, they are under threat like never before,” Davis Moss said. 

Child abuse, neglect or endangerment laws were used to charge hundreds of pregnant people with crimes in the two years after the U.S. Supreme Court overturned Roe v. Wade, underscoring the rise of fetal personhood laws, according to a new report. (Getty Images)

More than 400 people were charged with pregnancy-related crimes during the two years after the U.S. Supreme Court overturned federal abortion rights, research released Tuesday shows.

Prosecutors across the country often charged people with some form of child neglect, endangerment or abuse based on allegations of substance use during pregnancy, according to an annual report from the nonprofit Pregnancy Justice. 

Nearly three dozen cases were brought against people who miscarried or delivered stillborns, and in nine cases, pregnant people were accused of obtaining, attempting or researching abortion. 

“Prosecutors are wielding criminal laws to surveil and criminalize pregnant people, their behavior and their pregnancy outcomes,” Dana Sussman, Pregnancy Justice’s senior vice president, told States Newsroom.

Although charges against those experiencing pregnancy loss are less common, Sussman said she fears they could lead people to avoid seeking miscarriage care. 

For instance, a woman who miscarried at home was charged with abuse of a corpse in September 2023, Ohio Capital Journal reported. 

Brittany Watts was around 21 weeks pregnant when she went to the hospital but waited for hours and didn’t get help, according to the Capital Journal, and after she miscarried at home, she returned to the hospital, where staff called police. She was never indicted, and she filed a federal lawsuit in January against the city of Warren, police, hospital officials and hospital staff. 

“Rather than being able to grieve her loss, she was taken away in handcuffs. She was interrogated in her hospital bed while she was still tethered to IVs, and so she wants compensation for her own trauma, but most importantly, wants to make sure that this doesn’t happen to anyone else,” Rachel Brady, Watts’ attorney, told States Newsroom in June.

Watts’ lawsuit alleges local law enforcement and the hospital violated the Fourth and Fourteenth Amendment and the Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals that receive Medicare funding to provide stabilizing medical treatment regardless of a person’s ability to pay or insurance status. The defendants denied liability and the plaintiff’s claims, according to court documents filed in September. 

In this year’s report, pregnancy-related cases cropped up in 16 states, and states with strict abortion bans topped the list again: Alabama (192), Oklahoma (112) and South Carolina (62).

“If you are doing anything that exposes your pregnancy, your fetus to some real risk, perceived or assumed risk, in certain parts of the country, that is a felony,” Sussman said. 

Fetal personhood — the notion that fetuses, zygotes and embryos should have the same legal rights as human beings — comes into play when pregnant people struggling with addiction are drug tested during checkups or at labor and delivery units, Sussman said. 

“In several states, it’s become relatively common practice for people to be charged with a felony for child endangerment or neglect for simply testing positive” on toxicology tests, Sussman said. “And that carries years in prison, and of course, immediate family separation from your newborn and even from your other children in your home, in your family.” 

An investigation by The Marshall Project, Mississippi Today and three other news outlets in 2023 found that local law enforcement and prosecutors in Alabama, Mississippi, Oklahoma and South Carolina applied child abuse and neglect laws to fetuses when pursuing charges against pregnant women. 

Lawmakers in a few states have pitched legislation seeking to curb punitive approaches to addiction among expectant and new mothers. 

A bill advancing in the New York Legislature would require informed consent for drug testing and screening pregnant and postpartum patients unless it’s medically necessary. Legislation took effect in Washington state this summer that prevents the criminalization of pregnancy loss, and requires officials at jails, prisons and immigrant detention centers to report miscarriages and stillbirths to the state annually. Massachusetts legislators passed a law in December that prevents medical professionals from automatically referring substance-exposed newborns to the state Department of Children and Families. 

Prosecutors obtained information about pregnancy-related crimes from health care facilities in 264 out of 412 cases, even in incidents that did not allege substance use, according to the Pregnancy Justice report.

“If people are worrying about losing their children because of family separation through the child welfare system or by going to jail, they are not going to get the care that they need,” Sussman said. “Pregnancy is seen as a moment and a window of opportunity for people to get care. People are motivated, uniquely motivated, and we really squander that opportunity when we turn health care into a place of reporting.”