Depending upon where you live, that is
Last night, I retold my son‘s favorite story.
It was a crisp Chicago night in May, 2012. We had just come back from the movies (Five Year Engagement) and were settling in for the evening – which wasn’t altogether easy because I was at the stage of pregnancy when “settling in” has a different meaning.
I felt a little uneasy. Then I felt a twinge, and a squeeze…
And then there was a flurry of activity, as we realized what was happening.
I put a few things in a bag, threw on my running shoes, and together with my husband headed off for the hospital.
But I didn’t wait for him to bring the car around, or to hail a cab.
Because we walked.
The hospital where I delivered my son was literally down the street, and across two parking lots, from my Chicago condo. The distance is less than a half a mile. I remember it being a lovely, leisurely stroll (with a few pauses). But of course had anything been truly emergent, I would have been at the hospital even quicker.
Walking less than five minutes to deliver your child is unique – even for Chicago, even for a blue city in a blue state.
But the disparity, the uniqueness of my situation, the privilege of that experience, really hit home last night because of a Signal chat. In the context of discussing the impact of GOP policies on rural health care, a member of a Signal group I’m part of explained that the doctor who delivered their children is now the only OBGYN to serve 54 counties. They explained that expectant parents reserve hotel rooms two weeks before their due date, and hope for the best.
Hope for the best.
And that’s happening now. That’s happening before the brunt of the new Republican policies hits.
Each year the March of Dimes comes out with a comprehensive report describing the state of maternal and obstetric care in the United States. The bleak picture it paints directly contradicts the Republican pro-life messaging.
Because what it shows is a country that devalues women and mothers and rural people.
Thirty percent of this country is in a maternal health desert. Thirty percent. 1,104 US counties don’t have a birthing facility or OBGYN. (That’s one in three).
In the last two years, one in 25 birthing centers have closed. And 70% of the remaining birthing centers are in just 10 states.
And the states where there are the most maternal healthcare deserts? They’re all red states.
Image: March of Dimes, Nowhere to Go: Maternity Care Deserts Across the US
The sad fact is that hospitals lose money on obstetrics. According to the American Hospital Association, in 2024 “Medicaid paid rural hospitals [just] 63 cents on the dollar for inpatient obstetrics care”. Perhaps that low reimbursement rate is why the AHA also found that “[t]here has been a 16% decline in rural counties with hospital-based obstetric care services over the last decade.”
But rather than looking for ways to decrease the number of maternal health deserts in their states, Republicans have supported policies that will make things even worse. (Again, “pro-life” is branding, not belief.) According to the National Partnership for Women and Families, another 144 rural hospitals with birthing units are at risk of closing, or will likely face severe cutbacks in the coming years as a direct result of the immoral budget that was passed earlier this month.
Rural hospitals that are already strapped for funding will be forced to make difficult decisions.
And women will pay the price.
Friend, I see issues like this and I get angry all over again. Because these are policy choices.
Choices.
And we can make different choices.
For god’s sake, we live in the wealthiest country in the history of the world, but women risk giving birth in their cars because they’re driving over an hour to the nearest birthing hospital.
We know what policies will improve this situation – the number one recommendation from the March of Dimes is to increase reimbursement rates for Medicaid.
Instead, Republicans cut Medicaid, gave tax breaks to billionaires, and stuffed so much money in ICE’s pockets that they’re giving $50k signing bonuses to new agents. They showed their priorities; it’s time for Democrats to show our own.
Stagnation and gridlock has led to inertia of imagination; Democrats need to shake it off, and get loud.
Listen, I know that not everyone in America is going to have a hospital within walking distance of their house.
But getting to your hospital shouldn’t require a hotel reservation, either.
We can do better, America.
Let’s get to work.
Actions for the Week of July 22, 2025
Friend, things may be heavy – but you can lighten that load by doing something small – a “small deed” – to bring about the world that you want to see. In doing so we tell the world, the universe, our leaders – and most importantly, ourselves – that we will not go quietly into that good night.
I call it Action Therapy.
That’s why in each Tuesday post I share a few “small things” – usually a Small Thing to Read, a Small Event to Attend, and a Small Call to Make or Action to Take. My intention here is to give you actions you can tuck into your week with ease – and know that you’re doing something today to make tomorrow better.
Join me in doing so. It matters.
Small Call to Make: Extend the ACA Credits (H/T: 5calls)
The ACA credits are set to expire at the end of 2025 – and the resulting premium increases for people are projected to be 75%. With costs set to nearly double (and that’s before any other rate increases, which are averaging 10-20% right now) we’ll see a lot of people leaving the marketplace. That will be bad for everyone. (I did a quick video explaining why, which you can watch here:
5Calls has a great script and explainer here, so check it out here.
For ease, here’s their recommended script:
Hi, my name is [NAME] and I’m a constituent from [city]
I’m calling to ask Rep. [name] to protect the accessibility of affordable healthcare by extending the ACA tax credits. Millions of Americans rely on the ACA for coverage, and a 75% increase in the cost of premiums on January 1st will be financially devastating for so many people. Thank you for your time and consideration.
Small Event to Attend: Families First + Indivisible Events
This weekend, Families First (a collaboration of AFSCME, AFT, Caring Across Generations, Community Change, Fair Share America, Families Over Billionaires, Family Values Work, Moms Rising, MoveOn, National Domestic Workers Alliance, NEA, People’s Action Institute, Planned Parenthood, SEIU, and Working Families Power) is hosting events across the country to say: our families come first, and we will protect each other.
You can find an event near you here: https://www.familiesfirstnow.org/#take-action
And learn more here: https://www.familiesfirstnow.org/#about
Also, Indivisible has a few events over the next week that I wanted to highlight. Tonight from 8-9pm eastern they are hosting Fight Back With Friends, which they describe as “a national program designed to help you activate your community.” This is a one-hour training on how to use their Empower app to connect with friends, family, and neighbors. Sign up here.
Second, on July 30 (next Wednesday) they are hosting their next One Million Rising call: “a national effort to train one million people in the strategic logic and practice of non-cooperation, as well as the basics of community organizing and campaign design. This is how we build people power that can’t be ignored.” It’s a 1.5 hour event, and you can sign up here.
Small Thing to Read: March of Dimes Maternal Health Report
I highly recommend reading – or at least flipping through – the March of Dimes report that I referenced multiple times in this piece. It’s jarring, but important.
Check it out here: https://www.marchofdimes.org/sites/default/files/2024-09/2024_MoD_MCD_Report.pdf
Thanks for reading, friend – I’m glad to see you here! You’re making a difference, I promise.
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