Since the landmark Supreme Court decision overturning Roe v. Wade in 2022, the United States has been swept into a reproductive health crisis that, by mid-2025, has only become more severe and more urgent. According to the Reproductive Health Coalition—an alliance representing over 180 organizations and 150 million individuals—nearly one in five patients seeking abortion care, including those needing care for miscarriage, have been forced to travel out of state. That’s more than double the number from just three years ago, as reported by Doctors for America and the American Medical Women’s Association. The fallout from the Dobbs decision has sent shockwaves through the healthcare system, impacting not just abortion access but also the broader landscape of maternal and child health in America.
But the story doesn’t end there. As lawmakers across the country push for new restrictions on medication abortion, defund essential clinical programs, and exclude family planning clinics from Medicaid, the nation faces a growing fracture in its healthcare system—a fracture that endangers lives and deepens existing disparities. In states with restrictive abortion laws, providers are now navigating a maze of vague legal threats and the ever-present fear of prosecution. The result? Patients suffering miscarriages have reported horrifying delays in care, sometimes forced to wait until they are hemorrhaging or septic before receiving treatment. “This is unacceptable,” say leaders of the Reproductive Health Coalition. It’s not just a theoretical debate about politics, they argue; it’s a matter of basic health and human dignity.
The crisis is not confined to abortion alone. American children are dying and getting sick at rates that are simply staggering compared to their peers in other wealthy nations. A 2025 study published in JAMA found that, over the past two decades, American children have died at nearly twice the rate of children in similar countries. U.S. children are more than twice as likely to die in traffic accidents, and a shocking 15 times as likely to die by firearms. American babies die at 1.78 times the rate of babies in comparable nations. While other wealthy countries see an average of 18 excess child deaths every day, the U.S. sees 54. These numbers are not just statistics—they represent a national tragedy that, experts argue, is largely the result of policy choices.
Nearly a third of American children now live with at least one chronic health condition, including depression, anxiety, diabetes, and obesity (with one in five children affected). An American child in 2023 was as much as 20 percent more likely to be living with a chronic health condition compared to a child just a decade earlier. According to Jill Filipovic, writing for Jill.substack.com, “American kids are sicker than kids in otherwise comparable nations, and they’re sicker than American kids used to be.”
Much of the blame, critics say, lands squarely at the feet of the Republican Party, which has long claimed to be the party of life. In recent years, Republican-led states have instituted strict abortion bans, many with no exceptions for rape, incest, severe fetal anomaly, or even the pregnant woman’s health. Women living in states that ban abortion are now roughly twice as likely to die during pregnancy, childbirth, or soon after compared to those in states where abortion remains legal. The numbers are stark: maternal mortality fell by 21 percent in states that preserved abortion access after Dobbs, but soared by 56 percent in Texas alone after its abortion ban. White Texas women experienced an even more dramatic 95 percent increase in maternal mortality. For Black women in states that ban abortion, the maternal mortality rate is more than three times that of white women. Latina pregnant women or new mothers in Texas are three times as likely to die as white women in California.
States with abortion restrictions also tend to have significantly higher infant mortality rates. Yet, despite the enormous resources dedicated to banning abortion and defending those bans in court, little has been done to address the alarming rates at which babies die during or soon after birth in those states. The ripple effects extend further: Republicans have tried to force child rape victims as young as 10 to carry pregnancies to term and have even prosecuted doctors who provided care. Cuts to Medicaid under the so-called “One Big Beautiful Bill” threaten to close as many as 144 rural labor and delivery units, a devastating blow to rural mothers who already face nearly double the mortality rate of their urban counterparts. The same bill handed ICE an additional $30 billion—an agency that has deported U.S. citizen children and is currently fighting to deport hundreds of unaccompanied Guatemalan children, some as young as three.
The crisis is exacerbated by decisions that undermine public health infrastructure. Trump’s HHS Secretary Robert F. Kennedy Jr. dismissed the entire board of CDC vaccine experts, replacing them with “vaccine skeptics.” Florida has ended vaccine requirements for schoolchildren. Not surprisingly, 2025 saw the largest measles outbreak in decades, with multiple child deaths—tragedies that experts say were wholly preventable. And as yet another mass shooting claimed the lives of children, the national conversation focused not on gun control but on the shooter’s transgender identity, leaving the real issue unaddressed.
Other policy choices have further endangered children’s health. The administration’s attempts to revoke parts of the Clean Air Act threaten to worsen air quality—a particular danger for children and fetuses with developing lungs. Efforts to dismantle the Department of Education and USAID are projected to cause the deaths of millions globally, including 4.5 million children over five years.
Internists—often the only regular medical contact for patients in rural and underserved areas—are on the front lines of this crisis. Their ability to provide quality care is now under direct threat from policies driven by ideology rather than evidence. Research consistently shows that access to comprehensive reproductive care, including abortion, improves maternal and infant health outcomes. Conversely, restrictions are linked to higher maternal mortality, especially among Black, Indigenous, and low-income populations. “Women’s health is not optional. Reproductive care is not a fringe issue. It is a core part of health care that affects half the population and impacts all of us,” write Christine Petrin and Susan Thompson Hingle, both internal medicine physicians, in a call to action published September 6, 2025.
The Reproductive Health Coalition has responded by helping to draft Shield Laws for states that continue to provide abortion services and creating legal guidance to help clinicians understand their protections. “No provider should have to choose between doing the right thing medically and risking their career or freedom,” they state. The coalition urges policymakers, clinicians, and voters to recognize that access to reproductive care is about more than rights—it is about survival.
As the nation grapples with these intersecting crises, the call from medical professionals and advocates is clear: silence only enables injustice. The conversation around reproductive health and child well-being must be reshaped, led by compassion, evidence, and integrity. The stakes could not be higher—not just for women, but for children and families across America.