Across the American South and beyond, a new wave of reports and polling data is casting a stark light on the persistent—and in some cases, worsening—barriers facing women and girls, especially in Black and low-income communities. Released on October 23, 2025, the Women’s Rights & Empowerment Network’s (WREN) 2025 Status of Women and Girls Statewide Report in South Carolina and a sweeping 10-state poll commissioned by In Our Own Voice: National Black Women’s Reproductive Justice Agenda both paint a picture of deep disparities in health care, economic security, and reproductive rights. The findings, echoed by advocates and community leaders, are prompting renewed calls for policy reforms and community action.
In South Carolina, WREN’s report leaves little room for ambiguity about the scale of the problem. Maternal and infant health, access to health care, housing, food insecurity, and child care all intersect to shape the lives of women and girls across the state. But as Dr. Amalia Luxardo, WREN’s CEO, put it in her introduction, “Behind every data point is a mother, a daughter, a caregiver, a worker, a student — someone whose potential is being shaped, and too often constrained, by systems that were not built with them in mind. These inequities are not a reflection of anyone’s worth, talent, or effort. They are the result of policies and structures that can, and must, be transformed.”
One of the most alarming findings in the WREN report is the degree to which geography determines health outcomes. According to their data, the pregnancy-related mortality rate (PRMR) in rural areas of South Carolina is a staggering 62% higher than in urban areas. This means that, for many women, the simple fact of where they live can be a matter of life or death. The disparities don’t stop at geography, either. The report highlights that Black women in South Carolina face significantly higher PRMRs compared to their white and Hispanic counterparts—a trend that mirrors national data and underscores the urgent need for targeted interventions.
These racial disparities extend beyond health outcomes to encompass economic wellbeing and access to vital services. WREN’s recommendations are clear: expanding access to reproductive healthcare, supporting affordable, high-quality childcare, and advancing workplace policies that reflect the realities of caregiving are essential steps toward improving outcomes for families across the state. “WREN remains committed to working alongside communities, advocates, and policymakers to build a South Carolina where all people have the resources and support they need to thrive,” the organization concludes.
Meanwhile, a parallel story is unfolding at the national level. The 10-state poll conducted by PerryUndem for In Our Own Voice surveyed 500 Black adults in each of ten states—California, Florida, Georgia, Michigan, North Carolina, New Jersey, Nevada, Ohio, Pennsylvania, and Virginia. The results, first shared by States Newsroom, highlight the central role Medicaid plays in the lives of Black Americans. At least 90% of Black respondents said Medicaid is important to them or their families, and more than half reported that they or a family member rely on public insurance.
Medicaid’s reach is particularly profound in reproductive health: the program covers nearly two-thirds of Black babies’ births in the United States and almost half of all births nationwide, according to the Centers for Disease Control and Prevention. But recent congressional cuts to Medicaid are already hitting hard, especially in Black and low-income communities. “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, president and CEO of In Our Own Voice.
The effects of these cuts are not merely theoretical. In September and October 2025, several Planned Parenthood clinics serving predominantly Black and low-income patients closed their doors after new laws blocked Medicaid reimbursements for clinics affiliated with abortion providers—even those that did not offer abortions. In Louisiana, where Planned Parenthood clinics had never performed abortions, both locations closed on September 30, with 60% of their patients being Black and most relying on Medicaid, as reported by States Newsroom. In Memphis, Tennessee, a city where more than 60% of the population is Black, one of two Planned Parenthood clinics temporarily shut down in October due to these funding changes, according to the Tennessee Lookout.
Danielle Atkinson, executive director of Mothering Justice, a Michigan-based advocacy group, warned that the closure of clinics will have ripple effects: “They’ll go without STI testing. They’ll go without cancer screening. They’ll go without counseling.” Four Planned Parenthood clinics in Michigan closed earlier this year after the Trump administration cut millions from Title X family-planning funding, reported the Michigan Advance.
But the crisis extends beyond clinics. Medicaid cuts are also contributing to a wave of maternity ward closures, particularly in rural areas. In northeast Georgia, a maternity ward is set to close at the end of October, with Medicaid cuts cited as a key factor, according to the Georgia Recorder. Advocates worry that the loss of these services will force more women to travel long distances for care—if they can access it at all.
The poll also reveals the economic anxieties shaping family planning decisions among Black Americans. Many Black adults of reproductive age want children, but high costs of living—especially for housing and child care—are causing them to delay or forgo expanding their families. In California, for example, there is a 28-percentage-point gap between those who want children (56%) and those planning to have them (28%). At least 69% of Black respondents in each state polled said they worry about being able to care for more children, while 67% pointed to housing costs and 57% 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 explained.
Abortion restrictions are another factor influencing family planning. At least 45% of respondents said they don’t want children because they or their loved one could die from pregnancy, 43% cited concerns about miscarriage care, and 30% said abortion bans are preventing them from growing their families. In states like Florida, Georgia, and North Carolina—where abortion bans are stricter than 20 weeks—these concerns are especially acute. However, in California, Michigan, and Ohio, recent reproductive rights amendments have secured the right to abortion up to fetal viability, while Nevada and Virginia may follow suit after the upcoming midterms.
Despite these challenges, the poll found that a majority of voters in all ten states support abortion rights and believe Black women should make their own pregnancy decisions. Nevertheless, at least half of Black adults polled are struggling with economic security, and Black women of reproductive age are more likely than Black men to expect less safety and security during the remainder of President Donald Trump’s second term.
As Regina Davis Moss reflected, “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.”
With disparities in health care access, economic insecurity, and reproductive rights all converging, advocates and organizations like WREN and In Our Own Voice are urging policymakers to take bold action. The data is clear: without systemic change, the barriers facing women and girls—especially in Black and rural communities—will persist, with consequences that ripple across families and generations.
