Funding for To the Contrary provided by The E. Rhodes and Leona B. Carpenter Foundation The Park Foundation and the Charles A. Frueauff Foundation This week on To the Contrary there's less health care for pregnant women in the U.S. in the places where they need it the most.

Then, right, left or center, the abortion debate is motivating voters in the upcoming elections.

♪♪ Hello, I'm Bonnie Erbe Welcome to To the Contrary , a discussion of news and social trends from diverse perspectives.

Up first.

Maternal and child health.

More than a third of U.S. counties are considered maternity deserts as they have no obstetric hospitals or providers, according to a new report.

And things are getting worse, not better.

According to the organization issuing the report.

The March of Dimes says obstetric hospitals and providers have closed down due to financial and logistical challenges, including those brought on by the COVID pandemic.

The situation is even more grim for rural communities of color.

One in four Native American babies and one in six black babies are born in these maternity deserts.

Mothers and babies in these areas are more likely to face bad outcomes, including death.

The report notes almost 1000 women died of pregnancy related causes in 2020.

The vast majority of these deaths were considered preventable.

Joining me today are Congresswoman Eleanor Holmes Norton Republican strategist Rina Shah, Sam Bennett from the New York Amsterdam News, and Republican consultant Ann Stone The question to you, Eleanor, is why is this happening?

Oh, this is happening in no small part because of the loss of obstetricians, obstetricians, and that's where they are needed most or where they are needed most would be where there are people of color and in rural areas.

And that's where we're losing them.

But there are also a lot of white people in rural areas.

And aren't they a lot of the voters in these states who are supporting efforts to Rural areas, white and black.

Are supporting efforts to take away constitutional rights.

Is where the loss of obstetricians is most pronounced.

Okay, Sam, I know you have focused on that topic in your career.

Why is this happening and what's the effect?

Well, unfortunately, the United States has had one of the lowest, if not the lowest maternal health rates among all the rich nations in the world for an extended period of time.

A lot of this reflects the lack of socialized call it what you will, national health care.

Running health care for profit is a profound problem for our country and is responsible for our citizens paying exponentially more per patient than any other country and receiving lower outcomes.

My stepfather was the hospital administrator of Duke University Medical Center, and even way back then he was talking about this.

So I think we have to look at the reality that health care for hire, health care for pay, health care as a profit center doesn't work.

And we're seeing it here in this situation.

We're also seeing deserts for children.

There are treating children in hospitals is not profitable.

And a lot of children's hospitals or children's wards in major hospitals are shutting down and taking in adult patients because they make a lot more money off of them.

What do you think of that?

Well, I think we have a really big problem in this country of not wanting to strengthen the American family the right way.

And we can start with mothers and children.

I mean, these we have to look at the most vulnerable among us in in the population.

And those are very young Americans.

I'm talking about children.

And when we talk about children having to travel miles away for just normal conditions like asthma.

Look in Tulsa, Oklahoma.

I recently read a story of a young boy with a number of chronic conditions, but respiratory being one of them, and the hospital that's closest to him had to convert beds into a COVID care unit.

So that left him at a disadvantage and leaves his parents at a great disadvantage.

Can you imagine the most the many issues, the multipronged effect that the shortage of and lack of access has on an American family unit?

I know because I have three kids and so I can only imagine and I can sort of only just understand what that feels like for most people.

More has to be done.

And I can tell you it's not just one entity that's the problem here.

It's the American Association of Medical Colleges, for example.

They need to open up more seats for residency.

There should be insurance companies involved.

People here don't generally access doula care because it's it's not paid for by insurances.

So there's a lot of actors here who can do better for women and children.

Now, uh Ann, what , do you think this is?

It seems like this is happening more in Republican controlled rural states.

Why is that?

Well, we have a few things going on here.

One is we're losing doctors, period.

Part of that's due to malpractise suits and other considerations, regulations that are confusing.

I think the abortion issue actually touches on this too, with the confusion around women's reproductive care.

So all of this is causing us to lose doctors, period.

But you know what?

The the amazing thing is this issue should be one that could bring the country together, because it is something that people on both the right and the left should be excited about working on together.

I mean, isn't that the truth is conservatives their are number one issue is not, you know, natal prenatal and post natal care.

(Ann)-Sure it is (Bonnie) for black babies (Ann) Oh, no, no, no, no They want they want lots of babies and they want healthy babies.

No this is something I don't know.

I have a conservative friend that would be thrilled to work on something like this to make things better for women who are pregnant.

So I think no, just the opposite.

This is an issue that could bring people together if someone would try.

Well, why isn't, who is trying?

And and let's be clear, too, that when you chase an ob-gyn out of the state, which anti-abortion people do they they put on line where their their addresses, they protest.

That was my point.

In the.

Worst case.

And it's been a long time, but a long time ago, there were several murders of OB GYNs.

So that's on their minds.

And when that movement gets too powerful in a state, it chases out the OB-GYNs, which, of course, not only affects maternity, which were mainly talking about here, but also young women's rights to abortion.

But again, we are losing doctors, period.

And you're right, it's what I was referring to earlier, the confusion and the angst that's over.

This abortion issue does spill over into this issue as well.

But it is something if someone would take the reins and focus is something that could bring both sides together.

Bonnie, I have an unpopular opinion here perhaps, and I'd like to throw this to our group here, because I'm the daughter of a physician, wife of one, sister of two.

I can tell you the lobbies of these other organizations have gotten far more powerful than the physicians lobbies.

I'm talking about nurse practitioners have more autonomy in certain states.

I'm talking about just a wide range of other health care professions.

Physicians assistants even have a more powerful lobby than physicians.

So I think in some ways doctors don't feel like they want to be doctors anymore because there's all these other people that want to be doctors and now have the capability of doing a lot of those things.

And they don't want to always be in rural areas like my native West Virginia.

It's a good thing that nurse practitioners in West Virginia, for example, can run a clinic.

But you're not going to get that many doctors graduating from these med schools anymore for a myriad of reasons.

But but in West, in your home state, is it legal for nurse practitioner practitioners to give abortions?

I don't think so.

Knowing how the political makeup of our state I mean, we have we had some trigger laws that went into effect.

Of course, with the overturning Roe.

I you know, I get it.

Abortion is a lightning rod issue.

I just don't think that has everything to do with the fact that maternal and infant care is abysmal in this country.

I think there are a number of reasons, and I don't think everything every one of those reasons can be solved legislatively.

I think there's a big hand here in the insurance companies having so much power.

And I know conservatives who don't want them to have that much power.

Is it insurance, the insurance companies driving these doctors out or is it the anti-abortion movement?

What's going on?

Well, the insurance companies are actually doing it.

But if there was more access to Medicaid, particularly after birth, postpartum, as we have in the District of Columbia, things would be much better nationwide.

Well, you think that's the that's the solution then, increase access to Medicaid?

I think it would certainly help.

If you're talking about maternity care and the maternity care deserts we have the loss of obstetricians as well.

The United States, as you well know, Eleanor, used to be a leader in this area and we have dropped way behind (Sam) way behind many undeveloped nations in terms of taking care of pregnant women and birthing babies.

How did that happen?

We used to be a leader in so many things and we are falling behind in many of them.

Well, that's why I said that Medicaid is important here, because there's no way for us to deal with these maternity care deserts except by more funding after a baby is born postpartum.

Sam, your thoughts?

I just want to share a quick story.

When I was a young mother.

I have three children and my youngest was two.

And I was pregnant with our second.

I'm visiting my husband's home country of England in Liverpool.

Knock, knock, knock.

I open the door and there is a maternity health nurse at my doorstep.

She pulled out a card.

We hear you're visiting.

Let me give you a checkup and let me check.

Emma doing this, which is a proactive focus on health care.

Yes, we have a mess, to your point, Rina, with insurance.

There's a myriad of issues here.

But to Congressman Norton's point, there are ways we can send, incentivize, right?

Doctors to we can erase their for example, we can the government can pay go to West Virginia, well take care of your student debt.

There are things.

That can be done that used to be done in the past, wasn't it?

We've done that before in this country.

Yes, there are the things we can do.

And to Rina's point, we can also empower proactive care with the growing number of nurse practitioners that we have in this country.

So there are ways around this.

But again, I had that amazing experience when I was a young mother.

We can do that.

To your question, what the heck's going on here?

We used to be number one in the world in so many things in the late sixties and seventies and have dropped precipitously since then.

I would contend that we have become complacent and we need to refocus on these because these aren't just health issues, which of course they are.

These are economic sustainability issues.

If we're a nation that has some of the lowest measurements in maternal health care, education, you name it, that's going to really impact our long term sustainability as a nation.

Alright, From maternity deserts to the midterm elections, AAd what is motivating voters to go to the polls.

The Supreme Court's abortion decision appears to be growing as a motivating factor in the upcoming midterm elections.

That, according to the Kaiser Family Foundation.

Its poll found half of voters say overturning Roe v Wade has made them more likely to vote next month, up from 43% shortly after the court decision and 37% before the decision.

And it's not just Democrats.

It's true.

Among half of independents and a third of Republicans.

About three quarters of those motivated voters say they want to vote for candidates who want to protect access to abortion.

There are a lot of progressives who want to believe this is going to be the case at the polls in November.

But I remember right after Roe was handed down by the Supreme Court for in the seventies, eighties, maybe even into the early for particularly women voters.

And then it just went completely away.

And we got two economic issues national security issues, leadership issues.

So do you think abortion will be a major factor in driving people to the polls this time?

I have a two part answer.

First, we warn the party that Dobbs decision would be like the dog chasing the car and he catches it.

And what does he do now that they, you know, to be careful what they wish for?

Because we knew there'd be a huge backlash.

However, I think the backlash is going to be felt more in the next election and the election after that than it will here.

The reason being, if inflation wasn't continuing as bad, if gas prices weren't back going up again and we didn't have so many other issues, you know, worldwide as well as in this country, this would be a bigger factor in 89 when Webster Webster decision came down, we almost lost Roe by one vote.

The backlash was so amazing.

Republicans lost elections across the board.

Things we should have won easily.

And it was all that issue.

Emory University did a study about the the elections from about 89 to about 94 called It's Abortion Stupid, and showed that suburban voters, men and women, mainly white women, really voted against the Republican Party on this issue.

This time, though, there's so many other factors that I think if the decision had happened closer to the election, it would be a bigger impact.

I think people have sort of ingested it now.

However, second part of my thing in upcoming elections, especially state legislative, because that's where the fight's going to be.

Republicans are going to lose a lot of state legislators because I think that if if our side and choice is smart, they're going to target the legislators because they're the ones that are going to determine the outcome going forward.

What about election secretaries?

You know, like in in Arizona.

It might.

But again, everybody's focus, the pocketbook issues are ultimately going to win out, I think, in this election.

But I will tell you again, it's going to have a greater it's going to mute the red wave.

It's probably going to keep us from getting 50 seats to maybe only 25.

But it's not going to stop the wave.

And it is a factor.

The Republicans know what, they've been terrified.

And, you know, I have to sort of chuckle because I warned them and they really thought, you know, oh, people won't react that way.

Something that you may know, maybe not your listeners probably don't know.

Every time this issue has had a direct vote by the voters with the state initiative, the pro-choice side has.

Always.

Won.

Always.

Doesn't mean that that that ensures, you know, elections for Democrats.

What it means is when they're given this issue to vote on directly in any state, whether it's conservative or liberal, red or blue, the pro-choice side has never lost.

I couldn't agree more with Ann, you know, most tellingly.

Right Ann?

The Kansas results.

Right?

Really told me.

They were surprised by it's like seriously, you're surprised anyway.

Yeah, it.

Was you know, no one expected that.

But I am going to differ from me.

I think, though, the pocketbook issues, of course, are tantamount.

I have never seen young women motivated the way I see them motivated right now.

I mean, I see young women.

I'm talking about my daughters who are in their 30 mid-thirties, their friends.

I was totally blown away by this big reaction by these young women to the reversal of Roe versus Wade, which, of course, is a tragedy and is not good for our country writ large.

But I think we can't be complacent right ?

about how this is going to positively impact Democratic outcomes.

But I don't think we need to underplay it.

I think it's very, very motivating for young women in particular.

I've long contended that the biggest problem we have in this country is we're so prosperous, we're so affluent relative to other nations.

It has caused us as women to become complacent.

We ourselves don't realize how far, how low our country ranks in terms of the rights we have as women relative to other rich nations and some other undeveloped nations.

So I think this is the whole Roe versus Wade overturn has been a big complacency breaker, which I'm hoping is going to make a big difference in these.

Rina young voters.

You're an expert in that.

You're a political advisor.

Are they going to be motivated to vote this November?

And who are they?

Are they independents who are going to flip to Democrats because of the Dobbs decision, or are they more Repub, more young Republican voters?

Who are they?

You know, millennial voters are people who are born after the year 1981.

And so if you think about it, you know, they're having children later anyway in life that much of us have become parents in our thirties, whereas our parents became parents in their twenties.

We're delaying things not only because I graduated at a time where the economy was in complete shambles the year 2005 came out and many of my peers just didn't have jobs.

There was nothing to go to.

And so you look at sort of over our lifetimes what we've had to weather in terms of economically or with our rights, frankly, being on the line, I think we've taken it for granted.

We didn't think Roe would be overturned when it happened.

I mean, obviously, you could see it coming down the pike with who's sitting on the highest court in the land.

They told us they would respect precedent.

Right.

And so there's the sense of outrage over these elected and unelected bureaucrats doing something that's fundamentally wrong for our way of life.

And I think there has been a real awakening.

I don't know how much the needle will be moved.

I think it's too fresh to kind of estimate that we won't know until next month.

But the growing swath of independent voters and in swing states, it's I mean, is growing at a number that was unconscionable before the overturn Roe.

I would say you're going to see a lot more black and brown voters because who this decision impacts is lower economic status and black and brown women.

I mean, nearly 60 million women of reproductive age and their rights are on the line.

I'm one of those women.

And I think when you couch it as reproductiv freedom, a word that was so pivotal in my career serving two Republicans on the House side, it makes more sense.

You're going to get a lot of those center right Republicans.

But again, I'm sort of of the mindset that this doesn't really change anything in the near term.

We're going to see a long term change in the way we elect people to office, and that's going to happen in the midterms to the right.

Why do you say that?

Why do you say it's long term?

It's not going to, you don't see it affecting this election?

In the near term.

Yeah, there will be a bump.

Of course there's definitely going to be a bump.

But are we going to see like this wave?

I don't know that because to be honest, there are so many other competing priorities.

I mean, when you see the prices on the shelf remain what they are for so many months, there becomes this feeling of like, who's even out there for me?

Should I even show up?

The court is going to act the way the court is going to act.

So what I am encouraged by, though, is the many conversations I'm having with women, again, millennial women that are saying this is the first midterms I'm showing up for.

And so that tells me that the turnout in the future will be better helped by by what's happened this year.

But the economy certainly doesn't help right now.

Eleanor, there are a record number of black women running for office this year.

There are three black women running for governor.

Are black voters nationwide going to be motivated?

When you have blacks running for such high offices, you're going to see a lot of motivation.

And in voting period, that is going to bring black people out.

In a way you have never seen before with with people running for such high offices, that's going to that's going to be a prime motivator.

We're going to get surprised by that, the way we were surprised by the the Kansas decisions?

Yes.

And and look what the Kansas decision has done.

It brought it to it told us that abortion was important for Republicans as well as Democrats.

That's right.

Eleanor, one more question.

Democrats have been using a lot more dudes and cowboys and men generally in their ads on the abortion issue to try to get, I guess, independent and Republican swing voters to come over to the Democrats.

How effective is that?

Well, I think that's very effective because abortion has been an issue that has been a prime motivator of Democrats, I think, more so than virtually any other issue.

And that's why you see abortion featured in the way it is across all the country.

Well, I'm going to ask you to do something you may not want to do, but does Stacey Abrams have a chance in Georgia?

I think the polls show her about seven points behind the incumbent governor.

And she's a very big candidate on pro-choice issues.

And, of course, in the Senate race in Georgia, we have Herschel Walker and and all his you know what?

I have some pertinent information on that.

Go, go ahead.

Go.

They actually, in the Herschel Walker case, they actually did polling to find out ahead of time before they did formal polling after because they knew that this was coming.

As to whether or not they would vote for or against him based on an issue like that and the voters told them they didn't care about that stuff.

They cared about how he was going to vote on the bigger issues.

So they actually knew when all that stuff broke on the abortion issue with him.

It wasn't going to affect his polling virtually at all.

And that's when they you mean Republican operatives in Georgia polling people went ahead and did the polling ahead of time.

And again, they found that he's basically bulletproof on that issue and now he's bringing up the Warnock stuff works problems with his wife and not paying child payments and a lot of other stuff.

But he's also paying off the mortgages for different poor people who are in housing that Warnock has effect over to one of his groups and maybe even his church.

And Walker is paying off all their mortgages for them because some of them were facing eviction.

One guy for 28 up being $28 behind, got served with an eviction notice.

So Walker has been very smart.

Hes done a lot of stuff to inoculate himself.

Okay.

That's it for this edition.

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♪♪ Funding for To the Contrary provided by the E. Rhodes and Leona B. Carpenter Foundation.

The Park Foundation and the Charles A. Frueauff Foundation.