Mind & Body · Monday, 12 October 2026

01 Briefing what happened

US maternity wards close as Medicaid cuts take effect: 52 shut since the law passed in July 2025, eight more announced

A US campaign group counts 52 birth wards closed since the law cutting Medicaid was passed, and the charity March of Dimes names 31 more rural ones at risk, while the federal survey that tracked mothers' health has been stopped.

US maternity wards closed since the law cutting Medicaid was passed in July 2025

Eight more have announced they will close. [1]

40%

of US births are paid for by Medicaid

The new law cuts federal Medicaid spending by about $911 billion over ten years. [2]

29 miles

added, on average, to the trip to give birth when a rural ward closes

A rural US birth centre that reopened cut that distance in half. [12]

1.59x

the odds of a serious birth complication for women in counties with almost no maternity care

From 9.2 million US births between 2019 and 2021. [6]

The lead story — what happened

Protect Our Care, a US group that campaigns for health cover, counts 52 maternity wards closed since July 2025. Eight more have announced they will close. [1]
July 2025 is when the law known as HR1 was passed. It cuts federal spending on Medicaid, the US health cover for people on low incomes, by about $911 billion over ten years. [1][2] It adds a $50 billion rural health fund but is expected to cut $137 billion from rural health spending. [2]
Centra Southside Community Hospital in Virginia and St Mary's Sacred Heart in rural north-east Georgia both closed their birth wards. Both named the coming Medicaid changes as a reason. [1]
Medicaid pays for about 40% of US births. [1] A birth ward must be staffed day and night, because babies come at any hour, and that makes it costly to run. [3]
Small rural hospitals have fewer births and more patients on Medicaid, which pays hospitals less. So their birth wards rarely pay for themselves. [3] In a survey of rural hospitals that closed one, 62% named money losses and 67% a shortage of doctors. [4]
March of Dimes, a US charity for mothers and babies, names 31 rural hospitals whose birth wards are at risk. If they close, 96 counties will be left with no labour and delivery unit. [1]
More than half of US counties already have no hospital where a baby can be delivered, March of Dimes says. [5] When a rural ward closes, the trip to give birth grows by 29 miles on average. [12] In rural America a pregnant woman may have to drive two hours to reach one. [9]
In a study of 9.2 million US births, women in counties with almost no maternity care had 1.59 times the odds of a serious complication. [6] These included needing a blood transfusion or an unplanned removal of the womb. [6] Rural US mothers died 81% more often than city mothers from 2016 to 2019. [8]
When wards close, births move to emergency rooms. In Los Angeles County, 14% more women went to an emergency room for birth care in 2023 than in 2016, though births fell 26%. [7]
Benjamin Sommers, a Harvard health economist, says many pregnant women are covered through a route that does not tell the state they are pregnant. So they could lose cover under new work rules that are meant to exempt them. [1]
The CDC, the US public health agency, put the team running a major national survey of mothers on leave in early 2025. Researchers say they can no longer track recent trends in mothers' health. [1]
Some towns are fighting closures. In Troy, New York, Democrats and Republicans together kept the county's last birthing center open. [10] Maine has lost 11 birthing units in a decade, and one town fought to save the unit at its hospital in Damariscotta. [11]

52 of 100

of every 100 US counties have no hospital where a baby can be delivered

Each dot is one in a hundred US counties. The filled dots are counties with no hospital birth unit, in March of Dimes' latest count.

Who is involved

Protect Our Care

a US non-profit that campaigns for health cover; it counted the 52 closed wards
March of Dimes

a US charity for the health of mothers and babies; it names 31 rural birth wards at risk
Benjamin Sommers

a health economist at Harvard and a former Biden-administration health official; he warns pregnant women can lose cover by mistake
Rita Hamad

a Harvard professor of public health; she says the stopped CDC survey leaves researchers unable to see recent trends

How it unfolded

2010 56% of US counties have a hospital that delivers babies [3]
2024 almost 300 counties have lost hospital birth care since 2010 [3]
Early 2025 the CDC team running the main survey of mothers is put on leave [1]
July 2025 HR1 is passed, cutting federal Medicaid spending [1][2]
Oct 2026 52 wards closed and eight more announced [1]
2027 the law comes fully into force in the new year [1]

Where this points

The test comes in the new year, when the law takes full effect: watch whether any of the 31 at-risk rural wards that March of Dimes named announce closures. [1]

What is pushing on the whole day

The bar and the word are our reading of how hard each one is pushing today. The arrow is where it is heading. The evidence is in the stories below.

Health money running short High↑

US hospitals are closing birth wards as Medicaid money is cut. [1] WHO says many countries still lack blood-pressure checks and basic medicines for pregnant women. [13] Only 41% of rural US hospitals with a birth ward say it brings in more than it costs. [4]

Health beliefs ahead of the evidence Building↑

Raw milk sales in the US rose 17.6% in 2024, though the FDA says there is no evidence for the health claims made for it. [15] Experts say there is no evidence that hips store old trauma. [28] Early studies raised fears that antidepressants in pregnancy cause autism, and later ones found the mother's depression explained much of it. [25]

Infections rising or changing Building↑

Flu in England was higher in September than in any of the past four seasons. [17] Gonorrhoea already resists the antibiotic in San Francisco's after-sex pill. [23] More than 100 Americans fell ill from raw milk this summer. [15]

The rest of the day

11 more stories on this beat.

Each with its own sources. None of these is a link to the story above.

02
WHO plan against high blood pressure in pregnancy

On 8 October the World Health Organization and its partners launched a plan, running to 2035, against high blood pressure in pregnancy. [13] These disorders affect 10 to 15% of pregnancies and kill about 42,000 women a year, along with more than 500,000 stillbirths and newborn deaths. [13] The most dangerous is pre-eclampsia: high blood pressure after 20 weeks of pregnancy that can lead to seizures. [14] No medicine has yet been developed and approved specifically to prevent or treat it. [13]

Why it matters — WHO says many women still cannot get a blood-pressure check, a urine test or magnesium sulfate, the drug given to prevent the seizures. [13][14] Whether a case turns fatal depends on whether emergency care is within reach, the same problem the US ward closures raise. [13]
03
US children's doctors call for a raw milk ban

The American Academy of Pediatrics, the main US body of children's doctors, called last week for a ban on selling unpasteurised milk. [15] Pasteurising means heating milk to kill germs, and US dairies took it up in the late 1800s. [15] Raw milk sales rose 17.6% in 2024. Doctors put that down to influencers and by Robert F Kennedy Jr, the US health secretary, who promoted it until recently. [15] This summer more than 100 people fell ill from raw milk, and 11 went to hospital. [15]

Why it matters — Children are most at risk, and most of those sickened in an E. coli outbreak linked to raw-milk cheese this year were aged three or under. [15] In a national survey in late 2025, about a third of Americans wanted raw milk sales made easier. [16]
04
England's flu starts earlier than in four years

Flu levels in England in September were higher than at the same point in any of the past four winters, the UK Health Security Agency (UKHSA) reported. [17] Cases are rising fastest among people aged 18 to 24. Two kinds of flu A, called H1N1 and H3N2, are both spreading. [17] Last winter also started early, with a changed H3N2 virus. [18] UKHSA estimates last winter's vaccines prevented about 100,000 hospital admissions and 7,000 deaths in England. [17]

Why it matters — An early start does not decide how bad a season gets, experts say. [17][18] The H1N1 virus has drifted a little from this year's vaccine, and it is too soon to say whether that weakens the jab. [17]
05
Why fewer English families say yes to organ donation

Since 2020 England has treated every adult as a willing organ donor unless they opt out, but the families still decide. [19] Family consent across the UK fell from 67% in 2020-21 to 57% last year, and donations after death are running 9% below last year. [20] NHS Blood and Transplant, which runs donation, launched its first-ever urgent response plan in September. [20] Families agree 87% of the time when the person had signed up, and 46% when consent was only presumed. [19]

Had signed up to donate87%
Consent only presumed46%
Had opted out0%
How often families in England agreed to donation, by what the person who died had recorded.

Why it matters — More than 8,700 people in the UK are waiting for a transplant, and nine die each week. [20] A specialist nurse in Gloucestershire says families often tell her they are not sure what their relative would have wanted. [21]
06
Unsteady drug levels cost kidney transplants

After a kidney transplant, patients take tacrolimus, a drug that stops the body rejecting the new kidney. [22] A review of 10 studies covering 11,647 adults, published on 12 October, looked at how much each patient's blood level of the drug swung up and down. [22] Those whose levels swung most were about twice as likely to lose the kidney, and about twice as likely to have a rejection episode. [22] The studies watched patients; none tested changing the dose. [22]

Why it matters — Donated kidneys are scarce, as the fall in UK donation shows. [20] The review treats wide swings as a warning sign that ordinary blood tests can pick up. [22]
07
An antibiotic after sex cut syphilis in San Francisco

In 2022 San Francisco began recommending doxy-PEP: one dose of the antibiotic doxycycline, taken a day or two after sex without a condom. [23] It was first offered to gay men and trans women who had had a sexual infection in the past year, and the CDC later took up the same approach. [23] Last year syphilis in the city fell 24% and chlamydia 18%, but gonorrhoea only 5%. [23]

Syphilis24%
Chlamydia18%
Gonorrhoea5%
How much each infection fell in San Francisco last year, after the city began offering the after-sex antibiotic.

Why it matters — Gonorrhoea already resists this family of antibiotics, and doctors worry wide use will breed harder-to-treat germs. [23] A US study estimated about 37 extra week-long courses of the antibiotic for each gonorrhoea case the pill prevents. [24]
08
Antidepressants in pregnancy and help at school

A University of Glasgow team followed 167,447 children born in Wales between 2009 and 2016, to see who needed extra help at school by about age six. [25] When the mother had neither depression nor antidepressants on record, 20 children in 100 needed it. [25] The figure was 23.6 when she had untreated depression, and 26.5 when she had depression and took antidepressants. [25] The study appeared in the journal PLOS Medicine. [25]

Neither on record20
Untreated depression23.6
Depression and antidepressants26.5
Children in every 100 who needed extra help at school, by what was on their mother's record in pregnancy.

Why it matters — Some pregnant women stop their medicine out of fear for the baby, which leaves the depression untreated. [25] The team could not rule out that the small extra rise reflects more severe depression rather than the drug. [25]
09
Pain and low mood together raise heart risk

Researchers followed 13,184 Chinese adults aged 45 and over for nine years, using a national survey of older people. [26] In that time 2,834 of them developed heart disease or had a stroke. [26] Compared with people who had neither, the risk was 23% higher for those with signs of depression, 33% higher for those reporting pain, and 59% higher for those with both. [26] The study was published in Scientific Reports on 12 October. [26]

Why it matters — Pain and low mood each went with more heart disease, and together they added up to more than either alone. [26] The study watched people over time and cannot show that easing either one would lower the risk. [26]
10
Brain tests on people addicted to etomidate

Etomidate is a fast-acting drug that works on GABA, the brain's main calming signal, and its misuse outside medicine is rising, researchers write. [27] Psychiatrists at the Second Xiangya Hospital in Changsha, China, compared 152 people addicted to it with 67 people who were not. [27] The users had stronger cravings, acted more on impulse, and did worse at stopping an action or switching to a new rule. [27] Their brain-wave patterns at rest also differed. [27]

Why it matters — It is the first full description of etomidate addiction, published on 12 October in Scientific Reports. [27] The groups were compared at one moment, so the study cannot show whether the drug caused the differences. [27]
11
No sign that hips store old trauma

A popular saying in yoga classes and on TikTok holds that the hips store tension from old trauma. [28] Experts told the Guardian there is no evidence for it. [28] The links between stress and muscle tension are strongest in the shoulders, the jaw and the pelvic floor. [28] People who lived through trauma, especially as children, are more likely to have long-term pain, but not more in the hips than anywhere else. [28]

Why it matters — Hip discomfort has ordinary causes, such as the shape of the hip socket or irritated tendons. [28] And how tight a muscle feels does not reliably show how tight it is. [28]
12
Heart rhythm a poor guide after spinal injury

Doctors at Uppsala University Hospital in Sweden studied 164 adults treated in intensive care after a spinal cord injury between 2008 and 2022. [29] For the first seven days they recorded the heart and blood pressure without a break. [29] They measured how much the time between heartbeats varied, a sign of how well the nervous system steers the heart. [29] These readings differed with where the spine was hurt and how badly. [29]

Why it matters — But the readings did little to predict who would recover or who would die within six months. [29] The authors say forecasting recovery may need measurements taken inside the spine itself. [29]

02 Lesson why it matters

When help must arrive within the hour, the distance to it decides who gets it

In a birth emergency, treatment works only if it starts in time, so every extra minute of road to a ward is added to the danger.

The twist

Closing a birth ward does not make emergencies rarer. It makes each one wait longer for help.

The picture

Counties with full maternity care1 x

Counties with almost none1.59 x

The odds of a serious birth complication, such as needing a transfusion, set at 1 for counties with full care. The study allowed for each woman's health and her county's poverty.

How it works

A birth emergency, such as heavy bleeding or a pre-eclampsia seizure, gets worse minute by minute
Blood, the right drug and a surgeon can stop it, if they reach the woman in time
Every minute of driving to them comes before treatment can start
When the nearest ward closes, the drive gets longer for every woman around it
Most births still go well, so the harm shows only in the rarer bad ones

The same force, elsewhere today

Where this chain is also running, in today's other stories.

WHO's plan against high blood pressure in pregnancy

Pre-eclampsia can turn into seizures, and WHO says whether a woman survives depends on whether emergency care is within reach when it turns severe.
England's early flu season

A flu jab takes a few weeks to give full protection, so a dose given after the peak comes too late to help that winter.
San Francisco's after-sex antibiotic

The pill is taken within a day or two after sex, so it helps only people who can get it that quickly.

Where you've seen this

Fire stations

towns place them by how many minutes an engine takes to reach each street, because a fire grows while it waits

Strokes

clot-busting treatment works only in the first hours, so people far from a stroke unit get it less often

Lifeguards

towers are spaced so a swimmer in trouble can be reached before they go under

The catch

Women who live far from a birth ward also tend to be poorer and less often insured, so studies cannot fully separate the drive from everything that comes with it.

And the whole of it

A hospital board sees a ward that loses money every year. A pregnant woman sees an hour of winter road, and nobody in the chain sees the emergency that now starts further from help. Most of us depend on some service that has to be staffed all night for the few nights it is needed.

03 Truth what's really going on

What is really going on

The US law that cuts about $911 billion from Medicaid over ten years is already closing birth wards before most of it takes effect: 52 have shut since July 2025, and hospitals in Virginia and Georgia named the Medicaid changes as a reason. [1][2] At the same time, the CDC survey that would show what happens to mothers next has been stopped. [1]

Why it works on us — A budget cut is announced as one national number, while each ward closes as a local decision about one hospital's losses, so the link between them has to be counted by a campaign group. [1]

Who gains

The US federal budget — The law spends about $911 billion less on Medicaid over ten years, and adds $50 billion for rural health over five. [2]
Rural hospitals that close a loss-making birth ward — They stop paying for staff on call day and night, and only 41% of rural hospitals with a birth ward say it brings in more than it costs. [3][4]
Raw milk farms selling through cow shares — A Virginia farm selling under a herd-share loophole says its sales grew 30% to 50% a year since 2020. [15]
People at risk of syphilis in San Francisco — Syphilis in the city fell 24% last year after the after-sex antibiotic was offered widely. [23]

Who pays

Pregnant women in rural US counties — Each closed rural ward adds 29 miles on average to the trip, and 31 more are at risk, which would leave 96 counties with no labour and delivery unit. [12][1]
Emergency rooms in Los Angeles County — They saw 14% more women for birth care in 2023 than in 2016, while births fell 26%. [7]
People waiting for a transplant in the UK — More than 8,700 are waiting and nine die each week, while donations after death run 9% below last year. [20]
Young children given raw milk — Most of those sickened in this year's E. coli outbreak linked to raw-milk cheese were aged three or under. [15]

What nobody knows yet

Open questions from across today’s stories — ours included.

01

How many of the 52 closures the Medicaid law caused.

Birth wards were closing long before it: almost 300 US counties lost hospital birth care between 2010 and 2024. [3] Protect Our Care counts closures since the law, and only some hospitals named it as a reason. [1]
02

Whether mothers and babies will be harmed, and by how much.

The CDC team that ran the main national survey of mothers was put on leave, and a Harvard researcher says the trend may simply go unmeasured. [1]
03

How many pregnant women will lose Medicaid by mistake.

Benjamin Sommers says many are covered through a route that does not tell the state they are pregnant, and no figure for that group has been published. [1]
04

How many US counties have no maternity care.

March of Dimes' latest count says more than half have no hospital birth unit. [5] A study using its 2020 count called 35% maternity care deserts, a stricter test that also needs no obstetric doctors nearby. [6]
05

How far UK family consent to organ donation has fallen.

NHS Blood and Transplant says it went from 67% in 2020-21 to 57% last year. [20] An analysis in The Conversation gives 69% in 2020-21 and 59% in 2024-25. [19]
06

Whether this flu season in England will be a bad one.

An early start does not decide how big a season gets, and the H1N1 virus has drifted from this year's vaccine in ways nobody can yet weigh. [17][18]
07

Whether San Francisco's after-sex antibiotic will breed resistant gonorrhoea.

Gonorrhoea fell only 5% and already resists this antibiotic family, and the extra antibiotic use is large: about 37 week-long courses per gonorrhoea case prevented, by one US estimate. [23][24]
08

Whether antidepressants or the depression itself explain the extra need for school help.

The Welsh study could not rule out that the small extra rise reflects more severe depression rather than the drug. [25]
09

Whether etomidate changes the brain, or people with those traits are drawn to it.

The Changsha study compared users and non-users at one moment, so it cannot tell which came first. [27]

04 Hope carry this

Last year in San Francisco, syphilis fell 24% and chlamydia 18% after the city began offering an antibiotic taken after sex.

Also true today

England's flu vaccines last winter prevented an estimated 100,000 hospital admissions and 7,000 deaths.
28.7 million people in England have now recorded a wish to donate their organs, up from 23.6 million in 2017.
In Troy, New York, Democrats and Republicans worked together and kept the county's last birthing center open.