Reproductive justice isn’t abstract theory. It’s whether you can get the IUD you need. Whether your insurance covers the abortion you’ve decided on. Whether your employer fires you for missing work due to hyperemesis gravidarum. Whether the hospital believes you when you say something’s wrong.

The EmpowerHER Journal connects medical expertise with practical action. We examine how laws, policies, and systems shape your ability to make real choices about your reproductive health—and what you can do about it.

What We Cover

Reproductive Rights in Practice

• State-by-state abortion access and legal updates

• Contraception access and insurance coverage

• Fertility treatment barriers and solutions

• Emergency contraception myths and realities

Navigating Healthcare Systems

• Advocating for yourself in medical settings

• Getting second opinions and specialist referrals

• Understanding insurance denials and appeals

• Finding culturally competent providers

Real-World Reproductive Decisions

• Pregnancy planning in restrictive states

• Abortion decision-making and access

• Fertility preservation and family planning

• Pregnancy termination for medical reasons

Your Rights & Resources

• What to do when care is denied

• Legal protections and limitations

• Financial assistance programs

• Support networks and community resources

Our Approach

We don’t sugarcoat reality. Reproductive healthcare in America is fractured, hostile, and often dangerous—especially for Black and Brown women. But we also don’t leave you hopeless.

Every piece provides:

• Clear explanation of what’s happening and why

• Practical guidance on navigating current reality

• Action steps you can take right now

• Resources for additional support

Who This Is For

You’re navigating reproductive decisions in a landscape where:

• Your state may criminalize the healthcare you need

• Your employer might not cover essential services

• Your doctor may be legally afraid to provide standard care

• Your insurance company denies coverage for political reasons

The EmpowerHER Journal gives you the information and tools to make the best decisions possible within impossible constraints.

Recent Topics

• “Planning Pregnancy After Dobbs: A State-by-State Decision Guide”

• “When Your Doctor Says No: Getting the IUD You Need”

• “Understanding Abortion Pills: Access, Legality, and Safety”

• “The Second Opinion Strategy: How and When to Get One”

Knowledge is power. Let’s build yours.

That’s not a dystopian plot. That’s Georgia in 2025.

Adriana Smith was a 30-year-old nurse, a mother of two, and newly pregnant with her third child when she collapsed from a massive brain hemorrhage.

She was declared brain dead—legally, medically dead. But because she was about eight weeks pregnant, the hospital kept her on life support.

Her body was no longer hers. It belonged to the law.

Why I Hesitated to Speak—And Why I Had To

When I first read Adriana’s story, I felt physically ill. The nausea hit first, then an overwhelming wave of sadness. I had to close the article and sit in silence.

Part of the grief was personal. My husband and I are considering having a fourth child. I’m turning 40 this year, which makes every decision more weighty. We’ve been blessed with three healthy children. But with age, risks increase—physically, emotionally, economically.

So yes, I believe deeply in the value of unborn life. But I also believe that life—real life—includes agency, consent, and dignity.

And what happened to Adriana was the opposite of that.

This Wasn’t Medicine. It Was a Hijacking.

Let’s walk through the facts:

• Adriana Smith was declared brain dead. That’s not a coma. That’s not a vegetative state. That is the legal definition of death.

• She was 8 weeks pregnant at the time—a point at which survival outside the womb is impossible.

• Her family says that they were not given a choice. The hospital maintained life support, citing the state’s abortion ban and the legal ambiguity surrounding fetal personhood.

• At 22 weeks, the fetus—now named Chance—was diagnosed with hydrocephalus, or fluid in the brain, a serious neurological condition that can lead to lifelong disability or death.

This was not care. This was control. The state took a dead woman’s body and repurposed it.

Her death became a battleground for ideology.

Respect for Life Must Include Respect for Death

As someone who has worked in hospitals and stood beside families during the worst days of their lives, I cannot overstate this: being kept on life support when there is no chance of recovery is not peaceful. It is traumatic.

The machines are loud. The tubes are invasive. The smells linger in your clothes and hair. Families visit day after day, hoping for signs that will never come. Medical teams go through the motions. Everyone knows—but no one says it out loud: this person is already gone.

Forcing a family to endure that, against their will, in service of a pregnancy that may not survive, is not medical care. It is torture—emotional, spiritual, and financial.

We are not honoring life when we desecrate death.

What This Case Reveals About Post-Roe America

Adriana’s case is not an outlier. It is a crystal-clear warning about what happens when:

• Fetal personhood is elevated above maternal autonomy

• Legal gray zones force hospitals to prioritize liability over ethics

• Medical decisions are dictated not by clinical judgment or family wishes, but by state pressure

• This is the America we’re living in post-Roe.

And it’s not just about abortion anymore. It’s about who owns your body—even after you die.

What Every Pregnant Person (and Their Loved Ones) Must Do Now

This isn’t theoretical. This could happen to you, your partner, your daughter, your best friend. So here’s what you can do today:

• Talk to Your Family About End-of-Life Wishes—Specifically Around Pregnancy

• Too many people assume their loved ones know what they’d want. They don’t. Not in a crisis.

• Say it out loud: “If I’m brain dead, I do not want to be kept on machines just because I’m pregnant.”

• Be clear about how long you’d want life support maintained (if at all).

• Let them know what quality of life means to you—what’s worth continuing, and what’s not.

These are hard conversations. But they are acts of love.

Create a Pregnancy-Specific Advance Directive or Living Will

In many states, your advance directive becomes legally void if you are pregnant.

Yes, you read that right. If you’ve filled out paperwork saying you don’t want to be on life support—but you’re pregnant—some states will ignore it.

What you can do:

• Look up your state’s laws using resources like the Pregnancy and Advance Directives report by the Center for Women Policy Studies.

• Talk to an attorney or legal aid clinic about creating an addendum to your directive that explicitly names your wishes if pregnant.

• Keep a copy of your directive on file with your OB, primary care doctor, and closest family members.

Ask Your Hospital What Their Policy Is

Don’t wait until you’re in crisis. Ask now:

• “If I were declared brain dead while pregnant, what would your policy be?”

• “Would my advance directive still be followed?”

• “Would my family be consulted before continuing life support?”

You deserve to know what kind of institution you’re trusting with your body and your baby.

Support Organizations Fighting for Reproductive Justice

We work with SisterSong, a Black-women-led reproductive justice organization based in Georgia. They are fighting battles like Adriana’s every day—through policy, advocacy, and direct support.

Other organizations to support include:

• If/When/How – focused on reproductive legal defense

• National Advocates for Pregnant Women

• Center for Reproductive Rights

Even $5 helps keep these groups going.

Share Adriana’s Story—And Don’t Look Away

This is not a one-off tragedy. This is the logical outcome of a legal regime that sees women as vessels.

If this moved you: I’m unpacked Adriana’s case in my series What happened to Adriana?
Read the full set here:

1. This Should Never Have Happened.

2. How a Headache Became a National Crisis.

3. The Clinical Alarm Was Ringing — No One Listened.

4. Brain Death and a Body Held Hostage.

5. A Baby Born Too Soon.

6. Preventable Tragedies: Lessons from Adriana Smith’s Story.

7. What We Owe Adriana Smith

We have to talk about it. We have to share it.
Because the only thing more dangerous than state violence is silence in the face of it.

Subscribe now

Navigating the healthcare system can be intimidating, especially for women, people of color, and other marginalized communities who often experience medical bias. Your voice is your most powerful tool. Knowing how to advocate for yourself can mean the difference between receiving quality care and being dismissed.

The Reality:

• Studies show that Black patients are 22% less likely to receive pain medication than white patients for the same conditions.

• Women’s symptoms are often downplayed, leading to delayed diagnoses for serious conditions like heart disease and autoimmune disorders.

• Many patients feel rushed, unheard, or dismissed by their providers.

You deserve respectful, evidence-based, and patient-centered care. This guide will equip you with strategies to ensure you are heard and your needs are met.

Step 1: Know Your Rights as a Patient

✅ You Have the Right to Be Heard – Your symptoms and concerns should be taken seriously.
✅ You Have the Right to Ask Questions – If something isn’t clear, ask for more information.
✅ You Have the Right to Refuse or Delay Treatment – You should never feel pressured into making a decision without understanding your options.
✅ You Have the Right to Seek a Second Opinion – If you feel uneasy about a diagnosis or treatment plan, consult another provider.

Step 2: How to Communicate Effectively with Your Provider

👂 Be Clear & Direct – Use concise language to explain your symptoms, concerns, and needs.
📝 Keep a Symptom Journal – Track symptoms, frequency, and severity to provide objective data.
📋 Bring a Written List of Questions – This ensures you don’t forget critical concerns.
🗣 Use Assertive Language – Instead of saying, “I think this might be an issue,” say, “I am concerned about this symptom and want further testing.”
👤 Bring an Advocate – A trusted friend, family member, or doula can help reinforce your concerns.

Step 3: Identifying and Addressing Medical Bias

🚩 Red Flags That Suggest Bias
❌ Your symptoms are dismissed as "stress," "anxiety," or "normal."
❌ You are rushed through your appointment without being fully evaluated.
❌ Your provider is reluctant to order tests despite persistent symptoms.
❌ You feel unheard, belittled, or pressured into a treatment you’re unsure about.

💡 What to Do if You Encounter Bias
✔ Ask for documentation – Request that your concerns be noted in your medical record.
✔ Use your voice – Say: “I feel like my symptoms are being dismissed. Can we explore all possible explanations?”
✔ Seek another provider – If your doctor doesn’t listen, find one who does.
✔ Report the issue – If discrimination occurs, file a complaint with the hospital or medical board.

Step 4: Building a Healthcare Support System

🏥 Find a Trusted Provider – Research and choose doctors who listen and respect your needs.
👩🏾‍⚕️ Work with Patient Advocates – Social workers, doulas, and advocacy organizations can support you.
📢 Educate Yourself – Understanding your condition and treatment options helps you make informed decisions.
🛠 Know Your Resources – Helplines, patient rights groups, and legal services can help if you face discrimination.

Final Thoughts: You Deserve Quality Care

Advocating for yourself in healthcare is not easy, but your health is worth fighting for. Keep asking questions, seek providers who respect you, and never accept subpar care. You are your best advocate.

🔹 A System Under Attack: Personal and Professional Perspectives

My journey through motherhood - having twins who are now three years old and a one-year-old - has deeply informed my understanding of maternal health challenges. The experience of carrying and delivering multiples, followed by a subsequent pregnancy, has given me unique insight into the complexities of maternal care. Being both a healthcare provider and a mother has highlighted the gaps between policy and practice in our healthcare system.

🔹 Funding Cuts to Medical Research The administration has announced substantial cuts to funding for biomedical and behavioral research, which are essential for advancing maternal health. These reductions threaten to delay crucial medical advancements and could force talented scientists out of the field. The policy specifically reduces reimbursement for researchers' indirect costs, which are vital for maintaining staff and laboratory facilities. This change jeopardizes the ability of research institutions to continue their work, potentially leading to closures and hindering progress in improving maternal health outcomes, especially among Black and Indigenous women.

🔹 Dismantling of USAID and Global Health Implications In a drastic move, the administration, with guidance from Elon Musk, has dismantled the U.S. Agency for International Development (USAID). This action jeopardizes global humanitarian initiatives, including programs that provide essential health services to women and children. The freeze on USAID's activities has led to the closure of clinics offering services such as cervical cancer screenings, HIV treatment, and contraceptives. This disruption not only affects global health but also undermines maternal health efforts domestically, as international health challenges can have far-reaching impacts.

🔹 Impact on Black Maternal Health As a Black mother and physician, I've observed how efforts to dismantle Diversity, Equity, and Inclusion (DEI) initiatives are particularly concerning. These actions threaten to reverse progress in reducing the disproportionately high maternal mortality rates among Black women in the U.S. The pandemic highlighted long-standing inequities in healthcare, including a pregnancy-related death rate for Black women that is more than three times that of white mothers. The rollback of DEI programs threatens to exacerbate these disparities.

Having experienced multiple pregnancies while working in healthcare, I've witnessed the cognitive dissonance Black women face daily - how can we participate in, depend on, and serve a system that fundamentally fails to value us? The healthcare system often lacks understanding of this complex dynamic.

🔹 Recommendations for Systemic Change Drawing from both personal and professional experience, I propose several key areas for reform:

1. Cultural Transformation in Healthcare: The medical profession, particularly in obstetrics and gynecology, needs to address inherent biases and create more inclusive environments. Long hours and stress should not excuse or perpetuate a culture of exclusion.

2. Comprehensive Workforce Diversity: We need representation at all levels, from technical staff to attending physicians. This diversity must be meaningful and supported by institutional policies.

3. Leadership Representation: Without Black men and women in leadership roles, we cannot expect the forward-thinking necessary for sweeping change. Leadership must reflect the communities they serve.

4. Policy Reform: We need concrete policy changes in reproductive rights, healthcare access, and workplace protections. These changes must go beyond surface-level diversity initiatives to address systemic barriers.

As a mother of three young children and an OB-GYN, I've seen how current policies affect families across multiple dimensions. The recent administrative changes threaten to worsen existing disparities rather than address them. We need more than acknowledgment of these issues; we need substantive, systemic change that protects and supports all mothers, particularly those from marginalized communities.

🔹 Navigating Current Reality While Working Toward Change

While these systemic changes are essential, we must acknowledge the current political reality: under this administration, many of these reforms face significant obstacles. This recognition doesn't mean we give up - instead, it means we must find alternative ways to protect women's health and safety while continuing to advocate for long-term change.

The battle we face isn't just about policy - it's about hearts and minds. The constant stream of negativity from the right has distorted public perception to the point where basic human decency is often viewed as an imposition. This manipulation of public sentiment requires us to fight on two fronts: we must work to reclaim the narrative around human dignity and healthcare access, while simultaneously developing practical strategies to protect and care for women within the current constraints.

One immediate priority must be ensuring access to effective contraception. By minimizing undesired pregnancies through comprehensive contraceptive access, we can help protect women's health and autonomy even in this challenging political climate. This isn't just about preventing pregnancy - it's about empowering women to make informed choices about their bodies and their futures.

Healthcare providers, advocates, and communities must work together to:

• Create informal support networks to help women navigate the healthcare system

• Share information about available resources and safe care options

• Build coalitions between healthcare providers committed to equitable care

• Document and share successful strategies for protecting patient safety within current constraints

• Maintain hope and determination while fighting for long-term systemic change

The path forward requires both immediate action to protect women now and sustained commitment to comprehensive reform. While the current political climate makes systemic changes challenging, we must continue working at every level - from individual healthcare providers to community organizations to institutional leadership - to create a healthcare system that truly serves all mothers and families. Our immediate focus on practical protection must go hand in hand with our long-term vision for transformation.

Bringing a baby into the world is a beautiful, transformative experience—but it can also be one of the biggest stress tests for relationships. Between sleepless nights, shifting identities, and the emotional rollercoaster of postpartum recovery, many couples find themselves struggling to stay connected.

Studies show that 70% of couples experience a decline in relationship satisfaction in the first year after having a baby. This doesn’t mean your relationship is doomed—it simply means that adjusting to parenthood requires intentional effort, patience, and a whole lot of grace.

So, how do you nurture your relationship while navigating the demands of new parenthood? Let’s break it down.

Understanding the Postpartum Relationship Shift

🍼 The Emotional Load: Parenthood introduces new stressors—baby’s needs, household responsibilities, and financial pressures. Unspoken expectations often lead to frustration and resentment.

😴 The Sleep Deprivation Effect: Studies show that new parents lose an average of 3 hours of sleep per night in the first year. Exhaustion fuels irritability, miscommunication, and emotional distance.

📊 Postpartum Mental Health Matters: 1 in 7 new moms experience postpartum mood disorders (like postpartum depression or anxiety), which can deeply impact emotional and physical intimacy.

💡 10 Ways to Strengthen Your Relationship Post-Baby

1️⃣ Communicate intentionally – Don’t assume your partner knows what you need. Speak up about your feelings and frustrations without blame.

2️⃣ Create small moments of connection – A 10-minute conversation or a shared meal (without baby distractions) can strengthen emotional intimacy.

3️⃣ Share the load – Divide baby care and household tasks fairly. No one should feel like they’re carrying the entire mental and physical load alone.

4️⃣ Have a weekly check-in – Set aside time to talk about how you both are feeling—emotionally, physically, and mentally.

5️⃣ Keep intimacy alive – Physical touch doesn’t have to mean sex. Hold hands, cuddle, send sweet texts—small gestures keep love alive.

6️⃣ Respect each other’s parenting styles – It’s okay if you have different approaches. Work as a team, not as opponents.

7️⃣ Prioritize sleep when possible – Sleep deprivation makes everything harder. Take shifts, nap when you can, and extend grace when tempers are short.

8️⃣ Accept help – If family or friends offer support, take it. A postpartum doula or babysitter can give you time to recharge together.

9️⃣ Watch for signs of PPD/PPA – Mental health struggles impact relationships. If either of you is struggling, seek support from a therapist or doctor.

🔟 Laugh together – Parenthood is messy, unpredictable, and sometimes hilarious. Laughter can be a powerful way to reconnect.

The Bottom Line

Your relationship will shift after having a baby—that’s natural. But by prioritizing communication, teamwork, and emotional connection, your bond can grow even stronger. Parenthood is an incredible journey, and while it changes your relationship, it doesn’t have to weaken it.

💬 How did your relationship evolve after having a baby? Let us know in comments!

Here’s a step-by-step guide to advocating for yourself, ensuring transparency, and accessing critical resources when you need them most.

1. Know Your Core Patient Rights

Your rights as a patient come from both federal and state laws. While federal law provides baseline protections, state laws vary significantly, especially regarding reproductive health.

Key Federal Protections (Apply in All States)

• Emergency Medical Treatment and Labor Act (EMTALA): Guarantees emergency room evaluation and stabilization, regardless of ability to pay.

• HIPAA (Health Insurance Portability and Accountability Act): Grants you the right to access your medical records and maintain privacy over your health information.

• Informed Consent Laws: Ensure you have the right to accept or refuse any medical procedure after receiving a full explanation of risks and benefits.

• Affordable Care Act (ACA) Protections: Prevent insurance companies from denying care due to preexisting conditions and protect coverage for pregnancy-related care.

State-Specific Rights

• Reproductive healthcare laws (vary significantly—some states severely restrict abortion and fertility treatments).

• Right to refuse medical treatment (states differ in protections around medical autonomy).

• Access to experimental treatments (some states have "Right to Try" laws for terminal illnesses).

• State-level patient complaint systems (each state has a medical board to investigate malpractice).

📌 Find your state’s patient rights: Check with your state health department or hospital patient services for a specific Patient Bill of Rights.

2. Requesting a Transfer If You Feel Unsafe or Unheard

If you feel that your current provider is not offering appropriate care, you can request a hospital transfer. Here’s how:

✅ Express Your Request Clearly – Tell your attending physician or hospital administration that you want a transfer.
✅ Know the Legal Criteria – The receiving hospital must accept you before you can be transferred.
✅ Use Medical Necessity if Possible – If your condition requires specialized care, hospitals are more likely to approve the transfer.
✅ Involve a Patient Advocate – Most hospitals have patient advocacy offices that can help negotiate the transfer.

⚠️ Hospitals may deny a transfer if they believe it is not medically necessary or if no accepting facility is available. If denied, escalate your request (see below).

3. Accessing Your Medical Records & Ensuring Billing Transparency

Under HIPAA, you have the right to:

• View, request, and obtain copies of your full medical record.

• Request a detailed, itemized medical bill for any care you receive.

How to Protect Yourself in Real-Time

🔹 Use Patient Portals – Many hospitals now provide access to medical records, test results, and billing online.
🔹 Ask for an Itemized Bill – If you receive unexpected charges, you can dispute them.
🔹 Request Written Treatment Plans – If a provider recommends a test or procedure, ask for documentation on why it’s necessary.
🔹 Know Your Insurance Coverage – Check your FSA/HSA funds and pre-authorization requirements.

4. What to Do If You Believe You’re Receiving Substandard Care

If you feel like your care is inadequate or unsafe, don’t assume you have no options. You do not have to accept whatever the on-call doctor recommends.

Immediate Actions You Can Take

🔹 Request a Second Opinion – Another hospital physician or an independent provider can assess your case.
🔹 Engage a Patient Advocate – They mediate disputes between patients and hospital staff.
🔹 Document Everything – Write down names, times, symptoms, treatment refusals, and inconsistencies in care.
🔹 Invoke Your Right to Informed Consent – If you don’t fully understand a treatment, you do not have to agreeimmediately.
🔹 Escalate Within the Hospital – Request to speak with:

• The attending hospital administrator

• The hospital’s ethics committee

• The medical director

🚨 If you feel you are in immediate danger: Call an external oversight body, such as your state’s Department of Health, or The Joint Commission (jointcommission.org).

5. Legal & Advocacy Resources Available to Patients

If you need legal assistance or help accessing reproductive care, refer to these resources:

• If/When/How’s Abortion Laws by State Map

• Repro Legal Helpline

• M+A Hotline

• Abortion Finder

• Abortion Funds Directory

• Brigid Alliance (Travel & Childcare Support)

• Repro Legal Defense Fund

For a full list of legal, youth, immigrant, and LGBTQ+ support networks, visit: If/When/How.

Final Thoughts: How to Stay Proactive About Your Health

✔ Always bring a support person to medical visits.
✔ Keep copies of your medical records and insurance policies.
✔ Speak up if something doesn’t feel right.
✔ Use online portals to track your lab results and treatment plans.
✔ Know where to escalate concerns if needed.

💡 Your health is your right—knowing how to advocate for yourself is your best tool for navigating today’s healthcare system.

List of If/When/How Links for Advocacy and Support

General Resources

• Abortion Laws by State Map

Abortion and Gender-Affirming Care Support

• Repro Legal Helpline

• M+A Hotline

• Abortion Finder

• Abortion Funds Directory

• Brigid Alliance - Travel & Childcare Support

• Repro Legal Defense Fund

• Keep Our Clinics

Support for Minors

• Judicial Bypass Information

• Jane’s Due Process (Texas)

• Michigan Organization of Adolescent Sexual Health

• National Center for Youth Law

• Advocates for Youth

Immigrant Rights & Resources

• Know Your Rights: Abortion & Immigration

• Immigrant Defense Project

• Legal Directory for Immigration Advocacy

• National Immigrant Detention Hotline

Trans and Nonbinary Support

• Transgender Law Center

• Trans Lifeline

• LGBTQ Freedom Fund

• Black & Pink

• Black Trans Travel Fund

For Helpers, Doulas, & Advocates

• Abortion Defense Network

• Apiary - Practical Support for Abortion Seekers

• Join the If/When/How Network

• Digital Defense Fund

For Lawyers

• Legal Assistance for Criminal Defense Attorneys

• Join the If/When/How Legal Network

For Healthcare Providers

• Mandated Reporting & Self-Managed Abortion Guidance

• Abortion Defense Network for Providers

• Physicians for Reproductive Health

• Interrupt Criminalization