Ellen Allen: Healthy babies require healthy women, policies (Opinion)

By Ellen Allen

This Op-Ed was originally published July 28, 2026 by Charleston Gazette-Mail. 

Healthy babies don’t begin in the delivery room. They begin long before a woman becomes pregnant — with access to preventive healthcare, contraception if and when she wants it, and the ability to decide when she’s ready to start a family. They continue with prenatal care, a
safe place to give birth and health coverage that supports both mother and baby after
delivery.

I have been through the full spectrum of this experience. We celebrated my daughter’s 32nd birthday on West Virginia Day this year. Yes, I know, I love West Virginia this much. Labor and delivery care looked very different in 1994, a marked difference from today’s landscape. I had the option of having my baby only two miles from home but chose to deliver in Bluefield which was only 10 miles away. Most rural community hospitals at that time maintained labor and delivery units.

Yet that continuum of care is steadily disappearing in West Virginia. In just 21 years, our state has lost more than half of its labor and delivery units, dropping from 35 hospitals offering obstetric services to just 16. Nearly half of our counties are now maternity care deserts, forcing expectant mothers to travel farther to safely deliver their babies.

As Charleston obstetrician Dr. Dara Aliff recently told lawmakers, “When a unit closes, women don’t stop giving birth.” Babies are born in emergency rooms, at home and even on the side of the road. Longer travel times delay prenatal care and increase the risk of complications for both mothers and babies.

Federal hits to women’s healthcare

But the maternal health crisis doesn’t begin when labor starts. Over the past year, a series of federal policy changes have weakened women’s healthcare at every stage.

The federal government ended Teen Pregnancy Prevention Program grants two years early, despite West Virginia having one of the nation’s highest teen birth rates. At the same time, the Trump administration has proposed reshaping Title X, the nation’s only dedicated family planning program, threatening access to affordable birth control, cancer screenings, STI testing, and other preventive care that thousands of West Virginia women rely on.

Beginning next year, new Medicaid work reporting requirements are also expected to cause tens of thousands of West Virginians to lose health insurance, jeopardizing access to postpartum care, mental health services, prescriptions, and treatment for chronic conditions.

At the very moment public health experts warn West Virginia could see more unintended pregnancies, we are simultaneously making it harder for women to access contraception, prenatal care, labor and delivery services, and postpartum healthcare.

These are not separate policy debates. They are one story.

A W.Va. double standard

West Virginia can’t say it wants stronger families while making it harder for women to prevent an unintended pregnancy, harder to receive prenatal care, harder to find a hospital to give birth, and harder to access healthcare after that baby is born. Together, these decisions are weakening the continuum of care women and families depend on.

The irony is impossible to ignore. Policymakers regularly speak about strengthening families and encouraging more births, yet many of the policies being advanced make it more difficult for women to access the care that leads to healthy pregnancies and healthy babies.

If we truly want more families to build their futures in West Virginia, we should be investing in the entire continuum of care. That means preserving preventive care through programs like Title X, supporting evidence-based teen pregnancy prevention, protecting Medicaid,
strengthening — not shrinking — our maternity care system and expanding access to postpartum services.

West Virginia already has some of the nation’s poorest maternal and infant health outcomes. We cannot expect those outcomes to improve while systematically weakening the healthcare infrastructure women depend on.

Healthy families don’t begin in the delivery room. They begin by ensuring women have access to care long before pregnancy — and long after childbirth. Our policies should reflect that.

 

Ellen Allen is executive director of West Virginians for Affordable Health Care.