Let’s call the Republicans’ so-called ‘big beautiful bill” what it is: a legislative double-barreled shotgun aimed at the bodies of women, especially Southern women and women who are Black, brown and low-income. One barrel blasts Medicaid access. The other guts Planned Parenthood. The result? A deliberate attempt to kill reproductive freedom, strip women of their basic dignity and destroy what progress this region has made in maternal health outcomes.
This isn’t just policy. It’s punishment.
This isn’t just policy. It’s punishment.
Cutting Medicaid while attacking Planned Parenthood isn’t fiscal responsibility. It’s a targeted cruelty that hurts women nationwide. But particularly for women in the South — where health systems are already under-resourced, rural clinics are vanishing and maternal mortality rates are similar to those in developing nations — it’s nothing short of a death sentence for them and their babies.
Let’s talk facts.
In 2023 in Mississippi, 57% of births were covered by Medicaid. In Louisiana, it was 64%. These aren’t just statistics. These are lives — sisters, daughters, mothers and aunties — trying to survive a system designed to abandon them.
In many rural ZIP codes, Planned Parenthood is the only accessible provider of cancer screenings, contraception, prenatal maternal care and postpartum care. Gutting its funding while simultaneously choking Medicaid is like setting fire to the only lifeboat in a flood. Let’s be even more real: If you are a woman living in rural Louisiana, Mississippi, Arkansas or Alabama, this bill doesn’t just inconvenience your access to care. It incinerates it.
In rural Southern counties, hospitals have shut down their labor and delivery units in droves. Some counties don’t have a single practicing OB-GYN. That’s not a policy failure — that’s an egregious policy choice being carried out with surgical precision.
Imagine being six months pregnant, with no car and no public transit and with the closest provider two hours away — if it’s even taking Medicaid patients. That’s not health care. That’s sanctioned neglect.
Rural women — especially Black, Indigenous and Latina women — have been treated like afterthoughts for generations. But now, they’re being treated like collateral damage in a culture war they didn’t ask to be in. This is structural racism at is deadliest.
If you’re a lawmaker who’s gutting access to women’s reproductive while smiling for photo ops at church on Sunday, understand this: Every rural woman who dies from a preventable complication, every baby born undernourished because its mother couldn’t access prenatal care, every ZIP code that loses a clinic because of these budget cuts is your fault.
These attacks aren’t incidental. They are ideological. They are part of a long game to control women’s bodies while criminalizing their autonomy — especially in Black and brown communities. It’s no coincidence that the same states eager to shred Medicaid expansion are the ones leading the charge against abortion rights, denying gender-affirming care to trans youths and standing opposed to the very notion of care as a public good.
What’s left when the clinic closes, the OB-GYN relocates and the Medicaid card is worthless?
That’s exactly why we released “Shift the South,” groundbreaking report rooted in the lived realities and leadership of women and girls of color across the American South. It maps the merciless, maniacal movement to suppress autonomy, erase reproductive justice and underfund communities into silence. But it also lifts up the blueprint for transformation — investing in Southern women as agents of change, not casualties of policy. It’s more than data — it’s our declaration. And in the face of cruelty disguised as governance, we offer clarity, courage and counterstrategy.
What’s left when the clinic closes, the OB-GYN relocates and the Medicaid card is worthless? Silence. Suffering. Stillbirths. We’ve been here before. But we refuse to die quietly this time. At the Women’s Foundation of the South, we refuse to act as if women are disposable. We know that maternal health, reproductive access and community wellness aren’t luxuries — they are basic rights. This bill? It’s not just bad policy. It’s a betrayal. We will fight it — not just with data and dollars, but with the righteous rage of every grandmother who buried a daughter too soon, every mother who had to drive 200 miles for care and every young girl growing up in a state that sees her more as a womb than a whole human being. Republicans Thursday passed their bill that cuts Medicaid and defunds Planned Parenthood, and Friday, President Trump signed it into law. They should all be aware, though, of the rage they’ve unleashed in women — in the South and across the country — who don’t plan to sit around silently and die.
Carmen James Randolph
Carmen James Randolph is the founding president and CEO of the Women’s Foundation of the South (WFS), a groundbreaking philanthropic force unapologetically investing in women and girls of color across the American South. She was named one of the Top 50 Women Leaders of Louisiana for two consecutive years. Under her leadership, WFS released the Shift the South Report, a bold, data-driven blueprint spotlighting the systemic challenges and policy shifts needed to transform the region. Join the community and the conversation at @womensfoundationsouth and sign up for our newsletter at womensfoundationsouth.org. 
