When Women Lose Their Voice: What Indiana's Health Gaps Say About Autonomy, Equity, and Power
Across Indiana, from urban centers to rural towns, women are losing more than access to care. They are losing their voice in a system that increasingly treats reproductive health not as a right, but as a privilege. Whether it's in Dearborn County, where only nine people accessed contraception education last year, or in Ripley County, where maternal services end abruptly after birth, or in Ohio County, where basic preventive care is miles out of reach—Indiana women are navigating a health landscape shaped more by control than by care.
Disconnected Systems, Common Outcomes
Despite the differences in geography, the pattern is strikingly consistent:
In Dearborn County, prenatal services are available, but contraceptive access is nearly nonexistent, suggesting a pro-natalist tilt where support is offered after pregnancy is assumed.
In Ripley County, 60 women received prenatal care, but only one got breastfeeding support, revealing a system that emphasizes childbirth but abandons postpartum wellness.
In Ohio County, the number of primary care physicians is more than 80% below the regional average. As a result, preventive screenings, cancer detection, and routine lab work are often limited or delayed, sometimes until a treatable condition becomes a severe health crisis.
The common denominator? A health system that frames women primarily as mothers and caregivers, not as full individuals deserving of comprehensive, autonomous care.
The Data Behind the Decline
Statewide, Indiana ranks 41st in the nation for women's health outcomes and has one of the highest maternal mortality rates in the country, double the national average, with worse outcomes for Black and rural women.
Despite these alarming figures:
Access to contraception remains fragmented, especially in counties without dedicated family planning clinics.
The state’s abortion ban has eliminated almost all legal access to termination, even in cases where pregnancy endangers a woman’s mental or economic well-being.
Preventive services like breast and cervical cancer screenings are underutilized in low-income and rural populations due to cost, lack of transportation, and cultural stigma.
When Policy Becomes Ideology
What connects these data points isn’t just a lack of funding—it’s ideological framing. In increasingly restrictive health environments, women’s identities are reduced to their reproductive role. This mirrors tactics seen in authoritarian systems around the globe, where governments celebrate motherhood as a moral and patriotic duty, while denying women the right to choose when or whether to become mothers in the first place.
When Indiana policies eliminate choice, restrict access, and fail to fund preventive care, they send a clear message: Women are valuable because they give birth, not regardless of it.
The Cost of Silence
These policies do more than hurt women’s health. They silence their voices. When women can't access contraception, can't afford screenings, and can't choose what happens to their own bodies, they lose the ability to participate fully in the workforce, in education, and in public life.
They are kept too busy recovering without support, mothering without respite, and navigating a medical system that sees them only through the lens of reproduction.
Indiana can reverse course. But it will require leadership that listens to women, especially those in rural and underserved communities, and investments in the infrastructure of autonomy to:
Restore funding to community health clinics that offer full-spectrum reproductive services, not just prenatal care.
Expand access to preventive screenings and mobile diagnostic units, especially in counties with low provider density.
Build postpartum support systems, including mental health resources and lactation counseling.
Prioritize autonomy in policymaking, recognizing that reproductive freedom is central to economic development and public health.
When women are no longer free to speak about, access, or manage their health, the consequences ripple across every part of society. If Indiana wants to lead in workforce development, population health, and family strength, it must start by returning the mic to the very people who’ve been pushed to the margins.
Because when women lose their voice, we all lose our future.
Angie Carr Klitzsch is the CEO of Women4Change Indiana, a nonpartisan organization dedicated to empowering Hoosiers to engage in democracy and advocating for equitable outcomes for women and girls in Indiana.