The Labora Collective is a research and intelligence initiative of Diosa Ara, an emergency obstetrical infrastructure company. Dr. Yamicia Connor is an OB-GYN physician-scientist who founded Diosa Ara because she kept watching women die from things that should not kill anyone — and she understood that the deaths were not clinical failures. They were systems failures. The medicine exists. The protocols exist. The knowledge exists. What does not exist — what has never existed at sufficient scale in the United States — is the infrastructure to deliver that medicine to every woman who needs it, regardless of her race, her income, her zip code, or her immigration status. That is what Diosa Ara is building. That is what the Labora Collective was created to inform.
We built a weekly intelligence system in 2025 because clinical practice was showing us that the deterioration was accelerating at a rate that anecdotal observation could not keep up with. We began with ten research domains — clinical medicine, political and legal developments, economic analysis, health policy, innovation and research funding, reproductive rights, social determinants, the Trump administration, menopause, and sexual violence. As the work deepened, so did the scope: ten domains became twenty-six, then thirty-one, and now thirty-five, as the interconnections between clinical, political, and social systems demanded a wider lens. Every week, across all thirty-five domains, we systematically track what has changed, how fast it is changing, and what specific policy decision caused the change. This report — updated to reflect data through early 2026 — is the synthesis of everything that system has found. It covers twelve of those thirty-five domains in depth. The remaining twenty-three — including reproductive rights and legal warfare, federal power and executive action, economics of reproductive health, transgender and gender-nonconforming health, environmental health and climate, disability and reproductive justice, rural and geographic health equity, digital surveillance and health data privacy, global comparative analysis, and others — are the subject of a second edition currently in development.
Through two terms in the White House, a pandemic marked by federal failure, the orchestrated fall of Roe v. Wade, and now the systematic dismantling of the nation's public health infrastructure, Donald Trump and the conservative political movement he leads have had a more detrimental effect on the health, lives, and economic security of women and children in the United States than any administration in modern American history.
This is not an opinion. It is a claim we will prove — domain by domain, data point by data point, dated action by dated action — across every dimension of women's and children's health: mortality, clinical care, infrastructure, funding, disease prevention, research, child welfare, sexual violence, and economic security.
You have a mother. You have a daughter, a sister, a wife, a partner. Someone in your life has been pregnant, will be pregnant, or is caring for someone who is. That person lives inside the system this report documents.
You go on vacation. You drive to your cabin. Your wife is seven months pregnant. She starts bleeding. Do you expect there to be a hospital that can help her? There might not be. One-third of all U.S. counties have no obstetric services at all. Over 500 hospitals have closed their maternity units since 2010. If your cabin is in rural Idaho, 43% of the OB-GYNs have left the state. If it is in rural Texas, the nearest labor and delivery unit may be two hours away. If your wife is Black, she is three and a half times more likely to die than if she is white. If she is Native American or Alaska Native, her risk is nearly five times the white rate — the highest of any racial group in the country. Both ratios are getting worse, not better.
There is not a single person connected to the human race that this crisis does not touch.
Infant mortality rates are among the most closely watched indicators in global development. They are not sentimental statistics. They are a direct measure of national infrastructure — of whether a country can keep its youngest citizens alive. Infant mortality captures everything: the quality of the healthcare system, the strength of the safety net, the investment in public health, the stability of the economy, the equity of the society. When infant mortality rises, it is not because babies got sicker. It is because the nation got weaker.
Women and children are not talking points for ideology. They are not culture war ammunition. They are data representing the infrastructure of a nation. And we are systematically destroying that infrastructure — in the obvious ways, through budget cuts and agency dismantlement, and in the less obvious ways, by allowing women and children to sicken, suffer, and die while the systems that should protect them are deliberately taken apart.
This report will show you exactly how it is being done. With data. With dates. With names.
Black and Native maternal mortality was ignored for decades. Black women in the United States have been dying at two, three, four times the rate of white women for as long as anyone has been counting. Native American and Alaska Native women have been dying at even higher rates — the highest of any group — but because they represent a smaller share of the national population, their deaths rarely made it into the headline statistics at all. Both facts were known. Both were published. Both were presented at conferences. And the system did nothing — for decades. That neglect was not neutral. It allowed the entire maternal health infrastructure to weaken, because the deaths were concentrated among women the system did not prioritize. By the time anyone with power decided to act, the foundation was already cracked. Finally — after years of advocacy, after mounting data, after it became politically impossible to ignore — there were the beginnings of a response. Maternal Mortality Review Committees. State-level quality improvement. California proved you could cut maternal mortality in half. There was a window.
Then Trump 1.0 happened (2016–2020). The first Trump administration was the instrument of a fifty-year conservative legal strategy. The Federalist Society. The Heritage Foundation. Decades of TRAP laws and trigger bans, staged and waiting. Three Supreme Court appointments in four years — Gorsuch, Kavanaugh, Barrett. The judicial infrastructure was locked into place. The "Domestic Gag Rule" gutted Title X, stripping 1,000 clinics from the program. The fuse was lit.
Then COVID happened (2020–2022). The pandemic struck a system that had no reserves. Maternal mortality hit 32.9 per 100,000 — the highest in modern history. Black maternal mortality reached 69.9 per 100,000. Prenatal care collapsed. Schools closed and child abuse detection disappeared. Mental health among adolescent girls cratered. The healthcare workforce broke. Nothing recovered before the next blow.
Then Dobbs happened (June 2022). The fall of Roe was not a surprise. It was the culmination of everything Trump 1.0 set in motion. Trigger bans activated in 13 states. Providers fled. Hospitals closed. Sepsis rates for miscarriage care jumped 50% in Texas. Domestic violence spiked 7–10% in ban counties. Women denied abortions fell into poverty at four times the rate. 412 women were criminally charged for pregnancy outcomes. The system that was already failing entered structural collapse.
Then Trump 2.0 happened (January 2025). And Trump 2.0 did not just fail to fix the damage. It stripped the car for parts. Fired the teams tracking pregnancy outcomes. Froze the clinics. Terminated the research grants. Gutted the institute studying why Black women die. Proposed $900 billion in Medicaid cuts. Withdrew from the WHO. Put a vaccine skeptic in charge of HHS and a TV doctor in charge of Medicaid. Reduced the health workforce by 20,000. Labeled the research into racial health disparities as "DEI" and defunded it.
And what you are going to see — what the data will prove across every chapter of this report — is that mothers and babies are not well. They are not thriving. They are dying at rates that are rising, in patterns that are predictable, from causes that are preventable, because of decisions that are documented. We are going to show you how bad it is, with the numbers right in front of your eyes, and walk you through exactly how the connections work — from the defunding to the death, from the policy to the patient, from the decision in Washington to the woman bleeding in a car on a highway two hours from the nearest hospital that can help her.
Each chapter covers one critical dimension of women's and children's health, and traces the same arc: where things stood before, what Trump 1.0 did, what the pandemic did, what began to recover, what Dobbs did, and what Trump 2.0 is doing now.
This is the introduction. The full report — sixteen chapters of data, dates, and names — is being released in stages, beginning with a free executive summary. The Labora Collective is building it in the open.
If you want the report the moment it lands — and the Packs, Playbooks, and Labora Rounds that turn it into something you can act on — come inside the community.
Come inside the Labora Collective →