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Content warning: This story contains details of a pregnancy loss.

ORANGEBURG, S.C. — Amari Marsh had just finished her junior year at South Carolina State University in May 2023 when she received a text message from a law enforcement officer.

“Sorry it has taken this long for paperwork to come back,” the officer wrote. “But I finally have the final report, and wanted to see if you and your boyfriend could meet me Wednesday afternoon for a follow up?”

Marsh understood that the report was related to a pregnancy loss she’d experienced that March, she said. During her second trimester, Marsh said, she unexpectedly gave birth in the middle of the night while on a toilet in her off-campus apartment. She remembered screaming and panicking and said the bathroom was covered in blood.

“I couldn’t breathe,” said Marsh, now 23.

The next day, when Marsh woke up in the hospital, she said, a law enforcement officer asked her questions. Then, a few weeks later, she said, she received a call saying she could collect her daughter’s ashes.

At that point, she said, she didn’t know she was being criminally investigated. Yet three months after her loss, Marsh was charged with murder/homicide by child abuse, law enforcement records show. She spent 22 days at the Orangeburg-Calhoun Regional Detention Center, where she was initially held without bond, facing 20 years to life in prison.

This August, 13 months after she was released from jail to house arrest with an ankle monitor, Marsh was cleared by a grand jury. Her case will not proceed to trial.

Her story raises questions about the state of reproductive rights in this country, disparities in health care, and pregnancy criminalization, especially for Black women like Marsh. More than two years after the U.S. Supreme Court issued its Dobbs v. Jackson Women’s Health Organization decision, which allowed states to outlaw abortion, the climate around these topics remains highly charged.

Marsh’s case also highlights what’s at stake in November. Sixty-one percent of voters want Congress to pass a federal law restoring a nationwide right to abortion, according to a recent poll by KFF, the health policy research, polling, and news organization that includes KFF Health News. These issues could shape who wins the White House and controls Congress, and will come to a head for voters in the 10 states where ballot initiatives about abortion will be decided.

Current Mississippi law bans abortions “except in the case where necessary for the preservation of the mother’s life” or where the pregnancy was caused by rape and reported to law enforcement. Doctors who perform abortions outside of those parameters face up to 10 years in prison, in addition to the loss of their license. 

OB-GYNs in the state told Mississippi Today the lack of clarity around the law worries them. Life-threatening conditions during pregnancy often occur on a spectrum and can develop over time – calling into question what does and does not constitute a threat to the life of the mother, one Jackson area physician told Mississippi Today after the Dobbs ruling in 2022.

The South Carolina case shows how pregnancy loss is being criminalized around the country, said U.S. Rep. James Clyburn, a Democrat whose congressional district includes Orangeburg, and an alumnus of the same university Marsh was attending.

“This is not a slogan when we talk about this being an ‘election about the restoration of our freedoms,’” Clyburn said.

‘I Was Scared’

When Marsh took an at-home pregnancy test in November 2022, the positive result scared her. “I didn’t know what to do. I didn’t want to let my parents down,” she said. “I was in a state of shock.”

She didn’t seek prenatal care, she said, because she kept having her period. She thought the pregnancy test might have been wrong.

An incident report filed by the Orangeburg County Sheriff’s Office on the day she lost the pregnancy stated that in January 2023 Marsh made an appointment at a Planned Parenthood clinic in Columbia to “take the Plan-C pill which would possibly cause an abortion to occur.” The report doesn’t specify whether she took — or even obtained — the drug.

During an interview at her parents’ house, Marsh denied going to Planned Parenthood or taking medicine to induce abortion.

“I’ve never been in trouble. I’ve never been pulled over. I’ve never been arrested,” Marsh said. “I never even got written up in school.”

She played clarinet as section leader in the marching band and once performed at Carnegie Hall. In college, she was majoring in biology and planned to become a doctor.

South Carolina state Rep. Seth Rose, a Democrat in Columbia and one of Marsh’s attorneys, called it a “really tragic” case. “It’s our position that she lost a child through natural causes,” he said.

On Feb. 28, 2023, Marsh said, she experienced abdominal pain that was “way worse” than regular menstrual cramps. She went to the emergency room, investigation records show, but left after several hours without being treated. Back at home, she said, the pain grew worse. She returned to the hospital, this time by ambulance.

Hospital staffers crowded around her, she said, and none of them explained what was happening to her. Bright lights shone in her face. “I was scared,” she said.

According to the sheriff’s department report, hospital staffers told Marsh that she was pregnant and that a fetal heartbeat could be detected. Freaked out and confused, she chose to leave the hospital a second time, she said, and her pain had subsided.

In the middle of the night, she said, the pain started again. She woke up, she recalled, feeling an intense urge to use the bathroom. “And when I did, the child came,” she said. “I screamed because I was scared, because I didn’t know what was going on.”

Her boyfriend at the time called 911. The emergency dispatcher “kept telling me to take the baby out” of the toilet, she recalled. “I couldn’t because I couldn’t even keep myself together.”

First medical responders detected signs of life and tried to perform lifesaving measures as they headed to Regional Medical Center in Orangeburg, the incident report said. But at the hospital, Marsh learned that her infant, a girl, had not survived.

“I kept asking to see the baby,” she said. “They wouldn’t let me.”

The following day, a sheriff’s deputy told Marsh in her hospital room that the incident was under investigation but said that Marsh “was currently not in any trouble,” according to the report. Marsh responded that “she did not feel as though she did anything wrong.”

More than 10 weeks later, nothing about the text messages she received from an officer in mid-May implied that the follow-up meeting about the final report was urgent.

“Oh it doesn’t have to be Wednesday, it can be next week or another week,” the officer wrote in an exchange that Marsh shared with KFF Health News. “I just have to meet with y’all in person before I can close the case out. I am so sorry”

“No problem I understand,” Marsh wrote back.

She didn’t tell her parents or consider hiring a lawyer. “I didn’t think I needed one,” she said.

Marsh arranged to meet the officer on June 2, 2023. During that meeting, she was arrested. Her boyfriend was not charged.

Her father, Herman Marsh, the band director at a local public school in Orangeburg, thought it was a bad joke until reality set in. “I told my wife, I said, ‘We need to get an attorney now.’”

Pregnancy Criminalization

When Marsh lost her pregnancy on March 1, 2023, women in South Carolina could still obtain an abortion until 20 weeks beyond fertilization, or the gestational age of 22 weeks.

Later that spring, South Carolina’s Republican-controlled legislature passed a ban that prohibits providers from performing abortions after fetal cardiac activity can be detected, with some exceptions made for cases of rape, incest, or when the mother’s life is in jeopardy. That law does not allow criminal penalties for women who seek or obtain abortions.

Solicitor David Pascoe, a Democrat elected to South Carolina’s 1st Judicial Circuit whose office handled Marsh’s prosecution, said the issues of abortion and reproductive rights weren’t relevant to this case.

“It had nothing to do with that,” he told KFF Health News.

The arrest warrant alleges that not moving the infant from the toilet at the urging of the dispatcher was ultimately “a proximate cause of her daughter’s death.” The warrant also cites as the cause of death “respiratory complications” due to a premature delivery stemming from a maternal chlamydia infection. Marsh said she was unaware of the infection until after the pregnancy loss.

Pascoe said the question raised by investigators was whether Marsh failed to render aid to the infant before emergency responders arrived at the apartment, he said. Ultimately, the grand jury decided there wasn’t probable cause to proceed with a criminal trial, he said. “I respect the grand jury’s opinion.”

Marsh’s case is a “prime example of how pregnancy loss can become a criminal investigation very quickly,” said Dana Sussman, senior vice president of Pregnancy Justice, a nonprofit that tracks such cases. While similar cases predate the Supreme Court’s Dobbs decision, she said, they seem to be increasing.

“The Dobbs decision unleashed and empowered prosecutors to look at pregnant people as a suspect class and at pregnancy loss as a suspicious event,” she said.

Local and national anti-abortion groups seized on Marsh’s story when her name and mug shot were published online by The Times and Democrat of Orangeburg. Holly Gatling, executive director of South Carolina Citizens for Life, wrote a blog post about Marsh titled, in part, “Orangeburg Newborn Dies in Toilet” that was published by National Right to Life. Gatling and National Right to Life did not respond to interview requests.

Marsh said she made the mistake of googling herself when she was released from jail.

“It was heartbreaking to see all those things,” she said. “I cried so many times.”

Some physicians are also afraid of being painted as criminals. The nonprofit Physicians for Human Rights published a report on Sept. 17 about Florida’s six-week abortion ban that included input from two dozen doctors, many of whom expressed fear about the criminal penalties imposed by the law.

“The health care systems are afraid,” said Michele Heisler, medical director for the nonprofit. “There’s all these gray areas. So everyone is just trying to be extra careful. Unfortunately, as a result, patients are suffering.”

Chelsea Daniels, a family medicine doctor who works for Planned Parenthood in Miami and performs abortions, said that in early September she saw a patient who had a miscarriage during the first trimester of her pregnancy. The patient had been to four hospitals and brought in the ultrasound scans performed at each facility.

“No one would touch her,” Daniels said. “Each ultrasound scan she brought in represents, on the other side, a really terrified doctor who is doing their best to interpret the really murky legal language around abortion care and miscarriage management, which are the same things, essentially.”

Florida is one of the 10 states with a ballot measure related to abortion in November, although it is the only Southern state with one. Others are Montana, Missouri, and Maryland.

‘I Found My Strength’

Zipporah Sumpter, one of Marsh’s lawyers, said the law enforcement system treated her client as a criminal instead of a grieving mother. “This is not a criminal matter,” Sumpter said.

It was not just the fraught climate around pregnancy that caused Marsh to suffer; “race definitely played a factor,” said Sumpter, who does not believe Marsh received compassionate care when she went to the hospital the first or second time.

The management of Regional Medical Center, where Marsh was treated, changed shortly after her hospitalization. The hospital is now managed by the Medical University of South Carolina, and its spokesperson declined to comment on Marsh’s case.

Historically, birth outcomes for Black women in Orangeburg County, where Marsh lost her pregnancy, have ranked among the worst in South Carolina. From 2020 through 2022, the average mortality rate for Black infants born in Orangeburg County was more than three times as high as the average rate for white infants statewide.

Today, Marsh is still trying to process all that happened. She moved back in with her parents and is seeing a therapist. She is taking classes at a local community college and hopes to reenroll at South Carolina State University to earn a four-year degree. She still wants to become a doctor. She keeps her daughter’s ashes on a bookshelf in her bedroom.

“Through all of this, I found my strength. I found my voice. I want to help other young women that are in my position now and will be in the future,” she said. “I always had faith that God was going to be on my side, but I didn’t know how it was going to go with the justice system we have today.”

KFF Health News Florida correspondent Daniel Chang contributed to this article. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Mississippi Today’s Kate Royals contributed to this report.

The post She was accused of murder after losing her pregnancy. South Carolina woman now tells her story. appeared first on Mississippi Today.

The PGA Tour years ago produced a memorable TV commercial with golf pros hitting booming drives, precise iron shots, and perfect chips and putts that went in from every angle. There was lots of fist-pumping, lots of back-slapping and wild celebrating. At the end, you heard these words: “These guys are good!”

On a warm, sunny Thursday at Country Club of Jackson, they could have shot 50 commercials like that during the first round of the Sanderson Farms Championship. Heck, they could have shot seven or eight commercials just from David Skinns’ round.

“David Skinns?” you ask. Yes, David Skinns, a gray-bearded, 42-year-old journeyman pro from the United Kingdom who played his college golf two decades ago for Tennessee. All Skinns did was make 12 birdies en route to a career-best round of 60, which broke the course record at CCJ by a single shot. This is the 57th edition of Mississippi’s only PGA Tour Tournament. This was the lowest round in history of the event.

Skinns narrowly missed the magical number of 59, misfiring on a nine-foot birdie putt on his 18th hole, the ninth at CCJ. He missed the downhill, right-to-left putt on the low side, then made a 2-footer for the 60. That was one shot better than Will Zalatoris — a much more familiar name — shot three years ago in the second round of the Sanderson.

Of the putt that would have broken 60, Skinns said, “I played it a ball out on the right. If I had it to do over again, I’d play it a full cup out. Just broke way more than I thought.”

Skinns said he simply read the putt wrong, but added, “But there were a lot of them out there that I got right, so I am going to focus on the ones I got right.”

The question is: How will he focus on so much? He made 12 birdie putts totaling 167 feet, including a 54-footer on the par-3 seventh hole, his 16th. 

When that long one went in, Skinns knew 59 was a possibility. He just needed to birdie the last two holes. He took care of the first one, wedging to within two feet on the par-4 eighth and tapping that in. He then boomed a 307-yard drive on the ninth hole and hit another really good wedge shot that finished nine feet, one inch from the cup.

Remarkably, that was the shortest putt he missed all day. 

These guys are better than really, really good. Understand, CCJ is not a pitch and putt golf course. No, it stretches out to almost 7,500 yards. The fairways are not abnormally wide and the Bermuda-grass rough is thick in most spots. Your average 6-handicapper at your local club would be lucky to break 100.

But as Thursday progressed, the low scores just kept coming. Michael Thorbjornsen, a 23-year-old former U.S. Junior champion, shot a 63. As these words are typed mid-afternoon, there already have been four 65s, three 66s and the birdies keeping falling.

Why?

“The greens are soft and there’s hardly any wind,” said Jackson native Wilson Furr, who practically grew up on this golf course and shot a 70 Thursday. “The greens are receptive and they roll perfectly. That’s a recipe for what you’re seeing out there today. I’m not at all surprised.”

Furr and Skinns are well-acquainted. Both graduated from the Korn Ferry Tour to the PGA after the 2023 season. 

“He’s a really good player,” Furr said of Skinns. “But honestly everybody out here is good. Am I surprised he shot 60? Maybe a little, but I’m not shocked. He’s a really good player. Everybody out here is capable of it. Everybody is really good.”

As this is written, 100 of the 132 players are under par.

Golfing readers out there may wonder, as I, what it feels like to make 167 feet of birdie putts in one round of golf.

“Just a bit of a dream really,” Skinns answered when asked that very question. “Great to see a couple go in that maybe some days don’t. Just kind of catapulted me and I was able to keep the momentum going, which is what I was most pleased about, and I never really thought about the score too much, just where I was going to hit the next shot.”

Skinns won three tournaments on the Korn Ferry Tour, golf’s Class AAA. He won seven times on the old Hooters Tour. His best finish on the PGA Tour has been a tie for fourth place at the Cognizant Classic in Palm Beaches, Florida, last March.

The first-round 60 doesn’t change his game plan in Jackson.

“One hole at a time,” he said. “I am going to reset and concentrate on playing the first hole tomorrow.”

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Jackson State University has been eying an empty hotel in downtown Jackson as a potential solution to its shortage of student housing. 

President Marcus Thompson pitched the project — a $5 million purchase of the Jackson Marriott at 200 E. Amite St. — to the university’s governing board last month, calling it a forward-thinking win-win for the historically Black university and the capital city. 

“As Jackson grows, Jackson State grows, and vice versa, similar to what I believe and I’ve seen over the years at an Oxford or a Starkville,” Thompson told the Institutions of Higher Learning Board of Trustees at its retreat at Mississippi State University’s Riley Center in Meridian. 

The effort comes as the state’s largest HBCU recently received roughly 800 more housing applications than it had room to accommodate, Thompson told trustees. The campus has about 2,000 available beds. In fall 2022, Jackson State had about 4,900 undergraduate students, according to federal data.

Enter the Marriott, a 15-story, 303-bed hotel that has been unused since the pandemic. It has had a number of owners over the years but is currently owned by a limited liability company affiliated with a Florida-based developer named Charles Everhardt. Everhardt could not be reached before press time.

Thompson told trustees some of them likely saw the hotel years ago. The IHL board has a policy that universities are required to seek approval for real estate purchases above $100,000. Jackson State did not respond to inquiries by press time.

“Housing has been a topic and an issue for our university for a number of years,” Thompson said. “We’re really excited about the possibility to bring forward a solution to the issue of housing through this Marriott project.” 

Jackson State hopes to purchase the hotel for $5.25 million, about $2 million below its assessed value, Thompson told trustees. It would provide housing to roughly 500 students, as well as meeting and parking space and leasing revenue. 

The university has already obtained $7 million from the Legislature and conducted several key reports and assessments, Thompson said, adding that Jackson State anticipated the Marriott could be available to students in one to two years if the plan goes forward. 

Originally, Thompson sought to get $68 million in funding to construct a new residence hall, but earlier this year, he asked Al Rankins, the IHL commissioner, for permission to pivot to purchasing an existing space that could be available sooner. 

In January, the administration had to relocate students after discovering mold in its University Pointe apartment complex, which was purchased in 2015. Another dorm for female students, McAllister Whiteside, has been offline since 2021 due to mechanical, electrical and utility failures and broken equipment.

The housing shortage is a particular issue for out-of-state students who make up about a quarter of the university’s enrollment, Thompson said. During his presidential tour, he talked with parents in cities like Memphis and Chicago who told him it was a struggle to find off-campus housing. And, Thompson added that students with federal student loans may also not be able to afford off-campus housing. 

“Our students come from a population who, perhaps, mostly aren’t able to go out and secure leases on their own,” he said. About 65% of the student population comes from a low-income family that receives federal tuition assistance, according to the College Scorecard.

The Marriott also fulfills one of Thompson’s goals to see Jackson State further expand into downtown, where the university already has a satellite campus and a number of apartment leases for student housing.

It’s unclear how much it will cost to renovate the Marriott or what that would entail. Thompson said that figures in a comprehensive assessment conducted over the summer reflected a “complete gut renovation” that wouldn’t be necessary, and the university can use certain federal funds to renovate academic spaces.

“Many of those things are cosmetic things that don’t necessarily have to be replaced, and we can speak to those things later,” he said. 

After Thompson finished his presentation, he asked the board for questions. Trustees immediately voted to go into executive session, citing a section of the Open Meetings Act that permits closing a meeting to discuss the “transaction of business and discussion regarding the prospective purchase, sale or leasing of lands.” 

Trustees deliberated for about an hour before calling Thompson and his administration into the room, where they spoke for about another hour.

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A post-Roe agenda should include paid maternity leave for state employees, Attorney General Lynn Fitch said to lawmakers Wednesday. 

This recommendation is part of her office’s Empowerment Project, which was launched in 2023 after abortion in Mississippi became illegal – a “game changer,” Fitch told members of the Senate Study Group on Women, Children and Families. 

Lt. Gov. Delbert Hosemann tasked the Senate group with reviewing the needs of Mississippi families and children from birth to age 3, following the Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization that allowed the state’s near-total abortion ban to take effect.

Mississippi has no paid family leave on the books. Currently state employees may take up to 12 weeks of unpaid leave under the federal Family and Medical Leave Act.

There are around 85,000 state employees – including public school teachers and staff and faculty from public universities and colleges – and tens of thousands of Mississippi women could benefit from legislation offering paid maternity leave. 

It’s a critical workforce issue, Fitch said in response to a question from Sen. Nicole Boyd, R-Oxford, and it could be the deciding factor for someone choosing between a private sector job and a public sector job. 

“This is a great tool, a great resource, to have these women in public service and to keep them there,” she said. 

Mississippi has the nation’s lowest workforce participation rate. Despite the fact there are more working-age women than men, women have a lower rate at 48.5%. 

Last year, a bill authored by Boyd to give state employees six weeks of paid maternity leave died in the Public Health committee, chaired by Sen. Hob Bryan, D-Amory. Bryan did not respond to a request for comment from Mississippi Today by the time this story published. 

Fitch urged lawmakers to reconsider their decision this year.

“Coming up in this session I’d like for you to consider paid maternity leave for state employees … I know many times here we look at who else has done that, and I just want to tell you that Georgia, Arkansas, Tennessee, Texas, North Carolina, Louisiana and Virginia have all passed these laws. And so I would encourage you to take a hard look at this.”

Fitch, who petitioned the U.S. Supreme Court to hear the Dobbs case that overturned the constitutional right to abortion, has faced pressure to advocate for policies that would benefit low-income women in the state with the highest maternal mortality and poverty rates. 

The five pillars of her Empowerment Project, Fitch said, are making quality child care affordable and accessible; promoting workforce flexibility; improving child support enforcement; fixing the state’s broken foster care and adoption systems; and giving women the opportunities and resources to “upscale and educate.”

Mississippi is one of only 10 states not to expand Medicaid to the working poor under the Affordable Care Act. And while pregnant women making less than 194% of the federal poverty level – roughly $30,000 annually for a single mother – are eligible for Medicaid, a policy that would streamline the application process and provide timely prenatal care only just became law in Mississippi and is currently awaiting federal approval. 

Fitch lauded lawmakers for several measures passed in the last two years, including 12 months postpartum coverage for mothers on Medicaid, tax credits for crisis pregnancy centers and Safe Haven Baby Boxes. 

Fitch said the baby boxes are “a very safe, anonymous way for a very courageous young mother to place her child in the care of others,” and that the state will increase the number of them. 

Committee members weren’t able to ask follow-up questions to Fitch, who also addressed child support enforcement and the foster care system, due to her schedule. 

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Mississippi Today, a Pulitzer Prize-winning newsroom, is seeking a reporter to join our Politics Team. Regarded across Mississippi and the South as a vital investigative watchdog and champion of government accountability and transparency, the Politics Team at Mississippi Today goes beyond covering public meetings and legislative committees, digging deep to examine the systems of power in our state. 

The Politics and Government Reporter will be a member of this award-winning team, which serves Mississippians with engaging reporting that leaves readers better informed on critical issues facing our state. 

The ideal journalist will be someone who understands the complexity and history of Mississippi politics; challenges and threats to democratic values; and the concerns of Mississippians of all walks of life. This reporter will focus on daily/breaking news stories with a special focus on investigative projects that involve data, fact finding and in-depth explainer political journalism. 

Mississippi is a gold mine for eager journalists. In this position, you’ll travel the state and meet a diverse range of residents. As a member of Mississippi Today’s Politics Team, you will have an opportunity to work with some of the best reporters in the South and play an important role in fulfilling accountability journalism that will impact the way policy is debated and passed in Mississippi.

Expectations:

• Work with a small team of journalists who are focused on politics and government in Mississippi.
• Develop story ideas as well as collaborate closely with journalists and editors across the newsroom.
• Get people to talk, find willing sources and protect them while telling sensitive and timely stories.
• Build trust. Many Mississippians have for generations been victims of predatory actions from other journalists or media outlets. Mississippi Today seeks to rebuild trust with people across this state, which requires empathy, patience and savvy from our reporters.
• Work with our Audience Team and data and visual journalists to create compelling story presentations.

It’s a plus if you have:

• At least four years of reporting experience — and it’s a plus if you have Mississippi and political reporting experience
• Proficiency with public records requests.
• Experience writing a combination of both longform stories and investigations.
• A demonstrated ability to work quickly under tight deadlines.
• A knowledge and understanding of nonprofit journalism.
• Experience working in a collaborative newsroom setting.

What you’ll get:

• The opportunity to work alongside award-winning journalists and make significant contributions to Mississippi’s only fully staffed, nonprofit, nonpartisan digital news and information source.
• Highly competitive salary with medical insurance, and options for vision and dental insurance.
• 29 days paid time off.
• Up to 12 weeks of parental family leave, with return-to-work flexibility.
• Simple IRA with 3 percent company matching. Group-term life insurance provided to employees ($15,000 policy).
• Support for professional training and attending industry conferences.

How to Apply:

We’re committed to building an inclusive newsroom that represents the people and communities we serve. We especially encourage members of traditionally underrepresented communities to apply for this position, including women, people of color, LGBTQ people and people who are differently abled.

Please click this link to apply.

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Mississippi Today poverty reporter Anna Wolfe has been named to the 2024 TIME100 Next list.

According to Time, the list aims to recognize “rising leaders in health, climate, business, sports, and more—and by doing so, not just show the stories that are capturing headlines in 2024, but also introduce you to the people who we believe will play an important role in leading the future.”

A majority of this year’s honorees are people of color; more than half are women.

“Mississippians have come to know and respect Anna as a champion for people whose voices are overlooked or ignored, and as someone who is not afraid to speak truth to power,” says Adam Ganuchaeu, editor-in-chief at Mississippi Today. “It’s awesome for her to get even more national recognition for just that. This is so deserving a recognition for a true Mississippi legend, and all of us are so lucky to have her here.”

Wolfe won the 2023 Pulitzer Prize for Local Reporting for her remarkable investigation “The Backchannel,” which uncovered the depth of the sprawling $77 million welfare scandal, the largest embezzlement of federal funds in the state’s history.

In her profile of Wolfe for 2024 TIME100 Next, PBS senior correspondent Judy Woodruff writes, “at a time when journalism is struggling to survive, Anna reminds us why it matters.”

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OXFORD, Miss. (AP) — It’s hard to miss the overflowing bowl of condoms at the entrance of the gym.

Some University of Mississippi students walking past after their workout snicker and point, and the few who step forward to consider grabbing a condom rethink it when their friends catch up, laughter trailing behind them. Almost no one actually reaches in to take one.

Though officials say they refill the bowl multiple times a day, and condoms are available at multiple places on campus, Ole Miss students say the disinterest is indicative of changing attitudes.

Fewer young people are having sex, but the teens and young adults who are sexually active aren’t using condoms as regularly, if at all. And people ages 15 to 24 made up half of new chlamydia, gonorrhea and syphilis cases in 2022.

The downward trend in condom usage is due to a few things: medical advancements like long-term birth control options and drugs that prevent sexually transmitted infections; a fading fear of contracting HIV; and widely varying degrees of sex education in high schools.

Is this the end of condoms? Not exactly. But it does have some public health experts thinking about how to help younger generations have safe sex, be aware of their options — condoms included — and get tested for STIs regularly.

“Old condom ads were meant to scare you, and all of us were scared for the longest time,” said Dr. Joseph Cherabie, medical director of the St. Louis HIV Prevention Training Center. “Now we’re trying to move away from that and focus more on what works for you.”

A shift in attitudes

Downtown Oxford was thrumming the day before the first football game of the season. The fall semester had just started.

Lines of college students with tequila-soda breath waited to be let in dim bars with loud music. Hands wandered, drifting into back pockets of jeans, and they leaned on one another.

It’s likely that many of those students didn’t use a condom, said Magan Perry, president of the college’s Public Health Student Association.

“Using a condom is just a big, ‘uh, no,’” the senior said.

Young women often have to initiate using condoms with men, she said, adding that she’s heard of men who tell a sexual partner they’ll just buy emergency contraception the next day instead.

“I’ve had friends who go home with a guy and say they’re not having sex unless they use a condom, and immediately the reaction is either a reluctant, ‘OK, fine,’ or ‘If you don’t trust me, then I shouldn’t even be here,’” Perry said. “They’re like, ‘Well, I’m not dirty, so why would I use them?’”

Women have long had the onus of preventing pregnancy or STIs, Cherabie said, and buying condoms or emergency contraceptives — which are often in a locked cabinet or behind a counter — can be an uncomfortable experience and “inserts a certain amount of shame,” Cherabie said.

If pregnancy risk has been the driving factor for condom usage among heterosexual couples, the fear of contracting HIV was the motivation for condom use among men who have sex with men.

But as that fear has subsided, so has condom use, according to a recent study that focused on a population of HIV-negative men who have sex with men.

Grindr, a popular gay dating app, even lists condom use under “kinks” instead of “health.” Things like that make Steven Goodreau, an HIV expert at the University of Washington who led the study, worry that the change in attitudes toward condoms is trickling down to younger generations.

Goodreau believes the promotion of pre-exposure prophylaxis (PrEP), a drug that prevents HIV, is overshadowing condoms as a prevention strategy. A strategic plan for federal HIV research through 2025 doesn’t mention condoms, and neither does the national Ending the HIV Epidemic plan.

The Centers for Disease Control and Prevention acknowledges that condoms are still an effective tool that can be used “alongside newer prevention strategies.”

“We know that condom use has declined among some groups, but they still have an important role to play in STI prevention,” said Dr. Bradley Stoner, director of the CDC’s Division of STD Prevention. “Condoms can be accessed without navigating the health care system, can be used on-demand, are generally affordable and most importantly – they are effective at preventing HIV and STIs when used consistently and correctly.”

Medical advances allow for more options

Pleasure — for both men and women — has long been an undeniable factor for the lack of condom use, according to Dr. Cynthia Graham, a member of the Kinsey Institute team that studies condoms.

But more so, advances in medicine have expanded the options for both STI and pregnancy prevention.

Young cisgender women have been turning to contraceptive implants like intrauterine devices and birth control pills to keep from getting pregnant. And researchers say that once women are in committed relationships or have one sexual partner for a significant amount of time, they often switch to longer-term birth control methods.

Ole Miss junior Madeline Webb said she and her partner seem like outliers — they have been seeing each other for four years, but still use condoms. They also share the responsibility of buying condoms.

“People see condoms as an inconvenience … but they do serve a purpose even if you’re on birth control because there is always a chance of an STD,” Webb said.

A new drug on the market could mean even more STI prevention options for men and possibly women.

Doxycycline post-exposure prophylaxis, or doxy PEP, can be taken within 72 hours after unprotected sex and can help prevent chlamydia, gonorrhea and syphilis. It has to be prescribed by a doctor. Trials are still being conducted for women, but the drug is gaining traction among men who have sex with men and transgender women.

With widespread uptake, the drug has the potential to make a significant impact in STI prevention strategies.

“When PrEP came out, everyone was excited because it was one less thing to worry about in terms of HIV acquisition,” Cherabie said. “With another thing on board that can help decrease our likelihood of getting other STIs, on top of not having to worry about HIV, it gives our community and patients a little less anxiety about their sex lives.”

And in just a decade, PrEP has become a main preventive measure against HIV and other STIs for men who have sex with men – though it is disproportionately used by white men.

Condom use now is “pretty much a thing of the past” for men who have sex with men compared to the 1980s and early 1990s during the AIDS epidemic, said Andres Acosta Ardilla, a community outreach director at an Orlando-based nonprofit primary care clinic that focuses on Latinos with HIV.

“Part of what we have to talk about is that there is something enticing about having condomless sex,” Acosta Ardilla said. “And we have to, as people who are working in public health, plan for the fact that people will choose to have condomless sex.”

The fight over sex ed

Despite the relentless Southern sun, a handful of people representing various student organizations sat at tables in the heart of Ole Miss’ campus. Students walked past and grabbed buttons, wristbands and fidget toys. One table offered gold-packaged condoms – for cups to prevent drinks from being spiked.

Actual condoms are noticeably absent. They’re also absent in the state’s public schools.

Condom demonstrations are banned in Mississippi classrooms, and school districts can provide abstinence-only or “abstinence-plus” sexual education — both of which can involve discussing condoms and contraceptives.

Focus on the Family, an Christian organization that advocates for teaching abstinence until marriage, is concerned that comprehensive sex education “exposes students to explicit materials.” Abstinence-centered education is “age-appropriate” and keeps students safe and healthy, Focus on the Family analyst Jeff Johnston said in an emailed statement.

But Josh McCawley, deputy director of Teen Health Mississippi, an organization that works with youth to increase access to health resources, said the effects are clear.

“The obvious consequence is the rise of sexually transmitted infections, which is what we’re seeing right now, which can be a burden on the health care system,” he said, “but also there could be long-term consequences for young people in terms of thinking about what it means to be healthy and how to protect themselves, and that goes beyond a person’s sexual health.”

The latest CDC data from 2022 shows Mississippi has the highest teen birth rate in the country.

Scott Clements, who oversees health information for the state education department, was hesitant to criticize Mississippi’s sex education standards because they’re “legislatively mandated.”

“If the legislature wants to make changes to this, we will certainly follow their lead,” he added — though attempts to pass more advanced sexual education standards have died repeatedly in the Mississippi statehouse over the past eight years.

Nationally, there is no set standard for sex education, according to Michelle Slaybaugh, policy and advocacy director for the Sexuality Information and Education Council for the United States, which advocates for comprehensive sex ed.

Not every state mandates sex education. Some states emphasize abstinence. Less than half of states require information on contraception.

“There is no definitive way to describe what sex ed looks like from classroom to classroom, even in the same state, even in the same district,” Slaybaugh said, “because it will really be determined by who teaches it.”

Compare Mississippi to Oregon, which has extensive state standards that require all public school districts to teach medically accurate and comprehensive sexual education. Students in Portland are shown how to put on a condom starting in middle school and have access to free condoms at most high schools.

Lori Kuykendall of Dallas, who helped write abstinence-focused standards, said condom demonstrations like those in Portland “normalize sexual activity in a classroom full of young people who the majority of are not sexually active.” She also points to increasingly easy access to pornography — in which people typically do not wear condoms — is a contributing factor to the decline in condom use among young people.

Jenny Withycombe, the assistant director for health and physical education at Portland Public Schools, acknowledged the standards see pushback in the more conservative and rural parts of Oregon. But the idea is to prepare students for future interactions.

“Our job is to hopefully build the skills so that even if it’s been a while since the (condom) demo … the person has the skills to go seek out that information, whether it’s from the health center or other reliable and reputable resources,” Withycombe said.

Those standards seem to contribute to a more progressive view of condoms and sex in young adults, said Gavin Leonard, a senior at Reed College in Portland and a former peer advocate for the school’s sexual health and relationship program.

Leonard, who grew up in Memphis – not far from Oxford, Mississippi, said his peers at Reed may not consistently use condoms, but, in his experience, better understand the consequences of not doing so. They know their options, and they know how to access them.

Slaybaugh wants that level of education for Mississippi students — and the rest of the country.

“We would never send a soldier into war without training or the resources they need to keep themselves safe,” she said. “We would not send them into a battle without a helmet or a bulletproof vest. So why is it OK for us to send young people off to college without the information that they need to protect themselves?”

___

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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Schools, community organizations and hospitality groups now have access to free bulk naloxone, an opioid overdose reversal drug, thanks to recent state legislation and federal funding.

In the first two months since the new law went into effect, the Mississippi Department of Health has distributed 3,470 boxes of bulk naloxone. That’s more than it distributed in the prior 10 months combined. 

The Legislature passed House Bill 1137, authored by Rep. Fabian Nelson, D-Jackson, and a freshman legislator, in the spring. Nelson said the impetus for the bill, which expands what types of groups can receive the overdose reversal drug, was a conversation with a local advocate who showed him the need for more access across the state. 

Nelson worked closely with Department of Mental Health Executive Director Wendy Bailey to draft the legislation. 

The Department of Mental Health also distributes naloxone through a program called Stand Up Mississippi. The focus of that program has been on law enforcement and first responders, Bailey said. 

“There was a core group that was missing there – nonprofits, recovery support groups that really needed to have access to more than just one dose,” said Bailey. 

Nelson teamed up with House Public Health and Human Services Chair Sam Creekmore, R-New Albany, and Senate Judiciary A Chairman Brice Wiggins, R-Pascagoula, to shepherd the legislation – which allows community organizations, educational groups and any other “high-risk opioid overdose touchpoint” to receive the drug – through the process. The bill passed both the House and Senate unanimously. 

“If we can save one person, we’ve done our job,” said Nelson.

As the father of teenagers, Nelson said he believes schools in particular need access to the drug. 

“I’m telling my district, and Hinds County School District, we need this in the school. Because what’s happening is kids are bringing edibles to school and some are laced with fentanyl,” he said. “If a child overdoses at school and there’s no Narcan, by the time EMT gets there, the child could’ve passed away.”

READ MORE: Millions in opioid settlement dollars are coming to Mississippi. Here’s what you need to know.

He said he also keeps Narcan at his home.

“I have three sons – three teenagers – I know what my kids are doing, I don’t think my kids are doing drugs, but I have Narcan at home because you never know what they may get from a friend.” 

Hundreds of Mississippians die every year from opioid overdoses, and the epidemic has claimed the lives of tens of thousands more nationwide.

Ocean Springs School District placed an order for naloxone thanks to the new state law.

Jessie Galloway, the chief of the district’s campus police, said after an incident involving a near overdose at a neighboring school district, he thought it was important the district be prepared in case something similar occurred.

“Due to the amount of vapes, drugs, and drug paraphernalia becoming increasingly available to the youth, we felt we should be proactive and prepared in the event of an accidental overdose of a student or other individual," he said in a statement to Mississippi Today.  "In addition to our campus duties, we come in contact with many outside individuals attending various school events and having a medication like naloxone on-hand can make the difference in saving a life …”

The Gulf Coast is the hardest hit region of Mississippi in the opioid crisis and represents an outsize portion of Mississippi’s suspected overdose deaths, emergency medical services naloxone administrations and drug-related arrests. 

To request naloxone kits for an individual or organization, visit the Department of Health's site here.

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The Sanderson Farms Championship returns to Country Club of Jackson, and Randy Watkins, who played in the tournament and later was the executive director, returns to the Crooked Letter Podcast. We also discuss Ole Miss’s first loss and perhaps Mississippi State’s best showing of the football season.

Stream all episodes here.

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A new facility for Mississippians with mental illness who are involved in the criminal justice system will open early next year. 

The 83-bed maximum-security building at Mississippi State Hospital in Whitfield should open in January, Department of Mental Health Executive Director Wendy Bailey told Mississippi Today. 

Once staffed, the new building will bring the state’s forensic bed count to 123, up from 65 current beds.

Officials are hopeful the new building will cut down on wait times for mental health treatment for people in prison. Mississippi has the second-longest wait time for such treatment in the country, according to a study by the nonprofit Treatment Advocacy Center. 

“We are proud to be able to offer this service to Mississipians and to offer this environment to the people that we’re serving and to our staff as well,” she said.  

Forensic services are for people with criminal charges who need mental health treatment before facing trial and people who have been deemed not guilty by reason of insanity.

Agency spokesperson Adam Moore said at the end of August, 68 people were waiting for inpatient evaluation or competency restoration services, he said. Fifty-five of those people were awaiting services from jail. 

The Department of Mental Health plans to permanently close 25 maximum security forensic beds in a 70-year-old facility.

The current maximum security unit has notable deficiencies, including “rampant” plumbing issues, blind corners, no centralized fire suppression system and padlocks on the door, said Dr. Tom Recore, medical director at the Department of Mental Health. It also requires high numbers of personnel to staff. 

The building’s closure has been long awaited. 

“We could have used a new forensic unit 20 years ago,” Bailey said.

In comparison, the new building will be a safe, “therapeutic” environment, she said. 

“If you create a space that folks feel is something worth taking care of, then patients, staff and everyone alike ends up behaving in ways that end up being more prosocial,” Recore said.  

Construction on the new building should be completed in November, said Bailey. The Department of Mental Health will begin a “heavy recruiting effort” to staff the unit this fall.

The Legislature awarded $4 million for six months’ staffing of the new building, given the facility’s mid-fiscal year opening. 

Plans for the new 83-bed building have been in the works for years now, said Bailey. 

In 2016, the department’s forensic services unit was composed of just 35 maximum security beds, she said. 

The Department of Mental Health first put out a bid for preplanning of renovation or replacement of the building in 2018, but the project stalled during the COVID-19 pandemic. The agency was forced to reissue a call for bids, with bids coming back “significantly higher” than before, Bailey said. 

Construction costs for the building totalled $36.5 million. The state legislature allocated funding for the project in 2018, 2023 and 2024.

The new facility is a crucial part of building out a “continuum of care” within the state’s forensic system, said Recore. 

The maximum security facility will provide an entry point for people receiving forensic services, but placement in a medium-security unit, group homes and work programs will be options for patients based on a clinical review team’s evaluation. 

The group homes at Central Mississippi Residential Center in Newton have not been staffed yet, but are the next step to creating a more robust continuum of services, said Recore. 

Twenty-four beds will eventually be staffed at Central Mississippi Residential Center, and Recore envisions an outpatient supervision system as the next horizon. 

“And then, you have an actually functioning forensic system in a state that hasn’t had one before,” he said.

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