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MARQUETTE, Iowa – It was just before sunset on the Mississippi River, the day’s last bits of golden light dancing on the water, when four members of the band Big Blue Sky picked up their instruments for one of their defining songs.

During the summer, the group plays Friday nights for Maiden Voyage Tours, a northeast Iowa riverboat company. Its 40-some passengers that evening had been sharing bottles of wine and hearing tales of Mississippi River history as they cruised along, speedboats occasionally racing by on either side.

Then the boat captain pulled over to an island and cut the motor. It was time for the water song.

Moving and unforgettable, “Water Song” urges listeners to think about how they treat the natural resource, so vital for life on earth. The tune was written in 2015 and came together in minutes, recalled Big Blue Sky singers and songwriters Jon Stravers and Sophia Landis. Much of the group’s music is about the river and the surrounding region, a place of curiosity, adventure and solace for Stravers and his late son, Jon-Jon.

Big Blue Sky’s work adds to a centuries-long tradition of music inspired and transported by the Mississippi River. The river’s role as a major shipping artery and a force of nature, as well as its historical and cultural significance to the nation, make it an easy thing to write about. And riverboats not altogether different from this one carried songs north and south, spreading jazz and the delta blues across the heart of the country.

Most importantly, the music describes people’s personal connections to the river — something intensely evident in Stravers’ words on the boat.

In song, he and Landis rhapsodized. In speaking, he kept it simple: “This is a good stretch of the river. It’s important. And people love it.”

Mississippi River moved and shaped jazz, delta blues

Perhaps no style of music is as intertwined with the Mississippi River as the delta blues, rooted in the musical traditions of enslaved Black Americans who were forced to work long hours in the fields of the Mississippi Delta region. Though slavery had technically ended, many Black Americans remained in unfair and oppressive working conditions at the turn of the 20th century.

Unlike gospel music sung in church, blues reflected their real lives and real feelings, said Maie Smith, group tour manager and operations manager at the Delta Blues Museum in Clarksdale, Mississippi.

“Delta blues music is a music that works from the heart to the outside,” Smith said. “It starts with your most inner being, and helps to lift you up and rise you above whatever circumstances you were in.”

Lots of delta blues musicians worked on the river, Smith said, including those forced to build levees to protect fields from floodwaters. They endured the Great Mississippi River Flood of 1927, which killed upwards of a thousand people and displaced almost 640,000 people from Illinois to Louisiana. Many songs were written about this historic disaster and other river floods, including Charley Patton’s “High Water Everywhere,” Barbecue Bob’s “Mississippi Heavy Water Blues,” Bessie Smith’s “Backwater Blues” and Big Bill Broonzy’s “Southern Flood Blues.”

But the river also provided opportunities for blues musicians to travel, taking their songs with them. Blues and later jazz music came north to Memphis, Kansas City and Chicago, building a following and mixing with other music styles. Today, blues riffs underpin much of American popular music, Smith said, like rock and roll and hip hop.

Music was moving on the Mississippi even before then — during the so-called “golden age of steamboats” in the 19th century. Thousands of steamboats traveled the river and its major tributaries during that time, said Steve Marking, a river historian and guest performer for American Cruise Lines on its Mississippi River cruises.

The boats took on passengers as well as freight, and companies sought to hire the best musicians to entice people to pay to board, Marking said. Later, even influential jazz musician Louis Armstrong performed for a few years on the Streckfus Steamboat Line.

Other forms of music that arose and were popularized on the river include ragtime in St. Louis and river folk music that featured banjo, fiddle and percussion. Dixieland, a form of jazz, and country music also owe a debt to the river. 

Why capture the Mississippi River in song?

Rivers in general “have inspired almost as many songs as love,” Marking said.

Many people have some sort of connection with them, whether it’s traveling them by boat or simply watching them run. Marking pointed to the song “Watchin’ the River Go By,” by John Hartford, which depicts two people who get together each night on the porch to watch the Ohio River. It’s an experience anyone, young or old, can relate to, he said (well, maybe not completely — the people in the song do so in the nude).

But more than lakes, forests or prairies, rivers are captured in song over and over again. Why?

It could be their heavy symbolism. For Marking, rivers signify the passage of time, reminding us of our journey through life.

“If you’re standing on the shore,” he said, “upstream is the past, downstream is the future.”

Rivers also make a connection — between places, or even between the past and the future.

The musicians who still travel the river today are helping make that connection, Marking said, including the ones who make up Big Blue Sky. He described taking the boat tour and listening to them play “Water Song” as “one of the top five events of my entire life.”

It’s easy to see why. The group’s music both honors the river’s musical traditions and adds something new: an eye toward its ecological importance. In between songs, passengers got to hear about Stravers’ decades of bird research on this stretch of the river, including monitoring of the cerulean warbler, one of the rarest nesting warblers in Iowa. They stopped to watch a beaver on an island waddle through the sand to make his way back to the water. And they were granted what the captain called one of the best sunsets of the summer: a bright, show-stopping pink.

Though most of their songs evolve over time, Stravers said, “Water Song” pretty much gets played the same every time. The exception is in his echo to Landis’s main melody, where he regularly inserts the name of whatever water body they’re playing on to remind listeners they need it to live.

Sacred Mississippi River water, indeed. 

Want to hear more? Check out this Mississippi River playlist!

This story is a product of the Mississippi River Basin Ag & Water Desk, an independent reporting network based at the University of Missouri in partnership with Report for America, with major funding from the Walton Family Foundation. 

The post Rollin’ on the river: How the Mississippi flows through song and still inspires today appeared first on Mississippi Today.

Turnage Drug Store survived both world wars, the Great Depression, the rise of chain pharmacies and the decline in popularity of the soda fountain. 

But the 119-year-old Water Valley pharmacy may now be facing its greatest threat yet: untenable reimbursement rates and non-negotiable contracts from pharmacy benefit managers, said co-owner Robert Turnage. 

Turnage is one of many independent pharmacy owners in Mississippi who fear that if more stringent regulations are not imposed on pharmacy benefit managers, their businesses – some of the most accessible health care providers, particularly in rural parts of the state – may be forced to close. 

“Everyone here is on the verge of closing their doors if something drastic is not done,” Bob Lomenick, the owner and pharmacist at Tyson Drugs, Inc. in Holly Springs, told lawmakers at the House Select Committee on Prescription Drugs meeting Aug. 21 at the Capitol. The meeting room was filled with independent pharmacists who came from around the state to plead their case with legislators.

Pharmacy benefit managers are private companies that serve as the middlemen between pharmacies, drug manufacturers and insurers. They negotiate pricing and conditions for access to drugs, process prescription claims and manage retail pharmacy networks. 

A Federal Trade Commission report published in July sounded alarm bells about the companies’ “extraordinarily opaque” business practices and the considerable influence they exert upon independent pharmacies, or retail pharmacies not owned by a publicly traded company or affiliated with a large chain. 

Pharmacy benefit managers’ anti-competitive business practices have increased prescription drug costs and diminished access to medicine and patient choice about which pharmacy to patronize, the report said. 

U.S. Congress is also investigating the impact of pharmacy benefit managers’ business practices. 

There are about 380 independent pharmacies in Mississippi, said Robert Dozier, the executive director of the Mississippi Independent Pharmacy Association, an organization that advocates for the interests of 180 pharmacy members.

A significant portion of Mississippi’s population, especially in rural areas where chain pharmacies are less likely to exist, is reliant on independent pharmacies, said Meagan Rosenthal, an associate professor in the University of Mississippi’s Department of Pharmacy Administration. 

A pharmacy closure in a rural area is likely to create a pharmacy desert, or an area with limited or no access to a pharmacy. Research has shown that pharmacy closures have negative impacts on patients’ health, especially in medically underserved areas.  

Over 300 pharmacies closed nationwide in 2023, said Joel Kurzman, the director of state government affairs for the National Community Pharmacists Association, a national organization that advocates for independent pharmacies. 

“It’s a startling figure,” he said. 

Shrinking reimbursements

Sharon Bonck, a pharmacist at Sartin’s Discount Drugs in Gulfport, said the rates pharmacies are paid for dispensing prescription drugs to patients with health insurance have dwindled over the past 10 years. In the past two or three years, however, the rates have become “disastrous” for business. 

Some prescriptions yield negative, or “underwater,” reimbursements, or payments from health insurance plans that are less than the pharmacy’s cost to acquire the drug. Others don’t earn a profit high enough to meet the pharmacy’s average operating expenses.

Pharmacy benefit managers set reimbursement rates for pharmacies by contract. But independent pharmacies often do not have the leverage to negotiate the terms of the contracts.

“I’ve never, never, not one time, been able to negotiate a contract,” said Lomenick. “It’s take it or leave it. If I don’t take it, I won’t have patients coming into my store.” 

Independent pharmacies are faced with a difficult decision: sign a contract that may not adequately compensate them for their service, or turn it down and lose customers. 

As reimbursement payments for some health insurance plans have waned, pharmacists have begun to more often choose the latter. 

Russell Love, the owner of Love’s Pharmacy, a chain of three pharmacies on the coast, said he stopped filling prescriptions for patients with TRICARE, a health insurance program for military service members and their families, and Magnolia Health’s Ambetter health insurance this year, also due to low reimbursement rates. Beginning in 2025, he will not accept Medicare Part D plans. 

“A lot of veterans can’t get their meds at their local pharmacy,” said Todd Dear, associate director of the Mississippi Board of Pharmacy, at the legislative committee hearing Aug. 21. 

TRICARE prescription claims are managed by Express Scripts, one the three largest pharmacy benefit managers in the country. Together, CVS Caremark, Express Scripts and OptumRx managed 79 percent of prescription drug claims for about 270 million Americans in 2023, according to the Federal Trade Commission’s report. 

These three pharmacy benefit managers also own mail order and specialty pharmacies, health insurance plans, health care providers and companies that market and sell drugs, giving them “significant power over prescription drug access and prices,” wrote the federal agency’s findings. 

The report also indicated that in some cases, pharmacy benefit managers reimburse their affiliate pharmacies at higher rates for specialty, high-cost drugs than for unaffiliated pharmacies.

Express Scripts executives told lawmakers that pharmacy benefit managers work to negotiate rebates with drug manufacturers that result in cost savings for employers who sponsor health plans. 

“Pharmacy access is vital,” said Tony Grillo, Express Scripts’ vice president for supply chain finance. “We do need these independent pharmacists. There are a lot of communities in the state that are small and rural. There’s a lot of communities in this country that are small and rural. We need these pharmacies in our network. It’s not in our interest to put these folks out of business.”

Low reimbursement rates also impact what drugs Mississippians can access at independent pharmacies, like brand name drugs for diabetes and weight loss, including insulin, antidepressants and inhalers. 

GLP-1 drugs, which are used to treat type 2 diabetes and weight loss, have some of the most untenable reimbursement rates, said pharmacist Michelle Little, the owner of Freedom Pharmacy in Hattiesburg. The loss for pharmacies, paired with supply shortages, makes them difficult for patients to access.

Mississippi has some of the highest diabetes and obesity rates in the country. Fifteen percent of Mississippians have been diagnosed with diabetes, and 40% are obese. 

Little said she has been forced to turn patients away due to low reimbursement rates. 

“It breaks our heart,” she said. “…We’re not able to service our patients and customers like we have been in the past.”

Limited health care access

Pharmacies may choose not to fill a prescription due to low reimbursement rates, but in other cases, pharmacy benefit managers restrict which pharmacies insured patients can visit by creating pharmacy networks. 

Robert Turnage said some of his long-time patients’ insurance plans no longer allow them to fill their prescriptions at Turnage Drug Store. For Water Valley residents, that means a 60-minute round trip drive to Oxford, the closest town with major chain pharmacies. 

“That absolutely has consequences for patients,” said Rosenthal, who said patients may choose to go without their medication to avoid driving long distances. 

Pharmacies that participate in pharmacy benefit manager-designed networks usually agree to accept lower payments in exchange for a higher volume of patients, who are required to use an in-network pharmacy. 

Pharmacists fear being kicked out of pharmacy benefit managers’ networks as retaliation for lodging complaints with the Mississippi Board of Pharmacy, the board’s executive director Susan McCoy told lawmakers Aug. 21.

But more and more, she said, pharmacists are coming forward due to the precarious position of their business. 

“It’s getting desperate times,” McCoy said. “Our pharmacies are starting to come to us and say, ‘you know, it doesn’t matter if I get retaliated against, because I’m not going to be here anyway. Go ahead and do what you need to do to take action against the PBMs.’” 

Reform attempts in Mississippi

Three states have passed laws setting reimbursement floors for prescription drugs and requiring transparency of drug pricing, said Kurzman. Several other states have regulations for their state health plans. 

The Mississippi Legislature passed a law in 2020 that gave the Mississippi Board of Pharmacy additional authority to ensure that pharmacy benefit managers are following the law, including levying fines. 

The board completed an audit of Optum Rx this year – the first pharmacy benefit manager the board has audited – but has not yet released its findings.

It took several years for the board to hire staff to carry out the law and receive approval for budget increases due to the high cost of audits, said McCoy. 

But independent pharmacists say the law isn’t enough – setting minimum reimbursement rates and increasing price transparency are desperately needed reforms to ensure that pharmacies stay afloat. 

For the past several years, state lawmakers have proposed legislation to further regulate pharmacy benefit managers.

In 2023, a bill that would have set minimum reimbursements for prescriptions at the national average drug acquisition cost, or NADAC, died in the House Insurance Committee, chaired by Rep. Jerry Turner, R-Baldwyn. 

NADAC is a price index that approximates the amount pharmacies pay for prescription drugs. 

But pharmacists argue NADAC as a baseline is not enough, because it does not factor in pharmacists’ dispensing and operational costs. Arkansas, which uses a NADAC pricing model, will require pharmacy benefit managers to include dispensing fees in their reimbursements to pharmacies, as a result of an emergency rule passed in September.

A 2024 bill that would have increased pricing transparency and prohibited pharmacy benefit managers from retaliating against pharmacies or charging insurance plans or patients more than the amount they paid pharmacies for a prescription died during the legislative session.

The House Select Committee on Prescription Drugs will make recommendations to the state Legislature after several more hearings. 

“I’m optimistic that the State of Mississippi is going to do something,” said pharmacist Chris Bonner, the owner of Chris’ Pharmacy in Columbus. “It’s going to be too late for some people if they don’t do something soon.” 

The post ‘Desperate times’: Independent pharmacies fear closure, due in part to pharmacy benefit managers appeared first on Mississippi Today.

Lance Evans, the state’s new superintendent of education, said if private schools receive public money they should be held to the same standards as public schools.

“I am going to be very clear — I am a public educator,” Evans said Monday in response to a question about vouchers during a lunch meeting of the Mississippi State University Stennis Institute of Government/Capitol Press Corps. “Bottom line — never doubt that. I support public schools.”

But if the Mississippi Legislature adopts some type of voucher system to send public funds to private schools and it is upheld by the courts, Evans said he would follow those guidelines.

But he said if that should happen, “My goal is to make sure every student has a quality education … I do believe if one single dollar of public money goes into a private school, then every single child in that school has to be subjected to the same assessment of every single student in public school. What I will tell you — that is not just the opinion of Lance Evans. That is the opinion of any superintendent you talk to, any principal.”

If the private schools receive public funds, they also should be mandated – just like the public schools – to accept all students interested in enrolling despite any issue that might make the child more costly to educate.

 “We all have to be held to the same measure. That is the bottom line,” Evans said

Evans, a Mantachie native who previously served as superintendent of the New Albany School District in Northeast Mississippi, was selected in December by the state Board of Education as Mississippi’s superintendent of education. He was confirmed by the Legislature during the 2024 session in April with no dissenting votes, replacing Carey Wright who resigned in June 2022.

Evans assumed his new duties in July.

In recent years as surrounding states enhanced their school voucher programs, there has been growing pressure on Mississippi’s Republican-dominated Legislature to do the same. Those exerting the pressure, though, have made no attempt to change the state Constitution that states clearly that public funds are prohibited from being directed to private schools.

Evans did not address the constitutional language.

While reiterating he would work within the parameters established by the Legislature, he stressed, “make no bones about it. You can write it anywhere you need to write it.  I am a public educator, every day, 365 days a year.”

The post New superintendent: Private schools receiving public money should be held to public education standards appeared first on Mississippi Today.

When Kevin Yu, a 26-year-old Taiwanese golf pro, first entered the gates of the Country Club of Jackson for the Sanderson Farms Championship last week, his dad, Tommy, was driving.

“My dad pulled into the first empty parking spot he saw,” Kevin Yu said. “I told him we couldn’t park there because there was a sign that said the spot was reserved for past champions.”

With no hesitation, Tommy Yu began backing the rental car out and replied to his son, “That’s OK, then we will park in this spot next year.”

Now then, here is the rest of that story: Kevin Yu, whose real name is Yu Chun-an, can park anywhere he wants to park at next year’s Sanderson Farms Championship at CCJ. He earned that privilege by shooting a final round 67, then winning a one-hole playoff with Beau Hossler to claim the first prize of $1,368,000 and his first PGA TOUR victory. The victory also means a two-year tour exemption and entry into The Masters, the Players Championship and the PGA Championship.

Yu did it the hard way. He came from two shots behind in the final round and birdied the difficult, 500-yard par-4 18th hole twice – first to force the tie with Hossler and then to claim the playoff victory. That’s right: He birdied perhaps the most difficult hole on the course twice, back-to-back, with the championship on the line.

“It is a dream come true for me, something I have dreamed about since I was like five years old,” Yu said. “This is the dream of all golfers, to win on the PGA Tour. To do it with my parents (Tommy and Eileen) here is really special.”

Kevin Yu’s dad is a golf pro in Taiwan and introduced his son to the sport at an early age and began teaching him at age 5. He taught him well. Kevin won his first tournament at age 7, beat his father for the first time at age 9 and began competing internationally at age 13.

He earned a golf scholarship to Arizona State, where he is the second-most accomplished golfer in that school’s rich golf history behind somebody named Jon Rahm. This is Yu’s third year on the PGA Tour and third time to play in Mississippi’s only PGA Tour Tournament. He finished tied for 19th in 2022 and missed the 36-hole cut last year. He said he loves everything about the tournament.

“I like the whole environment here,” Yu said. “I like the course layout. I think it suits me. The greens are so pure and they are fast and I like that, too. The atmosphere is easy-going, the course is great.”

Yu came here last week, thinking he was about to play in the last-ever Sanderson Farms Championship because of an announcement weeks ago that the Laurel-based poultry company was ending its sponsorship after a 12-year run.

Said Yu, “I was really sad, because I do love this place and this tournament.”

Then came Friday’s out-of-the-blue news that Sanderson Farms was extending its sponsorship for one more year. “I was so happy to hear that news,” Yu said. “Now I can come back and defend my title.”

And with preferred parking, he might have added.

Yu becomes the third Taiwanese player to win on golf’s most lucrative tour, following first T.C. Chen (1987 Los Angeles Open) and C. T. Pan (2019 Heritage Classic).

“I think this means a lot for all Taiwanese,” Yu said. “I feel like I can be an example. We don’t have a lot of golf courses in Taiwan and the conditions are just OK, not perfect. So I just show them that we can do it by working really hard and dreaming big.”

Yu shot three rounds of 66 and then Sunday’s 67. He did it all in a easy-going manner, smiling and chatting often with course volunteers with his playing partner Bud Cauley in the next-to-last group.

“I was really calm all week even to the last few holes today,” Yu said. He indicated his parents might have had something to do with that.

Tommy and Eileen Yu flew to Jackson from Taiwan last week, and Yu is mighty glad they did.

“I really don’t think I could this without my parents,” he said.

The post For PGA Tour champion Kevin Yu, father knew best and he called it appeared first on Mississippi Today.

Two federally qualified health centers in the Delta will receive a total of $3.6 million over four years from the federal government to expand and strengthen their maternal health services. 

Federally qualified health centers are nonprofits that provide health care to under-insured and uninsured patients and receive enhanced reimbursement from Medicare and Medicaid. They offer a sliding fee scale for services for patients.

Delta Health Center, with 17 locations throughout the Delta, and G.A. Carmichael Family Health Center, with six locations across central Mississippi, beat out applicants from several southeastern and midwestern states.

Two organizations in Tennessee and one in Alabama were also awarded funding this year. 

The grant is focused on improving access to perinatal care in rural communities in the greater Delta region – which includes 252 counties and parishes within the eight states of Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri and Tennessee, according to the Health Resources and Services Administration (HRSA).  

It’s the first of its kind in terms of goal and region, said HRSA Administrator Carole Johnson.

“We have not had a targeted maternal health initiative for the Delta before this program,” Johnson told Mississippi Today. “We’ve had a national competition for rural areas focused on maternal health, but what we were able to do here, in partnership with congressional leaders from the Delta region, was secure some resources that would go directly to the Delta region to be able to address this very important need.”

Johnson said Mississippi applicants stood out because of their ability to identify the most pressing issues facing mothers and babies. 

“What we saw from the applicants and awardees in Mississippi was a real commitment to prenatal care and early engagement in prenatal care, reducing preterm births, as well as expanding access to midwives and community-based doula services,” she said. “And all of those pieces together really resonate with the ways we’ve been looking at how to address maternal health services.”

At G.A. Carmichael Family Health Center, the funds will be directed mainly to expanding services in the three Delta counties in which the center has clinics – Humphreys, Yazoo and Leflore.

Yazoo and Humphreys counties are maternity care deserts – meaning they have no hospitals providing obstetric care, no OB-GYNs and no certified nurse midwives – and Greenwood Leflore Hospital closed its labor and delivery unit in 2022. While OB-GYNs still practice in Leflore County, mothers have to travel outside of it to deliver their babies.

Solving the transportation issue will be a top priority, according to the center’s CEO James L. Coleman Jr.

“We have situations where mothers have to travel 100 or so miles just for maternal health care,” Coleman said. “Especially in times of delivery, especially in times of emergency, that is unacceptable.”

Health care deserts pervade Mississippi, where 60% of counties have no OB-GYN and nearly half of rural hospitals are at risk of closing. 

Inadequate access to prenatal care has been linked to preterm births, in which Mississippi leads the nation. Preterm births can lead to chronic health problems and infant mortality – in which Mississippi also ranks highest. 

That’s why Delta Health Center is committed to using its funds to work together with affiliated organizations – including Delta Health System; Northwest Mississippi Regional Medical Center; Aaron E. Henry Community Health Center; and Converge – to “move the dial” on maternal health indicators across the Delta region, said John Fairman, the center’s CEO. 

“We face many challenges including the recruitment and retention of OB-GYNs to the area,” Fairman said, “and will be exploring models of care that are being implemented in other areas of the country that can be adopted to provide greater access and efficiencies for perinatal health care – with the overall goal of significantly decreasing rates of low birthweight and preterm birth in the Delta.”

The United States currently has the highest rate of maternal deaths among high-income countries, and Johnson said this grant is part of a continued effort from the Biden administration to change that. 

“The president and the vice president have made maternal health a priority since day one and have really called on all of us across the Department of Health and Human Services to lean in and identify where we can put resources and policy,” Johnson said. “One death is one death too many.”

The post Two Delta health centers awarded competitive federal grant for maternal care appeared first on Mississippi Today.

The post Marshall Ramsey: The Cut appeared first on Mississippi Today.

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.

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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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