Women’s Health
Where Have All the OB-GYNs Gone?
What's going on: In the three years after the Supreme Court overturned Roe v. Wade, more than a third of Idaho’s OB-GYNs stopped practicing or left the state. The New York Times found that as of December 2025, there were 170 obstetricians in the whole state, or fewer than two per 10,000 women. Even in more populated areas like Boise, women often have to wait nine months for an annual exam. Idaho has one of the country’s most restrictive abortion bans: Doctors can be charged with a felony and face two to five years in prison if they perform an abortion. While reproductive rights advocates fight to make abortion legal until fetal viability, current restrictions affect the care women receive. Many pharmacists choose not to stock mifepristone (which is used in both miscarriage management and medication abortion) out of fear of legal repercussions, and few doctors will perform dilation and evacuations after fetal demise. Emergency flights for pregnant patients have risen, with more seeking care out of state. One Idaho OB-GYN told the NYT: “My job is to keep a woman safe. But right now, there’s a limit to how well I can do that.”
It’s not just Idaho: A 2025 report found that almost half of US counties are in a “birthing care desert,” with rural areas hit especially hard. There are many factors contributing to the shortage, including lack of training opportunities, minimal institutional investment, and provider burnout. One study found that medical students prioritize states with fewer abortion restrictions “to ensure comprehensive clinical education.” Medical experts from states with the most restrictive abortion bans have also spoken about the exodus of OB-GYNs in the post-Roe environment. Take Iowa, which has the lowest number of OB-GYNs per capita in the US and bans abortion after six weeks. One OB-GYN who left Iowa for neighboring Minnesota, which has constitutional protections for abortion, told NPR, "I could either stay and ruin myself and my career … or I could go and continue to practice OB, which had always been my dream.”
Related: The Four States Where Abortion Rights Are on the Midterm Ballot (The Guttmacher Institute)
TOGETHER WITH MEMORIAL SLOAN KETTERING CANCER CENTER
Thing to Know
That’s what made it so difficult to treat. But now, new hope. In May, the FDA approved a new targeted therapy for TNBC based on a trial led by Memorial Sloan Kettering Cancer Center.
Christina, 33, started treatment after her cancer spread to her bones and she could barely walk. Just a few months later, she walked down the aisle as a bridesmaid at her sister-in-law's wedding. It's a real advance that gives people with TNBC more time and better days. MSK is building on this work, pursuing new treatments for every type of metastatic breast cancer.
Every gift will be triple-matched, helping fund breast cancer research and breakthroughs — but only until October 31 at midnight.
Skimm This
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Turn a word search into your favorite strategy game with Spelltower. Clear the board.
SPONSORED BY ELI LILLY AND COMPANY
Thing to Know
This promotional information is intended for US Residents ages 18 and older
Click here to view Indications and Safety Summary with Warnings.
Overall, about 85% of moderate-to-severe obstructive sleep apnea (OSA) cases go undiagnosed — even though it affects an estimated 24 million adults in the US, Shaquille O’Neal included.
For adults with moderate-to-severe obstructive sleep apnea (OSA) and obesity, symptoms may include loud snoring, choking or gasping for air while sleeping, and daytime exhaustion.
Zepbound® (tirzepatide) is the first and only prescription medicine indicated to treat moderate-to-severe OSA in adults with obesity, along with a reduced-calorie diet and increased physical activity. If these symptoms sound familiar to you or a loved one, it might be time to talk to a doctor.
INDICATIONS AND SAFETY SUMMARY WITH WARNINGS
Zepbound® (ZEHP-bownd) is an injectable prescription medicine used with a reduced-calorie diet and increased physical activity to help adults with:
obesity, or some adults with overweight who also have weight-related medical problems, to lose excess body weight and keep the weight off.
moderate-to-severe obstructive sleep apnea (OSA) and obesity to improve their OSA.
Zepbound contains tirzepatide and should not be used with other tirzepatide-containing products or any GLP-1 receptor agonist medicines. It is not known if Zepbound is safe and effective for use in children.
Warnings - Zepbound may cause tumors in the thyroid, including thyroid cancer. Watch for possible symptoms, such as a lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath. If you have any of these symptoms, tell your healthcare provider.
• Do not use Zepbound if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC).
• Do not use Zepbound if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• Do not use Zepbound if you have had a serious allergic reaction to tirzepatide or any of the ingredients in Zepbound.
KwikPen®: Do not share your KwikPen with other people, even if the pen needle has been changed. You may give other people a serious infection or get a serious infection from them.
Zepbound may cause serious side effects, including:
Severe stomach problems. Stomach problems, sometimes severe, have been reported in people who use Zepbound. Tell your healthcare provider if you have stomach problems that are severe or will not go away.
Dehydration leading to kidney problems. Diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems. It is important for you to drink fluids to help reduce your chance of dehydration. Tell your healthcare provider right away if you have nausea, vomiting, or diarrhea that does not go away.
Gallbladder problems. Gallbladder problems have happened in some people who use Zepbound. Tell your healthcare provider right away if you get symptoms of gallbladder problems, which may include pain in your upper stomach (abdomen), fever, yellowing of skin or eyes (jaundice), or clay-colored stools.
Inflammation of the pancreas (pancreatitis). Stop using Zepbound and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without nausea or vomiting. You may feel the pain from your abdomen to your back.
Serious allergic reactions. Stop using Zepbound and get medical help right away if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, or very rapid heartbeat.
Low blood sugar (hypoglycemia). Your risk for getting low blood sugar may be higher if you use Zepbound with medicines that can cause low blood sugar, such as a sulfonylurea or insulin. Signs and symptoms of low blood sugar may include dizziness or light-headedness, sweating, confusion or drowsiness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, mood changes, hunger, weakness or feeling jittery.
Changes in vision in patients with type 2 diabetes. Tell your healthcare provider if you have changes in vision during treatment with Zepbound.
Food or liquid getting into the lungs during surgery or other procedures that use anesthesia or deep sleepiness (deep sedation). Zepbound may increase the chance of food getting into your lungs during surgery or other procedures. Tell all your healthcare providers that you are taking Zepbound before you are scheduled to have surgery or other procedures.
Common side effects
The most common side effects of Zepbound include nausea, diarrhea, vomiting, constipation, stomach (abdominal) pain, indigestion, injection site reactions, feeling tired, allergic reactions, belching, hair loss, and heartburn. These are not all the possible side effects of Zepbound. Talk to your healthcare provider about any side effect that bothers you or doesn’t go away.
Tell your doctor if you have any side effects. You can report side effects at 1-800-FDA-1088 or www.fda.gov/medwatch.
Before using Zepbound
• Your healthcare provider should show you how to use Zepbound before you use it for the first time.
• Talk to your healthcare provider about low blood sugar and how to manage it. Tell your healthcare provider if you are taking medicines to treat diabetes including an insulin or sulfonylurea.
• If you take birth control pills by mouth, talk to your healthcare provider before you use Zepbound. Birth control pills may not work as well while using Zepbound. Your healthcare provider may recommend another type of birth control for 4 weeks after you start Zepbound and for 4 weeks after each increase in your dose of Zepbound.
Review these questions with your healthcare provider:
❑ Do you have other medical conditions, including problems with your pancreas, or severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems digesting food?
❑ Do you take diabetes medicines, such as insulin or sulfonylureas?
❑ Do you have a history of diabetic retinopathy?
❑ Are you scheduled to have surgery or other procedures that use anesthesia or deep sleepiness (deep sedation)?
❑ Do you take any other prescription medicines or over-the-counter drugs, vitamins, or herbal supplements?
❑ Are you pregnant, plan to become pregnant, breastfeeding, or plan to breastfeed? Zepbound may harm your unborn baby. Tell your healthcare provider if you become pregnant while using Zepbound. Zepbound may pass into your breast milk. You should talk with your healthcare provider about the best way to feed your baby while using Zepbound.
• Pregnancy Exposure Registry: There is a pregnancy exposure registry for women who have taken Zepbound during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry, or you may call 1-844-524-0039 or email at MILEregistry@thermofisher.com or visit https://pregnancyregistry.lilly.com/zepbound.
How to take
Read the Instructions for Use that come with Zepbound.
Use Zepbound exactly as your healthcare provider says.
Use Zepbound with a reduced-calorie diet and increased physical activity.
Inject Zepbound under the skin (subcutaneously) of your stomach (abdomen), thigh, or have another person inject in the back of the upper arm. Do not inject ZEPBOUND into a muscle (intramuscularly) or vein (intravenously).
Use Zepbound 1 time each week, at any time of the day.
Change (rotate) your injection site with each weekly injection. Do not use the same site for each injection.
If you take too much Zepbound, call your healthcare provider, call the Poison Help line at 1-800-222-1222 or go to the nearest hospital emergency room right away.
Zepbound is approved as a 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg injection.
Learn more
Zepbound is a prescription medicine. For more information, call 1-800-LillyRx (1-800-545-5979) or go to www.zepbound.lilly.com.
This summary provides basic information about Zepbound but does not include all information known about this medicine. Read the information that comes with your prescription each time your prescription is filled. This information does not take the place of talking with your healthcare provider. Be sure to talk to your healthcare provider about Zepbound and how to take it. Your healthcare provider is the best person to help you decide if Zepbound is right for you.
ZP CON BS 01SEP2026
Zepbound®, its delivery device base and KwikPen® are registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.
CMAT-45347 10/2026
© Lilly USA, LLC 2026. All rights reserved.
Do not reply to this email. If you have a medical emergency please call 911 or go to your nearest medical facility. If you have a question about a Lilly product, please call 1-800-LillyRx (1-800-545-5979)
PS: This is a sponsored post by Eli Lilly and Company. All rights reserved.
Women’s Health
Where Have All the OB-GYNs Gone?
What's going on: In the three years after the Supreme Court overturned Roe v. Wade, more than a third of Idaho’s OB-GYNs stopped practicing or left the state. The New York Times found that as of December 2025, there were 170 obstetricians in the whole state, or fewer than two per 10,000 women. Even in more populated areas like Boise, women often have to wait nine months for an annual exam. Idaho has one of the country’s most restrictive abortion bans: Doctors can be charged with a felony and face two to five years in prison if they perform an abortion. While reproductive rights advocates fight to make abortion legal until fetal viability, current restrictions affect the care women receive. Many pharmacists choose not to stock mifepristone (which is used in both miscarriage management and medication abortion) out of fear of legal repercussions, and few doctors will perform dilation and evacuations after fetal demise. Emergency flights for pregnant patients have risen, with more seeking care out of state. One Idaho OB-GYN told the NYT: “My job is to keep a woman safe. But right now, there’s a limit to how well I can do that.”
It’s not just Idaho: A 2025 report found that almost half of US counties are in a “birthing care desert,” with rural areas hit especially hard. There are many factors contributing to the shortage, including lack of training opportunities, minimal institutional investment, and provider burnout. One study found that medical students prioritize states with fewer abortion restrictions “to ensure comprehensive clinical education.” Medical experts from states with the most restrictive abortion bans have also spoken about the exodus of OB-GYNs in the post-Roe environment. Take Iowa, which has the lowest number of OB-GYNs per capita in the US and bans abortion after six weeks. One OB-GYN who left Iowa for neighboring Minnesota, which has constitutional protections for abortion, told NPR, "I could either stay and ruin myself and my career … or I could go and continue to practice OB, which had always been my dream.”
Related: The Four States Where Abortion Rights Are on the Midterm Ballot (The Guttmacher Institute)
TOGETHER WITH MEMORIAL SLOAN KETTERING CANCER CENTER
Thing to Know
That’s what made it so difficult to treat. But now, new hope. In May, the FDA approved a new targeted therapy for TNBC based on a trial led by Memorial Sloan Kettering Cancer Center.
Christina, 33, started treatment after her cancer spread to her bones and she could barely walk. Just a few months later, she walked down the aisle as a bridesmaid at her sister-in-law's wedding. It's a real advance that gives people with TNBC more time and better days. MSK is building on this work, pursuing new treatments for every type of metastatic breast cancer.
Every gift will be triple-matched, helping fund breast cancer research and breakthroughs — but only until October 31 at midnight.
Skimm This
Which skimm gets your vote?
SPONSORED BY ELI LILLY AND COMPANY
Thing to Know
This promotional information is intended for US Residents ages 18 and older
Click here to view Indications and Safety Summary with Warnings.
Overall, about 85% of moderate-to-severe obstructive sleep apnea (OSA) cases go undiagnosed — even though it affects an estimated 24 million adults in the US, Shaquille O’Neal included.
For adults with moderate-to-severe obstructive sleep apnea (OSA) and obesity, symptoms may include loud snoring, choking or gasping for air while sleeping, and daytime exhaustion.
Zepbound® (tirzepatide) is the first and only prescription medicine indicated to treat moderate-to-severe OSA in adults with obesity, along with a reduced-calorie diet and increased physical activity. If these symptoms sound familiar to you or a loved one, it might be time to talk to a doctor.
INDICATIONS AND SAFETY SUMMARY WITH WARNINGS
Zepbound® (ZEHP-bownd) is an injectable prescription medicine used with a reduced-calorie diet and increased physical activity to help adults with:
obesity, or some adults with overweight who also have weight-related medical problems, to lose excess body weight and keep the weight off.
moderate-to-severe obstructive sleep apnea (OSA) and obesity to improve their OSA.
Zepbound contains tirzepatide and should not be used with other tirzepatide-containing products or any GLP-1 receptor agonist medicines. It is not known if Zepbound is safe and effective for use in children.
Warnings - Zepbound may cause tumors in the thyroid, including thyroid cancer. Watch for possible symptoms, such as a lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath. If you have any of these symptoms, tell your healthcare provider.
• Do not use Zepbound if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC).
• Do not use Zepbound if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• Do not use Zepbound if you have had a serious allergic reaction to tirzepatide or any of the ingredients in Zepbound.
KwikPen®: Do not share your KwikPen with other people, even if the pen needle has been changed. You may give other people a serious infection or get a serious infection from them.
Zepbound may cause serious side effects, including:
Severe stomach problems. Stomach problems, sometimes severe, have been reported in people who use Zepbound. Tell your healthcare provider if you have stomach problems that are severe or will not go away.
Dehydration leading to kidney problems. Diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems. It is important for you to drink fluids to help reduce your chance of dehydration. Tell your healthcare provider right away if you have nausea, vomiting, or diarrhea that does not go away.
Gallbladder problems. Gallbladder problems have happened in some people who use Zepbound. Tell your healthcare provider right away if you get symptoms of gallbladder problems, which may include pain in your upper stomach (abdomen), fever, yellowing of skin or eyes (jaundice), or clay-colored stools.
Inflammation of the pancreas (pancreatitis). Stop using Zepbound and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without nausea or vomiting. You may feel the pain from your abdomen to your back.
Serious allergic reactions. Stop using Zepbound and get medical help right away if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, or very rapid heartbeat.
Low blood sugar (hypoglycemia). Your risk for getting low blood sugar may be higher if you use Zepbound with medicines that can cause low blood sugar, such as a sulfonylurea or insulin. Signs and symptoms of low blood sugar may include dizziness or light-headedness, sweating, confusion or drowsiness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, mood changes, hunger, weakness or feeling jittery.
Changes in vision in patients with type 2 diabetes. Tell your healthcare provider if you have changes in vision during treatment with Zepbound.
Food or liquid getting into the lungs during surgery or other procedures that use anesthesia or deep sleepiness (deep sedation). Zepbound may increase the chance of food getting into your lungs during surgery or other procedures. Tell all your healthcare providers that you are taking Zepbound before you are scheduled to have surgery or other procedures.
Common side effects
The most common side effects of Zepbound include nausea, diarrhea, vomiting, constipation, stomach (abdominal) pain, indigestion, injection site reactions, feeling tired, allergic reactions, belching, hair loss, and heartburn. These are not all the possible side effects of Zepbound. Talk to your healthcare provider about any side effect that bothers you or doesn’t go away.
Tell your doctor if you have any side effects. You can report side effects at 1-800-FDA-1088 or www.fda.gov/medwatch.
Before using Zepbound
• Your healthcare provider should show you how to use Zepbound before you use it for the first time.
• Talk to your healthcare provider about low blood sugar and how to manage it. Tell your healthcare provider if you are taking medicines to treat diabetes including an insulin or sulfonylurea.
• If you take birth control pills by mouth, talk to your healthcare provider before you use Zepbound. Birth control pills may not work as well while using Zepbound. Your healthcare provider may recommend another type of birth control for 4 weeks after you start Zepbound and for 4 weeks after each increase in your dose of Zepbound.
Review these questions with your healthcare provider:
❑ Do you have other medical conditions, including problems with your pancreas, or severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems digesting food?
❑ Do you take diabetes medicines, such as insulin or sulfonylureas?
❑ Do you have a history of diabetic retinopathy?
❑ Are you scheduled to have surgery or other procedures that use anesthesia or deep sleepiness (deep sedation)?
❑ Do you take any other prescription medicines or over-the-counter drugs, vitamins, or herbal supplements?
❑ Are you pregnant, plan to become pregnant, breastfeeding, or plan to breastfeed? Zepbound may harm your unborn baby. Tell your healthcare provider if you become pregnant while using Zepbound. Zepbound may pass into your breast milk. You should talk with your healthcare provider about the best way to feed your baby while using Zepbound.
• Pregnancy Exposure Registry: There is a pregnancy exposure registry for women who have taken Zepbound during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry, or you may call 1-844-524-0039 or email at MILEregistry@thermofisher.com or visit https://pregnancyregistry.lilly.com/zepbound.
How to take
Read the Instructions for Use that come with Zepbound.
Use Zepbound exactly as your healthcare provider says.
Use Zepbound with a reduced-calorie diet and increased physical activity.
Inject Zepbound under the skin (subcutaneously) of your stomach (abdomen), thigh, or have another person inject in the back of the upper arm. Do not inject ZEPBOUND into a muscle (intramuscularly) or vein (intravenously).
Use Zepbound 1 time each week, at any time of the day.
Change (rotate) your injection site with each weekly injection. Do not use the same site for each injection.
If you take too much Zepbound, call your healthcare provider, call the Poison Help line at 1-800-222-1222 or go to the nearest hospital emergency room right away.
Zepbound is approved as a 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg injection.
Learn more
Zepbound is a prescription medicine. For more information, call 1-800-LillyRx (1-800-545-5979) or go to www.zepbound.lilly.com.
This summary provides basic information about Zepbound but does not include all information known about this medicine. Read the information that comes with your prescription each time your prescription is filled. This information does not take the place of talking with your healthcare provider. Be sure to talk to your healthcare provider about Zepbound and how to take it. Your healthcare provider is the best person to help you decide if Zepbound is right for you.
ZP CON BS 01SEP2026
Zepbound®, its delivery device base and KwikPen® are registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.
CMAT-45347 10/2026
© Lilly USA, LLC 2026. All rights reserved.
Do not reply to this email. If you have a medical emergency please call 911 or go to your nearest medical facility. If you have a question about a Lilly product, please call 1-800-LillyRx (1-800-545-5979)
PS: This is a sponsored post by Eli Lilly and Company. All rights reserved.
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