Why The Five & One?
Health care doesn't fail women because we lack information. It fails because systems are slow to change and rarely built around women's bodies, lives, or timelines. The Five & One exists to make those systems visible.
Each week, we share five signals shaping women's health across care, policy, research, and access, plus one thing just for you. Not trends. Not tips. The real forces that decide what care women can get, and when.
This week
This week, progress takes center stage — but so do its limits. Coverage expands in some places while regulations block it in others. New tools are arriving before women know how to use them. That's the pattern we keep coming back to: the gap between what exists and what's actually reachable. Some of the most meaningful changes in women's health this week aren't happening in labs or hospitals — they're happening in courtrooms, workplaces, and on your wrist. And some of the most urgent problems aren't new. They're just finally getting the attention they've always deserved.
01. What Midwifery Restrictions Reveal About Care Gaps
We recently reported that insurers are expanding coverage for doulas — a real sign of progress in supportive maternity care. But progress in women's health is rarely a straight line, and this week midwives in Georgia are suing to challenge state laws that severely limit their ability to practice. In Georgia, certified professional midwives are required to have a formal collaborative agreement with a physician — a reasonable-sounding rule that in reality is nearly impossible to fulfill, as many physicians simply refuse to enter into these agreements, leaving midwives without a legal pathway and women without options.
The Breakdown
Georgia is one of 38 states that offers no path to licensure for certified professional midwives
More than one-third of Georgia counties are considered maternity care deserts — no OB providers, no birthing facilities
Restrictive scope-of-practice laws drive up intervention rates and eliminate patient-centered choices
Policy variation across states means where you live increasingly determines what care you can access
The Breakthrough: Legal challenges in Georgia, Mississippi, and Alabama signal growing momentum to modernize maternity care regulations, expand the types of providers recognized by law, and begin closing access gaps in the communities that need care most. These cases won't resolve overnight — but they're forcing a conversation that has been too easy to ignore.
Source: NBC News
02. The Workplace Protections Women Aren’t Using
Most pregnant workers don't know this law exists — and it could change everything about how they work. The Pregnant Workers Fairness Act, a federal law that came into effect in 2023, gives pregnant and postpartum employees the explicit right to request reasonable accommodations from their employer — including the ability to work remotely. Yet awareness remains remarkably low among both employees and the employers legally required to comply. A law can exist on paper and still fail to reach the people it was written for.
The Breakdown
The Pregnant Workers Fairness Act covers a wide range of accommodations — including remote work, modified schedules, and reduced physical demands
Most employees have never heard of it — and many employers haven't either, creating an enforcement gap before it even begins
The process for requesting accommodations isn't always clear, leaving women unsure of what to ask for or how
The gap between policy availability and real-world access is its own form of inequality
The Breakthrough: As awareness grows, the Pregnant Workers Fairness Act has the potential to meaningfully reshape how workplaces support women — reducing the health and financial strain of pregnancy and postpartum while keeping women in the workforce. Resources like the one linked below give women the language and confidence to start that conversation with their employer.
Source: Fast Company
03. From Fragmentation to Continuity in Postpartum Care
For too many women, care effectively ends the moment the baby arrives. A six-week postpartum visit — if it happens at all — is often the only formal checkpoint before a woman is considered recovered and returned to routine care. The problem is that postpartum health doesn't resolve in six weeks, and the Jacobs Institute of Women's Health is working to change that with a new initiative connecting the physical, mental, and social dimensions of recovery that have long been siloed across separate providers and systems.
The Breakdown
Postpartum care has historically been under-resourced and short-term, despite documented health risks extending well beyond the first weeks after delivery
1 in 5 women experience postpartum depression or anxiety — yet mental health screening and referral remain inconsistent across care settings
Care is fragmented — OB, primary care, and mental health providers rarely coordinate, leaving women to navigate the gaps on their own
Payment and policy models have only recently begun to recognize postpartum as a longitudinal health phase — meaning providers often aren't compensated for the extended support women actually need
Disparities are sharpest for women on Medicaid and communities of color, where access gaps compound the risk
The Breakthrough: This initiative signals a meaningful shift toward integrated, extended postpartum care — research, policy, and delivery working together to support maternal health well beyond birth. It's an acknowledgment, long overdue, that recovery is not an event. It's a process.
Source: GWU Public Health
04. Cardiovascular Health and Women: A Future We Can Still Change
Nearly 6 in 10 U.S. women are expected to develop some form of cardiovascular disease by 2050 — and we've heard directly from 51& members, including during our recent webinar, that this kind of data lands differently when you realize it's talking about you. Heart disease is the leading cause of death for women in the United States, yet most women still don't see themselves at risk, and many of their providers don't either. Risk accumulates quietly over decades — and the care model is still largely waiting for disease to arrive before responding.
The Breakdown
Heart disease is the #1 killer of women — yet it remains dramatically under-recognized and under-treated in women
Risk builds over time, but prevention and education typically start too late, often after disease has already taken hold
Women and their providers frequently miss sex-specific risk factors and symptoms — heart attacks don't always look the same in women as they do in men
Current care models are reactive by design: focused on treatment after disease onset rather than prevention before it
The Breakthrough: Greater data visibility and growing awareness are pushing care toward earlier education, proactive screening, and lifelong cardiovascular monitoring. The window to change these outcomes is open — but it won't stay open indefinitely.
Source: AHA
05. Your Body Is Talking. Now You Can Understand It Better.
Care isn't just fragmented across conditions — it rarely connects one life stage to the next. ŌURA, maker of the smart ring worn by millions, is developing a women's health-focused AI algorithm designed to track physiological signals — sleep, temperature, heart rate variability, and more — and translate them into personalized, continuous insights across cycles and life stages. The goal is helping women connect what their body is telling them to what it actually means.
The Breakdown
Most health tracking tools were built on male-default datasets — not designed to capture the cyclical, hormonal, and life-stage patterns that define women's health
Women's health signals are continuous; clinical care is episodic — the system sees you a few times a year; your body is signaling every day
There is a persistent disconnect between consumer health data and clinical decision-making — data that could inform care often never reaches a provider
Education gaps leave many women without the tools to interpret their own health signals, even when the data is right in front of them
The Breakthrough: AI-driven, longitudinal health models built specifically for women's bodies have the potential to translate everyday biometric data into earlier insights and more proactive care. The shift from reactive treatment to continuous health optimization is no longer theoretical — it's being built right now.
Source: Oura
Your+1: Where to Start with Strength Training
There is growing attention on the importance of strength training for women — especially in midlife — but knowing where to start can still feel overwhelming. The science is clear: strength training supports muscle mass, protects bone density, and keeps your metabolism working for you as hormonal changes accelerate physical decline. This is less a lifestyle choice and more a long-term health strategy — and one that doesn't require a gym, a trainer, or an hour a day to begin.
The Breakdown
Midlife hormonal shifts accelerate muscle loss, bone thinning, and changes in how your body burns energy — often faster than women expect
Strength training is consistently underutilized as a preventive strategy, despite strong evidence for its long-term impact
Fitness culture can feel intimidating and overly complex, and most health systems don't integrate practical fitness guidance into routine care
The barrier to entry is lower than most women think — consistency matters far more than intensity
The Breakthrough: Strength training is one of the highest-impact things a woman can do for her long-term health — and it can be started at any age, at any fitness level. The guide linked below cuts through the noise and gives you a clear, approachable place to begin.
Start small. Start now. Your future self will notice.
Source: Women’s Health Mag
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P.S. Everything in this issue is exactly why we built 51&. If you want to be part of the community working to close these gaps — in care, in policy, in access — lifetime membership is still open. Join us for $100!