The latest, in a decade-long series of report cards on women's health is out. and the news isn't good -- for the nation or for D.C., Maryland, and Virginia.

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The report gives barely-passing or failing grades to all but two states on many key women's health issues.

If states were students, very few would be promoted to the next grade based on the latest National Women's Health Report Card.

The National Women's Law Center in D.C. and Oregon Health Sciences University have teamed up for this study many times over the last decade and while some key issues are seeing slight improvement, the overall picture is bleak.

The report card shows failing grades in almost every state on key issues for women's health.

Fewer women are being screened for cervical cancer. And diabetes, hypertension, and obesity all on the rise.

The study is the fifth since 2000 and scores are based on 26 indicators, including guidelines set by the Department of Health and Human Services.

Dr. Michelle Tham of George Washington University Hospital says it's a doctor's responsibility to talk with patients about their health. She says that many doctors need to be more direct with patients about issues affecting their health.

"Speaking about weight is such a taboo and it shouldn't be," Tham says. "It's not an emotional evaluation of someone, it's a fact. And I think we should approach it and not be so afraid of talking about it."

As a whole, the U.S. got an unsatisfactory grade.

D.C. placed a dismal 43rd on the list -- failing.

Maryland and Virginia each received unsatisfactory grades overall.

On average, more than one in four women in Virginia, Maryland and D.C. is obese. Those numbers are up almost across the board from the last study, in 2007.

And a surprise is the escalation in binge drinking. In the past month, more than one in ten women consumed five or more drinks in one sitting.

In the Washington area, binge drinking is on the rise, too, with a more than 35 percent jump in the District since 2007.

Vermont and Massachusetts got the best grades -- and those were "satisfactory minus." Louisiana and Mississippi were at the bottom.

The report is broken down state by state, by ethnicity and age, and also gives the 2007 results in each category for comparison. You can see the study here.