Following the U.S. Supreme Court’s Dobbs decision in June 2022, the threat of Wisconsin’s 1849 abortion law, widely interpreted to criminalize abortion provision except in life-saving emergencies, detrimentally altered the ability of physicians to provide healthcare for pregnant patients and harmed patients facing pregnancy complications according to a new study by UW Collaborative for Reproductive Equity researchers.
The study, published today in JAMA Network Open, is the first to document the myriad harms caused by the threat of a criminal abortion ban in Wisconsin following the fall of Roe v. Wade. UW obstetrician-gynecologist and assistant professor Abigail Cutler led the work.
How they did it: Researchers interviewed 21 ob-gyns across Wisconsin between June 2022 and December 2023 to document the impact of the Dobbs decision on their ability to provide healthcare to patients with pregnancy complications and better understand the nuanced effects of legal uncertainty on obstetric care.
What they found: Legal ambiguity, compounded by inconsistent interpretations of the law and insufficient institutional guidance from healthcare systems, led to uncertainty and confusion among physicians caring for pregnant patients and substandard, delayed, and fragmented healthcare for pregnant people, including those experiencing medical emergencies.
Study participants described deep conflict between upholding their obligations to patients and jeopardizing their personal safety, wellbeing, and freedom (under the 1849 law, a doctor who provides an abortion can be charged with a felony).
Key context:
- Pregnancy termination may be offered or recommended to pregnant patients due to numerous pregnancy complications, according to widely accepted, evidence-based standards of care.
- For 13 months post-Dobbs, nearly no abortions were provided in Wisconsin. A court ruling in late 2023 partially restored access to services across the state.
Zooming in: Although the 1849 Wisconsin law allows abortions to “save the life of the mother,” physicians and hospitals lacked clarity about when it was legal to provide indicated care. Different interpretations of the vague law meant that the management of patients facing pregnancy complications varied widely across the state. This led to more patient transfers between hospitals and forced patients to travel out of state, both of which can delay or prevent access to care and worsen health outcomes.
The big picture: The Dobbs decision exacerbated preexisting threats to reproductive healthcare in Wisconsin, left physicians in a precarious position between legal vulnerability and patient care obligations, and increased barriers for patients in need of care.
Looking ahead: Findings from this study underscore the need for clear and consistent legal and institutional guidance in the face of abortion restrictions or ambiguous state laws. This guidance is essential to protect the wellbeing of both patients and clinicians.
For more: Read the complete study and view a one-page CORE snapshot summarizing the research.