Past Research Projects

Evidence-Based Policy Making: The Role of Experts in Reproductive Health Legislation in Wisconsin

State legislative committee hearings provide a primary venue for public participation in the policymaking process. In addition to providing legislators a gauge of public sentiment on particular bills, these hearings are also one of the few opportunities for experts to educate legislators on issues. This study examines who testifies in committee hearings on bills concerning reproductive health in Wisconsin and documents the barriers to providing testimony by experts in this field.

Examining the Impacts of State-Level Variation in Counseling and Waiting Periods on Racial/Ethnic and Nativity Disparities in Reproductive Health: Estimates for the 21st Century

Mandatory counseling and waiting periods are one of the most common ways that states have restricted abortion access. While supporters claim these laws ensure that patients can make informed care decisions, mandatory counseling often forces pregnant people to listen to misinformation about abortion. Waiting periods and two-visit requirements also lead to delays in abortion care, higher costs of care, and overall decreases in abortion. Yet, we know little about the causal impacts of these policies on the full spectrum of reproductive health outcomes. Understanding these impacts, particularly among marginalized groups who face heightened structural barriers to care, is vital to achieving reproductive equity in a post-Dobbs abortion environment.

To address these knowledge gaps, we examine the impacts of state-level variation in required counseling and waiting periods for abortions on racial/ethnic disparities in reproductive health outcomes. First, using rigorous legal epidemiology methods, we create a comprehensive historical database of state-level abortion restrictions related to mandatory counseling and waiting periods. We find significant increases over the past decade in such restrictions, particularly in the Midwestern and Southern United States. We will integrate these data with nationally representative data on pregnancy- and birth-related outcomes to estimate the causal impacts of these laws, particularly among non-Hispanic Black, Hispanic, and non-Hipsanic Asian pregnant people.

Impacts of Access to Contraception and Abortion Services on Men’s Life Course Outcomes

The life course impacts of contraceptive and abortion access for women as well as the next generation are well documented. Much less research has explored the impacts of these developments for men. This project estimates the effects of access to contraception and abortion on adult men’s outcomes.

Impacts of Poverty Reduction on Achieving Reproductive Health: Leveraging Findings from the Baby’s First Years Study

This project expands an existing study, Baby’s First Years, which estimates the effects of an unconditional cash gift of $4,000 a year for low-income mothers, to include more content on reproductive dignity. Adding this content will create an opportunity to understand the extent to which economic resources affect mothers’ ability to obtain the types of services and contraception they want, as well as more generally their ability to act in accordance with their own reproductive goals.

Patient and Provider Experiences with Medication Abortion in Wisconsin

No studies have examined medication abortion in light of 2012 Wisconsin legislation regarding the delivery of this healthcare service. This project uses qualitative methods to document reproductive healthcare providers’ experiences of medication abortion care delivery in Wisconsin and the impact these laws have on patient experiences.

People’s Abortion Barriers, Decisions, and Experiences as Documented in Anonymous Online Spaces

Accessing a desired abortion can be legally and logistically complicated, time-consuming, and expensive. Much of the research on abortion experiences thus far has taken place in clinical settings, after patients have already navigated systems and been able to access abortion care.

This project uses hundreds of anonymous posts to a widely used online social media platform to examine the real-time barriers and facilitators that abortion seekers encounter, as well as examine how people make abortion decisions and kinds of information and resources they seek. Team members conducted analyses with data from both before and immediately following the rise of COVID-19, allowing for glimpses into how the pandemic uniquely affected people’s abortion experiences.

Physician Attitudes toward Abortion Access at the UW School of Medicine and Public Health

Physicians’ attitudes about health issues—including abortion—can affect public understanding and policy. Little research has assessed abortion-related attitudes and practices of physicians outside the reproductive health sphere. To address this gap, investigators surveyed all University of Wisconsin-Madison clinical faculty about their attitudes and knowledge about abortion.

Racial/Ethnic and Socioeconomic Inequities in Access to Preferred Contraception during the COVID-19 Pandemic

Black, indigenous, and other individuals of color are less likely than non-Hispanic whites to have access to reproductive healthcare and desired contraception methods. It is likely that the COVID-19 pandemic has exacerbated existing inequalities in access to contraceptive methods, but little is known about how and why. To address this question, we use new data from an annual survey of Wisconsin residents to document racial/ethnic disparities in COVID-induced access to desired contraception and also explore the most salient drivers of these gaps.

Structural inequality fundamentally shapes racial/ethnic and socioeconomic inequities in access to reproductive healthcare and contraception. While researchers have traditionally focused on contraception uptake and adherence, we focus on a more relevant measure of reproductive autonomy: preferred contraception use. Specifically, we use new data from the Survey of the Health of Wisconsin collected in January-February 2021 to explore novel socioeconomic correlates of preferred contraception among cisgender women living in Wisconsin. Nearly one-third of participants reported that they were not using their preferred contraceptive method and non-Hispanic Black and other women of color were least likely to do so compared to their non-Hispanic White counterparts. Housing instability, food insecurity, and financial stress were negatively associated with using one’s preferred contraception method. These findings suggest that it is critical to look beyond income alone to reduce socioeconomic inequities in reproductive autonomy.

Religious Restrictions on Reproductive Healthcare: Wisconsin Patient Perspectives

Religiously-owned hospitals, which­ may restrict critical reproductive health services, comprise a large share of hospitals in Wisconsin. However, little is known about how women experience care restrictions in religious health care settings.

In this study, we are fielding a population-representative survey of reproductive-aged women in order to understand Wisconsin patients’ preferences for and firsthand experiences with religious healthcare. We also include a sizeable sample of residents in rural communities, including those in which religious health care is the only feasible option for inpatient care.

Reproductive Knowledge, Attitudes, and Behaviors in the Wisconsin Communication Ecology

While reproductive policies are a matter of intense debate by the current Wisconsin state legislature, we know very little about residents’ knowledge and attitudes in this policy area and how these matters connect to individuals’ political knowledge, preferences, and civic participation.

This study seeks to understand what Wisconsinites’ attitudes about reproductive policies are, how much they know about reproductive rights in their state, and what kinds of appeals are more likely to hold their attention, change their views, and spur them to action. The study includes panel surveys in Wisconsin, Minnesota, Georgia, and Ohio, and combines information from social media, news coverage, legislative behavior, and election data.

Sexual Acceptability’s Role in Women’s Contraceptive Preference and Behavior

Many people are unsatisfied with their contraceptive method, and the majority discontinue their method after several months of use. A critical but understudied influence on contraceptive behavior is sexual acceptability, or contraception’s effects on sexuality.

This NIH-funded study (R01 HD095661-01) investigates sexual acceptability of six reversible contraceptive methods among approximately 2,000 new-start contraceptive users over time, with the ultimate goals of more satisfied and consistent contraceptive users and less frequent unwanted pregnancy.

The Contraceptive Autonomy Project

Contraception is a transformative force for good when people choose it freely, but family planning has not been an emancipatory project for all people since its inception. Rather, family planning has been intertwined with a range of efforts to limit population and to decide what kind of people should see their fertility restricted.

Grounded in this history, this study aims to develop and pilot new metrics that focus on reproductive freedom rather than contraceptive uptake or fertility. Using a sequential mixed-methods study design, this project explores issues of contraceptive coercion and decision-making in global family planning.

Understanding Variation in the Ability to Detect Early Pregnancy

This study follows a diverse group of 4 million U.S. women who use a reproductive health app to track menstrual cycles, ovulation, and/or pregnancy, including women who are trying to avoid pregnancy. We examine menstrual cycle characteristics to understand variation in when women could possibly learn about pregnancy. This research investigates physiological barriers to learning about pregnancy early on—and in particular, physiological barriers that inhibit peoples’ ability to seek abortion in the presence of early gestation abortion bans.

Undue Burden Beyond Texas: An Analysis of Abortion Clinic Closures, Births, and Abortions in Wisconsin

This study estimates the impacts of abortion clinic closures in Wisconsin on access to clinics in terms of distance and congestion, abortion rates, and birth rates.

Who Uses Reproductive Health Tracking Tools? Differences between Users and Non-Users and their Program and Policy Implications

Between one-quarter and one-third of reproductive-age women in the U.S. use reproductive health apps to track menstrual cycles, ovulation, and pregnancy. This study evaluates who uses these apps, why they use or do not use these apps, and how their health, pregnancy, and socioeconomic characteristics differ from those who do not. Understanding the difference between users and non-users is critical given the rapid expansion in efforts to:
– study early pregnancy among app users;
– use apps as a tool to help women avoid pregnancy;
– connect women with services early in pregnancy; and
– apply findings from app-based studies to healthcare referrals and policy environments.