The Supreme Court’s controversial Dobbs v. Jackson Women’s Health Organization decision, which was released on June 24, has led to vast disparities in reproductive healthcare access between states. In Wisconsin, the reversal of Roe v. Wade allowed the state’s 173-year-old abortion legislation to be enforced.
Wisconsin’s current abortion legislation comes from an era that had a much less comprehensive understanding of medicine, leaving today’s healthcare practitioners frustrated by unclear language and struggling to apply the law to the modern day.
The 1849 abortion ban includes an exception only in instances during which the mother’s life is at risk. It does not make exceptions for rape or incest. This stands in opposition to the public opinion across the state — a ten-year study by the Marquette University Law School found that roughly 60% of Wisconsinites support abortion access in all or most cases.
Samantha Crowley is a second-year medical student and the leader of the University of Wisconsin–Madison chapter of Medical Students for Choice. Her interest in politics and public health led her to pursue a career in family health or obstetrics and gynecology, but she has been left unsure of her field’s future in her home state.
She expressed frustration with the legislation’s archaic understanding of abortion, which does not indicate whether its definition of abortion comprises procedures in cases of ectopic pregnancy or miscarriage.
“Right now, doctors in Wisconsin don’t know if it’s legal to do their jobs, and that’s terrifying,” Crowley said. “In an emergency, doctors should not have to call a lawyer to ask if they are able to save a patient’s life without being charged with a felony.”
Crowley emphasized her belief that any legislation surrounding healthcare and medicine should be written in close consultation with medical professionals. In failing to do so, legislators risk ambiguities and inconsistencies that can have profound consequences.
Despite being a native Wisconsinite, Crowley expressed reservations about providing reproductive healthcare in the state so long as these laws remain in place. She said a healthcare practitioner wants to work in a place that “provides support for evidence-based treatment,” but Wisconsin’s new restrictions detract from that.
A junior pre-medical student who chose to remain anonymous scorned the fact that these laws take healthcare decisions out of doctors’ hands. He believes that providers being unable to make final decisions on healthcare will “erode the relationship and trust between people and medicine, particularly underserved groups.”
A dearth of available care, particularly in reproductive health, is a problem that existed in Wisconsin long before the Dobbs decision. According to Crowley, “the [reproductive health] landscape in Wisconsin was already bad — there were only four abortion clinics in the state.”
Healthcare inequity is also prevalent in Wisconsin. The state has the nation’s worst record for Black infant mortality, and Black individuals die in childbirth at a rate five times higher than white Wisconsinites.
Sophia Vrba, the president of UW Medical School’s Medical Students Association, is currently in her second year of UW’s MD-PhD program. She is studying to become an OB-GYN, driven by a desire to advocate for patients, and she emphasized the disproportionate impact this decision is sure to have on disadvantaged communities.
Vrba noted that while those with the means to cross state lines will seek abortions in Minnesota or Illinois, groups already suffering from a lack of healthcare access will face much greater “barriers to travel.”
A second-year medical student who chose to remain anonymous expressed concern about what these policies mean for the future of the UW Medical School. If an individual wants to practice as an OB-GYN, she explained, they would be reluctant to attend a school in a state where they would not be able to train and learn about certain procedures.
She also stated UW Medical School is supposedly denying academic credit and malpractice insurance to students seeking externships in less restrictive states so that they can learn procedures such as abortion.
The school’s administration seems reluctant to outline its policy on what training will be provided in these fields, and this was likely because the administration knew it would decrease interest in the program, according to the student.
Gwen McIntosh, the University of Wisconsin School of Medicine and Public Health Associate Dean for Students, said medical students receive didactic training in the full range of reproductive care. However, UWSMPH does not permit medical students to participate in hands-on training for pregnancy termination or abortion due to Wisconsin State Law Wis. Stat. 940.04.
Crowley added that even if the Dobbs decision were to be reversed in the future, Wisconsin would still find itself with a huge number of healthcare practitioners who had not trained in reproductive care procedures, one of many ways in which these laws could have implications far beyond the immediate future.
As healthcare practitioners and legal professionals alike attempt to navigate the suddenly murky landscape of Wisconsin reproductive healthcare, medical students are facing uncertainty and frustration. However, for those who seek to improve Wisconsinites’ quality of life and access to resources, it represents a new set of challenges for providers and patients.