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What Overturning Roe v. Wade Really Means for People in Wisconsin

Now that Roe v. Wade has been overturned by the new extreme U.S. Supreme Court majority, the Shepherd Express sat down with two Milwaukee doctors who work for Planned Parenthood and asked them how life has changed for both them and their patients in need of an abortion following the Dobbs decision.

PEOPLE MUST HAVE THE FREEDOM TO MAKE DECISIONS OVER THEIR OWN BODIES

KATHY KING, MD, MEDICAL DIRECTOR, PLANNED PARENTHOOD OF WISCONSIN

On Friday morning June 24 when the news came down that the Supreme Court had just taken away pregnant people’s right to bodily autonomy, I was at Planned Parenthood of Wisconsin’s Water Street health center with a waiting room full of people from across Wisconsin who had appointments for abortion services.

Suddenly at 9:10 a.m. without the federal protection of Roe, we who care so deeply about being there for our patients, could not be there for them at one of the most pivotal times in their life. I and my staff had to explain to each of them that, even though they had an appointment, we could no longer provide them with the healthcare they needed. There were tears all around, and it was definitely one of the most devastating days of my 25-year career as an OBGYN.

That day and each day since has been far worse for Wisconsinites who continue to be denied access to essentially all abortion care in Wisconsin. The extreme criminal abortion ban written 173 years ago makes all abortions a felony unless they are deemed necessary to save a person’s life.

Today, Planned Parenthood affiliates in Wisconsin and Illinois are collaborating to increase access for patients needing to travel to access legal abortion. Me and a team of our medical providers travel to the Planned Parenthood of Illinois health center in Waukegan several days a month to provide abortion care. Last week I cared for people from Wisconsin, Indiana, Ohio, and Kentucky - all who were able to overcome enormous barriers to access the healthcare they deserved.

While there are many organizations including PPWI trying to help people access care out of state, we know for some individuals the barriers are insurmountable. Disproportionately Black, Latino and Indigenous people, those with low incomes, and people in rural areas face the greatest barriers to abortion access. Already, people who struggle to make ends meet are often forced to delay abortion services because they need time to secure the funds. They are also less able to take time off from work, secure childcare and access transportation to travel out of state to get the care they need.

IT’S OFTEN MORE COMPLICATED THAN IT MAY APPEAR

Each person’s circumstances for seeking abortion care is different and each pregnancy is unique. I can honestly say that some of my greatest teachers have been the patients for whom I provided abortion care. They have taught me to trust that they know their lives, their needs, and hopes for the future better than anyone else. Making decisions about pregnancy is deeply personal and private. In a country that cherishes liberty and freedom I hope we can all agree that people must have the right to make decisions over their own bodies.

What is often lost in the divisive legal and political arguments swirling around the topic of abortion are these individuals’ lived experiences and stories. Some stories are devastating such as the 13-year-old pregnant after a brutal gang rape. Some stories are heartbreaking, such as the 35-year-old whose desired pregnancy is complicated by a lethal fetal anomaly. And many stories are about the everyday lived experience of those faced with a pregnancy they do not feel they can continue. Over 60% of abortions are performed on people who already have children, so for them it’s about wanting to be the best possible parent to the children they already have.

On the day of the Dobbs decision, I had to deny care to a person whose prior delivery was complicated by a life-threatening uterine rupture. Because of access to timely medical care, she and her baby survived. She was counseled against future pregnancy because the risk would be too great. When she found out she was again pregnant despite using birth control, she chose abortion as the safest option. Abortion was an option she never contemplated before, but now knew it was the best option to protect her health and her ability to care for her family.

WISCONSIN’S EXTREME 173-YEAR-OLD ABORTION LAW

Wisconsin is one of 17 states where abortion is currently inaccessible or severely restricted. In Wisconsin, abortion has been suspended due to the 1849 criminal abortion ban. There is no exception for rape, incest, or risk to physical health. The only exception is to “save the life of the mother” which is ill-defined.

A 2021 STUDY CONCLUDED THAT BANNING ABORTION NATIONWIDE WOULD FURTHER INCREASE MATERNAL MORTALITY BY 21% AMONG ALL WOMEN AND 33% FOR BLACK WOMEN.

Just prior to the Dobbs decision, one of my colleagues performed an abortion for a 12-year-old girl pregnant due to incest. Under the 173-year-old criminal abortion ban in Wisconsin, my colleague could face criminal felony charges with a prison sentence of 6-15 years for helping a child in trauma. Most of my medical colleagues would agree that an abortion in this instance is lifesaving, but that does not prevent a prosecutor from disagreeing given the vague wording of the law. There are situations that are not imminently life threatening such as my patient with a history of uterine rupture when an abortion is the safest medical option. Medical decision making should be based on evidence and accepted standards of care and not influenced by punitive laws written by politicians, especially those written 173 years ago.

Health care providers should never be placed in the position of questioning an otherwise sound and scientifically based medical decision for fear they will be criminally prosecuted. I am seeing negative ripple effects in many aspects of early pregnancy care due to fear and misunderstanding of the law. My patient was denied medication at the pharmacy to treat her miscarriage. Another patient sought consultation because she was denied care for a second trimester fetal demise. A large hospital system questioned whether it was legal to provide care to someone with a stable ectopic pregnancy. There are ongoing efforts to educate healthcare providers on how to practice in a post-Roe landscape, but the reality is that healthcare is being compromised.

ABORTION BANS DISPROPORTIONATELY HARM PEOPLE OF COLOR

Banning abortion is not going to stop abortion—it will only stop safe abortion and it will disproportionately impact communities of color and those with low incomes. Forcing people to continue a pregnancy will magnify the pain, distress, injustice and inequity that already burdens their lives.

As a physician committed to the health and safety of my patients, I know the fall of Roe will exacerbate the maternal health crisis in this country. In Wisconsin, Black women are five times more likely to die from a pregnancy-related cause than white women. A 2021 study published in the journal Demography concluded that banning abortion nationwide would further increase maternal mortality by 21% among all women and 33% for black women.

People who have abortions are your friends, family, neighbors, coworkers, church members. They are people we know and care about. They should not be denied the ability to safely access time-sensitive health care.

Me and my colleagues at Planned Parenthood won’t back down, and we won’t stop fighting with everything we've got to be able to provide our patients with the sexual and reproductive health services and information they need to determine the course of their own life.

ABORTION SAVE LIVES

ALLISON LINTON, MD, MPH, ASSOCIATE MEDICAL DIRECTOR FOR PLANNED PARENTHOOD OF WISCONSIN

I am an OB-GYN who provides abortions. Deciding if or when to become a parent is one of the most personal and life-changing decisions many of us will make. Abortion save lives. This is not just a phrase on T-shirts and bumper stickers. This is a fact. As one of the few abortion providers in a tertiary care hospital, I have been called in to help patients with pregnancies before viability experiencing sepsis after their water broke too early or a hemorrhage from a placenta trying to detach— many of whom were transferred from hospitals that would not or could not provide the abortion the patient needed. Emergency abortions saved their lives.

I have treated patients with new cancer diagnoses unable to receive treatment while pregnant, with severe heart conditions where continuation of pregnancy would be catastrophic, or with organ dysfunction caused by severely high blood pressure related to pregnancy. Abortions saved their lives.

I have cared for individuals who were being trafficked, were raped or were in abusive relationships where the thought of continuing a pregnancy was leading to thoughts of suicide. In all these cases, abortions saved their lives.

NO ONE EXPECTS TO HAVE AN ABORTION

I have met with thousands of patients seeking abortion services, and not a single one of them expected to be there. Life happens. Circumstances change. Complications arise. You don’t know that you’ll need an abortion until you need an abortion. I assure you— you don’t know what you would do, even if you think you do. While people may have differing views about abortion, most of us can agree that we’d want to be able to make our own medical decisions and to access the health care we need when we need it.

Many of us were not alive or are not old enough to remember what accessing an abortion was like prior to 1973 when Roe v. Wade was decided. Whether you “believe” in abortion or not, the ability to access abortion if you, or a partner, or a friend needs it, has been something many of us have been able to take for granted. But if you talk with doctors who practiced before Roe or read their books and essays, you realize abortion prohibitions didn’t stop abortion, they just made them more dangerous.

AS DOCTORS WE TAKE AN OATH TO DO NO HARM AND TO DO WHAT IS IN THE BEST INTEREST FOR THE PATIENT. TODAY, WE ARE FORCED INTO THE IMPOSSIBLE POSITION OF TURNING OUR BACKS ON THAT OATH AND OUR PATIENTS.

Entire wards the hospitals were dedicated to individuals who were sick after unsafe abortions. Pregnant patients died regularly from infection and hemorrhage. Their bodies were scarred from desperate attempts to end their pregnancies—stabbing a sharp object into their vagina, or inserting bleach, acid or other corrosive materials that would burn and erode their vaginal tissues. People who do not want to be pregnant will find a way to not be pregnant. Some will be able to afford to travel to a nearby state where a safe abortion is accessible or access medications through international pharmacies. Others will not be so fortunate.

AS DOCTORS WE TAKE AN OATH TO DO NO HARM AND TO DO WHAT IS IN THE BEST INTEREST FOR THE PATIENT. TODAY, WE ARE FORCED INTO THE IMPOSSIBLE POSITION OF TURNING OUR BACKS ON THAT OATH AND OUR PATIENTS.

IT ALL DEPENDS ON WHERE YOU LIVE

Now that Roe v Wade has been overturned, your ability to access legal abortion depends on what state you happen to live in. Here in Wisconsin, abortion has been suspended due to a 173-year-old law passed decades before women had a right to vote. This law outlaw's abortion with no exceptions for rape, incest or the health of the pregnant person. It makes abortion a felony with prison sentences of up to six years for doctors. Unless our law is changed, doctors face the threat of criminal prosecution and prison time if prosecutors disagree with the medical determination that an abortion was necessary to save the pregnant patient’s life.

This law was written by politicians who had no medical training and passed during a time before ultrasound and other modern medical technology that can now give us the ability to see what is happening with a pregnancy. As doctors we take an oath to do no harm and to do what is in the best interest for the patient. Today, we are forced into the impossible position of turning our backs on that oath and our patients. We must wait until a patient is sick enough to intervene with a lifesaving abortion. We are forced to send our patients who have pregnancy complications, victims of violent crimes and those who are simply not ready or able to be a parent over the border to unfamiliar territory, longer wait times and prolonged personal hardship to access the care they need and want.

Although abortion is currently not accessible in Wisconsin, Planned Parenthood and a team of dedicated health care providers are expanding our efforts to ensure that patients in need of abortion services and other reproductive care get the help they need. Patient navigators from Planned Parenthood of Wisconsin and other affiliates around the country work closely with patients who are forced to travel for essential care to overcome legal, financial, and practical barriers to services. A new partnership between Planned Parenthood of Wisconsin and Planned Parenthood of Illinois has resulted in a dozen Planned Parenthood Wisconsin team members, including physicians, clinicians, registered nurses, and medical assistants traveling to Illinois to support patient care.

I am proud to be a part of this team. Through this effort, we have doubled the capacity to provide abortion at Planned Parenthood of Illinois’ Waukegan health center, helping to meet the 10-fold increase in patient demand from Wisconsin alone.

The reality is, most of us do not realize just how much these laws and court rulings will have serious consequences for people we love and care about. My patients are your family members, friends and neighbors ... maybe even you. They deserve to have the ability to make their own decisions and access the health care they need. I will continue to do what I can to protect this access. I ask that you do, too.

Find out more at PPWI.org

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