Wisconsin before and after Roe v. Wade fell

Sarah, a practicing Catholic, registered nurse and mother of four, got pregnant during her freshman year at the University of Wisconsin–Madison. She made an appointment at Planned Parenthood for an abortion, then never showed up. “I chose to have the baby, who is my almost 16-year-old daughter,” says Sarah, who insisted on anonymity to protect her children’s privacy.

It’s the kind of story that anti-abortion protesters like to put on posters, but Sarah is no poster child. “If I’d had the abortion, my life would have probably been great also,” she says. “It was just the choice I made in that moment.”

Sarah embodies the myriad nuances that challenge the narrative that abortion is a black-and-white issue when, in reality, it’s a kaleidoscope. Her upbringing was steeped in nuances. Her grandmothers, both strong, intelligent women she admired, couldn’t have held more opposing views. One was a staunchly pro-life, conservative Irish Catholic who ran her state’s “right to life” organization. The other packed up her kids and drove across the country for an illegal abortion in the 1960s after her husband impregnated her for the fifth time in five years.

Sarah’s pro-choice Catholic mother was open about her abortions. Sarah’s childhood friend, an evangelical Christian, brought her along to anti-abortion rallies. Sarah’s experience has run the gamut and, unlike most, she’s witnessed hundreds of widely varying reproductive experiences — she started her career working in birth centers, then worked two years in abortion and comprehensive care at Planned Parenthood.

“I [was] openly a Planned Parenthood worker at the Catholic Church, I [was] openly Catholic at my work, within reason,” she says, adding that many of the abortion-seekers she met at Planned Parenthood were religious, one even asking to pray together and read from the Bible during a procedure. “When you serve people, especially in trauma work, you need to be able to really check your own stuff at the door in every way.”

Sarah worked at Planned Parenthood in the years after the Wisconsin GOP and Gov. Scott Walker’s administration defunded the organization’s family planning health centers in 2011 (and passed additional abortion restrictions) at a time when only three of its clinics offered surgical abortions in the entire state. She saw patients of “every background you could possibly imagine,” she says. “There is no ‘kind’ of woman who has an abortion.”

In all of Sarah’s professional roles, she carries powerful advice she once received: “You are meeting people at one moment in their life,” she says. “Do not make a story about who they are or what their life is, because you have no idea.”

ALREADY A POST-ROE STATE
While pundits and proselytizers may claim abortion is rare or extreme, one in four women will have an abortion by age 45, according to the Guttmacher Foundation. Most Americans believe in at least some level of abortion access. According to the Pew Research Organization, a clear majority — 61% of Americans — believe abortion should be legal in all or most cases. Yet in June 2022, the nine-person U.S. Supreme Court’s Dobbs v. Jackson decision overturned Roe v. Wade, turning the fate of abortion over to the states.

In Wisconsin, the Dobbs decision automatically triggered an 1849 Wisconsin state law that makes conducting abortions a felony, even in cases of rape or incest, with the one exception being to “save the life” of the mother — a subjective phrase that has left doctors confused and fearful. Twice, Gov. Tony Evers attempted to introduce updated measures to protect abortion access. Twice, Wisconsin’s GOP-led Legislature gaveled in and gaveled out. In the November election’s advisory referendum, 85% of Dane County voters said they wanted the 1849 law overturned. In 2022, multiple Marquette University Law polls showed that an average of 60% of Wisconsin voters opposed the overturning of Roe, and 83% believe in exceptions for rape and incest. Democrats narrowly held on to the governor and attorney general’s seats, but the GOP majority and the much-contested redistricting lines remain, and so does Wisconsin’s ban.

Many who seek abortion are already parents; across the U.S., 59% of abortion-seekers have completed a pregnancy. According to Department of Health Services records, 6,472 people induced abortions at Wisconsin clinics in 2021. Sixty percent were age 25 or older  — only 3% were younger than 17. Twelve percent were married at the time and 90% had at least a high school diploma or GED.

Those numbers only track Wisconsin clinics. Between 2015 and 2020, an average of 529 Wisconsinites each year accessed abortion at clinics in Illinois, which doesn’t require mandatory waiting periods or counseling. Post-Roe, the number of Wisconsinites seeking abortions in Illinois was anticipated to surge into the thousands, and the Rockford Family Planning Foundation, a new Madison-based nonprofit, is leading an effort with retired OB-GYN Dr. Dennis Christensen to build an abortion clinic just over the state line.

In 2021, Wisconsin’s abortion rate was 5.9 per 1,000 women ages 15-44, about half the national average of 11.4. Nationwide, the abortion rate has dwindled from a peak of 29.3 in 1981 as a result of decades of state-level barriers designed to eliminate abortion entirely. A February 2022 report also estimated that 54% of all abortions are done with pills (a combination of misoprostol and mifepristone), up from just 39% in 2017. That percentage will likely rise, as at-home abortion pills are now accessible through the mail from Europe-based nonprofit Aid Access — and requests from Wisconsin have tripled since Roe fell, according to research cited in a Wisconsin State Journal report. This year alone (as of October 2022), 54 new abortion restrictions were enacted across the U.S. All of this and more is why many see the fall of Roe not as the end result of a long-waged campaign, but as the beginning of more restrictive measures to come.

“Roe v. Wade is one step on the way to abortion abolition. Abolition [means] under no circumstances in any state in the country for anybody, no exceptions, no abortion,” says Mary Moore, one of Madison’s longest-serving certified nurse midwives — she has “caught” more than 1,800 babies, and cared for women and birthing individuals at every stage of their reproductive lives. “There have been a million different steps. The strategy for many years has been obstruct, obstruct, obstruct. Chip away from the side, make more conditions, make it harder, decrease access by harassing providers, and sometimes killing them … then putting in place legislation that just makes it harder and harder and harder.”

COMPLEX AND MULTIFACETED
Putting up barriers doesn’t stop abortion; it just makes it more traumatic and dangerous, particularly for those with additional barriers. For example, according to the Centers for Disease Control, Black women are three times more likely to die from a pregnancy-related cause than white women — five times likelier in Wisconsin, which also ranks first in the nation for Black infant mortality — due to multiple factors including implicit bias in health care, structural racism and unfair social determinants. Black women sought 35% of all abortions in Wisconsin last year. Now the last four remaining abortion clinics (including two in Milwaukee County, where 69.4 percent of Wisconsin’s Black population lives) are gone.

“I think about the barriers that have been created right now, and particularly as a Black woman, how dangerous that is when you live in a community where giving birth makes you three times more likely to die if you are Black,” says Ali Muldrow, president of the Madison Metropolitan School District Board of Education. “It’s almost as if there is a movement that wants you to risk your health and safety whether it is right for you or not, for the sheer sake of doing it, with no relationship to positive outcomes. With no relationship to supporting parents. With no relationship to investing in education.”

Those most at risk of poor outcomes — relating to social, socioeconomic, emotional, mental and physical health, as well as racial and gender identity, particularly transgender men and nonbinary individuals — are people who don’t or can’t speak out. (In declining our interview request, one local woman who works directly with these at-risk populations said that she hoped her allies could “carry the heavy lift on this one.”)

Despite her identities as a Black, queer mother, Muldrow requested we use her full name and likeness in this article. She says her high-visibility roles on the school board and as co-executive director of the Gay Straight Alliance for Safe Schools of Wisconsin give her a level of privilege.

“I think in the areas where I’m not safe, being quiet isn’t going to protect someone like me. I am Black and I am queer, and just trying to get along isn’t going to work,” Muldrow says.

Muldrow grew up in poverty on the eastside of Madison, but she felt resource-rich in a lot of ways — she was part of a supportive spoken word community and had a mom who made sure she knew where the feminist bookstore was. Still, when she became violently ill at age 16 and was shocked to find out she was pregnant, she didn’t want her family to know. On the back of a bookmark she’d snagged from A Room of One’s Own bookstore was a list of resources, including the number for an attorney who could secure a judicial bypass, which is a legal option for pregnant minors to obtain an abortion without parental consent. (Twenty-three such petitions were granted in Wisconsin in 2021.)

“I could thank this woman every day of my life. She asked me questions about what I wanted for my life and who I thought I was and why this was the right decision for me,” says Muldrow, who felt the same way about the female judge. “They were so kind, they were so gentle, they were so encouraging. They had so much respect for me as a young person and it was a life-changing experience in so many ways.”

Muldrow took $500 of her earnings from her job at KFC and went to Planned Parenthood as a Jane Doe. While she has complex emotions around how that legal process unnecessarily prolonged an unwanted pregnancy, she’s grateful for that abortion.

“I was a 16-year-old who was really struggling in a lot of ways and thriving in a lot of ways simultaneously,” she says. “I wanted the time to see myself become the person I wanted to be.”

Muldrow also saw how her pregnant peers who were forced to give birth or chose to keep their babies were treated.

“It’s not like when you’re a teenager who decides to have a kid, people are happy for you [or] show up to support you,” she says.

Starting during college, Muldrow spent four years in an emotionally and physically abusive relationship, further validating her decision. “I wasn’t at a place in my life where I valued myself enough to protect myself from harm,” she says. “What would it have looked like to drag a toddler into that space in my life?”

Then she got pregnant at 22. “I think domestic violence and coercion around pregnancy and birth are deeply linked, and I do think that was part of my experience,” she says. This time, she felt a strong desire to become a mother, “and what I had thought was tolerable for me as a single young person was not tolerable for me as a parent.”

Muldrow left her abuser when her baby was 8 days old.

“I’ve always wanted to be a parent, so it’s not that I don’t value the opportunity to have kids,” says Muldrow, who is now married with three children. “I just think it has to be on your terms, and those are complex and personal and multifaceted for everybody.”

As a member of the LGBTQ+ community, Muldrow respects and values adoption as a “passport to parenthood” for families who want a child, but not as a required alternative to abortion as some people argue.

“Adoption isn’t this magical thing [where] a kid is born unwanted and there’s always just a great home right around the corner. That isn’t how it works,” she says. “They’re not saying that [adoption is the best alternative] because they’ve given a kid up for adoption [or] they were adopted. They’re saying this from a completely dissociative place, from this posturing of compassion and empathy that isn’t rooted in any kind of reality or personal experience.”

It also forces people to endure an unintended and unwanted pregnancy, which research shows is negative in every way.

GRAVE CONSEQUENCES
In October, the University of Wisconsin–Madison’s Collaborative for Reproductive Equity, or CORE, released updated research predicting, post-Roe, a 20% reduction in abortions among Wisconsin residents and 30% fewer among Dane County residents — a victory, no doubt, for anti-abortion activists. Fewer abortions — what could be bad about that?

For one thing, it doesn’t necessarily mean fewer abortions; many Wisconsinites already travel out of state for services. For another, CORE’s update built on existing research that suggests that people who are forced to carry out unwanted pregnancies suffer “major negative health and wellbeing consequences.”

“[That includes] people who face income scarcity,” says CORE Director Jenny Higgins, “[and] people living in rural areas who have lost physical access to clinics, as they’ve closed as a result of a variety of restrictions put into place after Walker’s administration took over.”

Abortion restrictions hit low-income families hardest, putting the burden of securing transportation, time off work and child care on top of the expensive, out-of-pocket procedure. Most insurance plans don’t cover abortion, and the 1973 Hyde Amendment blocks the use of federal funds for abortion care, including for anyone on Medicaid or Indian Health Service benefits, and for Wisconsin state employees. In its 2017 report, Guttmacher showed that 49% of abortion-seekers lived below the federal poverty level and another 26% lived just above it. By 2017, long before the fall of Roe, 70% of all Wisconsin women lived in counties without an abortion clinic.

“We’ve already documented that those closures led to a significant decrease in abortion and significant increases in births in those counties that lost the most physical access,” says Higgins. To be clear, CORE researchers aren’t studying the outcomes of unplanned pregnancy itself — they are specifically studying what happens when you deny abortion to people who want it.

“Research has documented abortion restrictions with increases in maternal mortality … they are more likely to stay in abusive relationships … more likely to be living in poverty in the years following,” Higgins says, citing the University of California–San Francisco’s landmark, longitudinal The Turnaway Study, which conducted interviews with nearly 1,000 women across 21 states over five years. Across multiple measures, restricting access to abortion had negative outcomes for the women and often serious financial and developmental implications for the born children.

Notably, The Turnaway Study also showed that successfully accessing abortion did not increase women’s risk of suicidal thoughts, PTSD, depression or anxiety. It did not increase their use of alcohol, tobacco or other drugs. Those who received a wanted abortion were more likely to have a positive outlook on their future and achieve aspirational life plans within one year, and 95% said abortion was the right decision for them.

TRAUMATIC SYSTEMS
As a domestic violence survivor, Katherine, who insisted we withhold her last name to protect her and her children’s safety, has firsthand experience with reproductive coercion leading to unwanted pregnancies. (Examples of reproductive coercion may include tampering with birth control, or the nonconsensual removal of a condom during intercourse — a violation known as “stealthing,” which is not illegal in Wisconsin.) As a former midwife, she worked with a nonprofit serving abuse victims, teens, refugees, and low-income and incarcerated individuals, where she assisted births in which the women were shackled to beds. She says it’s the systemic barriers to abortion that are traumatic, not abortion itself.

“It’s a big life decision to not carry a pregnancy and it’s a very desperate, dire, vulnerable, exhausting and isolating situation that, without personal care and without personal community, is traumatic,” she says. “Abortion is not new. Women have always had abortions, and we’ve had safe abortions. … Desperate women are going to have unsafe abortions because they don’t know where to look for help and care.”

Katherine was already a mother of two when she began miscarrying after an unplanned pregnancy that occurred while she was on birth control. She went to the hospital dictated by her health insurance but was turned away because it is Catholic-owned, as 30%-40% of Wisconsin hospital beds now are.

“It was prior to when a heartbeat could be detected and, due to Catholic policies, if a heartbeat cannot be detected then they could not tell if the pregnancy was viable so they were unwilling to give me care to complete the miscarriage,” she says. Unable to afford the out-of-pocket expense somewhere else, she was sent home twice — then hospitalized with septic shock, after which she endured an emergency dilation and curettage procedure, or D&C, under anesthesia and spent four days in the hospital. After, her physicians warned her she might lose her fertility due to how extensive the infection was.

“And this was just due to, despite the fact that abortion was legal in Wisconsin, this specific policy from this hospital that dictated that I wasn’t eligible to receive care due to their religious beliefs,” she says.

There is an urge to justify abortion protections by highlighting the most traumatic examples — child sexual assault, rape, incest, saving the life of the pregnant person. But there are plenty of people who say that abortion saved their lives in a very ordinary way.

Dana Maya, a first-generation Mexican American, was a 26-year-old broke graduate student in a stable, long-term relationship with a “really good guy” when she found out she was pregnant despite having used contraception. They knew immediately that abortion was the right decision for them — sad, but “it wasn’t a tragedy at all,” she says — and she went to Planned Parenthood. “I just remember one of the nurses holding my hand when the procedure was happening and giving me that human connection, and I just felt super supported throughout,” she says. “I only remember those positive things.”

Two years later, Maya met the man who would become her husband of 24 years and the father of her now-19-year-old twins. They built the life they wanted, each earning higher degrees and snagging good jobs with good benefits; Maya removed her IUD two days after her husband got a tenure-track position, the decision to become a parent so deeply entwined with having a stable income.

Looking back, Maya now sees her abortion not as a way she avoided mothering, but as a way she actually mothered herself, her future daughters, and even her own mother and grandmother, both powerful single mothers and immigrants of Mexican heritage who managed to raise families despite major systemic barriers. In choosing to share her abortion experience with them instead of keeping it hidden, and in sharing it for this story, she hopes to add her voice to those who refuse to be silenced.

“I’m so glad to be vocal as someone who has had an abortion,” she says. “And I’m just so mad, too, that it would be [considered] brave.”

UNSUITED FOR LEGISLATION
Ingrid Andersson’s parents met in Chicago in the 1960s, where her Swedish immigrant mother endured traumatic birth experiences in hospitals and positive, empowering (albeit illegal and mafia-run) abortions in backstreet hotels.

“The whole abortion and bodily autonomy issue for me is both simpler than it appears in American society and way more complex,” Andersson says. “I grew up with that culture that even the most conservative, right-wing [politicians] in Sweden would not question the right to abortion on demand. It’s not that people are different, but the systems are different.”

Andersson, like Mary Moore, is a longtime certified nurse midwife who has “caught” more than 1,200 Madison-area babies. She served as past president of the Women’s Medical Fund, which helps fund abortions, and in 2019 she co-founded Pregnancy Options Wisconsin: Education, Resources & Support Inc., or POWERS, “an organization of doctors, midwives, doulas, educators and activists committed to strengthening our communities and world through trust in pregnant people.” POWERS offers resources on a range of options from “pregnancy continuation” (including adoption) to “pregnancy release” (including miscarriage). Andersson’s primary goal is destigmatizing abortion and bringing it into the fold of “basic health care.” She’s been on the front lines of the fight for reproductive autonomy nearly all of her life, but she had a different response than many did to the fall of Roe v. Wade.

“Everybody else was devastated, kicked in the gut, telling me they wanted to vomit — and I wanted to jump for joy,” Andersson says. To be clear, she was devastated — but unsurprised, and well aware of the ways in which abortion access was already restricted in Wisconsin. She suspected the extreme move would mobilize people. Sure enough, in the short months between Justice Samuel Alito’s leaked brief and the Dobbs decision, the Women’s Medical Fund gained hundreds of new volunteers and thousands of first-time donors. “So it’s been very clarifying and motivating and hopeful,” she says.

Moore doesn’t characterize how she feels as hopeful, but she does want people to know that educating about abortion options is not illegal — at least not yet.

As a certified nurse midwife, or CNM, for 26 years who has practiced in both hospitals and home settings, Moore couldn’t give out abortion pills, even when abortion was legal. CNMs are legal prescribers just like nurse practitioners or physician assistants, but those roles are considered “mid-level providers,” and in Wisconsin, mid-level providers are not allowed to perform abortions. (In 2019, Planned Parenthood sued the state of Wisconsin over this.) Despite the current legal landscape, Moore is happy to counsel people about their options.

“I’m happy to talk to people about what self-managed abortion looks like,” Moore says. “I’m happy to talk with people who are bleeding when they’re pregnant, about how much is OK at home and when they should go in and seek care … and help them sort out what they need so that they’re not just sitting alone.”

Wisconsin’s governor and attorney general (who narrowly retained their seats against vocal anti-abortion candidates), Dane County’s district attorney, and Madison’s mayor and police chief have all said they won’t prosecute people for providing abortions. But many worry about the opportunity for selective enforcement, particularly for those living in areas outside of Democratic strongholds.

“There are places in the state where the prosecutors are waiting for somebody, waiting to find a test case,” Moore says. “Being at the mercy of [these people] is frightening for the docs who are working out in those areas.”

Selective enforcement is not only a potential threat to those who travel out of state or undertake self-managed abortions at home, but also to educators like the University of Wisconsin School of Medicine, who now find themselves in the bizarre position of being required to make abortion training available for OB-GYN residents in order to maintain national accreditation in a state where abortion is illegal. This training is critical for patients who need life-saving emergency terminations because of medical complications, including ectopic pregnancies, and also comes into play at the 20-week ultrasound, where fetal anomalies and nonviable fetuses are sometimes discovered.

“It’s always been a hard job to be the person who has to walk in the room and tell a family with a wanted pregnancy that they have a fetal baby that’s not OK,” Moore says. “Now that job is complicated by, ‘What can we do for them?’ ”

Moore says every pregnancy is a “cataclysm in someone’s life.” No matter what a person chooses, “You are not the same person you were before,” she says. “Nothing about your body is the same. Nothing about your psyche is the same. Nothing about how the logistics of your day-to-day life works is the same. It’s not OK to say to somebody, who has a mass of cells in their body the size of a walnut, that they are obligated to that life course. It’s not OK. It’s just not OK.”

Incidentally, like Sarah, Moore was raised Catholic and attended 12 years of Catholic school. She says she is “not unsympathetic to the religious perspectives” at play here. But what about after those babies are born? It’s not pro-family to defund public schools, she says, or to deny funding for day care, family leave or health insurance. “It’s ridiculous to say this is a pro-family culture — we’re probably one of the least pro-family cultures on the planet,” she says.

It’s complicated — and Moore says that’s the point.

“To me what that says is legislation cannot have anything to do with this,” Moore says. “This is not appropriate to legislate, period, full stop. It’s just not.”

Maggie Ginsberg is a senior editor at Madison Magazine. IG: @maggie.ginsberg

Editor’s note: A clarification was made to this web article after it went to print to make it more clear that the Planned Parenthood clinics that were defunded in 2011 were not the clinics providing abortion services.