University of Wisconsin–Madison Medical College of Wisconsin

‘The Biggest Problem With Access’: Provider Reports of the Effects of Wisconsin 2011 Act 217 Medication Abortion Legislation

Taryn McGinn Valley, MA; Meghan Zander, BA; Laura Jacques, MD; Jenny A. Higgins, PhD, MPH

WMJ. 2023;122(1):15-19

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Introduction: Abortion legislation in the United States determines people’s access to services, including the abortion modality of their choice. In 2012, Wisconsin legislators passed Act 217, banning telemedicine for medication abortion and requiring the same physician to be physically present when patients signed state-mandated abortion consent forms and to administer abortion medications over 24 hours later.

Objective: No research documented real-time outcomes of 2011 Act 217 in Wisconsin; this study documents providers’ descriptions of the effects of Wisconsin abortion regulations on providers, patients, and abortion care in the state.

Methods: We interviewed 22 Wisconsin abortion care providers (18 physicians and 4 staff members) about how Act 217 affected abortion provision. We coded transcripts using a combined deductive and inductive approach, then identified themes about how this legislation affects patients and providers.

Results: Providers interviewed universally reported that Act 217 negatively affected abortion care, with the same-physician requirement especially increasing risk to patients and demoralizing providers. Interviewees emphasized the lack of medical need for this legislation and explained that Act 217 and the previously enacted 24-hour waiting period worked synergistically to decrease access to medication abortion, disproportionately affecting rural and low-income Wisconsinites. Finally, providers felt Wisconsin’s legislative ban on telemedicine medication abortion should be lifted.

Conclusions: Wisconsin abortion providers interviewed underscored how Act 217, alongside previous regulations, limited medication abortion access in the state. This evidence helps build a case for the harmful effects of non–evidence-based abortion restrictions, which is crucial considering recent deferral to state law after the fall of Roe v Wade in 2022.

Author Affiliations: Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Valley, Zander, Jacques, Higgins); Department of Anthropology, University of Wisconsin-Madison, Madison, Wis (Valley).
Corresponding Author: Taryn McGinn Valley, MA, Collaborative for Reproductive Equity, Medical Sciences 4245, 1300 University Ave, Madison, WI 53706; email; ORCID ID 0000-0003-2866-9518
Acknowledgements: The authors express gratitude for the anonymous family foundation that supported this project and the Collaborative for Reproductive Equity (CORE). They also thank 2 research assistants at CORE at the time of this project: Barbara Alvarez, MLIS, now a PhD student at The Information School at UW-Madison (no disclosures),  for her assistance with coding, and Dr. Emma Carpenter, now a Presidential Management Fellow in the National Institute for Child Health and Human Development (no disclosures), for her assistance with study design. We also thank Amy Williamson of CORE (no disclosures) for her indispensable administrative aplomb.
Funding/Support: This research was supported by a grant from a large, anonymous family foundation. That same foundation provides center funding for UW CORE (The Collaborative for Reproductive Equity), which supplied administrative and research management support for the project. Taryn McGinn Valley is additionally funded by the University of Wisconsin Medical Scientist Training Program NIH grant T32 GM140935. Meghan Zander was supported by the Herman and Gwendolyn Shapiro Foundation through a summer research award and the UW-Madison Department of Obstetrics and Gynecology.
Financial Disclosures: None declared.
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