Health care providers march for abortion rights at a Madison rally in October 2022. (Photo by Baylor Spears/Wisconsin Examiner)

The Wisconsin State Senate passed SB 553 on Tuesday, Nov. 18, in their last floor session of the year. This bill, purportedly written to define abortion, is actually a covert attempt to exclude abortion from the broader scope of reproductive healthcare. 

Anti-abortion legislators pushing this bill are attempting to play to their religious base who voted them into office to promote an anti-abortion agenda. This is a failing strategy, however, when we’ve seen in countless elections around the country that abortion access is a winning issue, including in Wisconsin. 

The bigger problem, though, is how proponents of the bill are describing it as a way to allow physicians to safely provide care and clarify abortion restrictions, by excluding medical procedures intended to save a person’s life, such as C-sections, the removal of dead embryos, and treatment for ectopic pregnancy, to name a few, from the definition of “abortion.”

Lawmakers are misleading people into thinking that this bill will further define the nuances of care that physicians provide and actually allow, rather than restrict, the provision of care. 

This could not be farther from the truth. We have too many examples nationwide of physicians practicing in states hostile to reproductive rights who are unsure about what care is legal to provide, ultimately leading to unnecessary delays in caring for pregnant people. It is telling that physicians who provide miscarriage and abortion care were not called on to write the text of this legislation. 

Nationally, we have already seen pregnant people die preventable deaths while waiting for essential care for early pregnancy complications because lawmakers stirred confusion and meddled in healthcare decisions. This bill will amplify those dangers in our state, where 13.2 people out of 100,000 die in pregnancy, childbirth, or 42 days after termination of a pregnancy. A study by researchers at the University of Washington and Massachusetts General Hospital showed that these trends, across race, have been worsening in Wisconsin since 2010. 

Black birthing people in Wisconsin account for a disproportionate amount of the disparities in maternal mortality. Adding these racial and systemic inequities to a bill that will delay care for folks across the board, it’s nearly guaranteed that certain groups will have a greater share of these poor outcomes.

As a family medicine and obstetrics physician, I care for folks across the entire spectrum of pregnancy — including miscarriage and abortion. I want to emphasize the similarities in those two scenarios and how they significantly overlap. 

The procedure performed for abortion is identical to the procedure performed for a miscarriage. When a person has a miscarriage or an abortion in the first trimester, generally, a procedure called a “manual vacuum aspiration” or “MVA” can be performed to remove the pregnancy contents. For miscarriages or abortions that occur later in pregnancy, the procedure involves dilating the cervix and removing the pregnancy via a procedure called a dilation and curettage (D&C) or dilation and evacuation (D&E), based on gestational age. 

Additionally, when managing a miscarriage with medications, physicians use mifepristone and misoprostol — medications that lawmakers and anti-abortion activists are actively seeking to restrict because they’re used identically in first-trimester abortions. 

That is the underlying, root issue here: amplifying and reinforcing stigma and criminalization around abortion. 

Carving out the definition of abortion doesn’t actually create medical clarity for providers; instead, it creates a stigmatizing health care space where patients have to disclose and justify why they need certain essential health care. People deserve care and compassion, not judgment or punishment. 

Whether due to miscarriage, abortion, or self-managed abortion, pregnancy loss is not a crime. People should not fear jail time for getting the health care they need. SB 553 aims to differentiate abortion based on intent — a dystopian concept where politicians are in the private space of a doctor’s office. Wisconsinites currently have an opportunity to combat this stigma and call out politicians who are actively harming patients and the patient/provider relationship. 

In my practice already I have seen patients who are hesitant to disclose their pregnancy history for fear that sharing a history of needing abortion care could get them in trouble. Imagine how that influences future decisions to engage with health care providers around miscarriage, abortion and pregnancy complications. 

Wisconsin already heavily regulates how medications for miscarriage are prescribed, including a mandatory in-person dispensing requirement. Those of us who offer this care should not need to feel we must pit our medical expertise against legal jargon when it comes to providing normal, essential care. We need people to be able to trust their health care providers, and we need politicians to stop making laws that pigeonhole physicians into even narrower definitions of care. 

Now that this dangerous bill has been passed in the Senate, it will next head to the Assembly before ultimately landing on Gov. Tony Evers’ desk. In his seven years in office Evers has consistently vetoed anti-abortion legislation, and he has vowed to veto any bill that would limit access to abortion, including SB 553. 

As a physician, it’s devastating to rely on a single individual to preserve my ability to practice safe and necessary health care for countless people and families across the state without political interference. 

There is no other type of health care that is regulated in the unique, stigmatizing, harmful way that abortion care is. Our state politicians need to understand that health care decisions should remain between a patient and their trusted provider. SB 553 ignores that and should not become law.