Reading Time: 6 minutes

This article is part of the Cap Times series Deadly Divide, investigating Wisconsin’s ongoing Black infant mortality crisis. Erin McGroarty reported this story as a USC Annenberg Center for Health Journalism 2026 National Fellow and a participant in the Center’s engagement initiative.

David Crowley leads the largest county in Wisconsin, which regularly ranks among the worst states in the nation for its Black infant mortality rate.

A majority of those deaths typically are concentrated in Crowley’s county, in central Milwaukee ZIP codes.

This crisis isn’t just a policy priority, the Democratic candidate for governor told the Cap Times. It’s a measure of whether Wisconsin can consider itself a success.

Crowley provided those insights in response to a questionnaire from the Cap Times, where health reporter Erin McGroarty is investigating the state’s long-standing status as one of the deadliest states for Black newborns.

U.S. Rep. Tom Tiffany, the Republican nominee for governor, did not complete the questionnaire or respond to multiple emails and phone calls over a seven-week period requesting responses.

The Cap Times has been unable to locate any public statements by Tiffany’s campaign about Black infant health in Wisconsin.

Crowley’s responses to the questionnaire can be found below.

Some responses have been edited for brevity.

Do you consider Black infant mortality a public health priority in Wisconsin?

Black infant mortality is not only a public health priority — it is one of the clearest measures of whether our systems work for every family.

Changing that requires looking beyond hospitals and clinics to include access to maternal health care, doulas, community health workers, stable housing, paid family and medical leave and economic security.

Wisconsin has long known about this disparity. We need sustained commitment to change it.

Would you support policies to improve access to early and consistent prenatal care for Black mothers and others who struggle to access these services?

I would expand access to early and consistent prenatal care through Medicaid. I also support greater access to care through paid family and medical leave, transportation, telehealth, group prenatal care and postpartum home visits.

In 2026, the Wisconsin Legislature passed a bill later signed into law by Gov. Tony Evers to extend the period of time Medicaid covers postpartum care for mothers. Do you support expanding or further modifying Wisconsin’s Medicaid program to improve maternal and infant health?

Yes. However, maternal health begins long before pregnancy. Chronic conditions like hypertension, diabetes, cardiovascular disease and mental health needs often go untreated for years, driving poor birth outcomes and maternal mortality. Expanding health care coverage through a public option is foundational for improving outcomes.

Wisconsin must strengthen maternal health benefits throughout pregnancy and the postpartum year. I support coverage for doulas, community health workers, dental health, nutrition, postpartum home visits and mental health and substance use screening and treatment. Coverage must translate into actual care, requiring stronger reimbursement and provider participation — especially in rural and underserved communities.

Would you support or propose policy to improve access to maternal mental health services, including screening and treatment for postpartum depression and other complications?

Maternal mental health must be treated as a core part of prenatal and postpartum care. I would expand access to routine screening, timely referral and treatment for postpartum depression, anxiety, substance use disorders, and other complications. Medicaid and private insurance should cover these services, including telehealth, home-based support and care delivered through doulas and community health workers. Wisconsin should also expand successful community-based efforts such as the First Breath perinatal care pilot and improve coordination, so families are not left to navigate complex systems on their own.

Do you support initiatives to recruit, train and retain a more diverse maternal and infant health workforce?

A maternal and infant health workforce that reflects the communities it serves can strengthen trust, communication and continuity of care. I would build on the Governor’s Task Force on the Healthcare Workforce recommendations by expanding education and apprenticeship pathways, scholarships and loan repayment, clinical placements in underserved communities, and support for community-based doula and community health worker careers. Recruitment must be paired with fair compensation, supportive workplaces and clear advancement opportunities so Wisconsin can retain the people it trains.

What role should hospitals and health systems play in reducing racial disparities in maternal and infant health outcomes? Would you support statewide quality improvement initiatives or reporting requirements?

Hospitals and health systems should be accountable partners in eliminating racial disparities. They can leverage existing health assessment and improvement-planning processes to identify needs and improve population health. Wisconsin should strengthen this infrastructure so inequities are not hidden within statewide averages.

This requires consistent public reporting of maternal and infant health outcomes by race and geography, strong alignment between local and state efforts, and measurable goals. In addition, hospitals should partner directly with communities to set priorities and design solutions.

Ultimately, quality improvement must be measured by change. When assessments reveal racial disparities, institutions must shift resources to improve outcomes.

Should state government address non-medical factors such as housing stability, nutrition, transportation, environmental exposures and economic opportunity that affect infant and maternal health?

Housing, income, transportation, environmental conditions, food security, paid leave, and child care are maternal and infant health issues because they shape the conditions in which people experience pregnancy, recover from childbirth and raise their children.

I support coordinated investments in affordable housing, nutrition, transportation, environmental protections, paid family and medical leave, affordable child care, and economic security. If we are serious about improving maternal and infant health, we have to invest not only in health care, but in the conditions that make health possible.

Wisconsin does not have an infant death review board as it does for maternal deaths. Do you support creating such a board?

Wisconsin should establish an infant death review system that complements the existing maternal mortality review process. Many states establish a local process, which is a national best practice. Regardless, the process should examine medical and non-medical contributing factors, identify preventable patterns, protect family privacy and issue regular public recommendations. The goal should be learning and prevention — not blame — and the board should include clinicians, public health professionals, community representatives, and people with lived experience.

If elected, would you support specific funding priorities in a state budget to reduce Black infant mortality?

My budget priorities include expanding health coverage, doula and community health worker reimbursement, nurse home visiting, maternal mental health services, prenatal care access, telehealth, paid family leave, and grants for community-led birth equity programs.

Reducing Black infant mortality requires us to be intentional about racial disparities, but these investments also improve outcomes for all Wisconsin families.

Would you support state funding for services such as community health workers or access to doulas care?

Community health workers and doulas provide trusted, culturally responsive support before, during and after birth. I would fund these services through Medicaid reimbursement and sustainable state grants that reflect the true cost of providing these services. Funding should include family-supporting compensation, benefits and training for these workers — not require workers or community organizations to subsidize essential health care through underpaid or uncompensated labor.

Families should be able to choose CHW and doula support without cost or geography becoming a barrier, and the people providing support should be able to build sustainable careers doing this work.

Would you be willing to set measurable goals during your term to reduce Black infant mortality and improve birth outcomes? How would the public know whether your policies are working?

I would establish clear statewide goals to improve maternal and infant health outcomes for all Wisconsin families, with specific goals for reducing Black infant mortality and narrowing persistent racial disparities in birth outcomes.

Those goals should include interim benchmarks developed in partnership with DHS, local health departments, health systems, tribal nations, community organizations, and families. The state should publish an annual dashboard reporting infant mortality, preterm birth, low birth weight, prenatal care access, postpartum follow-up, and other key measures by race and geography.

The public should see where outcomes are improving, where disparities persist and how state investments are performing.

Are there any other state policies or additional funding you believe would improve access to maternal care and decrease infant mortality disparities?

Improving maternal care also requires investments in the conditions that shape health before and after birth. I would support policies that strengthen housing stability, food security, transportation, environmental health, paid leave, child care, and early education. I would also expand access to telehealth and community-based care so rural families and families facing transportation or provider shortages can receive consistent support.

Ultimately, reducing infant mortality requires both a strong health care system and policies that give families the resources and stability necessary to be healthy.

Describe an issue on which you would be willing to work across party lines to improve maternal and infant health.

I would work across party lines to create a statewide infant death review system and expand evidence-based home visiting, doula care and rural maternal health services. These are practical steps that can improve care, identify preventable causes of infant death and give policymakers better information about where resources are needed. Maternal and infant health should be an area where legislators can set politics aside and focus on results for families.

Explain your overall vision for ensuring that every baby born in Wisconsin has an equal opportunity for a healthy start in life, regardless of race or ZIP code.

Every baby born in Wisconsin should have an equal opportunity for a healthy start — but that work begins long before a baby is born.

Healthy pregnancies are shaped across the life course: by whether people can access health care before pregnancy, whether families have stable housing and economic security, whether parents can take paid time to recover and care for a newborn, and whether communities have trusted providers and resources close to home.

My vision is a Wisconsin that improves maternal and infant health for everyone while being intentional about eliminating the racial and geographic disparities that have persisted for far too long. Those goals are not in competition. Many of the investments that can help close the Black infant mortality gap … can strengthen families across our state, including rural communities facing significant health care shortages.

Families and communities should help shape these solutions and government should be accountable for results. We should publicly measure whether outcomes are improving, whether disparities are closing and whether our investments are reaching the people who need them most.

A healthy start should not depend on a family’s race, income, employer or ZIP code. Wisconsin has both the responsibility and the ability to build the conditions in which every family can thrive.

David Crowley says Black infant health is a priority; no response from Tom Tiffany is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 8 minutes

This story is part of the Cap Times series Deadly Divide, investigating Wisconsin’s ongoing Black infant mortality crisis. Erin McGroarty reported this story as a USC Annenberg Center for Health Journalism 2026 National Fellow.

On the night her daughter was born, Masompe Chisenga named her baby Ayah, which means miracle. 

Ayah’s life began far too early. Born at just 22 weeks and 3 days and weighing less than a pound, the newborn fit in her mother’s palm. 

The first 10 months of Ayah’s life would be measured in the quiet hum of a neonatal intensive care unit, the beep of medical machinery, the whir of supplemental oxygen and the prayers of her mother and father. 

That Ayah is now 3 1/2 years old is a testament to her name. 

It’s also a testament, her mother says, to the groundbreaking care she received at American Family Children’s Hospital and UnityPoint Health-Meriter in Madison through a program called Small Baby Care, designed to save the tiniest infants born as early as five months into a pregnancy.

‘Lost for words’

Chisenga never expected to deliver her daughter so early. She carried her first pregnancy to 39 weeks, delivering Ayah’s older brother, Munshya, through cesarean because he was breech, when a baby is situated feet-first in the uterus instead of the typical head-down presentation. 

In Ayah’s case, “everyone was just lost for words because I was only five months pregnant,” Chisenga said. “I was lost and hopeless because at that point I had never heard of any possibility of babies being born that early.”

Doctors came to speak with Chisenga in her hospital room after it was realized she was fully dilated and delivery was inevitable. They explained two options for how to proceed: Chisenga could deliver her daughter and wait for the baby to die, or the doctors could intervene, provide advanced resuscitative care and try to save Ayah. Even with the second option, there would be no guarantee the little girl would survive or, if she did live, ever be able to walk or talk.

“At that moment, they were asking what I wanted to do, and I had no answer,” she said. 

Chisenga spoke with her husband. The two decided they wanted the medical team to try to save their daughter’s life. 

After 28 hours of labor, Chisenga delivered Ayah. The tiny child weighed 15.8 ounces, less than one-seventh the average size of a full-term newborn girl. 

In the maternity ward at UnityPoint Health-Meriter Hospital, a team of neonatologists, nurses, advanced practitioners and specialists were waiting to give her a fighting chance.

“When Ayah was born, I was only allowed to see her for a second, and then they had to take her away and start the process of putting in a breathing tube to get her stabilized,” Chisenga said. “She was very tiny and she was very fragile.”

Ayah was quickly whisked away to the neonatal intensive care unit, or NICU. Chisenga said she felt like she couldn’t breathe wondering whether her child would survive her first day and night.

“For those 24 hours, we waited,” she said. “It was very difficult.”

A nurse helped Chisenga into a wheelchair and brought her next to her daughter’s incubator. The box was full of tubes and wires. Beneath it all, Ayah was fighting for her life. 

It would be 21 days before Chisenga could hold her daughter. 

‘Beacon of hope’ 

Babies born this early are so tiny and fragile that doctors and other providers have to handle them with the utmost care because every aspect of their body, even their skin, is underdeveloped. 

They can’t breathe on their own. They can’t nurse. It isn’t even safe for them to open their eyes because their retinas are too sensitive for the intense therapeutic lights installed in incubators.

Prematurity is considered any delivery before 37 weeks gestation. A delivery between 33 and 37 weeks is considered late preterm, 29-33 weeks is considered moderately preterm, and extremely preterm is any baby born at 28 weeks or earlier. 

In 2024, one in 10 babies in the United States were born preterm, according to the National Center for Health Statistics. For Black infants, that number is closer to one in six. In Wisconsin, about 9.3% of white infants were born preterm in 2024. Among Black infants, 15.6% were born preterm. 

Preterm-related causes of death account for more than 35% of all infant deaths in the United States. For white infants, the percentage is lower, around 15%. The percentage of Black infants in the U.S. whose death can be attributed to being born too early and two small is nearly three times that. 

At the center of Ayah’s care team was Dr. Claudette Onyelobi, a UW Health Kids neonatologist, associate professor of pediatrics at the University of Wisconsin School of Medicine and Public Health and the director of Small Baby Care at American Family Children’s Hospital and UnityPoint Health-Meriter.

“It breaks my heart,” Onyelobi said of the fact that she will statistically see more Black families in her NICU than those of any other race. 

In a perfect world, she said, Black babies would not face such stark disparities in mortality and preterm birth. But until those risks can be eliminated, Onyelobi will work to save the ones who came too soon.

Onyelobi clearly remembers the moment she chose her specialty in neonatology, and it haunts her to this day. 

Nearing the end of her clinical training in 2018, Onyelobi provided care for a family in Wisconsin who delivered their baby at 22 weeks. The hospital in which Onyelobi was practicing didn’t have the medical capabilities to provide life-saving interventions for a baby that small. 

Onyelobi’s only option was to deliver the infant, wrap the baby in a blanket and advise the family that they would need to say goodbye. 

“I held it together for as long as I could stay in that room, and then I stepped out of the room, and I cried all the way to my call room, and then I cried some more the rest of that night, and I cried a little bit more next week, and the week after that,” Onyelobi said. “I said to myself, ‘I am never in my life going to do that again.’”

A lot of doctors have these key moments, typically earlier in their career, when a particular case hits them especially hard and serves as inspiration for years to come. 

“That was the personal experience for me. Maybe it’s not my own child, maybe it’s not a sister or a brother or this person who’s connected to my family, but that was enough for me,” Onyelobi said. “For those families who need me, I will be that beacon of hope.”

This was eight years ago. Since then, a lot has changed.

American Family Children’s Hospital opened its Level IV NICU in 2014, the most advanced ranking a neonatal intensive care unit can receive. Since 2018, Onyelobi has created, along with a team of other specialists, one of the most advanced neonatal programs in the country. 

Neonatology is still considered a relatively new field of medicine, minted in the 1960s and ’70s. There are only about 5,000 neonatologists in the United States. By comparison, more than 34,000 cardiologists are practicing in the U.S.

One of a few

Just 850 neonatal programs in the country have capabilities to care for infants as young as 22 weeks gestation. Beyond capacity, these NICUs need specially trained staff and specialized equipment designed for the smallest of newborns: Breathing tubes the size of a coffee straw. A stethoscope the size of a quarter. 

The collaborative program between UW Health and UnityPoint Health-Meriter is one of only a handful in the country that has all of the factors needed to care for the tiniest premature infants: the capacity, equipment and specially trained staff.

Premature babies born in the maternity ward at Meriter will typically be treated in the hospital’s 42-bed Level III NICU until they are stable enough to transfer to American Family Children’s Hospital’s 26-bed Level IV unit — one of only two Level IV NICUs in Wisconsin.

“We’ve had people from the University of Iowa and different places come and show us how it’s done, so that we can then hone our skill and figure it out,” Onyelobi said.

Babies born this early require extreme medical interventions before delivery even starts. 

As soon as obstetricians realize they can no longer delay birth, the providers start giving the mom medications like steroids, magnesium sulfate and antibiotics to help improve the infant’s chances of survival. 

These interventions have become part of the standard practice over only the last two or three decades, Onyelobi explained.

In the early 1990s, the medical field developed the ability to inject surfactant into a preterm baby’s lungs to mimic a type of protein that coats the inside of our lungs and helps us breathe. 

Infants who are born this early have not naturally developed this lung coating yet, so the injections have been a game changer in helping extremely preterm infants breathe with still underdeveloped lungs. 

These advancements, and the fact she was able to receive them in Madison, are part of why Ayah lived when so many babies born this early do not.

Ayah was born on the edges of viability, and it took a village for her to survive, Onyelobi recalled. 

At this point of development, every breath and every hour make a difference. 

The little girl spent 48 days in the NICU at Meriter before she was transferred to American Family Children’s Hospital, where she spent another 7 1/2 months. 

Especially at the beginning of her life, many moments were touch and go. 

Chisenga remembers times when she would receive a call from the hospital, letting her know her daughter had taken a turn and she needed to come right away, potentially to say goodbye. 

“The first time I met Dr. Onyelobi at Meriter was a very difficult day,” Chisenga said. “I remember going in that day after getting a call saying I needed to go, and things weren’t looking good. And when I walked in, there were a few nurses and Dr. Onyelobi. She was there trying to figure out what would help Ayah’s situation stabilize because it was hard for her to breathe.”

Chisenga began to cry, preparing to lose her daughter. Onyelobi comforted her, Chisenga said, explained the situation and began using a breathing bag to help Ayah’s oxygen levels increase. 

“I cried so much,” Chisenga said.

When she held Ayah for the first time, 21 days after giving birth, Chisenga said she was surrounded by doctors, specialists and nurses in case something went wrong. She couldn’t be alone with her daughter because of Ayah’s critical condition. 

Chisenga would visit her daughter often, speaking to Ayah through the protective box of her incubator. 

“I was telling her that no matter the circumstances, we loved her. We loved her so much,” Chisenga said. “We wanted her to be here, and we were happy that she was staying strong for us. No matter the circumstances, love was waiting for her at home. And she was strong and she was mighty.”

‘A good goodbye’

When Chisenga and her husband brought Ayah home, she still required supplemental oxygen and an oxygen monitor. The equipment was so sensitive the alarm would sound if Ayah moved her leg. 

Chisenga said she was always on edge, grateful to have her daughter home with her, her husband and Ayah’s older brother, who was 2 at the time. But Chisenga said she was constantly terrified something would go wrong.

Now, as a 3-year-old, Ayah dances and skips around her living room. Even as a newborn, the little girl was eager to move. 

“She kept wiggling, and the machines kept going off,” Chisenga said of when her daughter was brought home from the NICU. 

Ayah required supplemental oxygen until she was 2 years old. Now, she loves to sing. 

Doctors were unsure if Ayah would ever walk. Now, she loves to dance. 

“I couldn’t be more proud,” Chisenga said as she watched her daughter make silly faces.

Ayah is the longest surviving infant of Onyelobi’s tiny baby program. She went home from the hospital in December 2023. These are the most humbling moments of Onyelobi’s career, seeing the smallest patients graduate from her specialized care.

“It’s a tearful, tearful, highly charged, emotional moment,” Onyelobi said. “It’s a good goodbye.”

Erin McGroarty is a health and policy reporter for the Cap Times in Madison. She can be reached at emcgroarty@captimes.com.

How a Madison doctor is saving the smallest lives is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 14 minutes

Editor’s note: This story was produced with financial support from the Education Writers Association’s Reporting Fellowship program.

Click here to read highlights from the story

• Wisconsin’s 2024 Wisconsin Guarantee law automatically admits students in the top 5% of their high school class to UW-Madison and top 10% to other UW campuses if they apply by the required deadlines.
• Early evidence suggests the program has had little effect on who applies to or enrolls at UW-Madison, despite reducing admissions anxiety for some students.
• An unpublished UW-Madison study estimates 95% of students admitted through the Wisconsin Guarantee would have been accepted anyway, with the program changing admissions outcomes for about 50 students annually.
• The policy has produced unintended consequences, prompting some students to treat UW-Madison as a “safety school” while raising concerns about fairness, class rank and grading differences among high schools.
• The Cap Times interviewed about 40 students, educators and researchers and obtained exclusive research for a first comprehensive look at how the law is working in practice.

Jaidyn Glaus was sitting in her English class at Durand-Arkansaw Middle & High School last fall when she was called to the principal’s office. She had no idea why.

The Pepin County school’s principal and guidance counselor had news: Thanks to her high grades, Glaus qualified for a new program called the Wisconsin Guarantee, automatically granting her a spot at the University of Wisconsin-Madison after graduation.

Glaus had never heard of the program. “It came really as a surprise,” she said.

A few weeks ago, Glaus moved into Smith Residence Hall and started classes at UW-Madison as part of the second group of students to enroll through the Wisconsin Guarantee.

State lawmakers created the program in 2024, believing automatic acceptance for top high schoolers would make the admissions process less cryptic and help ensure the state’s “best and brightest” attend Wisconsin’s 13 public universities, with a particular focus on Madison. Democratic Gov. Tony Evers signed the bill into law as one of 16 conditions in a controversial 2023 deal struck between Republican legislators and UW system leaders.

Under the law, students in the top 5% of their high school class are guaranteed admission at UW-Madison if they apply by an early deadline. All other UW campuses automatically accept students in the top 10% if they apply by a regular deadline. Homeschool students may also qualify depending on their ACT score, and National Merit finalists receive automatic admission to all the state’s public universities.

To provide a comprehensive first look at the program, the Cap Times spoke with about 40 people, including students, school administrators and researchers. While most people agreed with the Wisconsin Guarantee’s aspirations and believe it has reduced anxiety for some students, views were more mixed on how the program is affecting admissions.

The policy has raised concerns about fairness in college admissions as school districts rank students differently. Some administrators worry it places too great an emphasis on grades, which don’t necessarily capture the rigor of students’ coursework. The program is also prompting some students to view Wisconsin’s flagship as a “safety school” and apply to more competitive universities out of state — contrary to what lawmakers intended.

The majority of those interviewed doubt the Wisconsin Guarantee is making a substantial difference in who applies and enrolls at UW-Madison.

A research paper exclusively obtained by the Cap Times supports that view. The study, which has not yet been published, examined a decade’s worth of UW-Madison admissions data and estimates the Wisconsin Guarantee generated about 240 more applications annually from traditional public high schools — or a sliver of the roughly 75,000 applications UW-Madison has received in recent years.

About 95% of students who received the guarantee would’ve likely been admitted to UW-Madison anyway through its standard admissions process, the research also estimates. That rate would mean the guarantee changed admissions outcomes for about 50 students from public high schools each year.

“I hope that students eligible for the guarantee apply,” said Heather Little, a UW-Madison Ph.D. student who authored the working research paper. “And then for students who aren’t eligible for the guarantee, I don’t think you should be deterred because … there’s still a huge chance that you can be admitted.”

The long-term effects of the guarantee remain to be seen, though researchers questioned if the program will keep high-achieving students in the state. While some said the program could theoretically help rural or first-generation students access UW-Madison, others raised concern that the university’s student body could become less diverse.

The guarantee is another example in Wisconsin’s long history of implementing higher education policies that have “very little” evidentiary support and documented unintended consequences, said Taylor Odle, a UW-Madison assistant professor of education policy studies.

“This is a policy that’s well intentioned, that’s kind of mistargeted. … And it has no teeth,” Odle said.

‘More complicated than it might appear’

During a public hearing at the state Capitol three years ago, Sen. Rachael Cabral-Guevara, R-Fox Crossing, held up a thick document Republican legislators received from UW-Madison about its admissions process.

Cabral-Guevara paged through the document, revealing most of the contents were redacted. She shared how one high-achieving student in her district had approached her seeking answers after UW-Madison rejected their application. Cabral-Guevara said she couldn’t explain why.

The senator then raised doubts about UW-Madison’s standard admissions process, known as holistic admissions, in which the university evaluates students using a variety of factors, such as grades, course difficulty, extracurriculars and essays.

Citing her time teaching at UW-Oshkosh, Cabral-Guevara said she observed firsthand how holistic admissions could be “manipulated” to benefit one student over another.

“The public doesn’t even really know what it takes to get into the UW system,” she said. “We have many highly qualified students that are rejected every single day, and, in turn, they take up admission into other colleges and universities that might be out of our state.”

Wisconsin-born adults who move to other states tend to be more highly educated than residents who stay in the state or others who move here, according to a recent Wisconsin Policy Forum report.

“The bottom line is that we are losing too many of our ‘best and brightest’ high school graduates to neighboring colleges and universities,” Rep. Jerry O’Connor, R-Fond du Lac, said in written testimony. “Is this not a form of institutionalized brain drain?”

The solution proposed by Cabral-Guevara and her co-authors was a bill to automatically admit students who rank at the top of their high school classes based on criteria developed by local school districts.

The bill garnered praise from some Republicans at the hearing, including Rep. Dave Murphy, of Hortonville, who chairs the Assembly’s higher education committee. Murphy said he knew a high-achieving white student in the top of their class who didn’t get into UW-Madison and ended up going to the University of Minnesota.

“The bill could be labeled as an anti-DEI bill,” O’Connor added. “And I’ll just say, I don’t care about DEI in this situation. This is simply about not discriminating against the best of the best coming out of our high schools.”

UW-Madison and UW system representatives expressed concern in written testimonies about the bill, saying the state’s public universities were already accomplishing the bill’s intent of keeping high-achieving students in Wisconsin.

UW-Madison defended holistic admissions as the best way to acknowledge differences in resources and educational opportunities across high schools with “the desire to capture wide representation from talented and impressive graduates from all 72 Wisconsin counties.”

The university noted the bill would require K-12 schools to rank students and that many schools used different methods to calculate GPA, a scale that converts letter grades into numbers. A majority of applicants didn’t have class rankings on their transcripts at all, the university said.

“To be clear, this is not an impossible change,” UW-Madison wrote. “But it is more complicated than it might appear and one that deserves very careful consideration of the costs as well as the benefits.”

The final legislation signed by Evers required all high schools to use GPA as the “sole criterion” for ranking students.

At the time, it was unclear why the automatic admissions policy was included in a wide-ranging deal between Republicans and the UW system, which largely centered around cutting diversity-related positions and programs in exchange for hundreds of millions of dollars in funding for the UW system.

In a recent interview with the Cap Times, Murphy said he was involved in some talks over the deal and Republican leaders included the policy to avoid a potential veto from Evers.

“That bill probably wouldn’t have been signed by Gov. Evers otherwise without getting it into some kind of a package to make that work,” Murphy said.

A spokesperson for Evers didn’t respond to requests for comment.

Unintended consequences

A few months after the bill was signed into law in 2024, the first group of Wisconsin Guarantee recipients received notice from their high schools that they were automatically admitted based on their class rank at the end of their junior year.

Over a quarter of in-state students who enrolled at UW-Madison last fall received admission through the program. Public data on the second cohort, who started classes a few weeks ago, isn’t yet available.

The Cap Times spoke with students and school administrators from nearly 20 districts across the state, including high schools that historically send a lot of students to UW-Madison and some that don’t. They largely agreed the guarantee hasn’t been a significant factor in students deciding to go to UW-Madison, but it relieved some pressure in the application process.

“I still had to do all of the work,” said Elise Hendrickson, a Neenah High School graduate who received the guarantee and is now a sophomore at UW-Madison. “It’s just that I didn’t have to feel as stressed about like, ‘Oh, am I going to get in or not?’”

While the guarantee strengthened some high-achieving students’ confidence in attending UW-Madison, it nudged others to look outside the state.

“Some of our families, the kids will get the guarantee, and then they will shoot for the most selective schools in the country,” said Zach Galin, founder of the college admissions consulting firm Galin Education. “And if they don’t get in, they know they have this guarantee to go to UW-Madison. … They’re much more willing to apply broadly and see where the chips fall before making any decisions.”

That’s the calculus Lauren Alibali made. Shortly after the Madison West High School senior received the guarantee last fall, she met a friend at Indie Coffee on Regent Street. Alibali considered only applying to UW-Madison because she thought it would be easier.

But Alibali’s friend pushed back, reminding her of all the hard work she’d put in to qualify for the guarantee and be at the top of her class. Why not try to get into the country’s most prestigious schools?

Knowing she had “an awesome safety school” with UW-Madison, Alibali applied to Ivy League schools and other universities she considered to be a reach. Then she got into and decided to attend the University of Chicago.

“I don’t know if the opportunity of Chicago would present itself again,” she said.

Many school officials and students who spoke with the Cap Times had mixed feelings on whether the guarantee’s benefits outweigh its side effects.

Some school counselors and principals worried the program placed too great of a focus on grades alone. They felt the policy created unnecessary pressure for already stressed students to be at the top — even though many would still be well positioned for admission to UW-Madison without the guarantee.

“Whenever you have a rank, it’s a competition. Let’s be honest. And unfortunately, it pits students and families against each other at a very hard time,” said Deanne Lensert, principal of Waunakee Community High School. “We’ve definitely seen that as an unintended consequence.”

Stephen Trudeau, the high school principal of Durand-Arkansaw Middle & High School, feels torn. Growing up in a blue-collar family in Minnesota, he said college wasn’t often talked about as an option for him.

“I came from a small school. I didn’t have those types of opportunities,” he said, “so I think anytime we can create opportunities for kids to see pathways to these institutions and see themselves there, I think that’s really important.”

Still, Trudeau felt conflicted about promoting the program to his students because of the focus on rankings and grades. He knows some students may be ranked lower because they took more challenging coursework.

“Anytime we start talking rank and we start talking percentages … there becomes a game that gets played, right?” he said. “I think sometimes we lose the value of education. Are we learning for the purpose of learning, or are we learning for the purpose of some sort of external motivator or some sort of extrinsic award, such as … the guarantee?”

That’s part of why Trudeau waited to talk to top students about the guarantee until after they’d already qualified. That included Glaus, who started attending UW-Madison this fall.

Others worry the program is unfair. Vanessa Ivanov, who graduated from UW-Madison in December, has a little sister who wanted to follow in her footsteps as a Badger — but she missed the top 5% cutoff at Germantown High School by one spot. She wasn’t admitted through holistic admissions, either.

“She is very disappointed,” Ivanov said. “She ended up at UW-Milwaukee, which … is still a great school. But she looks at a lot of her classmates and the opportunities that they’re being given here at (UW-Madison), and she does not really view it as being fair or being equitable.”

Some high schools use unweighted GPAs, which award equal points for all courses regardless of difficulty. Weighted GPAs give more points for more challenging classes like Advanced Placement and honors classes.

“This program and not requiring that schools weigh their GPA puts a significant disadvantage for those who are actually taking those college preparatory classes and working to put themselves in a position where they’d be perhaps more able to succeed in that higher education environment,” Ivanov said.

Debate over weighted GPAs in response to the Wisconsin Guarantee continues to play out at certain high schools, especially those that typically send a greater share of students to UW-Madison. For some school districts with unweighted GPAs or that use other ranking systems, ties have emerged among the top students.

Representatives from some districts that have created tiebreakers or reworked GPA systems said the guarantee has sparked a lot of conversation — and stress — in their communities.

“We didn’t create the law, we didn’t create the rules, and we had no voice in the creation of the guidance,” said Curt Mould, director of digital media, innovation and strategy for the Sun Prairie Area School District. “But yet we’re on the hook for implementing. … It was never really explained to (school) systems why this was necessary.”

New research raises questions

As state lawmakers passed the Wisconsin Guarantee in 2024, policymakers in New York and elsewhere were eyeing top-percent admissions plans in response to a 2023 U.S. Supreme Court ruling banning race-conscious admissions.

Top-percent admissions plans originated in the 1990s following state-level affirmative action bans in places like Texas, Florida and California. Because most students attend schools close to their homes and because neighborhoods often are racially divided, policymakers hoped top-percent plans would help maintain diversity at selective public universities since the same proportion of top students at every high school receives automatic admission.

However, studies have largely found top-percent admissions programs have minimal effects on enrollment patterns in the long term and fall short of meaningfully changing which high schools send students to selective public universities.

The new paper by Little, the UW-Madison Ph.D. student, builds on that body of research by studying Wisconsin’s new top-percent policy.

Through a data partnership between UW-Madison’s Division of Enrollment Management and the Student Success Through Applied Research Lab, Little compiled application data from over 800 traditional public high schools in Wisconsin and Minnesota. The Minnesota schools served as a control group since Minnesota students receive tuition reciprocity but are ineligible for the guarantee.

Little’s findings suggest shortcomings in the Wisconsin Guarantee’s ability to persuade the state’s “best and brightest” to stay. She estimates just half of all guarantee-eligible students applied to UW-Madison, and top 5% students were less likely to enroll than applicants who were admitted through holistic admissions.

For students who received the guarantee but didn’t apply, it’s unclear where they landed after graduating high school. An informal survey Little conducted of high school counselors indicated the guarantee wasn’t a significant factor in students’ college decisions. Sixteen counselors who provided written responses pointed to factors like cost, geography and proximity to home as driving students’ decisions.

Little found the “rare” students whose applications likely received a “significant admissions boost” from the guarantee were those with high academic performance but less difficult classes. However, Little said it isn’t possible with the available data to determine whether certain students who just missed obtaining the guarantee were hurt by the program.

“The students who are more likely to be hurt by the policy are kind of like the last admit from these (schools that) were sending lots of people before,” Little said. “I don’t have any evidence of that … but that’s what economic theory would tell us.”

Little’s survey of high school counselors and written responses from about two dozen UW-Madison freshmen revealed conflicting sentiments about the guarantee. She said people who feel well served by the holistic admissions process may think the new program is unnecessary, while others who perceive admissions as opaque may appreciate the benefits.

“How you feel about the policy depends on how well you think holistic admissions is working,” she said.

‘A statement that we care’

Administrators at UW-Madison and the UW system said it’s too early to know the effects of the Wisconsin Guarantee. Johannes Britz, the UW system’s senior vice president for academic and student affairs, said it could take years to get a clearer picture.

However, the UW system said it’s not tracking how many students have enrolled through the program. It’s also unclear how many high school students have qualified for the program, regardless of whether they later applied to a state university. The Wisconsin Department of Public Instruction isn’t tracking that data, said John Johnson, a senior policy adviser for the state agency.

Murphy, the Republican lawmaker from Hortonville, said he has received fewer phone calls from parents complaining their child wasn’t admitted to UW-Madison with the guarantee in place. He previously fielded dozens of calls on this topic in any given legislative term, he said.

More transparency around UW-Madison’s admissions is still needed, he said, but the guarantee makes the UW admissions process better.

Cabral-Guevara called the guarantee “a critical first step in ensuring that Wisconsin’s best and brightest students are given a spot on our campuses.”

“As with any new program, I am happy to work with folks on ways to make improvements so that we can continue on the progress we’ve made so far,” she said in a statement.

Researchers who’ve examined top-percent programs elsewhere expressed surprise at the approach and policy aims outlined in Wisconsin’s guaranteed admissions law — as well as skepticism that it would achieve its goals.

“Most of the percentage plans have come out of a desire to increase racial diversity in a way that doesn’t explicitly use race in the process,” said Daniel Klasik, an associate professor at the University of North Carolina-Chapel Hill. “How far these policies can go in terms of actually generating new students into the system that weren’t already going before is a little bit unclear. I have a few … doubts about that.”

Some researchers questioned how the guarantee will change UW-Madison’s enrollment in the long run. Odle, the UW-Madison assistant professor, estimated the program will help support the admission of mostly affluent, white, female students — demographics overrepresented in the top 5% across Wisconsin, which the university is already good at recruiting and retaining.

Given Wisconsin’s population is less diverse than other states with top-percent admissions programs, some also questioned if the guarantee could decrease the racial and socioeconomic diversity among students at the flagship.

“In the end, wealthier schools and families will actually benefit more from a top-percentage plan than if everything is equal in terms of all the resources and opportunities across the state,” said Carson Byrd, an associate research scientist at the University of Michigan. “A lot of this sounds like it’s more meritorious, but really, what it’s doing is compounding the educational and socioeconomic inequalities of communities.”

Britz, the UW system official, said the guarantee provides the state’s public universities another recruitment tool, and he believes rural students could benefit.

“It is not a data thing,” Britz said. “It is, for me, a statement that we care for the best and the brightest.”

As Glaus moved into her dorm at UW-Madison a few weeks ago, her parents and her brother helped haul pillows, clothing cubes and a fake plant into the tight room.

Glaus’ mom, Miranda, proudly reported she hadn’t cried yet moving Glaus into the dorm — though she admitted to tearing up on the three-hour car ride to Madison and again during lunch at a campus dining hall.

With Glaus being a first-generation student, her admission and the move were bound to bring up a lot of emotions.

“Overwhelming. Proud. Excited. Sad,” Miranda Glaus said. “Dad is very nervous.”

“I’m glad she chose here,” Brad Glaus, her dad, added.

“It was either here or Michigan,” her mom said.

While Glaus debated enrolling at the University of Michigan, she chose UW-Madison for its kinesiology program and proximity to home, much to her parents’ delight. The Wisconsin Guarantee merely reinforced her choice to become a Badger.

“I’m not really sure that it influenced my decision too much,” she said. “It made me feel even better about going there, knowing that they want me.”

Whether or not the guarantee existed, Glaus’ parents never doubted their daughter would get into UW-Madison.

“I knew she deserved it,” Miranda Glaus said. “She was going to go wherever she wanted to go.”

Erin Gretzinger is a K-12 education reporter and Becky Jacobs is a higher education reporter for the Cap Times in Madison. They can be reached at egretzinger@captimes.com and bjacobs@captimes.com.

Wisconsin’s college admissions law has unintended consequences is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 10 minutes

This story is part of the Cap Times series Deadly Divide, investigating Wisconsin’s ongoing Black infant mortality crisis. The reporting is supported through a National Fellowship from the USC Annenberg Center for Health Journalism.

Click here to read highlights from the story

• Wisconsin’s Black infant mortality rate remains more than twice the rate for white infants. Nearly 850 Black babies died before their first birthdays from 2015 through 2024.
• Five women in the Wisconsin Legislative Black Caucus call the crisis deeply personal, citing their own experiences with premature births, frightening pregnancies and unequal treatment in health care. 
• Black Caucus lawmakers last session introduced a seven-bill Birth Equity Act addressing doula care, maternal mental health, dental care, postpartum support and other needs — but none of the bills received a committee hearing before the Republican-controlled Legislature adjourned.
• Republicans who control the Legislature have declined to advance similar legislation for years. 
• Black Caucus lawmakers say reducing Black infant deaths requires policy changes and greater trust in the medical system, including culturally competent care.

For decades, Wisconsin’s Black infant mortality crisis has been measured in painful numbers: babies who die before their first birthdays, families left grieving and an enormous racial disparity that never relents. 

Wisconsin regularly ranks among the worst in the nation when it comes to the rate at which Black babies die before reaching age 1. In 2024, the most recent year for which the Wisconsin Department of Health Services has publicized data, the state had an infant mortality rate of 12.5 deaths for every 1,000 live births among Black babies. For white babies, that rate was 4.8. 

Between 2015 and 2024, nearly 850 Black babies died in Wisconsin before turning 1, according to state data. Over the first half of that decade, nearly 25% of the deaths of Black infants were caused by being born into this world too early and too small to survive.

But for the five women in the Wisconsin Legislative Black Caucus who have pushed awareness of the issue year after year, the crisis is not abstract or statistical. It is personal. 

Wisconsin’s notorious peril for Black pregnancies is a fear and a pain they have known in their own bodies, and one they have returned to the Capitol session after session determined to change. 

One legislator delivered her daughter nearly eight weeks early. Another, state Rep. Margaret Arney of Wauwatosa, was born prematurely alongside her twin. State Rep. Sequanna Taylor of Milwaukee was told she was unlikely to carry her pregnancy to term, but not why. And this year, one of the lawmakers carried that same fear throughout her first pregnancy.

“Being a senator that knows all the data I think has made it more nerve-wracking,” said Sen. Dora Drake, D-Milwaukee, while holding her pregnant belly during a listening session with the Cap Times in July. Drake delivered her baby without complications in early September. 

Wisconsin continues to face one of the nation’s highest rates of Black infant mortality in the nation, a crisis these five women say cannot be separated from the lived experiences of the families and babies behind the numbers. 

But session after session, they say they have run into resistance from Republican leaders who have declined to give any one of their proposals even a committee hearing. 

“We encountered nothing but struggles in this building,” said Sen. LaTonya Johnson, D-Milwaukee. 

Last spring, Rep. Shelia Stubbs, D-Madison, worked with members of the Foundation for Black Women’s Wellness in Madison to develop the latest version of the Birth Equity Act — a package of seven bills aimed at improving birth outcomes and connecting expecting and new mothers with resources that increase their chances of carrying healthy pregnancies to term and managing the postpartum period with greater support. 

The proposals were based on what the foundation has heard from community members about what would help Black mothers, babies and families the most. 

“These bills came directly from Black women,” Stubbs said. 

• Assembly Bill 1082 would have created a sales tax exemption for breastfeeding equipment.
• Assembly Bill 1083 would have barred the state from seeking recovery or reimbursement of birth expenses from a new mom covered by the state’s Medicaid program.
• Assembly Bill 1084 would have ensured the Medicaid program covers services by a dentist or dental therapist and stipulated that pregnant patients should be able to receive timely dental care during pregnancy.
• Assembly Bill 1085 would have required Medicaid plans to cover care provided by a doula before, during and after delivery.
• Assembly Bill 1086 would have required Medicaid to cover maternal mental health screenings and required the state’s health department to develop — in consultation with advocates and providers within the Black community — a set of standards to ensure cultural competency in maternal mental health screening practices.
• Assembly Bill 1087 would have allowed for a pregnant person to enroll in a health insurance plan outside of a standard enrollment period after becoming pregnant to ensure prenatal care is covered by a health plan.
• Assembly Bill 1088 would have required hospitals to provide a postpartum home visit to a new mom and baby, if requested, within the first few weeks after giving birth. The bill also would have required health insurance plans to cover these visits. The visits could be conducted by a doula, midwife, nurse-midwife or other licensed health care provider who is certified to provide postpartum care.

But none of the bills introduced last February received a public hearing before the Republican-controlled Legislature adjourned its session early, Stubbs said. 

That included bills assigned to the committees she said were best suited to consider them, like the Assembly Committee of Health, Aging and Long-Term Care where she holds a seat. 

The proposals were aimed at shrinking disparities and improving maternal and infant health in Wisconsin through a variety of approaches ranging from insurance-covered doula care to ensuring pregnant women get adequate dental care. 

“Of all of the bills we introduced, absolutely none of them received a hearing, which is very shameful (and) unacceptable in the state of Wisconsin,” Stubbs said. “So even serving on a committee that’s most appropriate to have these bills, we still couldn’t get these bill hearings.”

Republican Rep. Clint Moses, who chairs the Assembly health committee and holds gatekeeping power over which bills receive hearings, did not respond to multiple requests for comment for this story. Committee chairs often decide which bills receive hearings in line with party leadership priorities. 

For Drake, the lack of movement comes down to a simple conclusion. 

“It’s not a priority for them, honestly, and that’s really the bottom line,” she said. 

A crisis measured in lives

Wisconsin’s Black infant mortality crisis has persisted for generations. And the women pushing for change say the disparities cannot be explained by income or individual behavior. 

Arney, a Democrat from Wauwatosa, knows that personally. 

“This is a generational issue,” Arney said. “I am a twin. My twin sister and I were born prematurely. Our lives were at risk.” 

Her mother was college-educated, she said, but that did not erase the risks associated with being a Black mother in America. 

“It’s more than just social class,” Arney said. 

Johnson, the senator from Milwaukee, said she has encountered resistance to policies specifically designed to address racial disparities based on an argument that helping Black families reduce disproportionate harm is discrimination itself. 

“A lot of the feeling in this building is that if something is targeted specifically, then it’s somehow discriminatory,”  said Johnson, the lawmaker who delivered her daughter two months early. 

But, she said, the nature of the crisis demands a targeted response. 

“It’s not discriminatory that it’s kids who look like us that are dying, but it’s discriminatory because we want to fix it?” Johnson said. 

The lawmakers pointed to policies that have passed as examples of what can happen when the Legislature works together. 

Johnson cited Act 102, signed by Gov. Tony Evers earlier this year, which extended the period of time Medicaid covers postpartum services. About 76% of Black women who give birth in Wisconsin are on Medicaid, making this law particularly important to fight to save Black babies, she said. 

“That bill will disproportionately impact Black women, which in this case is a good thing,” Johnson said. “That will be one piece of legislation that will start to uncover the core of what’s really taking place.”

But the lawmakers say broader changes — including greater access to doulas and culturally competent care — are still needed. 

“Several of us were working on trying to have that coverage provided, because the research shows that having doulas and midwives helps mitigate some of those harmful factors,” Drake said. 

Having that kind of support was important to her personally, she said, because “that was something that I really wanted to ensure I had someone I could trust.”

When the statistics become your own 

Before Johnson’s daughter was born — a few days shy of 32 weeks — a midwife recognized that Johnson and her pregnancy could be in danger. 

“My midwife went to the doctor and said ‘Look, she’s high risk. She needs another level of care other than what I can provide,’ and I didn’t get it,” Johnson said. 

Johnson spent two weeks in the hospital before her daughter was born, receiving steroid shots to help develop her baby’s lungs, she said. 

Her daughter was born on June 3 and went home on June 22, Johnson’s birthday. 

Johnson quickly returned to work, without giving herself time to recover from giving birth because she felt driven to make sure she could pay the bills as a single mother. 

“So when (my daughter) got home, she had a place to come home to,” Johnson said. 

But she later learned something about her pregnancy that she said doctors had not told her at the time: She had contracted an infection that caused premature delivery. 

“There was things I didn’t realize about my own pregnancy until I got a copy of the medical records,” Johnson said. “My experience was so horrible. I remember saying I would never have another baby.”

Her daughter survived and is now in her 20s.

“The fact that my daughter made it to her first birthday was a luxury that a lot of these Black babies are not afforded,” Johnson said. 

Rep. Taylor’s experience was different, but it left her with many of the same questions and a similar, lingering pain. 

During her pregnancy with her youngest daughter, Taylor said, her doctor told her she was unlikely to carry her baby to term. He never explained why. 

“They were so cold,” she said. “I know as doctors they can’t be emotional because they deal with so many people. But to tell me ‘There’s nothing you can do to help. This baby won’t go to term. Go home. If you start bleeding or something, come back…’’’

The interaction left Taylor feeling unable to connect to her pregnancy because she was so convinced she would lose it. 

Taylor, who is from Milwaukee, did carry her daughter to term. But after delivery she was rushed to emergency surgery because she couldn’t successfully deliver her placenta, a complication that can lead to serious infection. 

Taylor now wonders whether her medical team failed to adequately screen her for complications because they already assumed her pregnancy would fail. 

The fear of not being heard 

For the lawmakers, the problem is not only access to care. It is whether Black women are believed, listened to and treated with dignity when they seek it.

“There’s this notion of who gets to have access to health care,” Drake said, adding that she has experienced that dynamic herself. 

Two years ago, she went to a hospital in Milwaukee with a broken arm. When she told the staff she had state insurance — the coverage  provided to her as a Wisconsin legislator — the hospital assumed she meant Medicaid. 

During Stubbs’ pregnancy, a nurse mistakenly gave her the test results of another Black patient. 

“It wasn’t stressful carrying my child,” Stubbs said. “It was stressful going to the doctor.”

Arney said she has seen the same pattern play out over generations. 

Years ago, she participated in a focus group of Black women discussing their experiences giving birth. Arney said she was fortunate. Her sister, who is a doctor, was there. She had a doula, a midwife, an obstetrician and her husband supporting her. 

Nearly every other woman in the group, Arney said, described a traumatic birth experience. 

“Different years. Different times. This is what I’m talking about with the generational thing,” Arney said. “It’s like these kinds of things are not moving. This is not budging. This needs attention. It needs focus and it needs urgency.” 

A crisis of trust 

The lawmakers say those experiences have contributed to a broader lack of trust between Black women and the medical system. 

“People can go through history on how hospitals and medical professions have used Black women’s bodies for experimentation,” Drake said. “This is not hidden. This is known. This is documented.” 

One of the more egregious examples of this is by 19th-century physician James Marion Sims, the so-called “father of gynecology” who developed techniques in the field by performing dozens of experimental surgeries without anesthesia on three enslaved women without their consent. The women — Anarcha, Lucy and Betsey — have been memorialized in the Mothers of Gynecology sculpture in Montgomery, Alabama. 

That pain haunts the medical profession and is a traumatic history providers must intentionally work to move beyond, reestablishing trust among Black women, the lawmakers said. 

This work, Arney said, must go beyond individual providers. 

“I know there’s some health systems that are trying to take this on, but I hate to say it’s baked into our culture that there’s this callousness towards Black women,” Arney said. 

That distrust can make pregnancy itself more frightening, regardless of the resources you have sought for yourself. The data and statistics surrounding Black birth outcomes in Wisconsin have remained in the back of Drake’s mind throughout her pregnancy. Despite the fact that she is a college-educated professional social worker and a member of the Wisconsin Senate. “Those are still the realities we have in our state,” she said. 

Inside the Capitol

The women of Wisconsin’s Legislative Black Caucus say the political resistance to their proposals is part of the same struggle. 

Stubbs said her white Democratic colleagues have been supportive, often signing on as co-sponsors to her legislative proposals and allowing the Black Caucus to lead on issues they view as particularly tied to the Black community. 

That support matters, she said, because the Black lawmakers bring lived experience that their white colleagues don’t have in the same way. 

“It’s helpful, because nobody knows our struggle the way that we do, and they’re not going to understand,” Stubbs said. 

But there is a limit to simply standing behind the Black Caucus, she said. It’s not enough to simply sign onto legislative proposals or attend press conferences during Black History Month or in June, when Juneteenth falls.

“Sometimes it’s harmful to just be like ‘You got it,’ you know?,” Stubbs said of the type of support she gets from other Democrats.

Stubbs said she has also had conversations with white lawmakers who choose not to believe the evidence showing racial disparities in health outcomes. 

“In that building, we have many of our colleagues that don’t believe in diversity, equity or inclusion,” Stubbs said. “We have a federal government that doesn’t believe in that. So we’re fighting already systems that don’t believe in us.”

Some lawmakers, she said, see the Black Caucus’ efforts as blowing an issue out of proportion. 

“They don’t want to believe the data,” Stubbs said. “They think it’s us coming one more time with another inequity, but it’s a fact, and so it is our responsibility as a state to address this.”

The five legislators say they have heard about the pain and trauma of this crisis from constituents. They have lived it themselves; in premature births, frightening pregnancies, traumatic deliveries and the persistent pain of being made to feel less than. 

That’s why the fight is much more than a political one, they said. 

The stakes are measured in whether a baby gets to come home. 

“We have these stories,” Stubbs said, “and we are telling them because we want to save the next life.”

Erin McGroarty is a health and policy reporter for the Cap Times in Madison. She can be reached at emcgroarty@captimes.com.

How a fight to save Wisconsin’s Black babies keeps hitting a dead end is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 11 minutes

Note: This is the first story in the Cap Times series Deadly Divide, investigating Wisconsin’s ongoing Black infant mortality crisis. This reporting is supported through a National Fellowship from the USC Annenberg Center for Health Journalism. 

Click here to read highlights from the story

• Wisconsin’s Black infant mortality rate was 12.5 deaths per 1,000 live births in 2024, compared with 4.8 for white babies; nearly 850 Black babies died before age 1 from 2015 through 2024.
• Preterm birth and low birth weight are the leading causes of death among Black infants, and Black mothers in Wisconsin are 50% more likely to give birth early than white mothers.
• Experts say income, education and health care access alone do not explain the disparity, pointing instead to the lasting health effects of systemic racism, chronic stress, segregation and generational trauma.
• State health leaders say improving outcomes will require support before and beyond pregnancy — including more time and trust in health care settings, culturally informed care and efforts to address housing, child care and other stressors.

For generations, Black families in Wisconsin have buried babies at rates far higher than their white neighbors — a disparity that has withstood medical advances, public health initiatives and decades of promises to close the gap.

The numbers have remained stubbornly consistent, with Wisconsin regularly ranking the worst in the nation when it comes to the rate at which Black babies die before reaching age 1. In 2024, the most recent year for which the Wisconsin Department of Health Services has publicized data, the state had an infant mortality rate of 12.5 deaths for every 1,000 live births among Black babies. For white babies, that rate was 4.8. 

Between 2015 and 2024 nearly 850 Black babies died in Wisconsin before turning 1, according to state data. Over the first half of that decade, nearly 25% of the deaths of Black infants were caused by being born into this world too early and too small to survive. 

Researchers and health experts say the crisis cannot be explained by lack of access to quality health care alone. They point to the cumulative effects of systemic racism, chronic stress and generational trauma that shape maternal health long before pregnancy begins and influence birth outcomes from one generation to the next. 

That these disparities transcend socioeconomic factors like income or level of educational attainment show the root cause lies elsewhere. Black babies are dying at higher rates even when their parents make a decent living. Black babies are dying at higher rates even when their moms are well-educated.

For Dr. Jasmine Zapata, Wisconsin’s state epidemiologist for maternal and child health and chronic diseases, the numbers have never just been numbers. 

Every chart tracking premature births, every report on infant death and every statewide trend carries the memory of her own pregnancy, when she unexpectedly delivered her daughter at just 25 weeks. 

As a second-year medical student at the time, she knew something wasn’t right when she felt sharp pain in her lower abdomen. Her due date was not until Jan. 2. It was Sept. 20. 

Zapata’s pain was repeatedly dismissed by doctors as Braxton Hicks contractions — a type of contraction that typically takes place earlier in a pregnancy and doesn’t result in cervical dilation or labor.

“I called about two, three times and I was just brushed off,” Zapata said.

But when Zapata began bleeding, she rushed to the hospital where providers found her cervix was already 10 centimeters dilated, the threshold typically required to give birth. 

“They told me ‘You’re going to meet your daughter today,’” Zapata said.

Though she was nearly 15 weeks out from her due date and her baby was barely beyond the point of viability, Zapata gave birth to her little girl. 

“When my baby came out, she was not crying. It was quiet, because her little lungs were too fragile to even breathe,” Zapata said. “I knew that complications of prematurity, this little baby fighting for her life … I was right there at the verge of being one of the infant mortality statistics.”

Zapata’s experience with preterm birth, even though her pregnancy was not categorized as high-risk, is common in Wisconsin, where Black mothers are 50% more likely to give birth before their due dates than white women. 

Preterm birth and low birth weight are the leading causes of death among Black infants, defined as younger than age 1. 

National experts on health and development say there’s a painful and deep-rooted reason these statistics persist despite medical advancements. 

‘This is the world you’ll be born into’ 

Dr. Tony Iton, a nationally recognized public health leader and advocate for health equity, has spent much of his career studying how chronic stress related to discrimination puts people’s health at risk. Iton is the CEO of The Health Trust in California.

Decades of research, he said, shows that living in a society built on a legacy of structural racism can result in consistently elevated levels of cortisol, the body’s stress hormone. Those levels increase the risk of pregnancy complications like preeclampsia (pregnancy-related high blood pressure) and early labor. 

“We don’t have a preterm crisis, we have a chronic stress crisis,” he said in an interview with the Cap Times. 

Those effects don’t disappear when a pregnancy ends. They accumulate over a lifespan and, in many cases, across generations. 

Research has shown that prolonged exposure to adversity can influence fetal development through changes in the mother’s body and health, said Nicole Bush, a clinical psychologist and director of the Division of Developmental Medicine at the University of California San Francisco. 

The science, she said, increasingly shows that a mother’s environment and experiences across her lifespan can affect a child’s health before birth, with consequences that can then extend into that child’s adulthood.

Those intergenerational effects can happen through epigenetic changes. Different from genetic mutations, epigenetic changes don’t alter core DNA sequences but instead perform like chemical switches that can turn specific genes on or off, Bush said. That switch affects how genes activate processes in someone’s body.  

“Our epigenetic marks can be influenced by nutrition. They can be influenced by sleep. They can be influenced by social experience,” Bush said. “Epigenetic changes related to experience can be stable for a long time after they’ve been changed, and so major stressors can have a long-standing impact on our bodies. They can affect our perceptions, our brain chemistry, our physiology.”

As a result, trauma and stress that someone experiences as a child can alter how their body responds later in life and, during pregnancy, influence how a fetus develops and preemptively trains an infant in utero to expect more stress in life. 

“In addition to placing the mother and her uterus and her pregnancy functions at immediate risk for challenges such as preterm birth or postpartum depression, it can also send certain chemicals and signals to the baby in utero that then program that baby to come out ready for a strong fight or flight and reactive immune system,” Bush said, “because the mom’s biology is trying to communicate to the baby ‘This is the world you’ll be born into, come out as prepared as you can.’”

Where Wisconsin stands

Nationally, the Black infant mortality rate is 11 per 1,000 live births, according to 2024 data from the National Center for Health Statistics, an agency that is part of the U.S. Centers for Disease Control and Prevention. 

The national infant mortality rate for white babies that same year was 4.4 deaths per 1,000 births. 

Also that same year, Wisconsin health data showed Black women were five times more likely than white women to die from pregnancy-related complications.

According to a 2025 study published in the Annals of Internal Medicine, Americans are living longer than ever and the difference in mortality between Black and white Americans has shrunk over the last half century, except when it comes to infants, where the disparity in mortality between Black and white babies has grown. 

That Wisconsin ranks so poorly for Black infant and maternal mortality is not new. In 2009, Black babies were almost four times more likely to die within their first year of life than white babies. 

The year before that, Dr. Richard Allan Aronson submitted a white paper to the University of Wisconsin School of Medicine and Public Health highlighting racial disparities in the state’s birth outcomes. Aronson served as medical consultant and chief medical officer for family and community health at the Wisconsin Division of Public Health from 1988 to 2002.

The Wisconsin Department of Health Services publicizes infant mortality statistics going back to 1985. In the four decades since, the mortality rate among white babies has consistently decreased in line with medical advancement. The rate among Black babies has remained largely stagnant, with the state having a higher rate of mortality among Black infants in 2023 than it did in 1991.

In his 2008 paper, Aronson identified segregation and disparate access to services as key factors in the racial gap in birth outcomes. 

“Since infant mortality is a sentinel indicator of a community’s overall well being, the factors that contribute to racial and ethnic birth outcome disparities relate to all sectors of society. The neighborhoods in Wisconsin with the highest rates of black infant mortality are characterized by hypersegregation, unemployment, economic hardship, and inadequate housing,” Aronson wrote. “Systems that serve children and families in these communities are often fragmented, burdensome, culturally and linguistically disrespectful, and deficit-based.”

Aronson’s assessment of the situation in Wisconsin is as true today as it was nearly two decades ago. And from the year he issued his report to 2024, nearly 1,500 Black babies in Wisconsin died before their first birthday, according to data from the Wisconsin health department. 

Had the rate been the same as it was for white babies, more than 970 of them would have survived.

Gaps in access to care and a lack of culturally competent medical services still play a key role in how Black Wisconsinites interact with the health care system, particularly during and after pregnancy, Zapata said. 

Wisconsin’s largest cities still carry the spectre of racial segregation and redlining, policies that separated whole populations from necessary services.

Milwaukee, Wisconsin’s largest city with the highest population of Black residents and the highest total annual number of Black infant deaths, has also been consistently ranked as one of the most segregated cities in America. 

Madison, which has a far lower population of Black residents, also faces notable racial and subsequently connected socioeconomic segregation. 

“If you were going to design a strategy to adversely impact the well-being of a population, you couldn’t come up with a better policy than racial residential segregation. It’s actually brilliantly evil in its manifestations,” Iton, with The Health Trust in California, said.

‘It shouts racism’

Poor health outcomes are often explained away by poverty or low educational achievement, Iton said. But disparities in maternal and infant health outcomes for Black women and babies are shown to transcend both of these factors. This shows that something else is at work, he said.

National data shows Black mothers with a college degree still have higher infant mortality rates than white women who drop out of high school. 

“It shouts racism,” Iton said. “If you’re not protected by income and social status from this outcome, that suggests that it’s not just material poverty or lack of resources, but it’s also your situatedness in society and what you perceive to be essentially a pervasive, large-scale devaluation of you as a human being.”

Those effects become clearer looking at data that show Black immigrants have better health outcomes when they come to the United States but exhibit poorer health outcomes the longer they are here, Iton said.

“The birth outcomes are so much better in the African immigrant women, and then as they acculturate, spend more time in America, their birth outcomes get worse,” he explained. “So the suggestion is that it’s really something in the environment in the United States.”

‘Preventing the fire in the first place’

Zapata, Wisconsin’s state specialist in child and maternal health, said she wants more focus on preventing the problems that hurt people in the first place. 

“There’s always so much focus on just when you get pregnant and right after. It’s kind of like a house is on fire and it’s burning, and then you’re always just focusing on how can the fire truck get there faster,” she said. “Let’s focus on preventing the fire in the first place.”

That means addressing stressors faced by Black Wisconsinites across their lifespan. 

“It’s like once you’re pregnant, you can qualify for all these services. But sadly, from a physiological and biological standpoint, a lot of times it’s too late,” Zapata said. “Because that birthing person — what happened to them all the way into their childhood, and even what was going on with their parents, and when they were in utero, the environment, the stress that their parents were having — that impacts them, that impacts their birth outcomes.”

Zapata said reducing Wisconsin’s Black infant mortality rate will require more than improving medical care. It will require confronting the centuries of systemic racism and inequity that have shaped Black women’s experiences with health care, government and other institutions — and rebuilding trust that has been eroded over generations.

“We’re not going to be able to undo some of the things that got us here in just five years,” she said.

She pointed to a history of exclusion and abuse that is not as distant as it can seem. Less than a century ago, Black people were barred from medical schools, she said, while unethical government and medical practices against people of color have contributed to generations of distrust.

“All of that accumulated harm plays a role into what we’re seeing today,” Zapata said.

That history is reflected in the health care system Black women encounter today, she said. Even when women have access to a doctor or hospital, that doesn’t necessarily mean they feel heard, respected or safe enough to fully engage with the system.

“We’re working within a system that’s just not designed to provide equitable care to all people in all backgrounds,” Zapata said. “We want to look around and see that it reflects the diversity of our community, or just come in and see someone that looks like me.”

Building that trust, she said, requires something the current health care system often does not give providers or patients: time.

Providers can be expected to see dozens of patients a day, while appointments designed to take an hour are squeezed into 15-minute slots. Long waitlists can make it difficult for patients to establish relationships with providers in the first place.

For Black women who already approach the health care system with distrust, those constraints can be especially consequential, Zapata said. A rushed appointment can leave a patient feeling dismissed even when the provider is not intentionally doing so.

“Patients who feel brushed off will be less likely to engage with that system again,” she said.

If something goes wrong during a pregnancy, that can mean a mother is less likely to call her doctor or seek help.

“There’s a lot of Black women that are scared to have children in our state, just because of the statistics,” Zapata said. “When we come into a provider, because of that unique background, we need more time.”

That need extends beyond the exam room. Zapata recalled treating a mother who, just 24 hours after giving birth, was pleading to leave the hospital because she had no child care. Another mother was discharged with her newborn to a homeless shelter.

“They don’t even have a place for the baby to sleep,” she said. “It is just heartbreaking.”

Those circumstances can make it difficult for a mother to focus on her own health or her baby’s health, even when medical care is available.

“Do you think they’re listening to us with their whole heart, with their full attention?” Zapata said of patients in these circumstances. “No, because their brain is thinking about how they’re going to survive.”

Doulas are one option to help bridge some of that divide, she said. Because they can provide advocacy, emotional support and culturally informed guidance, doulas can help women feel safer navigating a health care system that might not feel built for them.

For Black women, she said, that kind of support is not an extra. It is part of what they are asking for as the state tries to change outcomes that have persisted for generations.

‘Too many funerals’

Zapata’s daughter, Aameira, was in the neonatal intensive care unit for three months after she was born. She is now almost 16 years old. Her mother describes her talent for photography, her sassy personality, her beautiful singing voice — each moment of praise an appreciation for the fact that her daughter survived what many babies born that early do not.

It was the moments, days, weeks and months that followed Aameira’s birth that Zapata says shaped the trajectory of her life’s work. 

“When I walked out of the NICU with her in my arms, I made a commitment that I’m going to dedicate my career to finding ways to make sure every baby gets to walk out,” Zapata said.

That has remained a driving factor in her work as a doctor, as a state health official, as a mother and as a resident of a state where too many babies don’t make it to age 1.

“I’ve been to too many funerals of babies who didn’t make it to their first birthday. Words can’t express that. I’ve had to do CPR on a baby that came into the hospital already basically gone,” Zapata said. “When you have those types of memories, and screams of family members, and faces drilled in your mind, in your soul, it just really impacts the work that you do.”

Erin McGroarty is a health and policy reporter for the Cap Times in Madison. She can be reached at emcgroarty@captimes.com.

‘Too many funerals’: Wisconsin’s Black infant mortality crisis is harming generations is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.