Abigail S Cutler, MD
Assistant Professor (CHS)
Academic Specialists in Obstetrics and Gynecology
Administrative Assistant
Chelsea R. Gatica
cgatica@wisc.edu
608-242-6840
Cutler discusses ob-gyn training and abortion restrictions on WNYC Science Daily
Abigail Cutler, MD, MPH, assistant professor in the Division of Academic Specialists in Ob-Gyn, joined Science Friday for a recent podcast episode focussing on the post-Dobbs landscape across the U.S. and its implications for physicians and abortion access.
In “Abortion-Restrictive States Leave Ob-Gyns With Tough Choices,” Cutler talked about how abortion restrictions have affected physician’s abilities to train Ob-Gyn students, and effectively help patients in need of a variety of reproductive health services, not just abortion.
“Research we’re conducting here at the University of Wisconsin, which does illustrate that some OBGYNs certainly have contemplated leaving the state because of how the post-Dobbs legal landscape threatens their ability to practice medicine, and not just their ability to provide abortions, but their ability to provide standard evidence-based pregnancy care to their patients, especially when a pregnancy-related complication arises.”
Listen to the whole interview here!
**by Ob-Gyn Communications Intern Paige Stevenson
Cutler fact checks pregnancy test claims with Milwaukee Journal Sentinel
In the article “Fact check: Claim that pregnancy can be detected the day after conception is false”, Cutler explained the typical timeline of fertilization and the way pregnancy tests work to detect hormonal changes:
“About five to 10 days after fertilization, the fertilized egg implants in the lining of the uterus. HCG is produced shortly afterward, Cutler said, first in low levels which rise rapidly over time.
“The very earliest someone can confirm whether they are pregnant is following implantation, the timing of which varies but can take a week or more,” she said.”
Read the whole article here.
Cutler introduces governor at Wisconsin Doctor Day 2024
This year, Doctor Day’s advocacy focus included extending Medicaid coverage for new moms up to one year postpartum. Thanks to all who attended and helped legislators connect to this important issue, and thank you Dr. Cutler for representing the department!
Cutler receives Group on Women in Medicine and Science Impact Award
Sincere congratulations to Abby Cutler, MD, MPH, assistant professor in the Division of Academic Specialists in Ob-Gyn, who received a 2023 UW School of Medicine and Public Health Group on Women in Medicine and Science (GWIMS) Impact Award! The award was presented during the annual GWIMS Symposium on November 28, 2023.
The Impact Award recognizes significant contributions with ongoing, substantive impact in areas like advocacy, research, clinical work, education, program development, community involvement, and more.
Cutler was nominated for the award for her tireless work in the wake of the 2022 Dobbs decision, including establishing a training partnership in Illinois for ob-gyn residents, working with media to highlight the challenges of abortion restrictions, participating in research that will help us understand the long-term impacts of Dobbs, and providing compassionate patient care through it all.
Congratulations on this well-deserved honor, Dr. Cutler!
Department of Ob-Gyn brings posters, presentations to 2023 Society of Family Planning Conference
Members of the Department of Ob-Gyn brought an impressive array of posters and panel sessions to the annual Society of Family Planning Conference on October 28-30, 2023 in Seattle. This conference aims to allow professionals to share research and learn from one another about abortion and contraception care. These are just a few of their exciting accomplishments:
Abigail Cutler, MD, MPH, assistant professor in the Division of Academic Specialists in Ob-Gyn and associate residency program director, moderated the panel “We travel the path of our patients: Establishing Illinois-based abortion training for Wisconsin Ob-Gyn residents". The panel included resident Alex Andes, MD, PGY-4, and colleagues from the University of Chicago, Medical College of Wisconsin, and Rush University.
Poster: “Increase in Patients Seeking Sterilization at a Single Wisconsin Hospital: 2016-2022.” Authors: Abigail Cutler, MD, MPH; Rachel Mojdehbakhsh, MD; Bridget Kelly, MD; Laura Hanks, MD; Eliza Bennett, MD; Laura Jacques, MD.
Laura Swan, PhD, LCSW, research scientist in the UW Collaborative for Reproductive Equity and Department of Population Health Sciences, presented the poster, “Coercion in contraceptive care: Differences based on racial/ethnic identity, sexual orientation, and gender identity.” Authors: Laura Swan, Lindsay Cannon, Madison Lands, Jenny Higgins, Tiffany Green.
Incredible work, all!
**by Ob-Gyn Communications Intern Paige Stevenson
Cutler discusses Convenient Contraception Act in Cap Times
In summer 2023, members of Congress introduced the Convenient Contraception Act, which could require insurers to cover up to a year’s supply of birth control at a time, with the potential of reducing the number of times an individual would need to pick up certain methods of birth control in a year. Wisconsin Senator Tammy Baldwin is a co-sponsor of the bill.
Abigail Cutler, MD, MPH, assistant professor in the UW Ob-Gyn Division of Academic Specialists in Ob-Gyn, spoke with the Cap Times about what the bill could mean for contraceptive access in Wisconsin:
“To Cutler, the benefits of the bill for people seeking birth control in Wisconsin are clear.
“I have seen an uptick anecdotally in the number of patients who come to me seeking contraception, whether reversible contraceptives like pills, patches, rings, or long-acting reversible contraceptive methods like IUDs or the arm implant, or even permanent contraception like sterilization, because of the changes in the laws here in our state,” Cutler said.”
Read the whole article here.
Cutler and Cox to become Associate Program Directors of UW Ob-Gyn Residency
Abigail Cutler, MD, MPH, assistant professor in the Division of Academic Specialists in Ob-Gyn, and Caroline Cox, MD, incoming assistant professor in the Division of Female Pelvic Medicine and Reconstructive Surgery, will become Associate Program Directors of the UW Ob-Gyn Residency Program in September 2023. Cutler and Cox will join incoming Residency Program Director Bridget Kelly, MD, on the residency leadership team.
Cutler joined our department in August 2021. Since arriving in Wisconsin, she has taken a leading role in resident education around family planning. She became director of our department’s Ryan Residency Program in 2022, has developed new family planning curriculum for our trainees, and worked tirelessly since last summer to organize an away rotation that allows residents to gain necessary skills and experience outside of Wisconsin. Cutler’s expertise and insight will be invaluable in this role.
Cox, who will join our department in September, has demonstrated a strong commitment to resident education throughout her career. During her residency here at UW, she was one of only two members of the UW Medical Board. She has been active in resident education as a faculty member at the University of Pennsylvania, including serving as director of gynecology simulation and preoperative curriculum, urogynecology educator, and a member of the resident mentorship and residency clinical competency committees.
Congratulations, Dr. Cutler and Dr. Cox, on these new roles! You will be exceptional educators, leaders, and champions for our residents.
Jacques, Cutler discuss sterilization trends with WPR
Since the US Supreme Court’s decision in the case Dobbs v. Jackson Women’s Health Organization in June 2022, health care providers across the state have seen an increase in requests for permanent sterilization.
Wisconsin Public Radio reported on new sterilization services to be offered at Planned Parenthood in Milwaukee. In “Planned Parenthood of Wisconsin to begin vasectomy services in Milwaukee”, Laura Jacques, MD, associate professor in the Division of Academic Specialists in Ob-Gyn (ASOG) and Abigail Cutler, MD, assistant professor in the Division of ASOG, spoke with WPR about trends in their own clinics:
“UW Health OB-GYN Laura Jacques said after the leaked opinion, she began to notice one or two patients per day would come to her requesting sterilization. Before that, it was one or two per month, she said….
Abigail Cutler, an OB-GYN at UW Health, has seen similar trends. Many patients cite the Supreme Court ruling as a major factor in their decision, she said. It's a legitimate reason, but one she said she wishes people didn't need to consider.”
Read the whole article here.
Cutler, Higgins publish in Perspectives on Sexual and Reproductive Health
In new research published in the journal Perspectives on Sexual and Reproductive Health, UW Ob-Gyn Assistant Professor Abigail Cutler, MD, UW Collaborative for Reproductive Equity and Division of Reproductive and Population Health Director Jenny Higgins, PhD, MPH, and co-authors use survey data to examine factors associated with physicians' level of concern and perceived consequences of publicly supporting abortion. Co-authors on the publication include postdoctoral research associate Laura Swan, PhD, and CORE Research Program Manager Madison Lands, MSW, MPH.
In “Characterizing physician concerns with publicly supporting abortion at Wisconsin's largest medical school”, the authors evaluated survey responses from physicians who expressed support for abortion to identify their perceived concerns about taking public stances on abortion:
“Nearly a quarter (22%) of respondents felt very or extremely concerned that taking a strong public stance on abortion would alienate patients and 17% felt very or extremely concerned that doing so would alienate coworkers. More than a quarter (27%) felt very or extremely concerned that publicly supporting abortion would lead to harassment or harm. Those with greater concerns about expressing public support for abortion were comparatively less willing to refer for or participate in abortion care themselves.”
Read the whole study here!
Harrison and Cutler publish op-ed on Medicaid sterilization consent practices in Health Affairs
In a new opinion piece published on Health Affairs, UW Ob-Gyn resident Margaret Harrison, MD, PGY-3, reflects on the origins of the Medicaid Sterilization Consent Form and suggests revisions to the consent form and process that could improve patient-centered, evidence-based, equitable ethical health care.
In “Medicaid Sterilization Consent Practices Increase Barriers To Effective Contraception”, Harrison and co-author Abigail Cutler, MD, assistant professor in the Division of Academic Specialists in Ob-Gyn, open with the story of a patient who faced barriers to desired care because of the current process around Medicaid sterilization consent, including the time restrictions and requirement for in-person signatures. Harrison shares data on how often Medicaid patients may not be able to access desired procedures because of barriers from the consent process, and offers options for updating the process that could improve patient experience:
“Reevaluation and revision of the Medicaid Sterilization Consent Form should be focused on how it can serve as a tool for informed and shared decision making rather than a barrier to access. A reasonable step toward equity for reproductive access would be elimination of in-person signatures. Amidst an ongoing health pandemic, growing concerns about access to shrinking comprehensive reproductive health care in a post-Dobbs world, and rising demand for permanent contraception, we urge policy makers to work toward equitable access to reproductive health care to all patients seeking sterilization by allowing electronic signatures and expanding telemedicine capabilities for consent to provide it.”
Read the whole article here!
Cutler and Higgins talk about impact of abortion restrictions with National Public Radio
A recent story on National Public Radio profiled a Wisconsin woman whose pregnancy plans changed in light of abortion restrictions in the state. UW Ob-Gyn Assistant Professor Abby Cutler, MD, and Division of Reproductive and Population Health and UW Collaborative for Reproductive Equity (CORE) Director Jenny Higgins, PhD, MPH, both added perspective to the story.
Cutler talked about the challenges patients and providers face in navigating the current legal restrictions:
“For doctors and patients in Wisconsin trying to live with an abortion ban in legal limbo, "the level of confusion and uncertainty and – [even] chaos – that this has injected into the provision of all sorts of pregnancy-related health care, not just induced abortion, cannot be overstated," Cutler says.”
CORE will work to measure the impacts of Wisconsin’s abortion ban. But Higgins says pregnancy intentions are nuanced, and some effects of the ban will be hard to quantify:
“"I think on balance, there'll be more people who want abortions who can't get them than people who want babies and choose not to have them because of these policies," she says. "But there'll still be a group of people – like [Petranek] – who are opting out of having another baby, and that has a major impact on their own hopes and dreams about family-making."”
Read or listen to the whole story here.
CORE researchers publish conference abstracts in Contraception
Faculty, researchers and trainees in the UW Collaborative for Reproductive Equity brought posters and presentations to the 2022 Society of Family Planning annual meeting in Baltimore, MD in December. Three abstracts presented at the conference were published in Contraception!
Characterizing physician concerns with publicly supporting abortion – AS Cutler, LT Swan, M Lands, NB Schmuhl, JA Higgins
Physician beliefs about abortion safety and their participation in abortion care – LT Swan, AS Cutler, M Lands, NB Schmuhl, JA Higgins
Covid-19 abortion experiences on reddit: A qualitative study – L Jacques, T Valley, S Zhao, N Rivera, M Lands, JA Higgins
Congratulations to all!
In the News: Cutler talks stigma and challenges in post-Dobbs Wisconsin
Abby Cutler, MD, assistant professor in the UW Ob-Gyn Division of Academic Specialists in Ob-Gyn, spoke with Grid News and appeared on a Wisconsin Health News panel about challenges to accessing abortion care in recent weeks.
More doctors are speaking out against abortion bans ahead of the 2022 midterm elections – Grid News
In this article, Cutler talks about how stigma may sway doctors’ decisions on whether or not to speak about abortion restrictions after the U.S. Supreme Court decision that overturned Roe v. Wade:
“In polls, doctors rank among the most trusted voices in American life. However, the stigma around abortion, and a widespread fear that their colleagues don’t share their concerns, may have stopped some from speaking out in the past, said Cutler. A survey of more than 900 doctors at her university’s healthcare system conducted before the Dobbs decision found that while 84 percent of the physicians supported abortion access for patients, only about 20 percent of them believed their colleagues felt the same way.”
Physicians ‘between a rock and a hard place’ when it comes to navigating abortion law – Wisconsin Health News
On this panel, Cutler talked about challenges for patients in Wisconsin who may have to leave the state to access abortion care:
““It is no small feat to seek an abortion in Illinois or Minnesota for someone in Wisconsin where the cost of travel, the cost of child care, the cost of the procedure itself, those are significant costs, financial, emotional, otherwise.””
Swan, Cutler, Higgins in publish study in AJOG
A new article in the American Journal of Obstetrics and Gynecology uses data from a 2019 survey of UW SMPH physicians to assess physicians’ understanding of whether contraceptive methods work by causing abortion. Laura Swan, PhD, LCSW, postdoctoral research associate in the Department of Population Health Sciences Green Inequality Lab, is first author on the study.
In “Physician Beliefs about Contraceptive Methods as Abortifacients”, Swan and co-authors (including UW Ob-Gyn Division of Reproductive and Population Health and UW Collaborative for Reproductive Equity Director Jenny Higgins, PhD, MPH and Abby Cutler, MD, assistant professor in the UW Ob-Gyn Division of Academic Specialists in Ob-Gyn) asked physicians whether they thought six common contraceptive methods worked by causing abortion. The authors then compared provider demographics with beliefs about contraception.
“Misconceptions about contraceptive methods were more common among male physicians than female physicians…Medical specialty was associated with the belief that IUDs and EC work by causing abortion.”
Read the whole study here!
Cutler talks about post-Dobbs impacts on ob-gyn training with WPR
A recent article published by Wisconsin Public Radio discusses the challenges facing ob-gyn and family medicine physicians after the U.S. Supreme Court’s Dobbs decision earlier this year, including uncertainty around how Wisconsin’s law criminalizing abortion will be enforced.
In “While enforceability of 1849 abortion ban is debated, health experts worry about OB-GYN recruitments”, Abby Cutler, MD, assistant professor in the UW Ob-Gyn Division of Academic Specialists in Ob-Gyn, talks about possible challenges when it comes to recruiting new physicians to a state with abortion restrictions:
"But in a state like Wisconsin, where we're already concerned about women's health care providers, OB-GYN shortages, this is a real worry that we would not be able to recruit and retain physicians who want to work in this space or even just doctors, you know, who want to live here and are worried about the impacts of this law on their own health," said Cutler.”
Read the whole article here.
Cutler discusses Dobbs’ impact on patient autonomy with New York Times
Abby Cutler, MD, assistant professor in the UW Ob-Gyn Division of Academic Specialists in Ob-Gyn, spoke with the New York Times as part of an article examining the impact of abortion bans in Wisconsin, Arizona, and Texas.
“Medical Impact of Roe Reversal Goes Well Beyond Abortion Clinics, Doctors Say” outlines the way abortion bans can affect pregnancy care, cancer care, emergency medicine, and other areas of health care. In the article, Cutler describes how overturning Roe v. Wade has taken some decision-making power away from patients:
“Roe, which prohibited states from banning abortion before viability, allowed doctors to offer patients options of how they wanted to be treated. “Now that patient autonomy has gone away,” said Dr. Abigail Cutler, an obstetrician-gynecologist at the University of Wisconsin-Madison.
“I’m compelled by my conscience to provide abortion care, and I have the training and the skills to do so compassionately and well,” she said. “And so to have my hands tied and not be able to help a person in front of me is devastating.””
Read the whole article here.
Cutler to take over as Ryan Residency Program director
Later this year, Abigail Cutler, MD, MPH, assistant professor in the UW Ob-Gyn Division of Academic Specialists in Ob-Gyn, will become director of the Ryan Residency Program. She will take over from Associate Professor Eliza Bennett, MD, who has led the program since 2010.
The Ryan Residency Program “works directly with ob-gyn residency programs to integrate training in abortion and contraception care (family planning) as a required rotation. All programs establish or expand abortion services in their teaching hospitals and may also create new partnerships with local clinics to train residents.”
Cutler, who is fellowship-trained in complex family planning, joined the department in 2021. Since arriving in Wisconsin, she has taken a leading role in resident education around family planning, developing a new curriculum and working tirelessly to organize an away rotation that will allow residents to build their skills outside of Wisconsin. Her expertise and insight will be invaluable in this role.
Please join us in thanking Dr. Bennett leading the Ryan Residency Program for 12 years, and congratulating Dr. Cutler on this new role!
In the News: Cutler shares insight in post-Roe reporting
Since the United States Supreme Court issued its decision in the case Dobbs v. Jackson Women’s Health Organization on June 24, overturning the constitutionally protected right to abortion, UW Ob-Gyn Assistant Professor Abigail Cutler, MD, of the Division of Academic Specialists in Ob-Gyn, has spoken with many news outlets to discuss what that decision could mean for the future of reproductive health care in Wisconsin and beyond:
After Roe, doctors grapple with limits placed on the care they can provide – NBC News
In a story about the gray area of abortion ban exceptions for the life of the pregnant person, Cutler talks about the challenges in applying the policy:
“Right now, all states with bans make exceptions for the life of the mother, meaning doctors can legally terminate a pregnancy if the mother will die. But doctors say that what constitutes imminent death has remained vague under the laws and they now fear that the shifting legal landscape is putting pregnant patients in grave danger.
“Abortion is still life-saving care,” Cutler said. “Someone is dying in front of you and if you do not intervene, they will die. But what constitutes saving the life of the mother can be impossible to pin down. How sick does a mother need to be? How much blood would they have lost?””
Wisconsin doctors scramble to understand abortion care post-Roe v. Wade – Wisconsin Public Radio
In this interview, Cutler talks about the many uncertainties facing clinical care providers in Wisconsin, including confusion about Wisconsin’s exception in cases where abortion is necessary to save the life of the pregnant person:
“"Knowing when that line is, when does a patient, when does a mother or a future mother become sick enough or is in enough danger to require life-saving treatment immediately," Cutler told Wisconsin Public Radio. "I think that's a really difficult line. There is no line, really.””
How Close to Death Does a Person Have to Be to Qualify for an Abortion Ban Exemption? – Mother Jones
In this article, Cutler also shared insights into the challenges of exceptions for abortion care in emergency situations:
“The ambiguity in Wisconsin’s state abortion ban, for instance, has left doctors like Abigail Cutler, an OBGYN in Wisconsin, in an impossible bind. Wisconsin’s law, written in 1849, allows abortions to “save the life of the mother.” “Where’s that line?” Cutler asks. “How close does a patient need to be? On the brink of death for me to step in and intervene? What if I wait too long and she dies in front of me? Or what if in the eyes of some prosecutor who’s not a doctor, not at the bedside, not staring at the patient bleeding or infected in front of them—to them, what if I intervene too soon, and I’m charged and risk going to prison?””
Cutler published in Women’s Health Issues
UW Ob-Gyn Assistant Professor Abigail Cutler, MD, of the Division of Academic Specialists in Ob-Gyn, published a randomized trial in Women’s Health Issues.
In “The Impact of First-Person Abortion Stories on Community-Level Abortion Stigma: A Randomized Trial”, Cutler and co-authors randomized participants to view either three video stories about someone’s abortion experience, or three narrated nature videos. Before, immediately after, and three months after watching the videos, participants responded to a questionnaire based on three existing stigma scales: the Community Abortion Attitudes Scale, Reproductive Experiences and Events Scale, and Community Level Abortion Stigma Scale:
“Evidence-based stigma reduction interventions are crucial for reproductive rights and public health advocates who seek to sway public opinion on abortion-related policy, for abortion care providers who endeavor to decrease abortion stigma toward their patients and themselves, for individuals who seek abortion care, and for their loved ones and friends who help them to navigate that experience. Despite the growing popularity of abortion storytelling, this randomized trial does not offer evidence that sharing first-person abortion stories with the general public decreases community-level abortion stigma.”
Read the whole study, and its implications for policy and practice, here.
Green, Cutler, Jacques discuss Wisconsin’s post-Roe future with Wisconsin Watch
Three UW Ob-Gyn faculty joined Wisconsin Watch in an audio interview on July 18 to discuss the current landscape of reproductive health care in Wisconsin after the United States Supreme Court decision that overturned Roe v. Wade. Wisconsin Watch hosted the conversation on Twitter, which you can listen to here.
Assistant Professor Abby Cutler, MD, of the Division of Academic Specialists in Ob-Gyn, shared trends in questions coming from patients since the Dobbs decision, including concerns about being able to access necessary care and criminalization of abortion care.
Assistant Professor Tiffany Green, PhD, of the Division of Reproductive and Population Health discussed the income and economic inequities deepened by Roe’s overturn.
Assistant Professor Laura Jacques, MD, of the Division of Academic Specialists in Ob-Gyn, answered questions about the effects of the Dobbs decision on counseling patients; stress and uncertainty added by Wisconsin legal restrictions to abortion; and impact on medical education in Wisconsin.
Listen to the whole conversation here.
Cutler and Higgins discuss possible impacts of Roe decision on physician training
A recent article in the Wisconsin Examiner investigated potential difficulties for physician training programs after the U.S. Supreme Court overturned Roe v. Wade.
“Medical training programs teach abortion procedures. What happens if abortion is outlawed?” outlines the national standards for training set by the Accreditation Council for Graduate Medical Education (ACGME), which requires a family planning curriculum and the option for resident physicians to be trained in the provision of abortion.
In the article, UW Ob-Gyn assistant professor Abigail Cutler, MD, discusses the potential downstream effects of limiting training in abortion procedures:
“In surveys of OB/GYN doctors, those who have had less training in abortion care or none at all have reported that they “felt less prepared to offer comprehensive care to people who are experiencing a miscarriage,” Cutler says. For doctors with more exposure to and practice in abortion care, “there was a correlation between that and their comfort level with surgically managing miscarriage later on.””
Also in the article, Division of Reproductive and Population Health and UW Collaborative for Reproductive Equity Director Jenny Higgins, MD, MPH, shares results from UW research that found broad support for abortion among physicians:
“In 2019, the Collaborative for Reproductive Equity (CORE) at the UW medical school polled the school’s doctors on the impact of restrictions on abortion that had been enacted since 2011. More than 900 doctors responded to the survey, and more than 90% said overturning Roe v Wade “would worsen Wisconsin women’s health,” says Jenny Higgins, CORE’s director.
“We surveyed people across all medical specialties, and we found overwhelming support for abortion services as well as abortion providers,” Higgins says. In addition to the concerns for women’s health, a majority said that more restrictions on abortion “make it more difficult to recruit faculty and trainees.””
Read the whole article here.
Wisconsin Watch interviews UW Ob-Gyn faculty on abortion laws
Wisconsin Watch, a nonprofit news organization, recently published two articles about the complex future of abortion in Wisconsin and physician opinions on why abortion is a necessary part of health care. UW Ob-Gyn faculty shared their expertise in both articles.
“Wisconsin faces a ‘tangled series’ of abortion laws dating back to 1849 as it heads into a possible post-Roe future” includes interviews with Abby Cutler, MD, associate professor in the UW Ob-Gyn Division of Academic Specialists in Ob-Gyn, and Division of Reproductive and Population Health/UW Collaborative for Reproductive Equity Director Jenny Higgins, MD, MPH.
Cutler discussed the impact the coming U.S. Supreme Court decision that may overturn Roe v. Wade could have on abortion care in Wisconsin. Higgins shared information on current barriers to accessing abortion care, and perspective on whether laws limiting abortion access are based in medicine and science.
In “Are abortions ever medically necessary? Wisconsin doctors say yes.”, Cutler and emeritus professor Doug Laube, MD talked about the physical risks that come with carrying a pregnancy, and instances where restrictions to abortion access may put peoples’ health at risk.