Reproductive Health Experiences and Access (RHEA) Study

Focus: Reproductive Health

My role: Co-Investigator

The Supreme Court’s decision in Dobbs v. Jackson Women's Health Organization, or Dobbs, overturned the constitutional right to abortion in 2022. The effects of this decision are likely far-reaching, but we don’t yet have the evidence to fully understand Dobbs’ impacts.

Our research, which includes a survey of more than 45,000 people and focus groups with directly affected people, will fill this knowledge gap.

The Urban Institute, SisterSong Women of Color Reproductive Justice Collective, and the University of Wisconsin–Madison are working together to rigorously assess how Dobbs has affected the broader reproductive health access and experiences, health outcomes, and social and economic well-being of women and other people who can get pregnant—especially for those from marginalized communities, who are likely disproportionately affected.

Black People's Pregnancy Preferences Study (BoPPS)

Focus: Reproductive Health

My role: Co-Investigator

The goal of this research is to investigate how reproductive-aged Black people value abortion method (medication vs. procedure) relative to other care attributes and to identify the structural and legal barriers that can shape those preferences. Medication abortion use has increased substantially in the two decades since the US Food and Drug Administration approved the use of mifepristone, now accounting for over half of US abortions. This proportion will likely grow, given COVID-related changes in medical care provision and the 2021 changes to the mifepristone Risk Evaluation and Mitigation Strategy, which now allows for remote dispensing of the medication. Further, many experts predict that the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, which dismantled Roe v. Wade and Planned Parenthood v. Casey is likely to increase pregnant people’s reliance on self-managed abortion, including medication abortion.

We will use a mixed-methods design to investigate: 1) abortion method preferences among Black people who can get pregnant and 2) how structural and legal barriers affect these preferences. Our proposed data collection is national in scope but also respondents from the US Midwest; this allows our work to have both national implications and to capture the experience of Midwestern Black people, who experience uniquely high levels of socioeconomic inequality and wide state-level variation in structural and legal barriers to abortion. Only by filling these gaps will we be able to serve the preferences and needs of Black people seeking abortions, whose access to desired care will be more constrained than ever in the post-Dobbs landscape. 

We will use a sequential mixed-methods study design. Specifically, we will first collect qualitative data using individual interviews with abortion facilitators (i.e., abortion providers, clinical support staff, research scholars, abortion doulas, abortion fund and practical support workers) and Black abortion seekers. We will use these qualitative data to inform the care attributes and levels embedded in our survey and discrete choice experiment.

Impacts of Birth Cost Recovery on Black Families in Wisconsin

Focus: Reproductive Justice

Sponsors: Wisconsin Partnership Program (WPP)

My role: Co-Investigator

Birth Cost Recovery (BCR) is a policy that holds some unmarried, non-custodial fathers responsible for Medicaid costs at the time of delivery. Wisconsin is the top enforcer of BCR in the United States, having collected $106 million between 2011 and 2015. Importantly, BCR disproportionately affects Black families, who are more likely than non-Black families to access prenatal BadgerCare and also experience among the worst pregnancy-related outcomes. While supporters of BCR argue that this policy promotes paternal responsibility, others contend that BCR causes financial strain, decreases paternal involvement, and leads to delays in prenatal care access. Yet, we have not established how BCR is impacting the health and wellbeing of Wisconsin families, nor centered the perspectives of the Black families disproportionately affected by this policy. On January 1st, 2020, Dane County stopped collecting new BCR funds, providing an important opportunity to evaluate how BCR impacts Black families.

This is a community-engaged pilot study to better understand how BCR affects Black families in Wisconsin. Specifically, we will be talking to Black parents about their experiences with healthcare, child support, and BCR, including the recent BCR changes in Dane County. We will use their perspectives to develop, refine, and test a survey to rigorously study the impacts of BCR. Specifically, we will:

• Invite Black parents in Wisconsin who have ongoing or past experience with prenatal Medicaid and/or BCR to participate in individual interviews or focus groups.
• Develop and refine a survey to capture the effects of BCR on Black parents and their families, including mental and physical health and relationships.
• Pilot test the survey and compare outcomes between Black Milwaukee families at risk of experiencing BCR and Dane County parents who are not at risk.