Higgins, Schmuhl, Wautlet, Rice publish in American Journal of Public Health

Findings from a UW Collaborative for Reproductive Equity study on how doctors view access to abortion has been published in the December issue of the American Journal of Public Health.

In the research-based editorial “The Importance of Physician Concern and Expertise in Increasing Abortion Health Care Access in Local Contexts, Jenny Higgins, PhD, Nicholas Schmuhl, PhD, Cynthie Wautlet, MD, and Laurel Rice, MD—all UW CORE investigators—chronicle the impacts of increasingly restrictive policies on abortion access, underscoring the key importance of local and state-level attitudes. Even with the current legal protections of Roe v. Wade, many state regulations already curtail abortion access. If the Supreme Court overturns the landmark case, which seems likely given the new makeup of the court, existing passed and signed state laws would immediately become enforceable, criminalizing abortion in Wisconsin and the majority of other US states.

Using Wisconsin as a case study, UW CORE researchers examined physician attitudes on the impacts of abortion policy on patients, the practice of medicine, and public health. With doctors ranking above teachers, police officers, and clergy in terms of their perceived ethics and trustworthiness, they comprise an important, but often understudied, group of influencers of public opinion and, ultimately, policy.

Wisconsin, a political battleground state now considered hostile to abortion access, witnessed a number of restrictive abortion policies implemented after the 2010 election. To better understand physicians’ attitudes toward abortion access and its impacts, UW CORE researchers surveyed doctors at the University of Wisconsin School of Medicine and Public Health—the state’s largest and only publicly-funded medical school. The team sent 1,357 surveys to doctors in all specialties and received 913 responses (a surprisingly high 67 percent response rate) between February and May 2019.

The investigators found that physicians across specialties majorly opposed restrictions on abortion health care services. In terms of patient care, 91 percent believed women’s health care would get worse if Roe v. Wade were overturned. An overwhelming majority of respondents, 99 percent, were concerned about legislation interfering with the doctor-patient relationship.

Ninety-one percent of doctors also opposed policies that prohibit their involvement in abortion care—namely, restrictive employment covenants that prevent them from providing abortion health services on personal time. Finally, physicians worried that abortion restrictions could negatively affect the UW–Madison School of Medicine and Public Health by curtailing faculty and trainee recruitment.

“We had expected physicians in our study to be concerned about abortion restrictions on patients,” said lead author Jenny Higgins. “But we were struck by the overwhelming degree to which they were also concerned about policy interference in how physicians can practice medicine, both in general and in regard to abortion. Another surprising finding is that physicians worried not only about effects on patient care and physician autonomy, but also on their institution’s reputation and ability to recruit quality faculty and trainees. It’s also notable that these attitudes were shared by providers across virtually all medical specialties, and not just Obstetrics and Gynecology.”

The authors argued that physicians have the potential to influence policy and change public perception. By more widely sharing their feelings about the negative impact of abortion restrictions, doctors could potentially help ease restrictions and shape both public attitudes and public policy. Doing so could protect women’s health as well as physician autonomy.

Read the whole article here.