The Reproductive Health Impact Study (RHIS) is a comprehensive research initiative that analyzed the effects of federal and state policy changes on publicly funded US family planning care from 2017 to 2024. The Guttmacher Institute worked with research and policy partners in four states—Arizona, Iowa, New Jersey and Wisconsin—to document the impact of these policies on family planning service delivery and the patients who rely on this care.

Wisconsin was selected as an RHIS focus state in 2019, following confirmation of significant shifts in Title X funding among state grantees.

The information in this state profile reflects the landscape in Wisconsin during the RHIS study period. For the most current information about the sexual and reproductive health research and policy landscape in Wisconsin, visit our state information page.

Overall Findings

The RHIS findings demonstrate that restrictions on sexual and reproductive health and rights undermine people’s reproductive autonomy through negative outcomes at the patient, provider and system levels. Additional and unexpected disruptions to the landscape during the study period, such as the COVID-19 pandemic and the US Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision overturning Roe v. Wade, exacerbated the harms of restrictive policies.

The main study findings include: 

• All types of sexual and reproductive health care are inextricably linked, and policy restrictions on sexual and reproductive health care have broader implications.
• Programs and policies that support person-centered care and focus on sexual and reproductive health equity are key to ensuring reproductive autonomy for all patients.
• Cost is a significant barrier to patients’ ability to access care and achieve reproductive autonomy.
• Person-centered contraceptive care is essential because contraceptive preferences vary.
• Publicly funded family planning programs, including Title X, are critical to making contraceptive services affordable.

Wisconsin’s Sexual and Reproductive Health Landscape, 2017–2024

In 2020, Wisconsin was home to 1.3 million women of reproductive age (15–49), 26% of whom had incomes below 200% of the federal poverty level.¹ In the same year, about 324,000 women in Wisconsin were considered likely to have a need for publicly supported contraceptive care.² Additionally, 7% of women in Wisconsin aged 15–49 were uninsured in 2019, compared with a national average of 12%.

Who Gets Publicly Funded Family Planning Services in Wisconsin?

During the study period, the number of female contraceptive patients served at publicly funded clinics in Wisconsin decreased. A publicly funded clinic is a site that offers contraceptive services to the general public and uses public funds (federal, state or local funding through programs such as Title X, Medicaid or the federally qualified health center program) to provide free or reduced-fee services to at least some clients.

In 2020, about 51,000 female contraceptive patients were served at publicly funded family planning clinics in Wisconsin, a 38% decrease from 2015. Patients younger than 20 made up about 12,000 of this group, a 38% decrease from 2015.² 

Only 16% of women in Wisconsin considered likely to have a need for publicly supported contraceptive care were served by publicly funded clinics in 2020, down from 24% in 2015.²

Where Do People Get Family Planning Services in Wisconsin?

The total number of publicly funded family planning clinics in Wisconsin decreased by 8% from 2015 to 2020, from 132 to 121. Of that total, the number of clinics receiving Title X funding nearly doubled, from 19 in 2015 to 37 in 2020, but the new sites served far fewer contraceptive patients than those that had left the Title X network as a result of 2019 changes in the program’s administrative regulations under Wisconsin’s state-specific gag rule and the federal domestic gag rule.² 

In 2019–2020, women in Wisconsin aged 18–44 most preferred to get contraceptives in-person from a provider (69%), from a pharmacy (67%) and via telehealth (58%) for pick-up or home delivery. Across three states (Arizona, New Jersey and Wisconsin), 73% of women of reproductive age preferred more than one source for contraceptives. 

What Family Planning Policies Changed in Wisconsin During the Study Period?

State and federal policy changes enacted during the RHIS study period disrupted the publicly supported reproductive health care system in Wisconsin. Planned Parenthood of Wisconsin had long been the state’s sole Title X grantee. In 2018, a Wisconsin state law went into effect, requiring the Wisconsin Department of Health Services (DHS) to apply for Title X funding. The law further required Wisconsin DHS to prioritize distributing Title X funds to public organizations and prohibited them from distributing these funds to agencies that provide abortions or are affiliated with organizations that provide abortions. Since 2019, Wisconsin DHS has been the state’s sole Title X grantee.

In 2019, the Trump-Pence administration implemented a series of changes to the Title X program’s administrative regulations that included a ban on abortion referrals, required physical and financial separation of Title X–funded activities from any related to abortion, and mandated coercive counseling standards for pregnant patients. As a result of this “domestic gag rule,” all Planned Parenthood affiliates left the Title X network later that year, although Planned Parenthood of Wisconsin continued to offer family planning services via other funding streams. In March 2019, Wisconsin joined 20 other states in filing a lawsuit opposing the gag rule. In 2021, the Biden-Harris administration’s Title X rule went into effect, revoking the 2019 rule and restoring the Title X national family planning program. 

Patients’ Experiences of Reproductive Health Care in Wisconsin

The restrictive state and federal policy changes enacted from 2017 to 2024 negatively impacted Wisconsin residents’ ability to access reproductive health care. 

Barriers to Accessing Care

Restrictive state and federal policies undermine person-centered care, the patient-provider relationship and patient health outcomes. Person-centered care—health care responsive to an individual patient’s preferences and values—is a central tenet of reproductive autonomy. In 2019–2020, only about one-third (35%) of women aged 18–44 in Wisconsin reported receiving “excellent” person-centered contraceptive care in the previous year.³

Although state-specific data are not available, national findings indicate that restrictive sexual and reproductive policies compound existing inequities. Therefore, the effects of the policies implemented during the RHIS study period are likely to have fallen particularly hard on marginalized groups in Wisconsin, including communities of color, people with low incomes and immigrant communities.

Effects of COVID-19 and Dobbs on Care

The COVID-19 pandemic further exacerbated the harmful impact of restrictive sexual and reproductive health policies. Between May 2020 and May 2021, nearly one-third (30%) of survey respondents at publicly supported health centers in Wisconsin reported that they were unable to access or delayed accessing sexual and reproductive health care, including contraceptive care, because of the pandemic. Respondents who had experienced financial instability during the pandemic were more likely than those who had not to experience pandemic-related delays in accessing sexual and reproductive health care.

Abortion-related policy changes during the study period also impacted people’s ability to access contraceptive care. In 2022–2023, following the Dobbs decision that overturned Roe, 10% of reproductive-aged women in Wisconsin reported having trouble or delays in accessing their preferred contraception, compared to 6% in 2021.

Reproductive Health Care Providers’ Experiences in Wisconsin

Restrictive state and federal policies disrupt providers’ ability to center and meet patients’ needs. They also increase existing inequities in sexual and reproductive health care, because these policies disproportionately impact marginalized groups.

Barriers to Providing Care

The state and federal policy changes enacted during the RHIS study period hindered publicly funded family planning providers in Wisconsin from offering patient-centered care. They negatively impacted clinic finances, providers’ ability to protect patient confidentiality, contraceptive counseling and service provision, and pregnancy options counseling.

Providers at clinics that opted to join or stay in the Title X national family planning program after the gag rule was enacted were required to prioritize fertility awareness–based methods and include parents in care decisions for minors (potentially compromising patient confidentiality). In addition, they were no longer able to provide comprehensive pregnancy options counseling. 

One Wisconsin provider reported: “We have to make sure that we're encouraging parental or guardian knowledge of contraceptive care and encourage them to talk with them, which has changed a lot, because previously, it wasn’t a concern because we are known as a confidential clinic, and in Wisconsin, they [were] able to seek those services without parental consent. It wasn't such a big deal, but now, adding that into our counseling has changed a little bit and figuring out that wording and making it sound appealing to the clients, especially those under 18, getting their parents involved. That's changed.” 

Another provider shared: “As a family planning provider, it's our job to educate women on all of their options and when it comes to abortion, I feel like I'm swearing when I say it now.…it's become a curse word in Wisconsin.…When we talk to our patients, we still get young moms that come in here that don’t want to proceed with their pregnancy. They are 14, they are not going to have a baby. So, not being able to educate them on [abortion], and we don’t because of the gag rules that have been put in place, we have to be very mindful of what we do so we don’t lose funding.”

Changes in Title X Funding

As a result of decreases or restrictions in funding, publicly funded family planning providers in all four RHIS study states—Arizona, Iowa, New Jersey and Wisconsin—had to rework payment options for patients. In some cases, they helped patients who would not otherwise be able to afford care access other government, clinic or donor funding sources.

Between 2018 and 2021, 31% of publicly funded clinics in Wisconsin left the Title X family planning program, likely because of the gag rule. In the same period, the share of publicly funded clinics providing comprehensive contraceptive counseling decreased.

COVID-19 and Reproductive Health Care Provision

The COVID-19 pandemic further complicated Wisconsin providers’ ability to provide person-centered sexual and reproductive health care during the study period. Family planning providers adapted their operations—including by implementing additional safety protocols, shifting service delivery and staffing to meet patient needs, and expanding telehealth services—to continue providing care during the pandemic.

Wisconsin’s Post-Roe Abortion Policy Landscape

Restrictive abortion laws can affect people’s ability to access contraceptive services and family planning providers’ capacity to provide contraceptive and other sexual and reproductive health care. Whether or not a reproductive health care provider offers abortion services, the ripple effects of abortion policies impact all types of care. 

After the Dobbs decision, all abortion clinics in Wisconsin stopped offering services while courts determined whether an 1849 state law criminalizing abortion was enforceable. As of 2024, Planned Parenthood of Wisconsin has resumed abortion services in three locations based on a county court ruling that the law did not prohibit voluntary abortions, and Affiliated Medical Services, an independent clinic in Milwaukee, has also resumed abortion services. The most current information about abortion-related policies in Wisconsin is available on Guttmacher’s interactive map of US state abortion policies. 

 

State Partners

The Guttmacher Institute partnered with the University of Wisconsin-Madison Collaborative for Reproductive Equity (UW CORE) and other Wisconsin-based research and policy partners for the RHIS. Additional information about reproductive health-related data and policies in Wisconsin can be found in the following resources:

• UW CORE: Contraception and Family Planning Programs
• UW CORE: Abortion
• UW CORE: Legislation and Health Policy

 

NOTES

1. Throughout this profile, we use the terms female and women to refer to individuals who may have the ability to become pregnant. However, not everyone who has the capacity to become pregnant identifies as female or as a woman. A limitation of the data sources used in our analyses is that they do not provide further detail on the sex or gender identity of respondents.