POWERS wants Wisconsin to trust pregnant people

A new billboard campaign seeks to connect Wisconsinites to a full spectrum
of pregnancy and birth resources.

A new billboard campaign seeks to connect Wisconsinites to a full spectrum of pregnancy and birth resources.

This story was produced in partnership with Red Madison, a publication of the Madison Area chapter of the Democratic Socialists of America.

Pregnancy Options Wisconsin: Education, Resources, and Support (POWERS) has launched a statewide billboard campaign, the group’s first foray into a communications medium most frequently utilized by abortion opponents. Per their name, POWERS’ focus is on providing education, resources, and support for the full spectrum of pregnancy, including not just abortion care, but miscarriage, pregnancy, birth, and adoption. The group’s new billboards, located off of highways in Central Wisconsin to start, read “Trust Pregnant People: Abortion, Adoption, Birth, Miscarriage.” The billboards direct viewers to the POWERS website and call line (608-514-1714).

POWERS began in 2019 with the intention of acting as a connector between pregnant people and the resources and information they need to make informed decisions about their pregnancies. The group’s website is a comprehensive directory of pregnancy-related information, from guidance for choosing a birth practitioner, to accessing abortion care, to a directory of licensed adoption agencies that are LGBTQ friendly and align with POWERS' mission, for making an adoption plan. POWERS also has a 24/7 phone line, staffed by three licensed midwives who can connect callers to resources or just provide emotional support for a pregnant person as they navigate the next step in their pregnancy plan. 

In a press release about the billboard campaign, POWERS president Johanna Hatch explained: “Wisconsinites deserve access to unbiased and full and factual information around all pregnancy options. Whether experiencing pregnancy release through abortion or miscarriage, planning for a safe birth at home, hospital, or birth center, or making an adoption plan, pregnant people deserve to be met with dignity and respect.” I spoke with Hatch last week about the campaign, the barriers that pregnant people in Wisconsin face, and the structural factors that limit their autonomy.

Tone Madison: Tell me about POWERS’ billboard campaign.

Johanna Hatch.

Johanna Hatch: If you've spent any time in the upper Midwest, there is only really one side that is well represented with billboards and large ads on many of our major roadways, and there's a lot of energy both from folks who are active in launching POWERS as well as from folks who would identify as supporters or people who are interested in what we're doing that, “Gosh, it would be so cool if POWERS had a billboard.” And so coming in at the end of 2020, we looked into that to see if it was actually feasible, and it turns out it's very feasible. I was joking, it's surprisingly easy to get a billboard as long as you contact the company and have a budget. It was something that turned out to be much more doable than I think we thought at the beginning, basically, and so we went for it to really spread a positive, holistic message around support for all pregnancy options for folks in Wisconsin. And right now we're started with, as you saw in the press release, primarily rural areas in Central Wisconsin. We know that folks who are seeking some pregnancy care, specifically abortion care in Wisconsin, if they’re rural have to travel long distances to Madison, Milwaukee, or Sheboygan to legally access that care.

So we wanted to get something, like I said, that was positive and holistic for folks who were working through their own pregnancy decisions to provide some balance and to hopefully provide greater outreach for folks who wanted support through those different decisions as well.

Tone Madison: The group must have taken some time and some care in crafting a message for a billboard. I'm interested in the thought process behind what you came up with, and I'm especially interested in the fact that your group used the word abortion, when a lot of pro-choice organizations tend to dance around it a little bit.

 Johanna Hatch: Like I said really, what I think is the core belief of everyone who is involved with POWERS is that we trust pregnant people as the authority over their lives and bodies, full stop. So for us, that means, among other things, being really clear that that includes abortion. And that includes the decision of how to access abortion. That includes what type of termination is best for them.

But also, when we're talking about pregnancy options, I think a lot just gets tacked onto abortion only. The conversation really gets boiled down to abortion. For us, in POWERS, it is also really, really important to talk about, what are your options with continuing your pregnancy? What are your options with birth? You can safely and legally have a birth at home, in a birth center, or in a hospital here in Wisconsin, attended by a licensed midwife, a certified nurse midwife, a family physician, or an OBGYN. 

Just as important as it is for people to have clear and accurate information about choosing to release a pregnancy through abortion, it is equally important that people have clear, factual, full information about what their options are with regard to pregnancy care and continuing pregnancy, giving birth, what their legal rights are with choosing to make an adoption plan for their child. And also we included miscarriage, because we really wanted to highlight the commonality of the experience of releasing a pregnancy either through abortion or miscarriage. It is extremely common and often not talked about.

So basically what that message is, we wanted to recenter the pregnant person as the focus of this discussion. And make sure that the conversation was wide open about all of our pregnancy options, but also it should be really clear and specific because people have a legal right to an abortion and we should not be afraid to say that.

Tone Madison: I would love to hear about what some of the barriers and information access are when it comes to people who are choosing to end a pregnancy via abortion, but I would also be interested in hearing about some of the barriers and information access when it comes to giving birth. What is prohibiting people in Wisconsin from giving birth the way that they want to, or what makes it harder to choose to give birth?

Johanna Hatch: I think there's some commonalities both if we're talking about choosing to release a pregnancy through abortion, or how we decide to give birth and where we decide to give birth. I think one of the big things is—so like, going back to how we specifically used the word "abortion." A lot of people don't talk about it...people may not feel comfortable asking those questions of their health care practitioner. Healthcare practitioners may not feel comfortable bringing up those options.

There's also, I think, in order for medical practitioners to get education about providing abortion care as well as even getting good information about it in their educational programs. At least through my experience as a nurse and a student nurse midwife, there's not a lot of time spent on those topics, and if you want deeper education and skills training, you often have to seek it out in addition to your program. That's not universally true, but for many medical practitioners that is the case. So I think that's one barrier is that maybe medical practitioners don't have the full scope of most current accurate information as well as knowledge about the intricacies of the legal requirements within the State of Wisconsin, so I think that's another piece.

It can be really, really complicated to legally access an abortion in the state of Wisconsin, and it's designed to be that way. That legal situation is just rife for creating confusion and the unintentional continuation of misinformation or incomplete information. That therefore also then makes it more difficult to access that care.

Secondly, for both abortion care and birth care, one of the difficulties of accessing the full range of options is insurance and money. I mean really, truthfully, because of the Hyde Amendment, BadgerCare will not cover abortion care in the state of Wisconsin. And it's been less than 10 years since licensed midwives or certified professional midwives could bill BadgerCare. So that's a relatively new development, and I think a lot of folks even know about that. They don’t even know that if you wanted to have a home birth and you have BadgerCare, your provider can be covered and provide that care for you, instead of having to pay out of pocket for that care.

And even with birth care, I think there continues to be a lot of misinformation about what exactly licensed midwives do, and their scope of care and their training. And how they provide safe care in the community rather than in the hospital. And so I think for us it's really about helping people get access to that information because it can be really hard.

Tone Madison: You mentioned that Wisconsin is a is a pretty tough landscape for abortion access in particular. What's the group’s outlook on what the next few years might look like in Wisconsin? Does POWERS get involved in lobbying at all?

Johanna Hatch: Our focus is not on lobbying. Our focus is definitely on being that place to provide education, resources, and support for pregnant folks in Wisconsin and always in our work, trying to model in healthcare of having the pregnant person at the center with the knowledge and authority over their own life. I don't know if I would say that we have a specific outlook on what the next few years will bring. We are living with the realities that there is a Supreme Court that is majority anti-choice. We live with the reality that Wisconsin has a criminal abortion statute from the 1800s still on the books, and recognizing what that could cause if Roe was overturned. And also being an island between two states, Illinois and Minnesota, that have state constitutional level protection for abortion care.

So it's kind of thinking about, where would we sit in that picture in the coming years? I think where we would always fit is dignity, autonomy, and the right of the pregnant person to decide what's best for them. And how that would look if the worst happened—we would just have to change and adapt, but that's always going to be the side that we're on.

Tone Madison: I think it's a surprise to folks to find out how difficult it is to get an abortion in Wisconsin. What is the current landscape like? How many clinics do we have? Is it the sort of thing where you can just make an appointment and show up?

Johanna Hatch: At my last glance, for clinics that provide abortion care, there is one in Madison that provides medication and surgical abortion up to 19 weeks, two in Milwaukee that provide the same service, and then a clinic in Sheboygan that provides medication abortion.

In the state of Wisconsin people are required to have two separate in-person visits at least 24 hours apart. So for a person who lives three or four hours from the nearest clinic, that means two separate trips on two different days. And the reality is that due to scheduling, there's often not back-to-back appointments, so in addition to having to find the money for the care that is not covered by insurance, they need to find transportation [and] probably someone to care for their own children [and] take time off of work.

 So all of these things really stack up and make it really difficult to access. Then the additional layer is if someone is under the age of 18, they are required to either have an adult who fits kind of certain legal criteria present with them, or they have to seek out the judicial bypass.

Just as a comparison point for people—just to help them understand—in Illinois, you make an appointment. You show up at the clinic. You get the care you need. It is covered by their state Medicaid, if you need it.

So it's very, very different based on which side of a state border you live on, how easy it is to access care.

Tone Madison: Do you think that there are people from Wisconsin who are already traveling to other states to get abortions because it's more accessible than trying to get one here? Is that already a reality?

Johanna Hatch: Oh, absolutely, absolutely. But I think there's also, with that, a question about who has access to the information, who can get transportation even further to cross the state line. So there are definitely people who make that decision, and I think it also is a question of privilege, about who gets to make that decision.

And then also the reality is that in the state of Wisconsin, as in many places across the United States where abortion is difficult to access, some people will choose self-managed abortion through medications that they've obtained online. And that's just a part of the picture here too.

Tone Madison: So we talked a little bit about the misinformation and how it's difficult for people to access information. To what extent is that a product of the issue of crisis pregnancy centers? Crisis pregnancy centers bill themselves as pregnancy options places. Even if they’re not providing information about abortion, are they providing good information and resources about pregnancy and birth?

Johanna Hatch: I'm not an expert on crisis pregnancy centers, but what I will say is if you are not clear with people upfront about the services that you do and do not provide, as well as how to access services that are still a constitutional right, you are not providing all options.

 I think that it's great to help people with material support during pregnancy. I think that can be very helpful to a lot of people. But I think the reality is if a person presents to you as a healthcare practitioner or somebody who is expressing themselves with the authority of a health care practitioner, and that person says, "full stop, I want to end my pregnancy and I'm trying to end my pregnancy," I think there is an ethical obligation to provide them with true, accurate information. Anything else can create delay, which with something that's really time-sensitive, like access to abortion care tends to create for the barriers to access, can create increased costs for people in getting that care. And so I think anything that's there as a delay or a diversion is really unhelpful.

I'm a student midwife and what I learned in my accredited educational institution is that when a person presents with a pregnancy and they tell you clearly that they do not want to continue the pregnancy, even if you disagree with their decision, you have an ethical responsibility to tell them the truth and to direct them and to refer appropriately, so anything that is attempting to subvert that it's not helpful.

Tone Madison: It’s not healthcare.

Johanna Hatch: Yeah. To a certain extent, there's probably a lot of variability with regard to crisis pregnancy centers, and as far as I know, not a lot of state oversight or credentialing, so it's hard to say things like, if a place also offers free ultrasounds, is that a ultrasound tech or a registered nurse with specialized additional training in providing ultrasounds? Or somebody who does not have that kind of specialized training? Is there a medical professional, like an advanced practice nurse or physician, who can properly interpret those ultrasounds? There's a lot of things that can be found on early ultrasounds that require quick referral and specialized care, like in ectopic pregnancy. What are the systems in place for that?

So I think those are questions that I have about what happens at a crisis pregnancy center. With regard to providing people free ultrasounds.

Tone Madison: Your website mentions support for reproductive justice for Black lives. Can you talk a bit more about that aspect of the work specifically?

Johanna Hatch: So this is definitely a place where we are always continuing to learn from Black women and to try to support the efforts of Black women in our state. So, among other things, we have been trying to do some solidarity grants and supporting efforts like the Harambee Village Doulas Birth Center plan.

Reproductive justice really is a movement that was conceptualized, and a framework that was designed, by Black women addressing the needs of their community. I will say clearly that at this time POWERS’ leadership is majority white, so I am very careful to not co-opt the language of reproductive justice and to acknowledge that it does not belong to the community that I come from and give full credit to the folks who pioneered it.

But I think that for us as an organization, that framework does resonate with us, and so we want to work to support the efforts and leadership of communities of color in this state who are already doing the work to uplift and, frankly, save the lives of Black women and Black babies and Black folks who are pregnant.

Tone Madison: What are some of the biggest challenges that POWERS has faced in its first year?

Johanna Hatch: Honestly, I think the challenge that everyone has faced, which is COVID. March of last year we had really just started to develop a couple different things that we're working on, trying to build more community connections. We had launched the website, we had the phone line going. In early February we did a training for abortion companions with folks who wanted to either incorporate it into work they’re already doing or begin doing work supporting folks through the abortion process. And then COVID hit. At first we were all just like, OK, well, we'll just pause and we'll figure out what happens next and then we're like, oh, it's never going to be over. We have to figure out what to do next.

So I think right now we are really trying for—and part of the billboards, too—is bringing our focus back, really highlighting the work of education, connecting folks with the resources they need, and providing support across the pregnancy spectrum. And that's helping folks connect to the website, which has lots and lots of information on it. And help connect folks if they need kind of the more real-time support with the phone line to know that this is an option and this is something that's available to them if they are having questions or having trouble accessing the resources they need or seeking support through the pregnancy process.

Tone Madison: What's the most effective way for people to support POWERS? And where should people who care about this idea of bodily autonomy, and of trusting pregnant people, be focusing their energy and attention?

Johanna Hatch: So I would welcome anyone who is interested in learning more and getting involved and, you know, any way that we can be helpful to other folks’ activism around this issue, can go to our website, which is pregnancyoptionswi.org. There's a "contact us" form and we can kind of get them connected.

I think there's a lot of places that folks can be focusing their attention.

I think there's so many pieces of bodily autonomy, especially around the type of pregnancy, people kind of hop on in different ways, so we would definitely welcome getting involved with POWERS, getting connected with us.

I think there is always room for folks to get to know what are the resources in your local community. Are there tools available in your community? Is there midwifery care available in your community? Who are the leaders with regard to reproductive justice? I always want to lift up the work of Maroon Calabash in Milwaukee. They are, through COVID, providing doula support and assistance for people of color to access midwifery care and support for people who are releasing pregnancy through abortion or miscarriage. Here in Madison, the Harambee Village doulas are doing amazing work of providing doula support and envisioning this birth center to try to reverse the huge disparities and infant mortality rates.

But we would love to connect with them with POWERS. We always want to connect with people in all parts of the state to help support them and uplift them in their work and also to just look around your community. Connect with the leaders in your community. Because there's always work to be done.

Tone Madison:  Is there anything that I didn't ask you about that you wish that I had or that you'd like to talk about?

Johanna Hatch: We always really try to highlight that POWERS is not affiliated with any political organization. We're totally independent. We're not affiliated with any religious group.

This really is something that came from a group of folks who are midwives, physicians, nurses, doulas, community activists who are really coming into this discussion about pregnancy options from a lot of different angles and experiences. I think that's why, for us it's so important that this is a place that is holistic and that this conversation is really inclusive of all pregnancy options and outcomes. Because we know that the truth of the matter is a person who has an abortion is going to be somebody who has a home birth later, or somebody who has had two or three babies could be a person who has an abortion five years later.

There's this false dichotomy that all these things are kind of silos, and they're all different and they're all disconnected. But the truth of our lives is that it's all really, deeply connected. And so we just seek to honor that connection and honor the truth of our lives, that they aren't separate. It's really not separate.