Wisconsin Republicans are introducing a new bill that is being promoted as an effort to protect emergency abortion care and ensure that pregnant patients aren't denied the treatment they need. As you will see, however, Assembly Bill 546 is a wolf in sheep's clothing.
You need to pay attention to this bill.
Assembly Bill 546 is not an abortion ban. Rather, the bill merely amends the several definitions of abortion already present in state laws by inserting additional language that describes what is not considered an abortion, for now. To the untrained eye, this additional language appears to exclude life-saving abortion care from the state's definitions of abortion, but this is a mirage.
The bill, which was authored by Rep. Joy Goeben (R-Hobart) and Sen. Romaine Quinn (R-Birchwood), is not designed to protect emergency abortion care. —It is designed to eliminate the exception for life-saving abortions altogether. A similar bill co-authored by Rep. Quinn and introduced in 2023, explicitly states, “The bill eliminates the therapeutic abortion exception.” That bill stalled the state senate.
Assembly Bill 546 does not contain that explicit declaration, demonstrating a slight shift in tactics. Rather than amend the definition of abortion and eliminate the life-saving exception all at the same time, Assembly Bill 546 lands the first blow in a one-two punch:
Amend the definition of abortion.
Eliminate the exception for the life of the pregnant person.
Assembly Bill 546 also adds several definitions into state laws. Yet, even these definitions are not what they seem.
As innocuous as this bill might appear to the untrained eye, it is not benign. Assembly Bill 546 is a new twist on an anti-abortion strategy, about which rePro-Truth previously alerted you, to achieve two of the movement's cruelest policy goals: forcing doctors to perform dangerous procedures instead of far safer procedural abortions in order to eliminate the exception in abortion bans to save the patient's life.
What follows is a deep, informative dive into Assembly Bill 546.
Let's dig in.
Amending state definitions of abortion
Abortion is a medical term defined as the ending — both spontaneous and induced — of an established pregnancy before fetal viability.123 However, politicians in each state have created and enshrined differing definitions that don't always align with the medical definition of abortion.
The State of Wisconsin has multiple definitions of abortion (see footnotes 4-8 to view each).45678 For example, Wisconsin's current ban (as of Oct. 2025) — which bans abortion at 20 weeks post-fertilization (21 weeks and 6 days LMP) — uses the definition of abortion that is found in WIS. STAT. ANN. § 253.10 (2a).
Assembly Bill 546 amends Wisconsin's several definitions of abortion by adding the following language to those existing definitions:
“Abortion” does not include a physician’s performance of a medical procedure or treatment designed or intended to prevent the death of a pregnant woman and not designed or intended to kill the unborn child, including an early induction or cesarean section performed due to a medical emergency or the removal of a dead embryo or dead fetus, or an ectopic pregnancy, anembryonic pregnancy, or molar pregnancy, which results in injury to or death of the woman’s unborn child when the physician makes reasonable medical efforts under the circumstances to preserve both the life of the woman and the life of her unborn child according to reasonable medical judgment and appropriate interventions for the gestational age of the child. (Emphasis added)
Rather than fully exempting emergency abortions from the state’s definitions of abortion, the above language places conditions on the performance of emergency abortions —conditions which must be met in order for a physician to be protected from criminal prosecution.
When used to save a patient’s life, some (not all) abortion methods will not be considered abortions if the following conditions are met:
The abortion method used is “not designed or intended to kill” the embryo or fetus.
The physician tries to “preserve the life” of the embryo or fetus.
Condition 1
Under the first condition, a physician who performs an emergency abortion must utilize an abortion method that is “not designed or intended to kill” an embryo or fetus. This is anti-abortion lingo that reclassifies certain abortion methods performed prior to fetal viability as not-an-abortion: labor induction abortion and hysterotomy abortion.
The safe procedural abortion methods are aspiration, dilation and curettage (D&C), and dilation and evacuation (D&E) abortions. Procedural abortions are far safer for the pregnant patient than labor induction abortion and hysterotomy abortion. For example, complications and adverse events are 2.6-7.9 times more common with labor induction abortion than with D&E abortion,9 and the adjusted risk ratio for labor induction abortion is 8.5 (95%, CI 3.7-19.8) compared to D&E abortion.10
However, as rePro-Truth previously alerted you, anti-abortion groups oppose procedural abortions and have been strategically working towards eliminating safe procedural abortions altogether. They say that procedural abortions are never permitted under the Principle of Double Effect.
Instead, anti-abortion groups want to force dying patients to endure labor or to be fileted open under general anesthesia. (Some anti-abortion organizations would even prohibit labor induction abortion to preserve a patient’s life in some circumstances.)
LABOR INDUCTION ABORTION, also referred to simply as induction abortion, “is ending a pregnancy by using medicines to start (induce) labor and delivery.”11
Induction abortions must be performed in a “facility that has the capacity to closely monitor a patient and provide adequate pain management (e.g., intravenous pain medication or an epidural). Induction abortions can last anywhere from five hours to three days; are extremely expensive; entail more pain, discomfort, medical risks, and recovery time for the patient—similar to giving birth—than procedural abortion.”12
Additionally, labor induction abortion is medically contraindicated for some patients.13 For example, “patients with comorbidities whose medical condition may worsen and thus necessitate an expedited” procedural abortion.14 Labor induction abortion also carries a higher “risk of hemorrhage or infection… [and] is associated with higher blood loss than [procedural] abortion.”15
HYSTEROTOMY ABORTION is a major surgery that requires general anesthesia.16 It involves slicing open the uterus through the abdomen similar to a cesarean section, but a hysterotomy requires a smaller incision.17 The fetus in then removed through the uterine incision.18
Hysterotomy abortion is associated with the highest mortality rate, and thus “it is no longer recommended and should no longer be used”19 except in rare circumstances,20 as the lower uterine segment where the incision is performed has not yet developed21 (the formation of the lower segment starts at approximately 26 weeks and is not completed until after 32 weeks22).
Hysterotomy abortions can not be performed in outpatient settings, because of the mortality and morbidity rates associated with the procedure.23 “These procedures are associated with a much higher risk of complication than [procedural] or medical abortion and should only be performed when the latter [other] procedures have failed or are contraindicated.”24
“At previable gestational ages, interventions to improve neonatal survival are futile. Hysterotomy increases the rate of maternal complications and complicates care in future pregnancies.”25
Performing a hysterotomy abortion instead of a far safer procedural abortion is “just nuts,” says Dr. Matthew Wynia, a physician who directs the Center for Bioethics and Humanities at the University of Colorado.26 “[A hysterotomy is] much more dangerous, much more risky – the woman may never have another pregnancy now because you’re trying to avoid being accused of having conducted [a procedural] abortion,” he added.27
“You are not only cutting into someone’s body needlessly and putting them at risk for hemorrhage, infection, and more, but forcing them to have long-lasting and recurring pregnancy complications,” says Dr. Ghazaleh Moayedi, an ob-gyn.28 Moayedi emphasizes that “[t]his has a deep impact on someone’s reproductive life and future.”29
Yet, that's exactly what anti-abortion groups want. —In fact, they explicitly recommend it.
For example, the Charlotte Lozier Institute (the non-profit arm of SBA Pro-Life America) recommends hysterotomy to terminate a pregnancy because it “shows greater respect for the human dignity of the fetus, even if she is too young or sick to survive.”30 Pregnant women’s human dignity is afforded no such concern.
The American Association of Pro-Life OBGYNs (AAPLOG), recommends hysterotomy be performed (beginning at 14 weeks gestation,31 long before the lower uterine segment is formed), calling the dangerous procedure “morally good.”32 AAPLOG acknowledges that “[m]any physicians are repelled by the idea of performing a [hysterotomy] in order to avoid” a procedural abortion, but says that fileting a dying women open “should not cause more repulsion than” a procedural abortion does.33 As if cutting into someone’s body needlessly and putting them at risk for hemorrhage and infection, and forcing them to have long-lasting and recurring pregnancy complications is no big deal.
Assembly Bill 546 would not only pressure physicians to perform more dangerous methods of emergency abortion; if the life-saving exception is subsequently eliminated then these more dangerous methods of abortion would be required by law, as procedural abortion would no longer be permitted under any circumstances.
Condition 2
The second condition for performing an emergency abortion is that “the physician makes reasonable medical efforts under the circumstances to preserve both the life of the woman and the life of her unborn child according to reasonable medical judgment and appropriate interventions for the gestational age of the child.” This language could mean several things.
It could merely be meant to reinforce the language in ‘condition 1’ stating that the abortion method must not be “designed or intended to kill” the embryo or fetus.
It could mean that the physician must try to keep the fetus alive or resuscitate it following a labor induction or hysterotomy abortion.
It could mean that physicians should try to keep the pregnancy going for as long as possible before proceeding with a labor induction or hysterotomy abortion.
Or all of the above.
Who knows? Your guess is as good as mine. What we know for certain is that this language is vague and confusing, and it would leave doctors guessing. Physicians, hospitals, and hospitals’ legal teams would inevitably interpret the language differently from one another, leading to disparate patient care.
Inserting new definitions into state abortion laws
Assembly Bill 546 also inserts definitions into Wisconsin laws for ectopic and molar pregnancy.
Assembly Bill 546 defines ectopic pregnancy as:
“Ectopic pregnancy” means a pregnancy in which the embryo implants outside of the uterus, most commonly in the fallopian tube. (Emphasis added)
The word ectopic means “out of place.” Hence, an ectopic pregnancy occurs when a fertilized egg implants “in an abnormal location, whether intrauterine (inside the uterus) or extrauterine (outside the uterus).”34 “Without timely diagnosis and treatment, ectopic pregnancy can become a life-threatening situation.”35 “Ectopic pregnancy can lead to massive hemorrhage, infertility, or death.”36
As you can see, the bill’s definition of ectopic pregnancy (above) excludes intrauterine ectopic pregnancies, such as cervical and cesarean scar ectopic pregnancies. Under the amended definition of abortion, how are intrauterine ectopic pregnancies supposed to be treated without procedural abortion? Labor induction abortion and hysterotomy abortion are contraindicated for cervical and cesarean scar pregnancies. With a life-saving exception in place, physicians can still perform procedural abortions, but what if the life-saving exception were to be subsequently eliminated? How would physicians fulfill the 2 conditions of the amended language defining abortion?
As for tubal ectopic pregnancies, a physician would be required to perform a salpingectomy, robbing the patient of her fertility and forcing her to endure the risks of invasive surgery. The pregnant patient would suffer extra harm without any advantage to the embryo. Yet this is the only treatment for tubal ectopic pregnancy that clearly meets ‘condition 1’ of the amended definition of abortion under Assembly Bill 546.
Whether a different procedure called a salpingostomy would be permitted is anyone's guess. Some anti-choicers insist that salpingostomies are prohibited under the Principle of Double Effect.
A far less invasive injection of methotrexate would most likely not meet ‘condition 1’ of the amended definition of abortion in Assembly Bill 546, as anti-abortion groups typically consider it prohibited under the Principle of Double Effect.
As for ‘condition 2,’ again your guess is as good as mine.
Assembly Bill 546 defines molar pregnancy as:
an abnormal pregnancy that occurs when a sperm fertilizes an egg that does not contain any genetic material and that cannot develop normally.
Molar pregnancy, also called hydatidiform mole, “is a rare abnormal pregnancy classified under gestational trophoblastic diseases”37 that are “premalignant and may lead to malignancy if left untreated.”38 Hydatidiform moles are categorized into 2 types: complete and partial.39
“In complete molar pregnancies, no embryo forms. It happens when a sperm fertilizes an empty egg. Because the egg is empty, the embryo can’t grow. The placental tissue grows but is abnormal and contains fluid-filled cysts (or tumors).”40
“A partial molar pregnancy occurs when two sperm fertilize one egg.”41 An abnormal placenta forms along with a non-viable embryo that may have detectable cardiac tones.42
Molar pregnancies must be treated as soon as possible “The initial treatment of a hydatidiform mole in patients who wish to preserve fertility is dilatation and curettage.”43 The other treatment option is hysterectomy, ending a patient’s chances of ever having children in the future.44
As you can see, the bill’s definition of molar pregnancy only describes a complete hydatidiform mole. Partial hydatidiform moles are excluded from the definition altogether.
Under the definition of molar pregnancy in Assembly Bill 546, all treatments methods for a complete hydatidiform mole appears permitted without restriction. However, how are partial molar pregnancies, which often involve a non-viable embryo or fetus with detectable cardiac tones, supposed to be treated without procedural abortion? With a life-saving exception in place, physicians can still perform procedural abortions, but what if the life-saving exception were to be subsequently eliminated? How would physicians fulfill the 2 conditions of the amended language defining abortion?
Would a physician be required to perform a hysterectomy as the means of removing the premalignant partial hydatidiform mole, permanently ending a patient’s ability to have children? Some anti-abortion organizations already approve of this. For example, EWTN contends that “the excision of a cancerous, pregnant uterus, is sometimes ethically permissible.”45
If this is the case, it would be none other than forced sterilization, assault, and mutilation.
This is how they ban life-saving abortions (while granting themselves plausible deniability)
By amending the state's several definitions of abortion to reclassify labor induction abortion, hysterotomy abortion, and salpingectomy for ectopic pregnancies as not-an-abortion, Republicans can blame doctors when a pregnant patient’s care is delayed due to abortion bans and can simultaneously pressure physicians to perform more dangerous procedures against patients’ wishes, functionally voiding patients’ rights to informed consent and autonomy.
By amending the state’s several definitions of abortion to reclassify labor induction abortion, hysterotomy abortion, and salpingectomy for ectopic pregnancies as not-an-abortion, Republicans can then eliminate the life-saving exception to abortion bans while repeating the bogus anti-abortion claim that “abortion is never necessary to save a woman’s life.”
Republicans are covering their asses and trying to distance themselves from the horrific consequences of their bans while testing out new strategies to advance their anti-abortion extremism. Assembly Bill 546 is the latest iteration of this strategy of extremism paired with plausible deniability dressed in benevolence and banality. And it won't be the last. That's why we must pay attention to all such efforts, never allowing ourselves to be fooled. Our lives and the lives of those we love depend on it.
WILLIAMS OBSTETRICS ch. 11 at 198 (F. Gary Cunningham, Kenneth J. Leveno, Jodi S. Dashe, Barbara L. Hoffman, Catherine Y. Spong & Brian M. Casey eds., 26th ed. 2022).
Abortion. Taber's Medical Dictionary, https://www.tabers.com/tabersonline/view/Tabers-Dictionary/766365/all/abortion
First- and Second-Trimester Pregnancy Loss. AccessMedicine, https://accessmedicine.mhmedical.com/content.aspx?sectionid=263815963&bookid=2977#263816185
WIS. STAT. ANN. § 253.10 (2a):
“Abortion” means the use of an instrument, medicine, drug or other substance or device with intent to terminate the pregnancy of a woman known to be pregnant or for whom there is reason to believe that she may be pregnant and with intent other than to increase the probability of a live birth, to preserve the life or health of the infant after live birth or to remove a dead fetus.
WIS. STAT. ANN. § 48.375 (2a):
“Abortion” means the use of any instrument, medicine, drug or any other substance or device with intent to terminate the pregnancy of a minor after implantation of a fertilized human ovum and with intent other than to increase the probability of a live birth, to preserve the life or health of the infant after live birth or to remove a dead fetus.
WIS. STAT. ANN. § 20.927 (1g):
In this section, “abortion” means the intentional destruction of the life of an unborn child, and "unborn child" means a human being from the time of conception until it is born alive.
WIS. STAT. ANN. § 69.01 (13m):
“Induced abortion” means the termination of a uterine pregnancy by a physician of a woman known by the physician to be pregnant, for a purpose other than to produce a live birth or to remove a dead fetus.
WIS. STAT. ANN. § 939.75 (2a):
In this subsection, “induced abortion” means the use of any instrument, medicine, drug or other substance or device in a medical procedure with the intent to terminate the pregnancy of a woman and with an intent other than to increase the probability of a live birth, to preserve the life or health of the infant after live birth or to remove a dead fetus.
Grimes, D. A. (2008). The Choice of Second Trimester Abortion Method: Evolution, Evidence and Ethics. Reproductive Health Matters, 16(31), 183–188. http://www.jstor.org/stable/25475416
Bryant, A. G., Grimes, D. A., Garrett, J. M., & Stuart, G. S. (2011). Second-trimester abortion for fetal anomalies or fetal death: labor induction compared with dilation and evacuation. Obstetrics and gynecology, 117(4), 788–792. https://doi.org/10.1097/AOG.0b013e31820c3d26
“Induction Abortion.” Kaiser Permanente, https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.induction-abortion.tw2562
Center for Reproductive Rights, Blackman v. State of Tennessee. Retrieved at: https://reproductiverights.org/wp-content/uploads/2023/09/TN-Complaint-Final-9-12.pdf
Sciences, N. A. of, Engineering, & Medicine, and. (2018c, March 16). The safety and quality of current abortion methods. The Safety and Quality of Abortion Care in the United States. https://www.ncbi.nlm.nih.gov/books/NBK507232/
Ibis Reproductive Health. (2024, December 1). Clinical research / standards. Clinical research / standards | Later Abortion Initiative. https://laterabortion.org/clinical-research-standards
Ibis Reproductive Health. (2024, December 1). Clinical research / standards. Clinical research / standards | Later Abortion Initiative. https://laterabortion.org/clinical-research-standards
Bygdeman, M., & Gemzell-Danielsson, K. (2008). An Historical Overview of Second Trimester Abortion Methods. Reproductive Health Matters, 16(sup31), 196–204. https://doi.org/10.1016/S0968-8080(08)31385-8
Kulier, R., Fekih, A., Hofmeyr, G. J., & Campana, A. (2001). Surgical methods for first trimester termination of pregnancy. The Cochrane database of systematic reviews, 2001(4), CD002900. https://doi.org/10.1002/14651858.CD002900
Bygdeman, M., & Gemzell-Danielsson, K. (2008). An Historical Overview of Second Trimester Abortion Methods. Reproductive Health Matters, 16(sup31), 196–204. https://doi.org/10.1016/S0968-8080(08)31385-8
Authoring team. (2023, September 7). Lower segment – primary care notebook. Primary Care Notebook. https://primarycarenotebook.com/pages/obstetrics/lower-segment
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 135: second-trimester abortion. Obstet Gynecol 2013;121:1394-1406. https://www.redaas.org.ar/era/fuentes/ACOG%20Second%20trimester%20abortion%202013.pdf
SJ Lambert, K Fiske, G Petryk, S Horvath, O20 - ASSOCIATION OF ABORTION RESTRICTIONS AND HYSTEROTOMY FOR PREVIABLE DELIVERY, Contraception, Volume 151, 2025, 111073, ISSN 0010-7824, https://doi.org/10.1016/j.contraception.2025.111073 (https://www.sciencedirect.com/science/article/pii/S0010782425002641)
Simmons-Duffin, S. (2022, November 23). Doctors who want to defy abortion laws say it’s too risky. NPR. https://www.npr.org/sections/health-shots/2022/11/23/1137756183/doctors-who-want-to-defy-abortion-laws-say-its-too-risky
Simmons-Duffin, S. (2022, November 23). Doctors who want to defy abortion laws say it’s too risky. NPR. https://www.npr.org/sections/health-shots/2022/11/23/1137756183/doctors-who-want-to-defy-abortion-laws-say-its-too-risky
Tuma, M. (2024, April 17). Fearing legal threats, doctors are performing C-sections in lieu of abortions. The Nation. https://www.thenation.com/article/society/c-sections-abortions-terrifying-new-reality/#
Tuma, M. (2024, April 17). Fearing legal threats, doctors are performing C-sections in lieu of abortions. The Nation. https://www.thenation.com/article/society/c-sections-abortions-terrifying-new-reality/#
Steupert, M. (2024, March 6). Pro-life laws protect mom and baby: Pregnant women’s lives are protected in all States. Lozier Institute. https://lozierinstitute.org/pro-life-laws-protect-mom-and-baby-pregnant-womens-lives-are-protected-in-all-states/
AAPLOG Practice Guideline bulletin (August 2025). https://aaplog.org/wp-content/uploads/2025/08/2025.08.15-Practice-Guideline-13-website-format-FINAL.pdf
AAPLOG Practice Guideline bulletin (August 2022). https://aaplog.org/wp-content/uploads/2023/04/PG-10-Concluding-Pregnancy-Ethically-updated.pdf
AAPLOG Practice Guideline bulletin (August 2022). https://aaplog.org/wp-content/uploads/2023/04/PG-10-Concluding-Pregnancy-Ethically-updated.pdf
Rodgers, S. K., Horrow, M. M., Doubilet, P. M., & Sohaey, R. (2024, August 27). A lexicon for first-Trimester us: Society of Radiologists in ... American Journal of Obstetrics and Gynecology . https://pubs.rsna.org/doi/abs/10.1148/radiol.240122
Sepilian, V. P., & Wood, E. (2024, September 30). Ectopic pregnancy. Practice Essentials, Background, Etiology. https://emedicine.medscape.com/article/2041923-overview#a3
Sepilian, V. P., & Wood, E. (2024, September 30). Ectopic pregnancy. Practice Essentials, Background, Etiology. https://emedicine.medscape.com/article/2041923-overview#a3
Cue L, Farci F, Ghassemzadeh S, et al. Hydatidiform Mole. [Updated 2024 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459155/
Cue L, Farci F, Ghassemzadeh S, et al. Hydatidiform Mole. [Updated 2024 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459155/
Cue L, Farci F, Ghassemzadeh S, et al. Hydatidiform Mole. [Updated 2024 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459155/
Cue L, Farci F, Ghassemzadeh S, et al. Hydatidiform Mole. [Updated 2024 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459155/
Cleveland Clinic . (2025, August 15). Molar pregnancy: Types, symptoms, causes & treatments. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17889-molar-pregnancy
Cleveland Clinic . (2025, August 15). Molar pregnancy: Types, symptoms, causes & treatments. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17889-molar-pregnancy
Cue L, Farci F, Ghassemzadeh S, et al. Hydatidiform Mole. [Updated 2024 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459155/
Cue L, Farci F, Ghassemzadeh S, et al. Hydatidiform Mole. [Updated 2024 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459155/
Robinson, E M. “Exception: To Save the Life of the Mother: EWTN.” EWTN Global Catholic Television Network, https://www.ewtn.com/catholicism/library/exception-to-save-the-life-of-the-mother-12052.