After hearing three hours of emotional comments on both sides, a University of Wisconsin Hospital board agreed to allow late-term abortions at a Madison outpatient clinic.
The vote was 11-3 Wednesday to provide abortions for women who are 19-22 weeks pregnant.
The University of Wisconsin and Meriter Hospital had proposed the idea after a Madison doctor who had performed such abortions retired in December.
No one else in the city does those procedures.
Board chairman David Walsh called the second-trimester abortions "the worst kind of service" among those who believe life starts at conception.
But he said women have a constitutional right to those abortions - and a great, full-service institution should do it if no one else will.
Walsh said the chance of a public backlash was worth the risk.
Opponents said they would boycott UW Hospital and stage demonstrations outside the clinic.
Doctors expected to perform about 120 abortions at the Madison Surgery Center each year. That center's board could act on the plan by the end of the week.
But officials said it could still take weeks or months for the procedures to begin.