How Kansas became an unlikely refuge for people seeking abortion

This is shaping up to be a record year for abortion restrictions. At least 561 laws, including 165 bans, have been introduced across 47 states in 2021, according to the Guttmacher Institute.  At least 90 new restrictions have been enacted, including the harshest to date, Texas Senate Bill 8. 

Effective September 1, Texas law prohibits abortions after a fetal heartbeat can be detected -- at about six weeks and before many women even know they’re pregnant. Under the law, private citizens can now sue anyone who helps a woman get an abortion.

The avalanche of restrictions, especially in the South and Midwest, has forced women to travel across state lines to terminate a pregnancy. The new Texas law is sure to accelerate the trend. In this atmosphere, Kansas — once Ground Zero for anti-abortion protests and violence — has become an unlikely destination for abortion. 

Fifty percent of abortion care in Kansas is provided to out-of-staters, the second-highest rate in the country after Washington, D.C., according to the Centers for Disease Control and Prevention.

A constitutional right to choose

Kansas may not be the first place that comes to mind for abortion care. Wichita is headquarters for Operation Rescue, a 35-year-old organization that rose to fame by organizing noisy protests outside abortion clinics and “screaming threats and prayers” to everyone who entered.

The state has imposed a long list of abortion restrictions, such as obligatory “abortion counseling,” waiting periods and parental consent requirement for minors. But in a landmark decision, the Kansas Supreme Court ruled in 2019 that the right to “life, liberty, and the pursuit of happiness,” guaranteed in the state Constitution, protects a woman’s right to make decisions about her body, including whether to carry or end a pregnancy.

The ruling has made abortion more accessible in Kansas than in its neighboring states to the south and southeast. The Center for Reproductive Rights projects that abortion would remain legal in Kansas even if the U.S. Supreme Court overturns Roe v. Wade. In May, the high court agreed to hear arguments on a Mississippi law banning most abortions after 15 weeks — a case widely seen as a major national test of Roe. 

"There's a lot of places in the country that are already existing in a post-Roe framework," said Zack Gingrich-Gaylord, interim communications director at Trust Women, a reproductive health care provider in Wichita. "Access is just functionally nonexistent. Getting the services you need is dependent on your ability to come up with the resources to travel someplace else." 

Trust Women was founded in 2009 with the aim of providing access to reproductive health care in underserved areas. In addition to Wichita, the group has a clinic in Oklahoma City.

Its name and mission commemorate Dr. George Richard Tiller, a Kansas physician and abortion provider. His clinic was firebombed; he was shot by an anti-abortion extremist in the 1990s; and he was assassinated by another extremist in a church on May 31, 2009. Ms. Magazine that summer remembered him as "A Man Who Trusted Women."

From 2019 to 2020, Kansas saw a significant jump in the number of people crossing state lines for abortion care. Seventy-four patients came from Arkansas, up from 40; 277 from Oklahoma, up from 85; and 289 from Texas, up from 25 just a year earlier, Gingrich-Gaylord said.

The increases were influenced by the pandemic. States including Texas, Oklahoma and Alabama limited abortion access in March 2020, deeming the procedure “non-essential.”

But Dr. Christina Bourne, a family medicine resident at Trust Women, anticipates that patient volume from other states will continue to grow in the face of ever-tighter abortion restrictions. And more women will come in later in pregnancy. 

Costs, barriers fuel racial inequities

Since Kansas and its neighbors restrict insurance coverage of abortion, Bourne says, a lot of the people she sees must come up with the money on their own. And not only money for the procedure – which can cost at least $650 (although abortion funds from organizations such as such as Access Reproductive Care (ARC)-Southeast can help) – but also money for child care and transportation. If somebody is over 18 weeks pregnant, it's often a two-day procedure, so there are lodging costs. 

"We’re just consistently putting up insurmountable barriers for people, especially people who are poor, Black or Brown,” Bourne said. “It's really just making it pretty impossible.”

A recent study found that out of 10,000 people seeking assistance from ARC-Southeast from 2017 to 2019, 81% were Black, 87% were uninsured or publicly insured, and 77% already had at least one child.

Bourne remembers a woman from Lafayette, Louisiana, whose story is “symbolic of mass amounts of inequity and injustice that we're experiencing in terms of health care access."

The woman had tried to obtain birth control but couldn't afford it without health insurance, which her job didn't offer. She found out she was six weeks pregnant and, with two children already, felt she couldn’t support another. She sought abortion care close to home, but in a state rife with restrictions, she couldn’t get an appointment.

With states bordering Louisiana having similar restrictions, the woman tried getting care in Oklahoma, but faced a long wait for an appointment. The next best place was Wichita, more than 700 miles away. 

"She jumped through so many hoops to get this done," Bourne said.

Not everyone can jump through numerous hoops and still manage to get care in time. What will happen if the Supreme Court overturns Roe or other states follow the lead of Texas, making it all but impossible for more women to get abortion care close to home?

Even if patients can travel to a clinic like Trust Women Wichita, will it have room for them?

Gingrich-Gaylord says Trust Women will try to be available for as many people as it can and work with abortion funders from across the region to help support patients in need. "Whether that's travel funds or funds for the procedures," he says, "we're not going to turn anybody away for lack of ability to pay."