WICHITA, Kansas — Abortion remains legal, if tightly restricted, in Kansas. That doesn't mean it's easy to get an appointment.
On the sidewalk outside the Trust Women clinic in Wichita, anti-abortion protestors shout at cars turning into the parking lot, recording their license plates.
Most come from out-of-state now, after abortion bans in states like Texas and Oklahoma sent women streaming across state lines — so much so that some Kansas women find themselves looking for appointments out-of-state.
It started last year, when Texas enacted a law banning abortion before most women know they’re pregnant. Another surge came in May, when Oklahoma became the first state to flat out ban abortion. And then it reached a fever pitch this summer, after the U.S. Supreme Court overturned Roe v. Wade.
“As soon as the decision came down, we fully anticipated — especially with the number of states around us with trigger bans — to see an increase,” said Ashley Brink, the Trust Women clinic director. “And we absolutely have seen an increase in not only the call volume, but the number of patients.”
She said patients coming from farther away tend to be further along in their pregnancies, sometimes already having been turned away by several other clinics. That means they often need more involved procedures.
The new reality has changed everything for staff, down to small talk.
“Three years ago, two years ago, what we talked about with patients was like, ‘Where are you going to go eat after?’ Because folks were local people accessing care in their state,” said Christina Bourne, the clinic’s medical director. “Versus now, our small talk has changed: ‘How far did you drive? Where are you from?’”
It means they’re turning more women away. Often, Brink has to tell patients to call back in a few weeks — or to try their luck at other clinics in other states.
If a patient is from Kansas, she might refer them to a clinic in Colorado. If someone is calling from Texas or Oklahoma, the closest alternative might be in New Mexico. Women from Arkansas and Louisiana might be directed to Illinois.
“Their next best options are going to be the coasts, if they can fly,” she said. “And we know that’s not feasible for everyone.”
Trust Women is hiring more staff and doing renovations so it can see more patients. But staff are sober about what one clinic can handle in the face of an explosion of demand.
“We truly could be doing abortion care 24 hours a day and we would not meet the demand,” Bourne said. “At the end of the day, we’re also humans. People have families. People have lives to attend to. We’re in this for the long haul, and if we burn ourselves out sprinting right out of the gate, it won’t be sustainable for us.”
The demand on Kansas clinics is only likely to increase as more states tighten abortion restrictions in the post-Roe era.
“Our entire region is struggling to figure out how to meet the (demand) because Kansas is a really essential point of access for care right now,” said Emily Wales, the president and CEO of Planned Parenthood Great Plains, which covers Kansas, Missouri, Oklahoma and Arkansas.
To help meet the demand, the organization opened a new clinic in Kansas City, Kansas, this summer. In addition to medication abortions, the clinic offers birth control, testing and treatment for sexually transmitted infections and transgender hormone therapy.
But Wales said that finding doctors for Planned Parenthood’s three Kansas sites remains a challenge.
“The care is not without scrutiny and oversight and fear, including in Kansas,” she said. “People ask us about that when they consider working with us.”
It also launched a new patient navigation center, headquartered in Wichita, to help people navigate the practical and emotional challenges associated with seeking abortion across state lines — something Wales said became important after the fall of Roe.
“We went from having a couple of staff members who would get called in for those patients who had more complicated questions to having a team of multiple people across four states trying to help patients figure out the logistics,” she said.
The Center for Abortion and Reproductive Equity will help people understand the patchwork of restrictions across the region and help coordinate funding and travel. It’s hiring social workers to help callers in distress, which the clinics are seeing more of as women deal with difficulties around things like getting time off from work. Sometimes the need for an out-of-state trip forces them to disclose their abortion to people they otherwise wouldn’t have told.
Wales wants the center to help the most vulnerable patients, especially those from communities of color and rural areas, who often face extra barriers to getting an abortion.
Planned Parenthood joins a handful of groups helping arrange abortions across the Midwest in a post-Roe world.
Elevated Access, which launched this spring, recruited 800-some volunteer pilots to fly patients across state lines on private planes. In June, the first flight took an Oklahoma woman to a clinic in Kansas City.
In Colorado, telemedicine abortion provider JustThePill — it offers mail-order abortion pills in Minnesota, Montana and Wyoming — recently opened a new mobile clinic out of a van.
Because of safety concerns, medical director Julie Amaon won’t say where in the state the clinic is located or what exactly it looks like.
“They’re very nondescript. They don’t have any logos on them. They look like any other large van you would see on the road — on purpose,” she said. “You wouldn’t be able to say, ‘that looks like a mobile health clinic,’ from the outside.”
If you live in a state like Kansas that has banned prescribing abortion pills over telemedicine, you can drive over the state line into Colorado, talk to a doctor from your car, and then pick up abortion pills from a lock box in the back of the van.
“We can be really nimble and change based on where patients need us most,” said Amaon.
JustThePill is fundraising to open mobile clinics in Illinois by the end of the year. Afterward, Amaon said the group’s sights are set on Kansas.
But abortion travel costs money.
The price of an abortion can range from several hundred dollars for a medication abortion to several thousand for a surgical procedure. In Kansas, most people have to pay out-of-pocket because of laws that prohibit public and private health insurance from covering abortion in most cases. And that’s not counting things like flights, hotels and childcare.
Sandy Brown, the president of the Kansas Abortion Fund, said there’s been a rise in requests for help this year.
“There are so many people coming to Kansas for abortion care that there may be a waiting time of two to three weeks, and that will create an uptick in the cost of the procedure,” she said.
A few weeks might mean the difference between abortion pills or a surgical abortion. Or it might mean the difference between a simple one-day procedure and something more complicated, over two days — making the procedure itself and extra expenses more costly.
Because of crowding at local clinics, more Kansas women are traveling out-of-state. That’s why the fund recently partnered with Midwest Access Coalition, an Illinois-based group that helps people pay for and coordinate abortion-related travel.
“We do all the bookings, transportation, accommodations. We send people money for food, child care, medicine,” said Alison Dreith, the group’s director of strategic partnerships. “We put it all on our credit cards so that clients won’t have to use a credit card. A lot of our clients don’t even have credit cards.”
“I had someone in Arkansas last week that went to Chicago; she cost $2,500 for her practical support. And some people just need $25 to get a friend to pay for gas to drive them.”
Abortion rights advocates say that support is especially critical for Black women — who are nationally almost three times as likely to die from complications related to childbirth as white women.
“We know from experience that if somebody has an unplanned pregnancy and they want an abortion, for people of color, the financial barriers really come into play,” said Sapphire Garcia-Lies, the founder of Kansas Birth Justice, a nonprofit trying to lower birth inequities in Black and brown communities.
“Black women and brown women need access to options — not only because we're more likely to die in childbirth, but because it's a human right. And it’s a human right that we've had less access to all along.”
Rose Conlon reports on health for KMUW and the Kansas News Service. You can follow her on Twitter at @rosebconlon or email her at conlon@kmuw.org.
The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.
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