When Planned Parenthood decided four years ago to open a new clinic in a medically underserved working-class neighborhood here, it envisioned a place that would save women who lived nearby from taking hours-long bus rides to get checkups of births, testing or abortion.
The— four days before the clinic opened — all that changed. Because Kansas is one of the few states in the region where abortion remains legal, the clinic soon found itself inundated with calls not only from panicked patients in Kansas and nearby Missouri, but also in Arkansas, Oklahoma, Texas — and even Louisiana.
This clinic and other Planned Parenthood centers in Kansas have done their best to help by extending hours, hiring staff and flying in doctors. However, they were only able to get 10% to 15% of patients seeking abortions.
“The ecosystem, it’s not even fragile. It’s broken,” said Emily Wales, president and CEO of Planned Parenthood Great Plains. “I think there’s a perception that if you’re looking for care, you can find it somewhere. And that’s not true.”
Haley Ruark, of Platte City, Missouri, was able to get an appointment on a recent Wednesday after a two-week wait — longer than she wanted, but better than driving hundreds of miles west to Colorado.
Ruark had panicked after a series of birth control mishaps. First a condom broke and then, despite using the morning-after pill, a pregnancy test came back positive. Missouri prohibits abortion in all but medical emergencies.
“It was just stupid to make a law where you can’t do what you feel is necessary for your body and not even your body, but your mental health,” Ruark said.
She already balances 12-hour shifts as a patient care technician at a hospital with caring for her 2- and 6-year-olds.
“The two guys, like they’re fine, you know, ends meet,” he said. “Bringing a baby into it, I just don’t think it would be a good idea right now.”
Ruark walked past shouting protesters to get inside the new clinic. It took her nearly two hours to get the abortion pill after meeting with Dr. Elizabeth Brett Daly. By law, Daily was only supposed to wait 30 minutes after Ruark’s arrival to administer the drug, but the clinic was busy.
Thousands of patients likely don’t have appointments at all, according to a national tracking effort called #WeCount, run by the Planned Parenthood Society, a nonprofit that promotes abortion and contraception research.
The society’s report, released in October, found that 6% fewer abortions were carried out nationally in August – when many of the most restrictive abortion bans came into force – compared with the number of abortions granted nationally in April, before Roe was overturned.
Some of the states with the bans saw the number of abortions drop from 2,770 in April to less than 10 in August, while neighboring states that still allow the procedure saw the number of abortions rise, the survey found. In Kansas, Colorado, Montana, Nebraska and North Carolina, the number of abortions performed in August was at least 30 percent higher than the number performed in April. In Illinois, 28% more abortions occurred in August than in April.
The study had some limitations, including that only 79% of all identified abortion providers — including clinics, private medical offices and hospitals — provided data. The society says the figures represent about 82% of all abortions provided nationally.
Few outside of Kansas expected the state to take on this larger role in providing abortions, said Elizabeth Nash, senior policy fellow for state affairs for the Guttmacher Institute, a research group that supports abortion rights.
“It’s a pretty conservative place. You know, it’s not like Colorado or Illinois where people thought these were going to be hotspots,” Nash said.
Abortion opponents have been influential in Kansas politics since the 1991 Summer of Mercy protests in Wichita, when thousands of anti-abortion activists gathered in Wichita, sparking protests that led to nearly 2,700 arrests.
Image may change. Voters continue to elect large anti-abortion majorities in the Legislature, but in August theywhich would pave the way for tighter restrictions or a ban on abortion.
The demand for abortions in Kansas only promises to grow. While the procedure remains legal in neighboring Iowa and Nebraska, both are conservative and Nash described the states as “waiting bans.”
Typically, staff turn away patients seeking appointments at the new clinic and the other two abortion clinics Planned Parenthood operates in Kansas, telling them they don’t keep a waiting list and if they can get an appointment in Colorado or New Mexico to get one.
But even in these two states there are no guarantees, said Dr. Kristina Tocce, medical director for Planned Parenthood of the Rocky Mountains.
“I guess for every patient that can get to us that we can see there are a lot of patients that don’t have access to care,” Tocce said, adding that the number of out-of-state patients has skyrocketed.
Getting a date in Kansas City is luck of the draw. Local patients do not have priority, but they do have an advantage because it is easier for them to get to mid-week appointments. Planned Parenthood leaders have said adding a fourth clinic is among options being considered to increase access, but have not provided details.
Daily, of the new Kansas clinic, said she was drawn to the job after a stint with the Peace Corps in Togo, West Africa. He saw victims of sexual assault and “many, many” women and their babies die during childbirth.
The doctor sees horror stories here too. A recent abortion patient was 13 years old, her face so bruised from the assault she endured that she could barely open one eye in the waiting room.
The everyday likening of an abortion appointment these days to winning the lottery.
“Think about our health care system today and how difficult it is to simply make a primary care visit,” he said. “A thousand times, why is abortion care so difficult today.”
Among the patients Daily saw recently was a 29-year-old mother of two who asked that her name not be used because she didn’t want her family and friends to know. The woman said she originally planned to carry her pregnancy to term. But then her 3-year-old daughter had a terrifying 40-minute seizure that left her temporarily paralyzed. It was her 13th major seizure in the past year.
Doctors intubated the little girl and the woman hurriedly arranged for her 9-month-old son to be with his father. The couple had separated, so she sat on her daughter’s bed alone.
“I thought to myself, ‘It’s not fair, you know, that I can’t give another child my full attention.’
She knows that some will not understand her decision.
“People are just quick to judge,” he said. “A lot of people have religious beliefs. “Oh, no. You can’t do that.’ But to me, I just don’t think people take the time to get to know someone and realize what their situation really is.”