PITTSBURG, Kansas (AP) — The Rev. Anthony Navaratnam stood before his congregation and asked them to pray for the women from surrounding states who flock to the city’s up-to-date abortion clinic that opened in August.
“God is giving us the opportunity to work as missionaries in Pittsburg, Kansas,” he told those present at the Flag Church, which was hosting a training session on protesting outside the clinic.
The debate over reproductive rights has landed in this college town of 20,000 in the southeast of one of the few states in the region where abortion is still legal. It is close to Missouri, Oklahoma and Arkansas and not too far from Texas.
A place of this size, especially in a historically Republican state, was unlikely to have an abortion clinic before the Roe v. Wade ruling was overturned in 2022. Since then, Kansas has become one of the five states where people are most likely to travel to get an abortion if they are unable to do so at home, says Caitlin Myers, an economics professor at Middlebury College who researches abortion policies.
According to a recent analysis by the abortion rights advocate Guttmacher Institute, abortion rates in Kansas have increased by 152 percent since Roe. By Myers’ calculation, six of the clinics in Kansas, Illinois, New Mexico, North Carolina and Virginia that opened or relocated since Roe are in communities with fewer than 25,000 residents. Two more are in communities with fewer than 50,000 residents.
“Kansas is really the only one in this region that can serve many people in the surrounding states,” said Kensey Wright, a member of the board of the Roe Fund in Oklahoma, which supports abortion clinics in Kansas through grants.
“Without abortion clinics in this state, we would have no hope,” Wright said.
Providing abortions to people from other states
The Planned Parenthood clinic in Pittsburgh is housed in a former urology office and is located across the street from a Catholic health system medical clinic. Behind the clinic are houses.
Clinic director Logan Rink said her mother worked in that building as a nurse — a connection that is “small-town in nature.” She loves this town and said her neighbors agree the clinic is necessary. But she was cautious in her optimism, saying, “The reception we’re going to get from the community will be positive in some ways, but probably not always.”
Experts say smaller clinics are less overwhelming for women from rural areas like the Pittsburg area. However, there is no anonymity in these smaller communities, as religious and family ties often run deep. Pittsburg was founded in 1876 and was settled largely by immigrants from predominantly Catholic countries who worked in the surrounding coal mines. It has a typical main street and a state university with about 7,400 students.
“In a small town, you don’t just know this person. Your family knows them. You’ve known them for 40 years,” said Dr. Emily Walters, a supporter of the Pittsburg clinic who works as an anesthesiologist at a hospital in neighboring Missouri. “Their stories will be intertwined.”
She asked herself out noisy, “How can I see you at a demonstration and then see you in the supermarket the next day and still be polite and civil to each other?”
Walters is also chairman of the Crawford County Democratic Party in an area that is increasingly Republican and has no Democratic representatives – a change from 20 years ago, when there were six. The county has also become more religious over the same period; it now has twice as many white evangelical Protestants as the national average and slightly more Catholics, according to the Public Religion Research Institute.
Just five weeks after Roe was overturned in 2022, Kansas voters had to decide whether to remove abortion rights from the state constitution, which could have led to an outright ban. Despite Republican and religious leanings, 55% of voters in Crawford County were among the 59% of voters statewide who rejected the proposal.
That’s in line with a 2024 Associated Press-NORC poll that found 6 in 10 Americans think their state should generally allow a person to have a legal abortion if they don’t want to get pregnant for any reason. But rural counties around Pittsburg decided otherwise at the ballot box.
“I remember people stealing yard signs and putting others up in other people’s yards,” said Anastin Journot, an 18-year-old from Independence, Kansas, who is studying elementary education at Pittsburg State. She said she was troubled when Roe was overturned and remembered thinking, “What if I’m in a situation where I need an abortion and that’s not an option?”
Abortion is generally legal in Kansas up to 22 weeks of pregnancy. The clinic’s southern location puts it closer to states that have banned abortions than sending patients to Kansas’ larger cities, where hours have been extended and appointments are still meager.
About 60 to 65 percent of women who call Planned Parenthood clinics in Kansas to make an appointment for an abortion are turned away because there isn’t enough capacity, said Emily Wales, president and CEO of Planned Parenthood Great Plains. Already, Wales said, most women seeking abortions in Kansas come from outside the state — primarily from Texas, about five hours south. That’s followed by Missouri, a few minutes’ drive east, and Oklahoma, less than an hour away. She said some come from as far away as Louisiana and even Florida, where the procedure is now banned after six weeks.
“Clinics strategically located near the state border can really help reduce crowding,” says Ushma Upadhyay, a health scientist at the University of California, San Francisco who studies abortion.
Most areas within 100 miles of the up-to-date clinic have a government-level medically underserved environment for primary health care, with the number of obstetricians and gynecologists per 100,000 female residents less than half the U.S. average.
For now, however, the Pittsburg clinic’s focus is abortion. Wales said Planned Parenthood plans to slowly add more services over the next two to three months, and a future goal for the clinic is to offer gender reassignment treatments. Neighboring states have also restricted this.
“Pittsburg will help many states in the South and help people get health care,” Wales said.
However, these up-to-date arrivals would only take place once staff had become accustomed to the patients and the presence of protesters and opposition, she added.
Demonstrators are ready
Donations to Vie Medical Clinic, the city’s crisis pregnancy center, have increased, said executive director Megan Newman. Such centers are typically religiously based and encourage patients to continue their pregnancies.
Opponents of the Planned Parenthood clinic are also collecting brochures about Vie to distribute to people seeking abortions. “When we heard that Planned Parenthood was coming, the feeling was felt in the city,” Newman said.
Jeanne Napier, a 68-year-old attendee at the local Baptist church, vowed while shopping at the local mall that she would “be there every day with signs.”
Her daughter, Terri Napier, said in a phone interview that she believes her parents are so opposed to the clinic in part because they saw her fight back about 20 years ago. She was in an abusive relationship with a man who has since died. She became pregnant. The family was afraid of putting a child in that situation.
She had an abortion and became addicted to drugs. “I had trouble forgiving myself,” says the 43-year-old, who is now tidy.
Jeanne Napier said she felt she had promoted abortion. “And I hate that,” she said, “because I wish I could take that sin upon myself, so it’s really personal. I actively participated in ending a life, and we have no right to do that.”
Brianna Barnes, a 19-year-old journalism student at Pittsburg State University from Wichita, protested and prayed outside a clinic in her hometown.
“When someone looked us in the eye, we would just smile at them and show them our love and care, because nobody responds well to yelling, screaming and violence, no matter which side it’s coming from,” she said shortly after arriving on campus for the fall semester. Most students AP spoke with expressed support for the clinic.
Her mother, Crystal Barnes, 42, turned to her daughter: “As a Catholic and a conservative, you are the outsider, especially on issues like abortion. The atmosphere is so heated.”
On the Friday before the clinic opened, workers were installing a wooden facade outside. The air was filled with the smell of freshly cut wood. Walters, the local anesthesiologist, had stopped by to see the progress.
Walters’ support has a personal background. When she was 20 and in the same week of pregnancy, she was admitted to the emergency room with bleeding. She said she was sent home to have a miscarriage rather than having her labor induced or the fetus removed.
The experience – “horrific and not considered standard treatment in modern practice,” she said – left her with deep compassion for women in challenging situations.
Shortly before the 2022 vote, an ad sponsored by 400 Kansas doctors who support abortion rights appeared in some of the state’s largest newspapers, including The Kansas City Star. Walters’ name was featured first. During that time, her home address appeared on the internet – a frightening prospect in a state where abortion doctor Dr. George Tiller was shot and killed by an anti-abortion extremist in his Wichita church in 2009.
“This is a vital health care issue for women,” she said. “It’s going to be very stressful for Pittsburgh. And that part hurts my heart.”
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Hanna reported from Topeka, Kansas.
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