Published August 18th, 2022 at 6:00 AM
Abortion advocates call it “going dark.”
The term is invoked when a state criminalizes abortion, triggered either by the U.S. Supreme Court’s historic decision to overturn Roe v. Wade, or through new restrictions passed by a conservative legislature now that the issue is governed state by state.
The result is an ever-shifting checkerboard of abortion access across the nation.
Texas is dark. Arkansas is dark. Missouri is dark. Oklahoma is dark.
Increasingly, this means Kansas is key for Midwesterners seeking reproductive care.
In Kansas, abortion is legal until 22 weeks of pregnancy. After that, it is strictly limited. Five clinics now are open across the state. Two are in Wichita. Two are in Overland Park. And one recently opened in Kansas City, Kansas.
But as people from other states arrive, slots quickly fill. Wait times for appointments in Kansas and other states still offering abortion services now stretch to three weeks out.
“It is scaring the daylight out of clients,” said Alison Dreith, director of strategic partnerships for the Chicago-based Midwest Access Coalition. “They are so fearful that the state they are scheduled at will go dark before they can reach their appointment.”
Timing is crucial. Abortion pills are effective until about 11 weeks. According to Guttmacher Institute, medication abortions “accounted for more than one-third (39%) of all abortions in the United States in 2017.”
But abortion costs can rise the longer someone waits, or they risk running into state limits, usually at fetal viability.
As a result, patients living in Wichita have driven to Omaha, unable or unwilling to wait until they could get an appointment in their own state, despite two clinics being nearby, Dreith said.
Commercial flights are being regularly booked to bring groups of clients from Texas to their Kansas appointments.
A group of private pilots has come together, forming a nationwide nonprofit called Elevated Access to fly people from isolated, rural areas to appointments in states where abortion remains legal.
Two women, longtime abortion clinic workers, recently drove to Kansas to be trained to provide care through one of the mobile clinics now operating along the Colorado/Kansas border.
The rapid pace is alternatively challenging and energizing for the all-volunteer Kansas Abortion Fund, which for 25 years has helped pay for the abortions of low-income Kansans. In the fiscal year that concluded at the end of June, the nonprofit aided 449 people, spending $105,000 in block grants to clinics.
The fund recently finalized a contract with Midwest Access Coalition to have the organization manage the outpouring of support people are offering, such as homes and vehicles to transport people arriving from out-of-state for appointments. Those people will have to undergo extensive background checks and training. Their cars and homes must be approved for safety, insurance and cleanliness.
The vision is to create a stealth, committed network of highly vetted people willing to help others with travel, lodging, gas, child care, or a bus ticket – whatever people need to reach Kansas and the abortion services that remain legal there due to a 2019 state Supreme Court ruling that recently survived a state ballot referendum challenge.
Each patient has different needs. And it’s a complex daily scramble to keep up.
Dreith jokes about her personal campaign to convince friends to move to Kansas or just across the state line in Missouri to help.
She works from her goat farm in rural Illinois, much like a social worker/travel agent, arranging individualized aid for people.
“It is part of our values to share minute-to-minute knowledge because things are changing so rapidly that we have to keep up,” Dreith said of the Midwest Access Coalition, which helps people who chose an abortion with related costs, like travel, but does not pay for abortions.
An organizing frame for the work is posted at the top of the organization’s website:
“At Midwest Access Coalition, we believe everyone should have access to safe, free, legal abortions wherever they live.”
New, post-Roe realities are emerging, Dreith said.
One woman had an abortion scheduled at an Overland Park clinic, a 10-hour drive from her home in rural southern Arkansas, one of the dark states.
With limited finances and virtually no family to help, her community was so isolated she couldn’t find a ride to get her to a bus station in a larger city. There was no Uber and no Lyft. Dreith tried to help arrange transportation, tapping her wide network.
Eventually, the woman obtained abortion pills herself through a mail order, connected with a doula via the internet and “self-managed” her own abortion.
It was the fifth self-managed abortion that Dreith knows of in the past month.
“Kansas and Missouri are perfect examples of states where people have been sounding the alarm for years about what is at stake,” Dreith said.
Missouri legislators whittled away at abortion access for years, to the point that Dreith considered the state effectively dark even before the U.S. Supreme Court’s July ruling in Dobbs v. Jackson Women’s Health Organization, which activated the state’s trigger law.
“None of us want to say, ‘I told you so,’ ” she said. “But here we are.”
More than 25 years ago, the Kansas Abortion Fund began as a phone tree in Lawrence.
Early organizers wanted to help other Kansans who couldn’t afford an abortion, a procedure that now costs about $750 in Kansas during the first trimester.
By the time Sandy Brown, a retired physical therapist, took over as president a decade ago, the group had graduated to using an Excel sheet to track donations. Itl remains an all-volunteer board of seven, but is intent on expanding its volunteer base.
“We fund abortion,” Brown said. “We do not have the capacity for practical support – meaning transportation, hotel, gas and child care. But all signs are pointing to our need to provide Kansans now with that practical support.”
So Brown turned to the Midwest Access Coalition, formalizing an agreement for logistical help for clients.
The fund will provide block grants to the coalition, similar to how it provides funding to Kansas clinics when they have a Kansas client who qualifies for financial assistance.
“Unfortunately, in Kansas, many times those who are able to access abortion depend on their zip code and their poverty level,” Brown said. “The people that we serve primarily are those who are marginalized.”
Donations from out-of-state have subsided a bit since the Aug. 2 vote when Kansans resoundingly voted to keep access to abortion a protected right within the state constitution.
But unique local fundraisers are still being organized.
One person held a barbecue in Bonner Springs. A Lawrence yoga studio held a class as a fundraiser on a football field. Local craft breweries have mounted fundraisers as well.
And the band Paramore is donating $1 of every ticket sold at their Oct. 14 concert at Azura Amphitheater to the Kansas Abortion Fund.
“Part of what is so rewarding for us is that we can help to create some modicum of equality by trying to provide care,” Brown said.
She’s especially grateful for the hundreds of “Bernie donations,” a nod to the smaller $5 and $10 contributions that former presidential candidate Bernie Sanders garnered from working class people who connected with his campaign.
Brown is equally moved by the heartfelt “thank yous” that clients send.
“Some of them are from the farmer’s wife, who has three kids, and they’re barely making it, and you know, she’s 45 years old and finds herself pregnant,” Brown said.
Another recent agreement for block grants was made with Just The Pill, an organization that is setting up roving mobile clinics along the Colorado/Kansas border. The group is remaining relatively under-the-radar. In part, that may be an acknowledgement of the violent protests that once encircled abortion access in Kansas and could threaten the safety of clients and staff.
The Kansas Abortion Fund offers the financial assistance, picking up extra costs after other avenues have been tapped, such as the National Abortion Federation.
But the increasing numbers of clients coming to Kansas for abortions is exactly the outcome that Value Them Both backers campaigned against in the recent ballot initiative seeking to strip the right to an abortion from the state constitution.
The measure failed by a roughly 60/40 margin.
The outcome is not expected to change, despite an effort that is forcing recounts in some of the most populous Kansas counties.
Widespread polling shows that most Americans support the right to an abortion, with limits. Public surveys underscore a growing mantra for pro-choice advocates: “Abortion is not unpopular. It’s gerrymandered.”
The statement illustrates the fact that recent redistricting solidified some regions of the country as almost guaranteed Republican seats in Congress and state legislatures. It’s a reality that won’t be changed anytime soon, since the newly drawn lines are based on the decennial U.S. Census.
If the Kansas ballot initiative had passed, it would have sent the issue back to the conservative-leaning Kansas Legislature.
“There is no state where banning abortion is popular,” said Josh Siebenaler, spokesperson for the Kansas Abortion Fund. “But in response to this tectonic shift in the health care landscape, we are seeing new bridges and ties being built across the nation.”
The Kansas Abortion Fund plans to begin advocating rolling back some of the current restrictions it believes are unnecessary barriers for clients seeking an abortion.
Kansas requires a 24-hour waiting period, counseling information that is state-directed and restricts the use of telemedicine. A doctor must be present to administer even a medicinal abortion, often done though a two-pill protocol.
Ultimately, the current situation needs to be understood as “a human-made crisis by the U.S. Supreme Court,” Siebenaler said.
Meanwhile, people seeking abortions in Kansas, but without the personal finances to afford one, continue to request help, often contacting Brown through the fund’s email.
Many are “terrified,” she said, unsure of even how to make an appointment at a clinic.
“We work with them,” Brown said. “And all we can do is prepare, stay vigilant and feed the positive.”
Mary Sanchez is senior reporter for Kansas City PBS.