Houston Chronicle Sunday

Clinic inundated by cross-state demand

Planned Parenthood facility in Kansas opened just days after Roe was overturned

- By Heather Hollingswo­rth

KANSAS CITY, Kan. — 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 living nearby from having to take hourslong bus rides to obtain birth control, testing or an abortion.

The U.S. Supreme Court’s June decision overturnin­g Roe v. Wade — four days before the clinic opened — changed all that. Because Kansas is one of the few states in the region where abortion remains legal, the clinic soon found itself inundated with calls not just from panicked patients in Kansas and nearby Missouri, but also in Arkansas, Oklahoma, Texas — even as far away as Louisiana.

This clinic and other Planned Parenthood centers in Kansas have been doing their best to help by lengthenin­g hours, hiring staff and flying in physicians. Still, they have only been able to take about 10 to 15 percent of the 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 are seeking care, you can find it somewhere. And that’s not true.”

Haley Ruark, of Platte City, Mo., 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 bans abortion in all cases but medical emergencie­s.

“It was just idiotic for a law to be put in place that you can’t do what you feel is necessary for your body and not even your body, but your mental health also,” Ruark said.

She already balances working 12-hour shifts as a patient care technician at a hospital with caring for her 2- and 6year-olds.

“The two kids, like they’re good, you know, ends are met,” she said. “Bringing a baby into that, I just don’t think that that would be a good idea right now.”

Ruark walked past shouting protesters to get inside the new clinic. It took her almost two hours to get the abortion pill after meeting with Dr. Elizabeth Brett Daily. By law, Daily only needed to wait 30 minutes after Ruark’s arrival to dispense the medication,

but the clinic was busy.

Thousands of patients likely aren’t getting appointmen­ts at all, according to a national tracking effort called #WeCount, which is led by the Society of Family Planning, a nonprofit organizati­on that promotes research on abortion and contracept­ion.

The society’s report, released in October, found 6 percent fewer abortions were administer­ed nationwide in August — when many of the more-restrictiv­e bans on abortion had taken effect — compared with the number of abortions administer­ed nationwide in April, before Roe was overturned.

Some of the states with bans saw the number of abortions drop from as many as 2,770 in April to below 10 in August, while bordering states that still permit the procedure saw their abortion numbers ramp up, the survey found. In Kansas, Colorado, Montana, Nebraska and North Carolina, the number of abortions administer­ed in August was at least 30 percent higher than the number administer­ed in April. In Illinois, 28 percent more abortions were administer­ed in August than in April.

The study had some limitation­s, including that only 79 percent of all identified abortion providers — including clinics, private medical offices and hospitals — provided data. The society says the figures represent an estimated 82 percent of all abortions provided nationwide.

Few outside Kansas anticipate­d the state would take on this larger role providing abortions, said Elizabeth Nash, principal policy associate for state issues 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 have been thinking these will definitely be access points,” 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.

The picture may be changing. Voters continue to elect large anti-abortion majorities to the Legislatur­e, but in August they overwhelmi­ngly rejected a constituti­onal amendment that would have cleared the way for tougher abortion restrictio­ns or a ban.

Abortion demand in Kansas promises only to grow. While the procedure remains legal in neighborin­g Iowa and Nebraska, both are conservati­ve and Nash described the states as “bans in waiting.”

Routinely, staff are turning away patients seeking appointmen­ts at the new clinic and the two other 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 take it.

But there are no guarantees in those two states either, said Dr. Kristina Tocce, medical director for Planned Parenthood of the Rocky Mountains.

“I hypothesiz­e that for every patient that can get to us and that we can see there are many patients who are not able to access care,” Tocce said, adding that the number of out-ofstate patients has soared.

Getting an appointmen­t in Kansas City is luck of the draw. Local patients aren’t prioritize­d, but have an advantage because it is easier for them to make it to mid-week consultati­ons. Planned Parenthood leaders said adding a fourth clinic is among the options under considerat­ion to increase access, but they haven’t released details.

Daily, of the new Kansas clinic, said she was drawn to the work after a stint with the Peace Corps in the West African nation of Togo. She saw sexual assault victims and “many, many” women and their babies die during childbirth.

The doctor sees horrific stories here, too. A recent abortion patient was 13, her face so bruised from the assault she endured that she could barely open one of her eyes in the waiting room.

Daily likens getting an appointmen­t for an abortion these days to winning the lottery.

“Think about our current health care system and how hard it is just to get like a primary care visit,” she said. “Times that by a thousand because that’s how hard it is for abortion care nowadays.”

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 acquaintan­ces to know. The woman said she initially had planned to carry her pregnancy to term. But then her 3-year-old daughter had a terrifying 40-minute seizure, which temporaril­y paralyzed her. It was her 13th major seizure in the past year.

Doctors intubated the little girl, and the woman hastily arranged for her 9month-old son to be with his father. The couple had separated, so she sat by her daughter’s bedside alone.

“I thought to myself, ‘It’s not fair, you know, to not be able to give another child my full attention.’ ”

She knows some people won’t understand her decision.

“People are just quick to judge,” she said. “A lot of people have religious beliefs. ‘Oh, no. You can’t do that.’ But for me, I just don’t think people take the time to get to know somebody and realize what their situation really is.”

 ?? Photos by Charlie Riedel/Associated Press ?? Dr. Elizabeth Brett Daily talks last month with patient Haley Ruark about the medical abortion process at the newest Planned Parenthood clinic in Kansas City, Kan., which opened four days after the U.S. Supreme Court’s decision overturnin­g Roe v. Wade.
Photos by Charlie Riedel/Associated Press Dr. Elizabeth Brett Daily talks last month with patient Haley Ruark about the medical abortion process at the newest Planned Parenthood clinic in Kansas City, Kan., which opened four days after the U.S. Supreme Court’s decision overturnin­g Roe v. Wade.
 ?? ?? Daily gives Ruark the first of two pills taken for a medical abortion. Ruark got an appointmen­t after a two-week wait.
Daily gives Ruark the first of two pills taken for a medical abortion. Ruark got an appointmen­t after a two-week wait.
 ?? Charlie Riedel/Associated Press ?? Demonstrat­ors for and against abortion rights protest outside the Kansas City Planned Parenthood clinic. It and others in Kansas have been inundated, able to take only 10 to 15 percent of patients seeking abortions.
Charlie Riedel/Associated Press Demonstrat­ors for and against abortion rights protest outside the Kansas City Planned Parenthood clinic. It and others in Kansas have been inundated, able to take only 10 to 15 percent of patients seeking abortions.

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