Moving to Kansas to defend abortion rights

You think you’re going to heaven after what you’ve done, Allison?” I started working as a medical assistant for a Planned Parenthood clinic in Denver in 2008. Our protesters, a colorful bunch of evangelicals and Catholics, asked this question regularly when sinners like me pulled into the parking lot. Many arrived from across the eastern plains in Kansas. More than one came in to end a pregnancy.

I wish I’d asked how a belief and a choice could be so wildly contradictory then reasoned away as a necessary exception, but I never did. I’ve never pictured myself living somewhere like Kansas, where strict Christian values can make these “exceptions” everyday realities. As the Supreme Court prepares to overturn Roe v. Wade, I’m coming to see this as crux of the culture wars, and subsequently, the abortion problem.

In 2011, I moved to rural northwest Colorado to manage two Planned Parenthood clinics. In one of them, we provided medication abortion up to nine weeks of pregnancy, the legal limit at the time, but only every other Wednesday. This was not by choice; the only doctor we could find to do any kind of abortions lived two hours away.

We searched for a better solution for over a year until Colorado legislators determined non-physicians could provide abortions. Jamie, our full-time nurse practitioner, jumped at the chance to offer medication abortions more frequently, but due to a lack of “in-clinic” abortion training spots, patients farther than nine weeks along still had to drive to Denver three hours away.

Once, a patient trying to escape a violent relationship was too far in her pregnancy to be seen by Jamie. We made plans for her to go to Denver, but as far as we know she never went. I wonder about her often.

While attending Columbia’s Mailman School of Public Health in 2014, I saw the impact of limited training opportunities on the national abortion provider pipeline. Despite one in four American women seeking an abortion in their lifetime and an incredibly high demand from medical professionals for training, fewer than half of medical schools provide any kind of abortion training — and OB/GYN, family medicine, and Advanced Practice Clinician (APC) programs aren’t better. It is these three specialties that make up the bulk of the abortion provider pool, and the majority of institutions where they can get abortion training are in progressive parts of the country like the West Coast and Northeast. There are plenty of abortion providers in the U.S.; they just tend to live where they train, much like their colleagues in other disciplines.

When I joined Planned Parenthood Federation of America in 2017, I saw this play out in real-time. I watched doctors competing with gusto for spots to fly to places like Kansas, while politely declining desperate pleas for them to relocate there. There are exceptions, of course, like Texas provider Dr. Bhavik Kumar, who told me in a 2019 interview that while providing abortions as a gay man of color in a conservative community was rewarding, it was also traumatic.

Fewer providers living in red states means fewer opportunities for local medical residents and trainees to learn abortion care, leading to fewer “home-grown” abortion providers, and subsequently, fewer abortion advocates on the ground. This geographical imbalance, combined with the impact of Targeted Restrictions of Abortion Providers (TRAP) laws, translates to a gross inequity in the abortion services patients can access depending on their ZIP code.

Depending on its August referendum determining whether abortion will remain a state-protected right, Kansas could become a beacon of hope for thousands in an otherwise bleak landscape. It could be where the 16-year-old incest victim goes, or the 20-year-old whose birth control failed. It could be where one of the countless parents who can’t imagine a future for their children with another mouth to feed goes.

My grandfather was an Episcopalian minister in Ann Arbor, Mich. He quietly sent desperate parishioners to end their pregnancies safely with a friend at the University of Michigan Hospital. He would tell me to go where people have different beliefs than mine and treat them as my friends and neighbors. If more people like me and the abortion providers I’ve worked with move to Kansas, maybe Oklahoma patients, where only one clinic is currently able to provide abortions (for free), will be able to escape a future they didn’t ask for like the protesters in Denver.

I spoke with a friend at a clinic in Kansas right before the leak on May 2. She told me four abortion patients threatened to kill themselves last month because demand is already so high the clinic couldn’t see them. She and her colleagues shouldn’t have to carry this weight on their own. I’ll move to Kansas for my movement, and for the great infrastructure, delicious beef and famously nice people.