How a small town in Kansas found itself at the center of a national abortion moment

PITTSBURG, Kan. (AP) — The Rev. Anthony Navaratnam stood before his congregation and urged them to pray for the women from neighboring states who will flock to the city’s new abortion clinic that opened in August.

“God is giving us the opportunity to be missionaries in Pittsburgh, Kansas,” he told those present at Flag Church, which organized a training session on how to protest in front of the clinic.

The debate over reproductive rights has reached this college town of 20,000 people in the far southeast corner of one of the few states in the region that still allows abortion. It is close to Missouri, Oklahoma and Arkansas and not too far from Texas.

It was unlikely that a place of this size, especially one in a historically Republican state, would have an abortion clinic before Roe v. Wade was overturned in 2022. Since then, Kansas has become one of the five states that people are most likely to travel to for abortions when they can’t do so at home, said Caitlin Myers, an economics professor at Middlebury College who researches abortion policy.

According to a recent analysis by the Guttmacher Institute, which supports abortion rights, abortions in Kansas increased by 152 percent after Roe. By Myers’ count, six of the clinics in Kansas, Illinois, New Mexico, North Carolina and Virginia that opened or relocated after Roe are in communities with fewer than 25,000 residents. Two others are in communities with fewer than 50,000 residents.

“Kansas is really the only state in this region that can provide care to a lot of people in these surrounding states,” said Kensey Wright, a board member of the Roe Fund in Oklahoma, which supports Kansas abortion clinics through grants.

“Without abortion clinics in that state, we would have no hope,” Wright said.

Providing abortions to people living out of state

The Pittsburgh Planned Parenthood clinic, housed in a former urology office, sits across the street from a medical clinic run by a Catholic health care system. Behind the clinic are houses.

Clinic director Logan Rink said her mother worked in the building as a nurse, a connection that is “a typical small-town thing.” She loves this town and said her neighbors agree the clinic is needed. But she was cautious in her optimism, saying “the reception we’re going to get from the community is going to be favorable in some ways and probably not always.”

Experts say smaller clinics can be less overwhelming for women who come from rural areas, such as those around Pittsburgh. But there is no anonymity in these smaller communities, where religious and family ties often run deep. Pittsburgh was founded in 1876 and settled largely by immigrants from Catholic-leaning countries who came to work in the surrounding coal mines. There is a typical Main Street and a state university with about 7,400 students.

“In a small town, not only will you know that person, but your family will know them. You’ve known them for 40 years,” said Dr. Emily Walters, a Pittsburgh clinic supporter who works as an anesthesiologist at a hospital in neighboring Missouri. “Their stories will be intertwined.”

She wondered out loud, “How can I see you at a protest and then see you the next day at the grocery store and still be able to be polite and civil to each other?”

Walters also chairs the Crawford County Democratic Party in an area that is increasingly Republican and has no Democratic state legislators — a change from 20 years ago, when there were six. The county has also become increasingly 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 the right to abortion from the state constitution, which could have led to an outright ban. Despite Republican and religious leanings, 55% of Crawford County voters were part of the 59% of voters statewide who rejected the proposition.

That’s in line with a 2024 Associated Press-NORC poll that showed 6 in 10 Americans believe their state should generally allow a person to obtain a legal abortion if they don’t want to get pregnant for whatever reason. But rural counties surrounding Pittsburgh chose the opposite at the polls.

“I remember people stealing yard signs and putting them in neighbors’ yards,” said Anastin Journot, an 18-year-old from Independence, Kansas, who is majoring in elementary education at Pittsburg State. She said she was alarmed by the overturning of Roe, and recalled thinking, “What if I’m in a situation where I need to have an abortion and it’s not an option?”

In Kansas, abortion is legal up to 22 weeks of pregnancy. The clinic’s southern location puts it closer to states that have banned abortions rather than sending women to larger Kansas cities, where hours have expanded and appointments remain scarce.

Emily Wales, president and CEO of Planned Parenthood Great Plains, said 60% to 65% of people who call Planned Parenthood clinics in Kansas for an abortion appointment are turned away because there isn’t enough capacity. Wales said most people seeking abortions in Kansas are already from out of state — primarily Texas, which is about five hours south. After that, there’s 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, which now bans the procedure after six weeks.

Clinics “strategically located near a state border can really help alleviate congestion,” said Ushma Upadhyay, a public health scientist at the University of California, San Francisco, who studies abortion.

Much of the area within 100 miles of the new clinic has been designated by the federal government as underserved, and the number of obstetricians and gynecologists per 100,000 female residents is less than half the U.S. average.

For now, though, the Pittsburgh clinic will focus on abortion. Wales said Planned Parenthood wants to slowly add more services over the next two to three months, and one of the clinic’s future goals is to provide gender-affirming care. Neighboring states have restricted that, too.

“Pittsburgh is going to help a lot of southern states and help people get health care,” Wales said.

But those additions, he added, will come after the staff gets used to the patients and the presence of protesters and opposition.

The protesters are ready

Donations have increased at Vie Medical Clinic, the city’s crisis pregnancy center, said executive director Megan Newman. These centers are often religiously affiliated and encourage clients to continue their pregnancies.

People opposed to the Planned Parenthood clinic are also collecting flyers about Vie to hand out to those seeking abortions. “When we heard that Planned Parenthood was coming, it was noticeable around town,” Newman said.

Jeanne Napier, a 68-year-old woman who attends a 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 telephone interview that she believes part of her parents’ opposition to the clinic stems from seeing her struggle about 20 years ago. She was in an abusive relationship with someone who has since passed away. She became pregnant. The family was afraid to bring a child into that situation.

She had an abortion and turned to drug use. “I was at war with the forgiveness that was offered to me,” said the 43-year-old, who is now clean.

Jeanne Napier said she felt she had encouraged abortion. “And I hate that,” she said, “because I wish I could take that sin on myself, so it’s very personal. I was actively involved in ending a life and we don’t have that right.”

Brianna Barnes, a 19-year-old journalism student at Pittsburg State who is originally from Wichita, protested and prayed outside a clinic in her hometown.

“If someone looked us in the eye, we smiled at them, showing love and concern, because no one responds well to yelling, screaming, violence, no matter what side they’re on,” she said just after arriving on campus for the fall semester. Most of the students AP spoke to expressed support for the clinic.

Her mother, Crystal Barnes, 42, told her daughter: “You are going to be the exception for being Catholic and conservative, especially on issues like abortion. The situation is very heated.”

On the Friday before the clinic opened, crews installed a wooden façade on the outside, and the air filled with the smell of freshly cut wood. Walters, the local anesthesiologist, had stopped by to check on the progress.

Walters’ support comes from a personal place. When she was 20 and the same number of weeks pregnant, she went to an emergency room for bleeding. She said she was sent home to have an abortion rather than have labor induced or undergo a procedure to remove the fetus.

That experience — “horrible and not considered a standard of care in modern practice,” she said — left her with a deep empathy for women in difficult situations.

Just before the 2022 vote, an ad backed by 400 Kansas doctors who support abortion rights ran in some of the state’s largest newspapers, including The Kansas City Star. Walters’ name appeared at the top of the list. During that time, her home address appeared online — a terrifying prospect in a state where Dr. George Tiller, an abortion provider, was shot and killed in 2009 at his Wichita church by an anti-abortion extremist.

“This is a fundamental health issue for women,” she said. “It’s going to be detrimental to Pittsburgh. And that part hurts my heart.”

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Hanna reported from Topeka, Kansas.

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