PITTSBURG, Kansas — The Reverend Anthony Navaratnam stood before his congregation and urged them to pray for the women from surrounding states who were flocking to the new abortion clinic in the city that opened in August.
“God is giving us the opportunity to be missionaries in Pittsburg, Kansas,” he told Flag Church staff, who were organizing a training on how to protest outside the clinic.
The debate about reproductive rights has landed in this college town of 20,000 in the southeast corner of one of the few states in the region that still allows abortions. It’s almost Missouri, Oklahoma And Arkansas and not so far from Texas.
A place of this size, especially in a historically red state, would have been previously unlikely to have an abortion clinic Roe v. Wade was overturned in 2022. Since then, Kansas has become one of the top five states where people most often travel to get an abortion if they can’t do so at home, said Caitlin Myers, an economics professor at Middlebury College who studies abortion policy.
According to a recent study, the number of abortions in Kansas increased by 152% after Roe. analysis by the Guttmacher Institute, which supports abortion rights. Using Myers’ count, six of the clinics in Kansas, Illinois, New MexicoNorth Carolina and Virginia 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 one in this region that can provide care to many people in the surrounding states,” said Kensey Wright, a member of the board of directors of the Roe Fund of Oklahoma, which supports abortion clinics in Kansas with grants.
“Without abortion clinics in that state, we would have no hope,” Wright said.
Housed in a former urology office, the Planned Parenthood clinic in Pittsburg is across the street from a medical clinic run by a Catholic health system. Behind the clinic are homes.
Clinic manager Logan Rink said her mother used to work in this building as a nurse — a connection that is “small-town stuff.” She loves the city 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 all of the time.”
Experts said smaller clinics can be less overwhelming for women who come from rural areas, such as those around Pittsburg. But there’s no anonymity in these smaller communities, where religious and family ties often run deep. Pittsburg was founded in 1876 and was populated largely by immigrants from Catholic-leaning countries who came to work in the surrounding coal mines. It has a typical Main Street and a state university with about 7,400 students.
“In a small town, it’s not just that you know the person. Your family knows them. You’ve known them for 40 years,” said Dr. Emily Walters, a Pittsburg clinic supporter who works as an anesthesiologist at a hospital in neighboring Missouri. “Your stories will be intertwined.”
She wondered out loud, “How can I see you at a protest and you the next day at the grocery store and still be civil and polite to each other?”
Walters also chairs the Crawford County Democratic Party in an increasingly Republican area with 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 strip abortion rights from the state constitution, which could have led to an outright ban. Despite Republican and religious leanings, 55% of Crawford County voters were among the 59% of voters statewide who killed the proposal.
It is in line with a An Associated Press-NORC poll from 2024 found that 6 in 10 Americans think that their state should generally allow a person to obtain a legal abortion if they do not want to become pregnant for whatever reason. But rural counties surrounding Pittsburg chose otherwise at the ballot box.
“I remember people stealing yard signs and putting them in 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 shocked when Roe was overturned, and she remembers thinking, “What if I’m in a situation where I have to get an abortion and that’s not an option?”
Abortion is generally legal in Kansas until the 22nd week of pregnancy. The clinic’s southern location puts it closer to states that have banned abortions, rather than sending people to Kansas’ larger cities, where hours have expanded and appointments remain scarce.
About 60 to 65 percent of people who call Planned Parenthood clinics in Kansas for abortion appointments are turned away because there is not enough capacity, said Emily Wales, president and CEO of Planned Parenthood Great Plains. Wales said the majority of people seeking abortions in Kansas come from out of state — primarily Texas, which is about five hours to the south. Then it’s Missouri, a few minutes’ drive to the 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 that are “strategically located near the (state) border can really help relieve the congestion,” said Ushma Upadhyay, a public health scientist at the University of California, San Francisco, who studies abortion.
Most of the area within 100 miles of the new clinic is federally designated as medically underserved for primary care. In addition, the number of gynecologists and obstetricians per 100,000 female residents is less than half the U.S. average.
But for now, the focus of the Pittsburg clinic is on 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-affirming care. Neighboring countries have also limited this.
“Pittsburg is going to lift up a lot of states in the South and help people get care,” Wales said.
But those expansions, she added, will not happen until staff gets used to the patients and the presence of protesters and opposition.
Donations at Vie Medical Clinic, the city’s clinic, have increased crisis pregnancy centersaid Executive Director Megan Newman. Such centers are typically religiously affiliated and encourage clients to continue their pregnancies.
People who oppose the Planned Parenthood clinic also collect pamphlets about Vie to hand out to people seeking abortions. “When we heard Planned Parenthood was coming, you could just feel it in the city,” Newman said.
Jeanne Napier, a 68-year-old woman who is a member of a local Baptist church, vowed while shopping at the local mall that she would “stand there with signs every day.”
Her daughter, Terri Napier, said in a telephone interview that she thinks part of her parents’ resistance to the clinic comes from watching her struggle about 20 years ago. She was in an abusive relationship with someone who is now deceased. She got pregnant. The family was afraid to bring a child into the situation.
She had an abortion and became entangled in drug use. “I was at war with forgiving myself,” said the 43-year-old, who is now clean.
Jeanne Napier said she felt like she was encouraging abortion. “And I hate that,” she said, “because I wish I could take that sin on myself, so it’s really personal. I played an active role in ending a life, and we don’t have that right.”
Brianna Barnes, a 19-year-old journalism student at Pittsburg State from Wichita, protested and prayed outside a clinic in her hometown.
“If someone made eye contact with us, we would just smile at them, kind of showing love and care, because no one responds well to yelling, screaming, violence, no matter what side it’s on,” she said shortly after arriving on campus for the fall semester. Most students the AP spoke with expressed support for the clinic.
Her mother, Crystal Barnes, 42, turned to her daughter: “You’re the odd one out being Catholic and conservative, especially with things like abortion. It’s so heated.”
The Friday before the clinic opened, crews were installing a wooden façade on the outside, the air filled with the smell of freshly sawn lumber. Walters, the resident anesthesiologist, had come by to check on progress.
Walters’ support comes from a personal source. When she was 20 and as many weeks pregnant, she went to the emergency room, bleeding. She said she was sent home to miscarry instead of having her labor induced or the fetus removed.
That experience — “horrific and would not be considered standard treatment in modern practice,” she said — has given her deep empathy for women in difficult positions.
Just before the 2022 vote, an ad appeared in several of the state’s largest newspapers, including The Kansas City Star, backed by 400 Kansas doctors who support abortion rights. Walters’ name was first. At the time, her home address appeared online, a terrifying prospect in a state where abortion doctor Dr. George Tiller was shot dead in his Wichita church in 2009 by an extremist who is against abortion.
“It’s critical health care for women,” she said. “It’s going to disrupt Pittsburgh. And that part hurts my heart.”
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Hanna reported from Topeka, Kansas.
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