Abortion in America has been on the decline for a generation.
Yet in few states has the trend been more dramatic in recent years than in Kansas, a change driven by laws limiting the procedure and by the violent death of the state’s most prominent abortion doctor in 2009.
No other state in the Midwest has seen abortions become so rare so quickly.
The number of abortions in Kansas has tumbled nearly 30 percent since 2006, the biggest percentage of decline among 13 Midwest states, including Ohio, Texas, Iowa and Missouri.
Kansas abortion clinics performed 7,788 abortions in 2011, compared with 11,173 in 2006.
The reduction stems partly from new regulations imposed on the state’s remaining clinics – one in Kansas City, Kan., and two in Overland Park – and partly from Wichita abortion doctor George Tiller’s murder nearly four years ago. His practice, believed to have performed 2,000 to 2,500 abortions a year, was subsequently closed.
Peter Brownlie, president and chief executive director of Planned Parenthood, said a decline in unintended pregnancies and the creation of new restrictions have led to the drop in abortions. He said the absence of Tiller’s clinic is likely a significant factor in shaping the statewide numbers.
“People in the past who went to Wichita for services are going somewhere else,” he said.
That Wichita facility now appears poised to reopen this year.
While the right to an abortion in America remains embedded in case law, many states chip aggressively at the edges. They impose waiting periods, mandatory ultrasounds, limits on insurance coverage, tighter clinic regulations and controversial late-term bans that could challenge the legal underpinnings of Roe v. Wade.
That 1973 landmark federal case upheld the right to abortion 40 years ago this week. Anti-abortion forces marched in Washington on Friday.
Last year saw the second highest number of abortion restrictions ever passed by legislatures nationwide, surpassed only by the previous year, according to the Guttmacher Institute, which tracks reproductive rights issues.
That surge of anti-abortion legislation prompted a corresponding wave of litigation from Kansas to Texas to Alaska to North Dakota. Kansas alone spent more than $700,000 defending its abortion laws in the last two years. Just last week, Kansas won a lawsuit challenging a law banning insurance coverage of abortion.
“I think we have more active litigation right now than we’ve ever had,” said Julie Rikelman, litigation director for the Center for Reproductive Rights. “The laws are getting more and more extreme.”
What some see as radical, abortion opponents such as Mary Kay Culp see as reasonable.
“There’s nothing extreme about the bills that have passed,” said Culp, the executive director of Kansans for Life. “Nothing bans an abortion from taking place.”
Culp said many of the bills are intended to enhance the safety of women or give them more information that doesn’t necessarily come from the abortion provider.
“If the end result is there are fewer abortions,” she said, “I don’t think anybody thinks that’s a bad thing.”
Both sides see the stakes rising and the legal battles intensifying.
“You’re going to see more laws passed,” said Denise Burke, vice president for legal affairs at Americans United for Life. “You’re going to see more court challenges and you’re going to see the law in this area continue to develop.”
Public opinion is increasingly conflicted.
A new Gallup poll out Tuesday found 53 percent of Americans do not want Roe overturned. Yet other polls indicate that only two in five Americans identify themselves as “pro-choice.”
While slightly more than half of Americans believe abortion should be available in certain circumstances, the new Gallup poll showed barely more than a fourth of the country thinks it should be available in all situations.
The abortion battle has been especially pronounced in Kansas. Former state attorney general Phill Kline doggedly pursued abortion clinics. Tiller’s clinic was the focus of protests for decades. It was once bombed. Tiller survived an anti-abortion-motivated shooting in 1993 before he was ultimately shot to death in his church 16 years later.
Then the election of Republican Gov. Sam Brownback two years ago gave new political clout to anti-abortion forces in the state.
Brownback signed five bills in his first year in office aimed at curbing abortion. They included the clinic rules that almost led to a shutdown of the state’s surviving abortion clinics. In his second year, he signed a bill into law allowing pharmacists to refuse to provide drugs they believe might cause an abortion.
“Kansas is really one of a handful of states that could be considered a testing ground for abortion regulations,” said Elizabeth Nash, state issues director for Guttmacher.
The new laws have made Kansas, once among the country’s least restrictive states on abortion, now one of the toughest places in the country to get the procedure. Americans United for Life ranked Kansas as the 11th most restrictive state for abortion laws.
“The changes in Kansas have been pretty dramatic,” said Glen Halva-Neubauer, a Furman University professor who has studied states’ abortion policies.
The shift traces largely to the election of Brownback, a politician who has made opposition to abortion a centerpiece of his career.
“Keep pushing for life,” Brownback told abortion opponents at a rally this week attended by more than 2,000 people in front of the Capitol. “Life is critical. Life is essential. Life is what it’s all about. That’s why we need you to continue to push and to march and to pray.”
Meanwhile, the number of abortions continues to drop nationwide. One of the best sources for national abortion data is kept by Guttmacher, but the numbers are current only through 2008.
Overall, abortions have dropped by about 25 percent nationally since they peaked at about 1.6 million in 1988. The number of providers has also dropped nearly 40 percent since 1982. Fewer than 1,800 clinics operate today.
In 1977, Kansas had as many as 26 providers.
Women have a right to abortion. In a 1992 ruling, the Supreme Court upheld the basics of the earlier Roe case. But the high court also said states may regulate abortions to protect the health of the mother and the life of the fetus, and may outlaw abortions of “viable” fetuses. That set the stage for mounting state regulations on abortion, allowed as long as they do not impose an undue burden on the woman.
Abortion foes have generally taken an incremental approach to tackling Roe. Yet some factions push more aggressively, in some instances attempting to bar any abortion when the fetus is advanced enough to produce an audible heartbeat.
Academics who study the issue say abortion opponents are savvy to focus on late-term abortions. Those procedures draw far less public support than early term abortions.
“The right-to-life people are extremely smart with their strategy,” said Halva-Neubauer, the Furman professor. “Go after late-term abortions and chip away, chip away, chip away. You are making an argument on late-term abortions that might end up being very useful to you as a limit on earlier abortions.”
One example of those late-term laws are the so-called “fetal pain” bills passed in Kansas and eight other states. The Kansas law, for example, bans abortion starting at 22 weeks – with some limited exceptions – regardless of whether the fetus was able to survive outside the womb. The law is based on the disputed claim that a fetus can feel pain at 22 weeks.
Critics say that bumps up against standing law which allows abortions until the fetus can survive beyond the womb. A challenge is now pending against a similar Arizona law, temporarily blocked and now on appeal, that bans abortions starting at 20 weeks.
“It’s marginalization, marginalization, marginalization,” Halva-Neubauer said of what’s happening to abortion in America. “I think that has a huge impact on its status as a medical procedure.”