Dr. Mila Means was raised in a family that considered abortion an accepted, reasonable idea. Her schoolteacher parents, social activists in the 1960s, instilled that attitude early in her life.
"I was in the ninth grade when my father told me if I were pregnant before I was 18, I would have an abortion," Means said.
That upbringing, and what she calls a non-mainstream approach to her medical practice and her personal life, guided the decision she made about a year ago to try to perform abortions in a city that hasn't had an abortion clinic since physician George Tiller was murdered by Scott Roeder in May 2009.
Means plans to form a nonprofit. She hopes to raise $800,000 to $1 million to buy and equip a clinic where she can provide early-term abortions. She would like to open it in 12 to 18 months.
Her desire to open a clinic comes as the climate for abortion clinics in Kansas grows increasingly prohibitive. Republican lawmakers, encouraged by Republican Gov. Sam Brownback, passed several laws this year further restricting abortion, including one with new licensing requirements for clinics.
Means has been the subject of a lawsuit; has received mail that was investigated by the U.S. Justice Department; and has had anti-abortion protesters show up at her office in southeast Wichita, at her farm in northern Sedgwick County and at office buildings she has looked at as potential abortion clinics.
Wichita-based anti-abortion organization Operation Rescue says it will do everything it can to prevent the opening of an abortion clinic.
Means, 54, a longtime Wichita family physician, had publicly been quiet about her plans until recently, when she decided to step into the spotlight by granting interviews to media outlets, including the New York Times.
She wants to draw attention to an event Friday night at the church where funeral services for Tiller were held. She will appear as part of a panel to discuss what organizers call "the intersection of religion, politics, abortion and terrorism."
State's new laws
One of the state's new laws restricting abortion requires abortion clinics to be licensed and comply with a long list of medical standards and practices. Supporters of the new rules say they will protect patients. But abortion advocates have voiced concern that the law will force the closure of the state's three existing abortion clinics, all in the Kansas City area.
The requirements are not discouraging, Means said.
"There are so many redundancies that are not important for the woman's safety that are built into this bill specifically to deny access, and that really makes me angry," she said. "That probably reinforced my decision to keep working in this direction."
Seated in her office in a chair she said was once owned by Tiller's father — she bought it from Tiller's clinic last year along with some of his abortion equipment — Means tries to draw a distinction between performing early-term abortions and Tiller's work performing late-term abortions. Means said she is not comfortable doing those risky procedures.
"I don't know if it will help or not in terms of security," Means said, "but I'd like to just differentiate myself that way."
It's a differentiation that abortion foes are unlikely to acknowledge.
"We find every abortion equally reprehensible, as do a majority of Americans, and more particularly over 70 percent of Wichitans," said Troy Newman, president of Operation Rescue.
Newman cited polling data gathered by his organization. A recent national survey reflected feelings that were more mixed. It found that 56 percent of Americans support abortion rights and 52 percent think abortion is morally wrong.
"We're going to do everything legally and morally within our power to keep her from opening an abortion clinic in this city," Newman said. "And she cannot underestimate our resolve."
Determined to proceed
Means said she is determined to proceed with her plans in spite of protests and security concerns.
"I have always kind of not been in the mainstream. I've always had a different idea of what health care should be and how we should be advocates for people's wellness. And I think abortion is part of the holistic approach to health care, having the ability for people to make that decision when they need to," Means said.
"And, frankly, unfortunately, women don't always decide when and where they have sex. And that's a huge part of the reason why we need abortion," she said.
Means said she has a supportive network, including a companion who is licensed to carry a concealed weapon, with whom she travels pretty much all the time.
Abortion opponent Angel Dillard of Valley Center sent her a letter in January saying thousands of people from across the United States were looking into Means' background. The letter talked about checking for explosives under Means' car.
"We'd gotten letters, but we hadn't gotten anything like the one she put together," Means said. "Definitely I took more precautions with my vehicle and things like that after I got that letter."
The U.S. Justice Department considered the letter a threat and filed a lawsuit against Dillard under a federal law aimed at protecting access to abortion services.
U.S. District Judge J. Thomas Marten decided that although Dillard's letter was meant to intimidate Means, it did not constitute a true threat. He denied the government's request for a preliminary injunction to keep Dillard at least 250 feet away from the doctor, citing the First Amendment. He is weighing whether to throw out the lawsuit.
Means has been training to perform abortions at a Kansas City, Kan., clinic, Aid for Women, which faces closure if it cannot meet the state's new clinic licensing regulations.
She said she may have to get licensed in another state to complete her training. Some of Tiller's former associates also may come to Wichita to help her train, she said.
Means said she knew Tiller during her early medical training, but as he moved into his abortion practice, she preferred to practice family medicine.
Family doctor since '85
Means has practiced family medicine since 1985. She graduated from Wichita State University in 1978 and from KU Medical School in 1982.
She was born in New Mexico, but her parents, who were from Hutchinson, moved back to the area to care for their aging parents when she was young.
She was 3 when she decided to become a doctor, even though there were no doctors in the family, she said.
Means attended high school in Valley Center through her junior year and finished at South High, where her mother taught, to take more advanced biology and physics classes.
She practiced with groups of physicians at the Wichita Clinic and Wesley Medical Center.
Means said she refused to meet patient quotas at some medical groups, which required her to limit her time with patients.
"I like to be in more in control of my own schedule and not have to follow cookie- cutter protocol," she said.
When her last group, Family Care Associates, broke up, she went out on her own.
The breakup was costly. In a 2009 arbitration, Means was ordered to pay $1,500 a month for the next 10 years in exit penalties to the only physician remaining in the practice. Two other physicians had to pay exit penalties as well, she said.
The decision to leave was purely financial, Means said. "It was going into bankruptcy, and nobody was willing to prevent that from happening," she said.
Means also pays alimony to her first husband, who is a bar bouncer and the brother of her best friend's husband. She had known him briefly in college.
She said she was left with more than $100,000 in debts after they divorced in 2001.
The marriage "pretty much just put me into financial ruin that I probably won't get out of," she said.
Means calls herself one of the least financially secure family physicians around.
"I'm not good at making business decisions for financial reasons," she said.
But money isn't a motive for her to do abortion procedures, she said.
"It certainly is costing me much more than if I'd gone on my merry way," she said.
Against the grain
Her private life is unconventional.
Means, who has no children, is married to a gay man, but doesn't live with him. She lives with a boyfriend, and her husband lives with another gay man.
Means said her husband's parents and hers were close friends. Her husband had quit a job to take care of Means' mother when she developed dementia. When he needed health insurance, Means married him in 2003, she said. The marriage is largely for financial reasons, she added.
"He's a godbrother, basically," she said.
The marriage led to trouble with the Kansas Board of Healing Arts in 2007. Means had been treating the man for bipolar depression since 2001. She also provided medical treatment for his mother and grandmother.
When she married him and moved in with his family, the physician-patient relationship continued. Her husband's mother reported the situation to the board as part of the fallout from a family feud, Means said.
The board ordered Means to end the physician-patient relationship with her husband and to complete education courses on professional boundaries and avoiding the pitfalls of diagnosing and managing major depression.
"I didn't even think about the fact we were married," Means said. "We went to a judge and did this thing for legal reasons, and it didn't occur to me to change that relationship. Plus, the truth is, all physicians write prescriptions and take care of people in their family."
Means said she won't divorce her husband.
"He's still my best friend and he still requires health care and other support. He's like my brother. We're in America, and gay partners can't provide health care for each other. I will not leave him without health care."
Means said her boyfriend, an aviation worker she declined to name, supports her efforts to begin giving abortions in spite of the personal risks.
Letters of support
Means also has received letters of encouragement from around the country, she said.
Still, much of her mail is filtered by her staff.
"I don't want to read in detail everything, because I just don't want to be that overwhelmed with what possibilities are out there," she said.
Means said she is reading a book about fear to help her become more aware of intuitive signs of danger.
Meanwhile, she is patient about finding a new building to perform abortions.
She won't perform them in her current office near Harry and Webb Road. The owner filed suit to prevent that, citing disruptions to other tenants in the office complex caused by anti-abortion demonstrations.
When word leaked that she was looking at offices on East Central and East Douglas, abortion foes appeared at those locations.
Newman claimed credit for Operation Rescue shutting down all three of her efforts to find a clinic so far.
He guesses Means has less than a 30 percent chance of ever opening a clinic. The odds are stacked against her, he said, thanks to the legislation that requires an extensive medical clinic, inspected by the state.
If she does open a clinic, he said, "We will have 100 people sitting on her doorstep on a daily basis."
Means said she may have to use a third party to buy a building, but she is certain she can find a location.
"The truth is, there is a lot of commercial real estate in Wichita that's unoccupied," she said. "At some point, somebody is going to want to do it just for the business aspect of it."