Half of Kansas abortions on visitors

Many women cross state line for procedure, especially in late term

Kansas abortion statistics

For the past decade, almost half of the abortions performed in Kansas have been for women who didn’t live here.

They come from far as California, Maine and even Alaska. But mostly they just cross over the state line from Missouri.

Data recently released by the Kansas Department of Health and Environment show that last year was no different. Of the 10,836 abortions done in Kansas in 2007, 5,162 (about 48 percent) were performed on women who lived outside of the state.

Those on both sides of the abortion issue have theories for why the out-of-state numbers are so high and what it adds to the debate in Kansas.

Most of the out-of-state numbers are attributed to the lack of abortion providers in Missouri.

Other contributing factors are the differences in state laws, especially in regard to those under age 18, and the late-term abortions performed by Wichita-based Dr. George Tiller.

Location, location, location

It’s a matter of geography and convenience, said Stanley Henshaw, senior fellow at the Guttmacher Institute, a national think tank for sexual and reproductive health issues.

“The (women) going out of Kansas for the most part aren’t going out in order to avoid the state’s restrictive laws and neither are the ones coming into the state,” Henshaw said.

Kansas’ abortion laws don’t differ dramatically from its neighbors.’ However, it sees its largest out-of-state patients from them.

Almost 90 percent of all out-of-state patients are from Missouri. Another 5 percent are from Oklahoma and Nebraska.

Peter Brownlie, president and CEO of Planned Parenthood of Kansas and Mid-Missouri, said a major factor is that all three of the surgical abortion providers in the Kansas City metro area are in Kansas.

The next closest surgical center is in Columbia, Mo., which apart from the St. Louis area is the only place in Missouri where abortions are performed.

Two years ago, a clinic in Springfield, Mo., closed, sending even more women into Kansas.

In 2006, 40 percent of all the abortions performed on Missouri women were done in Kansas.

“There is a lack of physicians who are willing to step forward and take the kinds of risks involved, both personal and physical risks,” Brownlie said.

Also, it is not rare for women seeking anonymity or the support of a friend or relative in a far-off city to leave their home state for the operation. And there are college students attending school outside of their home state, he said.

In 2005, the Centers for Disease Control and Prevention reported that Kansas had more women come from outside its borders for abortions than any other state. Only the District of Columbia’s numbers were higher.

Planned Parenthood’s Overland Park clinic is among those that see the patients crossing over the Missouri line.

“It just demonstrates that if a woman is pregnant at a time she wasn’t planning or intending to be and she is determined not to continue the pregnancy, many will go to great lengths to obtain abortion care if that is what is best for them,” Brownlie said.

Late-term abortions

Two of Kansas’ high-profile anti-abortion organizations point to Tiller’s clinic in Wichita as the main reason for the out-of-state numbers.

Tiller’s practice, one of the few in the country that offers late-term abortions, draws women from both coasts and many places in between.

In 2007, as in years past, abortions performed past 22 weeks of pregnancy made up a small percentage of Kansas’ overall total, less than 4 percent. Yet more than 90 percent of the women getting late-term abortions were from outside Kansas.

Troy Newman, president of Operation Rescue, said he moved the organization from Los Angeles to Wichita because of the number of women coming into what he calls the abortion capital of the world.

Under Kansas law, as in many other states, abortions can’t be performed past the 22-week mark unless a women’s life or health is at risk. Both physical and mental health are considered in the determination.

Newman and other anti-abortion organizations have claimed Tiller has continuously broken Kansas law by performing late-term abortions when there was no threat of a “substantial or irreversible impairment of a major bodily function.”

A Sedgwick County grand jury subpoenaed the medical files of 2,000 of Tiller’s patients. On Tuesday, the Kansas Supreme Court will hear three cases challenging those subpoenas.

“The lion’s share of his business comes from out-of-state clientele because he is willing to circumvent the laws in this state,” Newman said.

Brownlie and Henshaw, however, say Tiller provides a service – abortions for women carrying a fetus that will die shortly after birth and for those with fetal abnormalities.

In the past two years, women have come from 48 states, Canada and Puerto Rico to have abortions in Kansas.

“There isn’t very much need nationally for abortions past 20 weeks. You don’t need a lot of facilities,” Henshaw said.

Brownlie said that when he was director of a Fort Worth, Texas, Planned Parenthood he would refer patients to Tiller’s clinic for services the women couldn’t receive in Texas.

Restrictions on Tiller’s practice have national implications, Henshaw said.

“If Kansas succeeds in making it impossible to provide that service, that affects women in a lot of other states,” he said.

Minors

While Kansas abortion laws are similar to its neighbors’, one difference is clear. In Oklahoma and Missouri, minors must have a parent’s permission before getting an abortion. In Kansas, a parent just has to be told before a minor has an abortion.

In 2006, for abortions performed on girls under age 15, more were from out of state (39) than from Kansas (28).

“We have a definite weakness in our law pertaining to minors,” said Mary Kay Culp, Kansans for Life executive director.

Henshaw has done studies that show an increase in women going out of state when more restrictive laws are passed. When Mississippi passed a law requiring two trips to a clinic before an abortion was performed, more women went to Tennessee and Alabama if they lived near the state border. The same was true for a law requiring a parent’s consent for minors wanting abortions.

“I think there are some cases where state requirements have made it more difficult to provide services and therefore there are fewer facilities,” Henshaw said. “And that can theoretically cause women to travel to other states.”