by KANSAS CITY — It’s a city divided in more ways than one.
Divided by state lines, Kansas City has become a battleground for abortion rights supporters and opponents in recent years.
On one side is Kansas City, Missouri – the part of the city in a state that banned abortions in almost all cases, with exceptions for medical emergencies. On the other hand, Kansas City, Kansas, is part of a state that allows abortions up to twenty weeks after conception.
Two years after the pivotal reversal of Roe v. Wade, the landscape of reproductive health care in Central America has changed. And with Amendment 3 on the ballot, which would enshrine abortion rights in Missouri’s constitution, it is positioned to change again.
Kansas becomes a hub for abortion
Dr. Iman Alsaden has dedicated his life to offering abortions to people coming from more restrictive states.
Before 2022, Alsaden spent much of his time traveling between Oklahoma and Kansas to perform the procedure on patients from around the country — particularly from Texas, where Senate Bill 8 abortion regulations made it illegal to perform the procedure after a ‘fetus’. heartbeat” is detected.
The law also allowed civil lawsuits to be filed against doctors who illegally perform abortions.
“It was a very, very hectic time, and I’m very happy that we were able to provide care to so many people who had it taken away,” Alsaden said. “But it has been exhausting for the staff, myself and also for the patients – people who have had to drive hours and hours outside of their community to get medical care that should be available to them in their community. It’s just a lot. ask a patient.”
As chief medical officer of Planned Parenthood Great Plains – an organization that strongly advocates for the passage of Amendment 3 – Alsaden’s base of operations has moved to Kansas City, Kansas.
The company owns two abortion clinics just across the Missouri-Kansas border: one in Overland Park and one in Wyandotte.
“There are people here today in this clinic who come from Texas, right in the middle of Kansas City. That’s not unusual. It happens every day,” Alsaden said. “That was kind of a prelude to this unfortunate new normal that is now our daily life in this region of the country.”
When the U.S. Supreme Court overturned Roe v. Wade in 2022 with the Dobbs v. Jackson Women’s Health Organization decision, three other states surrounding Kansas banned abortion: Arkansas, Oklahoma and Missouri.
Alsaden said it has become too much to handle.
“It’s bad; it’s scary. This is a public health emergency,” Alsaden said. “There is no way to truly meet demand with the current abortion infrastructure in Kansas.”
More than 13,000 abortions were performed at health centers in Kansas between July 2023 and June 2024, according to Hanna Sumpter, director of communications at Planned Parenthood Great Plains. That number has forced several Kansas Planned Parenthood facilities to focus their services largely on abortion.
Sumpter said Kansas clinics are seeing more patients now than in “a normal year before Dobbs in three states.”
“I feel terrible for the patients who don’t have access to their basic human rights during that time,” Alsaden said. “It was like trying to drink from a fire hose. Very, very impossible to reach all the patients, to get appointments for all the patients who needed them. That’s still going on.”
What the ban has created in Missouri and other surrounding states, according to Alsaden, is a dangerous health care environment — where it has become the norm to travel hours away to get abortion care.
“Abortion is part of health care,” Alsaden says. “It affects many people throughout their lives. Many, many people have access to abortion throughout their lives, and it changes the course of their lives. Bringing abortion, and all health care, closer to the communities that need them, and putting them in a place where people can actually access it within their community is huge.”
With Amendment 3 on the ballot, Alsaden said there is an opportunity for Missouri to lighten the workload of Kansas clinics while reducing risks to patients seeking care.
Amendment 3, Alsaden said, would move one step closer to expanding access to abortion, not just in Missouri, but across the country.
“Hopefully, most patients in Missouri would be able to access abortion in their own home state, which I think is exactly what health care should be,” Alsaden said.
Alternative care options after 2022
However, opponents of abortion rights are not silent. Dioceses from major Missouri cities have all argued that traveling across state lines is not the way to go.
Bishop Shawn McKnight, of the Diocese of Jefferson City, said the stakes are higher than in a regular ballot.
“This is not just a policy issue. It is a profound moral question that touches on who we are as people,” McKnight said in reflecting on Amendment 3. “Legalizing abortion procedures — and removing any real opportunity to regulate their practice in Missouri — would not only ignoring the rights of the unborn child, but also continuing the social erosion of respect for life at all stages.”
Bishop James V. Johnston Jr. of the Diocese of Kansas City-St. Joseph, the religious governing body of Kansas City east of the state line, agrees. He called the amendment “extreme” and said it would have “many alarming consequences.”
“I urge you to vote ‘no’ on Amendment 3 so that Missouri women and newborn babies continue to be protected from the trauma of abortion and that Missourians will not give up their rights,” Johnston said.
Instead, the governing bodies behind Missouri’s Catholic churches refer potential abortion patients to unplanned pregnancy assistance centers, offering a comprehensive list of centers across the state on their website.
Leslie Kerns is director of one of these facilities. She said their goal is to inform, support and protect.
“I have always had a passion for children, including babies, and it is so good to have the opportunity to help people when they are confused and don’t know where to turn when they need help,” said Kerns. “We can help them, and it is very rewarding.”
Kerns’ Center, Central Missouri’s pregnancy resource center, offers services including pregnancy and STD testing, ultrasounds, counseling and financial programs.
All services are free and confidential to create what Kerns describes as an alternative to abortion.
“They appreciate the material things they get, but also just the support of knowing they’re not alone,” Kerns said. “We show them that there are all kinds of supports out there. We have a guide to help them find childcare, and if they need housing, we can help them find that insurance.”
These services are not new. The center of Kerns already existed before 2012.
But even with the support of statewide religious organizations and the amount of services the center provides, not much changed when Missouri’s abortion ban went into effect.
Data from the Pregnancy Health Center of Central Missouri suggests there was no significant influx of patients in or after 2022.
In 2021, the year before the ban, 227 clients came to the center for a pregnancy test – a metric that Kerns believes gives the best picture of clients who may want an abortion. The following year, when Roe v. Wade was overturned, only 55 unique clients used the center’s services – a total of 282 clients.
That figure has fallen steadily since then, to 266 the following year, and to 203 so far in 2024.
Now that Amendment 3 has been put to a vote, Kerns said she believes there is a risk to the people of Missouri.
“It takes away the safeguards when people order the abortion pill,” Kerns said. “A pregnancy can be ectopic, meaning the pregnancy is not in the uterus, and that is very dangerous.”
The abortion pills mifepristone and misoprostol work by expelling a pregnancy in the uterus, meaning they are not effective on ectopic pregnancies, which do not implant in the uterus. Taking the pill during an ectopic pregnancy can be dangerous because the symptoms of an ectopic pregnancy are similar to what a woman may experience after a medical abortion. Ectopic pregnancies are life-threatening and confusing the symptoms can cause the woman to delay treatment.
The solution, Kerns argues, is ‘more of these types of services’.
“There are pregnancy centers all over the United States that provide services,” Kerns said. “I’m just letting people know we’re here. There are options.’
Voters will decide on November 5 whether to adopt Amendment 3.
