The growing distances across the Mountain West's 'abortion deserts'
When Julie Burkhart learned about the Supreme Court draft opinion that would end abortion protections, she let out an involuntary shriek from her airplane seat. “Because it felt like such a gut punch,” Burkhart said. “And then after that, getting into the opinion and reading that — it was chilling.”
Burkhart, who lives in Colorado, has long been at the center of the abortion access battle, one that is deepening in the Mountain West and across the nation. She's worked to expand access to reproductive rights for decades. Her mentor Dr. George Tiller, an abortion provider in Witchita, Kan., was murdered by an anti-abortion extremist in 2009.
Tiller’s death, and trends limiting abortion access nationwide, compelled Burkhart to place a greater focus on what she calls “abortion deserts.”
Four years after Tiller’s death, Burkhart opened an abortion clinic in his former Witchita location, making it the only place to obtain an abortion within 200 miles.
Today, she's focused on another abortion desert — Wyoming, where there is just one provider in the entire state. Women’s Health and Family Care is located in Jackson, the exclusive mountain town in the far northwest corner of the state. It only offers medication abortions up to 10 weeks gestation.
Burkhart has had Wyoming on her radar for years, and little has changed in terms of its abortion resources. So her nonprofit, Wellspring Health Access, is opening the state’s only surgical abortion clinic this summer in Casper, a central Wyoming town of roughly 60,000 people. And she is moving forward despite protesters congregating outside the clinic each week, despite an act of suspected arson, and despite a new trigger law signed into law by Gov. Mark Gordon in March that will outlaw most abortions if Roe v. Wade is overturned.
The law's sponsor has called Wyoming's trigger law "an opportunity for women to work with life-affirming centers, to work with resources in their community, to help remove barriers so that they can carry to term.”
Wyoming's trigger law is "an opportunity for women to work with life-affirming centers, to work with resources in their community, to help remove barriers so that they can carry to term.”
But Burkhart says such arguments gloss over social inequalities. She points out that people of color and those with lower incomes are disproportionately affected by abortion deserts. In Wyoming, that includes Indigenous women, who face a maternal death rate more than twice that of white women. She and a group of Wyoming advocates chose Casper for the clinic’s central location, but they plan to offer mobile services for women living on the Wind River Reservation some 100 miles away and in other remote communities.
Liza Fuentes, a senior research scientist at the Guttmacher Institute, which advocates for reproductive rights, says these systemic inequities have deep roots. Black women (who face the highest maternal death rates) and Indigenous women have long been denied the rights and resources to take care of themselves and their families as a consequence of multiple policies — “not just abortion bans, not just the Hyde Amendment, but the fundamental segregation of health care, the disproportionate application of criminal enforcement all affects the ability of women of color to decide if, when, and how to have a child and raise those children in a healthy environment.” she said.
For many women of color living in places that have restricted abortion access, Fuentes says, the distance to the next nearest provider becomes much farther, so to speak, when you factor in cost of travel and taking time off from work.
That distance might take you to Colorado, which seems a continent away from Wyoming when it comes to abortion access. It recently codified the right to an abortion. Now advocates anticipate the state’s abortion providers will shoulder a disproportionate burden due to trigger laws not only in Wyoming but in Utah and Idaho as well.
Texas's abortion ban might offer a preview. Dr. Warren Hern, for one, says he is seeing “double the number of patients” at his Colorado clinic since the Texas law went into effect last September.
The 83-year-old physician has witnessed the long and tumultuous trajectory of reproductive rights in America. In 1973, when the Roe decision legalized abortion, he helped launch a nonprofit abortion clinic in Boulder. Today he describes his private practice as “an abortion intensive care unit.”
“We see patients from all over the country — and we have for decades — who can't be seen in other places because the situations are more complicated,” he said. “The patients are further along. Many have fetal abnormality.”
Hern says his patients sometimes come in sobbing because of those fetal abnormalities, conditions diagnosed in the second trimester that jeopardize the health of the mother or baby.
Through it all, he continues to see his work as a calling. He remembers his days as a Peace Corps physician in Brazil, where abortion is a crime. He describes one hospital where there were two wards full of women suffering from unsafe abortions. Half of those women in the abortion wards died because they were too sick to save, he said. Now he worries there will be more illegal – and dangerous – procedures across the West’s abortion deserts if Roe is overturned.
The prospect of this weighs heavy on Jennica Heywood. The Utah resident had an abortion in 2015.
“It was a really difficult decision. I've always wanted to be a mom. I’ve always wanted to have children,” she said.
Heywood was 20 and in an abusive relationship when she decided to have an abortion. She says a lack of education made it hard for her to discern the sexual coercion she experienced.
“Because there is little to no sex education here in Utah, coercion is not necessarily something that is understood, explained, covered or given any sort of weight,” she said.
“It was a really difficult decision. I've always wanted to be a mom. I’ve always wanted to have children."
She was confused about fundamental things even, such as how pregnancy occurs, how quickly it can happen.
Today, Heywood uses the word “gratitude” a lot. Gratitude that she could access a safe abortion through Planned Parenthood, “gratitude” that she did not have a child with the wrong partner. She wonders if she would ever be able to break away from the “abusive, manipulative relationship” she was in otherwise.
Back in Wyoming, Julie Burkhart has been assessing vandalism at the Casper abortion clinic. On May 25, someone set fire to the building, an act of suspected arson, and the damage is delaying its planned June opening. But Burkhart’s moving forward regardless, even as she braces for the Supreme Court to deliver a devastating verdict.
“At the end of the day, what do we want? We want to be able to provide reproductive health care services in the state of Wyoming, and we want to keep it legal,” Burkhart said. “And in this environment, that’s pretty big."
This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Nevada Public Radio, Boise State Public Radio in Idaho, KUNR in Nevada, the O'Connor Center for the Rocky Mountain West in Montana, KUNC in Colorado, KUNM in New Mexico, with support from affiliate stations across the region. Funding for the Mountain West News Bureau is provided in part by the Corporation for Public Broadcasting.