Welcome to Kansas, reflect your listeners to today's podcast with Emily wills, President and CEO of Planned Parenthood Great Plains. I mean for to reach me, Bill and I caught up with her organization's Overland Park office to talk about her ongoing fight for reproductive rights and litigation efforts. abortion providers have started a June lawsuit against provisions in the woman's right to know Act, which is state legislation that uses medically inaccurate information to dictate abortion restrictions. So we'll just get started really quickly with your background in this work. You joined Planned Parenthood in 2017. Right?
I did. I was the first general counsel and Chief Compliance Officer at this affiliate. So Planned Parenthood had had a lot of litigation in the four states that we serve here. And I think the team just realized they needed to rely on in house counsel. And it was it was wild. We had litigation in all four states when I started.
And in the US, since what have you seen let's start before the dogs decision.
The litigation has changed for sure. I mean, abortion access has changed a lot. So we had moments in time, Missouri's had the most spotty record, I guess, when it comes to abortion access. When I came, we had just relaunched abortion services in Missouri, we had litigation to try to protect them. But there was such a, there was such a complex web of restrictions, that Missouri really did look like abortion existed in Columbia and Kansas City for a period of months. And then there'll be a new restriction or we'd get an injunction lose an injunction. So that was constantly happening in Missouri, were really scrambling to try to protect and expand access there. Arkansas had litigation, but still had abortion access. We had two locations then that were providing medication, abortion. Oklahoma, we really worked to increase access. Part of that was that there had been independent providers in Oklahoma that were needing additional support. So we launched new services. And then Kansas was always really the least restricted states since I started. There had been drama in the past, you know, there was the Phil Kline era, there were criminal issues and cases, but it was relatively protected at the time I got here. And although there have been challenges, there was at least a semblance of ongoing access to care. What's happened since in the last few years really is it has been we talked about it before there was death by 1000 cuts, because increasingly, we jumped through so many hurdles, that it wasn't like, it wasn't the kind of care patients deserve, you know, we would have to tell them all sorts of state managed information would make them wait for days in Arkansas and Missouri to get care. It was such a confusing and terrible existence, you started memorizing, you know, the care looks different in this state than that state. And you've got to go through these hurdles here, but not there. But we got used to that world that was the, the world in which we lived. And then of course, when the Dobbs decision came down. It was heartbreaking in a lot of ways. But it had been not even a slow march, a pretty fast march in the last couple of years toward this terrible finale of losing access, and three of the four states we serve. We had in September of 2021, SB eight in Texas took effect. And so the care changed, literally overnight for us in our states in September of 2021. People talk about June of last year as being this pivotal moment. And it was, but really for our region of the country. When Texas lost so much of its access and had a six week ban. We started seeing Texans within the week showing up in Oklahoma within two weeks in Kansas. And it has only accelerated, you know, Dobbs meant, of course, more people coming. It meant instead of being a welcoming location for people who were fleeing from their homes in Oklahoma and Arkansas, we had to tell our neighbors and our family and our friends, you know, in those communities, you've got to get out of the state too. And fortunately, of course, we have Kansas where we've been able to continue to say, yes, you can come here, yes, you can get care. But nothing about what we do as complicated as it was in 2017 2018 2019. Nothing in this work really looks the same.
And let's talk about specifically here in the state of Kansas. I know like again, the dog has kind of changed things a bit for the state as well, but the woman's right to know, like, that's been impacting the state's reproductive choices for a long time, right, like,
absolutely. We do have some staff members who were here before 1997, who remember an era when we didn't have the women's right to know when we didn't have the massive restrictions we have now but for most Most of our team, myself included, it's just been part of the work we've had, we've just built into our processes and expectation that some patients won't complete the form correctly won't be able to print it out, we'll have to get rescheduled. And that was very frustrating for patients and upsetting for staff, but manageable in a way that it's not today, it was always medically unnecessary, and frankly, pretty offensive to have to tell patients here state mandated information, we'll do your real informed consent with actual medical education, either way, but the state requires that you receive this form and wait 24 hours, that was a problem. But once we started seeing as many people as we see, now, Texans, Oklahomans are Kansans, people from Louisiana. It just wasn't doable to say, Oh, he didn't get the form. Right? Or you didn't put it remember to print it out? Well, we'll try to fit you in tomorrow. Yeah, well, let's
back up a little bit and talk about some of the restrictions under the right to know. So what are the most egregious of these, in your opinion, like, what are you really fighting for?
The key thing is the 24 hour wait, there are pieces of the form that are outrageous and should make everybody roll their eyes, those would include things like having something in the right font in the right color. If a patient comes in and says, Oh, my printer was out of blacking, so it printed automatically in blue, it defaulted to blue, but doesn't meet the statutory requirements, we're not gonna be able to see you, you've got to get the form, again, which we'll supply here and wait another 24 hours. That is extremely annoying, but it is the 24 hour piece that is truly unreasonable. That's when we have to say to patients, okay, we recognize you just run the car for 14 hours from wherever you call home, you're stressed out, you're worried about your kids, you're worried about your job, and you printed the form in the wrong size. So you can't get care, we will help cover your hotel and keep you here. But for a lot of the people we serve, they will say I don't have the resources. And I don't have the time to do that. I can't take off another two or three days from my life. I've got to get back home. And so we are pretty adept at trying to comfort people in a crisis and then say, well, can you get back next week or the week after? We don't have enough appointments to see everybody. So the idea that somebody could get all the way here feel like they hit the lottery, which is pretty much what it feels like for patients right now, when you find out you're one of the few who get an appointment at all. And then you don't actually get the care you need. It is devastating.
And you were telling me that we'll come back to this in a bit. But you are having to turn away like between two and 10 patients per day because of these restrictions right now.
Yep, that's exactly right. So it varies, certainly, but it's hard for me to remember a day, certainly not in the last year where we haven't had anyone who doesn't get turned away. It's just part and we schedule around it anticipating that we're going to have a number of people turned away, because it's inevitable that someone comes and says yes, I got the reminder call. Yes, I got the email. Yes, I understand. I'm supposed to review the forum. But I'm scrambling to get here. I took off after my midnight shift got in the car showed up. And no, I didn't have time to really read the form. And also, there's a level of people being punished for being honest. And saying when we say did you review the form which you are required by the state test to see if they say, oh, no, I haven't yet. Can I read it in the waiting room? The answer for us is no, you can't because the state requires 24 hours after you review the form. Yeah, we've seen the faces of people so often where it sinks in, that it's not medically necessary, that it is not a thing we can work around. It just is what it is. And we're thinking about those faces. And those people when we filed the lawsuit, this really is for them because they have every right to deserve and access the care they need. And so having a political forum block their path is infuriating.
And how does it feel to see those faces as a healthcare provider?
I think for everybody who works here, there's a brief moment of panic, and then triage, and we're used to it but you see the frustration and the devastation and the anger. And of course we're the people who are here to receive it and we're comforting and folks understand it's not us, but it doesn't make sense. It is totally illogical to explain to someone No, you wouldn't have this in any other type of health care. Know you might be annoying your primary care physician if you didn't sign something before you got there read and complete the you know, pre work, but you can still be seen whereas here we just have to say it is what it is and let's start planning whether we can get you in another day or whether we can get you to Colorado or Illinois. Yeah, it is exhausting. I think in a way that's hard to capture. It feels like a job Just a draining moment for everybody involved.
So the woman's right to know this was blocking you even before Dobbs, right? Like, this has been an ongoing issue for years. I heard someone describe it as like death by Will you just describe it to us like death by 1000? Different little cuts? Right? Yep. So then Dobbs is overturned, but all right to abortion is no longer guaranteed Kansas becomes one of the only few safe havens for abortion left. And what have you seen since then?
In some ways, I think we were among the first abortion providers in the country to start raising the the flag and the alarm and saying you've got to prepare, because we think the end of Roe was coming, and it looks terrible. You we all knew, in theory, some of the challenges. But I think until that moment, we were not sure what people would do in states that lost access. What it meant for us was seeing people arrive really for the first time ever with kids in the car. And that would happen on rare occasions. But people are so afraid of their home states and of the politicians in their home states that they will arrive and say, I think my mom would be supportive, or I think my partner would be supportive. But I don't know if they get in trouble if they helped me access abortion, because of these vigilante justice style laws that are passing in Texas and Oklahoma. So I didn't tell anyone, and I just put my kids in the car, can they stay in the parking lot? You know, we never before had to come up with a list of local parks a list of local food places we provide, you know, vouchers meal support, because care changed so quickly. And that we're just seeing that in an intensified level. For a while it was only Texans, who were really forced every day to flee if they were after six weeks in their pregnancy. But now it's all kinds of people. And the trends are the same. People are not as a rule, able to get in on a plane and fly states away. If they are planning around their jobs and their gas and their kids, they're not able to move a whole family there, right? There's a reason that the states who are really feeling the impact of the jobs decision are ones that border whole regions without access. And that's because people are getting in the car and driving.
And then here, like we've seen the data just show the skyrocketing rates. And I know that's really upset a couple of anti abortion groups. Have you had any sort of antagonism towards you guys increase in the week since abortion reports for this year and last year were released?
We really haven't? I think the the biggest response has been that, you know, this is what we warned you of this is, you know, what we feared would happen. And I think there is a level of it not understanding the human part of this situation, right that when we are able to see folks from other states, there is an appreciation for the care but also for the state of Kansas and the reasonableness of the citizens who live here and allowing folks to access health care. You know, the the same way we see that devastating look like you anticipated when someone says I don't have the form or I didn't get it. We brace for that moment. But we also are so used to seeing people literally breathe easier when they check in and find out they're gonna get care, because they have been living in this world of unknown of fear. And they walk into Kansas and they feel safer.
So voters in the Supreme Court of Kansas both like waiting the 2019 judgment from the Supreme Court, that abortion is a constitutional right under the Kansas laws. And then, like last year, we're almost coming up on the one year anniversary of that abortion amendment in which Kansans overwhelmingly voted yes, we will want to keep this right, we want to protect it. So since then, we have seen some attempts by the legislature to sort of overturn that most recent views has been like the abortion reversal method, which has now been inserted into the woman's right to know act. And that is just, it's basically a fake junk science notion that abortion can be reversed and within a certain time period after taking the first abortion pill. Now, this, again, is kind of a health risk to people I've heard it causes like risk of bleeding if anyone actually undergoes it. And it's now kind of required or it will be required. So this was part of the reason for coming up with a lawsuit. Right?
That's exactly right. We decided to file a suit challenging the restrictions really for two reasons. The immediate was the medication abortion reversal. Other attempts to pass similar requirements in other states have been blocked and primarily for the reasons you stated. There are no peer reviewed medical studies that show that this is effective. And in fact, the studies that are out there show the opposite. You know the the risk to patients are so high that they've had to halt studies early because of complications. Our staff are used to jumping through hurdles to get people to care But telling providers, you've got to give not only inaccurate information, like some of the bogus stuff that's been out there for years about some tie to breast cancer, That's bogus. But we will say the state mandates this information. This is if you leave here, we are forced to tell you something that could put you in immediate risk, you could be imminently in danger by trying to seek this care that is not proven to be medically accurate. We felt compelled to say, Okay, this puts people in imminent danger, it absolutely violates our providers and our staffs first amendment rights by forcing them to give us information, and we cannot send people hours away from our health centers, telling them when you go back home, try this method, potentially, that the State forces to tell you about not once, not twice, but I think five times six times, and see how it works when you're back home, and you're so afraid, you can't even tell your family or friends. What is the process to support those folks? That's one of the reasons we filed the lawsuit. And then the other really was this changing landscape, that historically we could say to people we can get you in next week, if we can't get you in two weeks from now, that's not true now, because our schedules are so full. So the 24 hour consent went from a violation of your constitutional right, that was really frustrating to a violation of your constitutional right, that will ensure for some people, you never access that right. That's the real difference today.
So these two reasons were sort of the breaking point you filed the lawsuit. How's that been going? What's the response been?
Our staff is thrilled, which makes a difference, I think there is a moment for people to realize that it might be possible. If we win in this suit for people to access abortion care, like they would other types of health care, where you still get the same high quality service we delivered before. And you still get medically accurate informed consent from your healthcare provider. But you don't have the state directly interfering in the provision of care. That's pretty mind blowing for our team who are so used to being constantly impacted by the politics of the state. So that's exciting. The response, I think, coming out of the hearing, was definite optimism. It seemed clear from the courts questions that the judge understands the real impact has some experience with informed consent medical practice, and just what an outlier and a burden these restrictions are.
And how do you feel like the response from the legislature I mean, they've been again, pushing these sort of anti abortion laws and rules and regulations every session, are you worried about that impact continuing on to the next legislative session?
It's hard to imagine it won't continue. You know, we're less than a year, we were less than a year from the August 2 vote, which was so resounding and clear about Kansans not wanting political interference in the practice of medicine, and particularly for abortion rights. And still they passed this medication abortion reversal, which targets abortion, and also puts people at risk Kansans, who are served in theory by these legislators, were going to be impacted by receiving bogus information that could really hurt them physically hurt them. That's alarming and disappointing. And I think there's no clear message that folks who are in the legislature who are anti abortion, are going to use this as a fundraising political tool and are not prioritizing the people they serve, not just because of the vote. But when you hear this isn't. This isn't an annoying introduction of something into the woman's right to know, it's not a slight burden. It is a direct, hurtful change that would affect people who live here in the state or receive care in this state. It should be alarming to every person, how are you feeling about abortion, the idea that a politician would say, here's some junk science, here's some speculative practice, we're going to try it out on you. That should be pretty shocking.
But that's our legislature. And then also the Attorney General said some of these things like the abortion reversal, or common sense measures, I think that's like a direct quote. I mean, how do you find that sort of thing? Like it's all the sort of a lot of how your political powers are against you? How do you continue functioning?
One of the key things you have to do is talk about the work we do that was the awesome thing about August 2. You know, we didn't choose that fight. I'm glad it happened. And I'm amazed at the outcome. But talking about the August 2 vote about abortion access, it meant for the first time that a lot of the people who quietly support us felt compelled to share their stories with their family and friends. We joke sometimes at Planned Parenthood about how confessional the work is, and that when you start telling people you work here, it's immediate that someone pulls you aside at a party or at a restaurant. and says, Here's my abortion story or my mom's or my partners. And I've never told anyone. And the difference about August 2 was that we had more than 50 house parties just in this area, talking to local supporters inviting their friends or family. And coming out of those meetings again, and again, people said, I am going to tell my daughter, my partner, my parent that I had abortion care, because I want them to think of me when they go into the voting booth. And know that this care is not someone different someone else, someone who made a bad decision, but it is me their loved one. And that's what I think we have to do now too, we have to keep talking about the care. Because just based on the data, you know, and love someone who's had an abortion, and you do need to be thinking about them, when you vote, when you decide what should happen to health care. When you think about how to support Planned Parenthood or other abortion providers. It affects way too many people to be as polarizing as it is.
So a way to fight this is just by D stigmatizing it by showing everyone your loved ones also have this sort of thing.
I think that's right. I mean, we we show up in the legislature, we're realistic, that it's hard to change hearts and minds when they are fundraising off of this. And they see it as a wedge issue. And they're talking to a base that is not representative of Kansans. Like Kansans were listening last year, you know, whatever the politics and the sort of political messages around this, individuals did go in to the voting booth and think about people, I think, and you saw it in the vote.
So how's the future looking in terms of reproductive rights and reproductive care in the state? Are you optimistic are you thinking is going to be looking up?
I'm really grateful. The past year has been really hard. You know, we do serve four states. And so it has been an interesting and tough dynamic to have staff members who were part of the surge of care in the past year, who now can't support their local communities. It's a really hard thing to live in Oklahoma City, or Tulsa, where we have abortion facilities that are new, and designed to support a whole lot of people who can't do the work that they were created to do. They do other important things, obviously. But that's been hard. And I think there's a level of I don't know if it's jealousy, but it's hard not to feel different when you have colleagues who have more rights than you do. And that's just the reality of being a first aid organization where we are right now. At the same time, the work is not done in Kansas, we are really trying to be thoughtful about how we increase patient volume, try to support more people getting care. We're making no secret about the fact that we're just not serving enough people, you know, answering as many calls as we do, and telling as many people as we do, you've got to go somewhere else. We can do more. And so we're trying to do that at the same time. Yeah, so optimistic, somewhat, but I think we're going to be in this public health crisis for potentially years to come. But it's encouraged. It's encouraging to see Ohio and Michigan and other states who are taking some power back from the legislature and ensuring that people can have access to care. But those fights, as we know, well here in Kansas are not easy, and they're not cheap. Sort of anecdotally, when we speak among the providers here, we all know we're not doing enough. We all feel underwater, because of the extremely high demand. abortion care is also time sensitive. So it doesn't work for people. If you say, Sure, let's get it out months from now, that's not doable for anyone. As far as the number of abortion clinics, there are, let me count it out. We have clinics in Casey K, Overland Park and Wichita. There are two independent providers also in Wichita. And then there's one other independent provider Dr. Nasir, who's here in Overland Park. That's a handful of providers that are now supporting many, many people from Texas, plus locals from Kansas, Missouri. And you add in Arkansas, Oklahoma, Louisiana, sometimes we see Alabama. That's not enough. I'll say that
if you do win this lawsuit, and then what was the positive like consequences of that? Like what would what would be like a celebration of that?
Yeah, it'll it'll be huge in many ways. I won't open appointment access. You know, the the reality is we have to do two things. We have to try to create more appointments more hours. We've been doing that for over a year now. But it will mean that we can see the patients who show up and need care and don't have the form or when we have someone cancelled or say that, you know, they don't need the care they can't get here. We can put some other patients into that spot, which has been a challenge you know, you keep a waitlist But you also have to say, have you seen the form because if you haven't, or you haven't, you know, read it, you we can't slide you into an appointment that day. So that would be would be pretty remarkable. And there would just be an incredible amount of relief, to not have to give patients the dangerous information about medication abortion reversal.
And then in terms of building security itself, I have heard of like, you know, people being scared to go into these is that an issue here in Kansas,
patients are sometimes scared. Our staff is fairly used to the protocols we have in place, the the sad, complex history of abortion in Kansas with which is both protected and more accessible than in other states, but also carries in the not distant memory of Dr. tiller's murder. It is not ever far from our team's hearts or minds. So we think about it. I don't think there has been a dramatic uptick. Honestly, in the security we, we try to be really thoughtful, we do quite a bit of training, we support the team. There are times where it's just the back of your mind, right? You get so used to the the calls, you know that opposed to the work or will try to get you a different job, that some of the instinct we have really is protection for patients. And I think it can be a bit of a rallying cry for our team, like you went through sometimes literal hell to get in the front door. And we're going to do everything we can to make this a good experience.
Are you seeing protesters much anymore, like on average in a week, would you see one or two
most days, we have protesters in Overland Park? Many days we have them in KC K. The protesters are unsurprisingly very focused on the work. So they know for the most part when we're open, they know when our appointments are scheduled. So it's maybe not surprising to anyone that if we have a day when the health center is closed, but administrative staff are here, they're not here. There, they really try to interrupt patient care. That is their goal is to persuade and interrupt patients who are trying to get in the front door. So yeah, most of the time we have some protests or presents at our centers.
Give me an example of that, like, what does that look like? Is it just signs of the yelling? Like, what do you have to do to get in that door every day,
it can vary the usual suspects. At our centers carry signs, we generally have four or five people very often right now they are men. That's not always true. But it seems to be a bit of a trend that are Kansas centers now. And they will carry signs, a lot of times they are you know sort of scare tactics, either about threatening where you will end up in the next life. If they think that the you will go to hell or burn in hell, sometimes the science say that sometimes they try to persuade you to choose parenting, not knowing, of course, any of the reasons that a patient is here for care. And sometimes it is literally about blocking patients from getting in, you know, we don't see these tactics all the time, we're fortunate to have pretty good relationships with law enforcement. So we can call for support. But there are, there are certainly days when we have folks try to block the entrance or block the parking lot in a, I think, belief that it will prevent people from getting care. But when you have someone who's driven especially 15 hours to get here, they're going to wait patiently while you move out of the way so that they can get into get health care.
And then for our listeners, let's humanize the face of abortion a little bit here. What is the average of abortion seeker? Like, you know, what was the goal there? What do they look like? What are they trying to fight for?
Every single patient who comes here is different, of course. And we provide care to people for many, many reasons. Whether it is because it's not the right time because of financial issues because they're seeking education, or because there are fetal anomalies, or complications in the pregnancy. All of those patients get care at our health centers. As far as who they are, I don't think it's surprising. The majority of our patients are already parents. They've got children, it is one of the most cited reasons for patients who seek abortion care is they are thinking about their family and their resources and what's best to support the children they have. And they tend to be not super young. I think there's a perception that the majority of our patients must be 18 or 19 or 20. And instead, most of our patients are mid to late 20s.
And part of the Talk to go obviously is like legal pursuits. Are you thinking about any other lawsuits after this one's concluded?
It's a great question. We don't have anything in the works. We're not planning to do that at this point. But if I've learned anything, as a lawyer for Planned Parenthood or now in my current role, it's that you have to be prepared for whatever comes your way. And I don't think I would have predicted that the legislature would have passed medication abortion reversal. Within a year. I thought we'd see restrictions. I thought with the conversation about abortion, but doing something that really is as dangerous and as selfish as what they did in the last session is a reminder that anything's possible.
So thank you for being here today.
Absolutely. Thank you so much. This has been great