By Kate Zernike, The New York Times
CASPER, Wyo. — It was not such an implausible idea, back in 2020, when a philanthropist emailed Julie Burkhart to ask if she would consider opening an abortion clinic in Wyoming, one of the nation’s most conservative states and the one that had twice given Donald Trump his biggest margin of victory.
In fact, Burkhart had the same idea more than a decade earlier, after an anti-abortion extremist killed her boss and mentor, George Tiller, in Wichita, Kansas, where he ran one of the nation’s few clinics that provided abortion late in pregnancy.
Tiller’s work had drawn the wrath of the nation’s anti-abortion groups — his clinic had been blockaded, bombed and flooded with a hose before he was shot to death while ushering his regular Sunday church service. When she reopened it instead of moving, the death threats and stalkers shifted to Burkhart, or, as they called her, Julie Darkheart.
Running a clinic in a red state had worn her down, and she was looking to put Wichita and all it represented behind her. But if Wyoming was even more conservative than Kansas, she understood that it was more Cowboy State conservatism, shaped by self-reliance and small government, less interested in regulating what people do behind their drapes.
So she said yes.
Then, three months before Burkhart planned to open her clinic in 2022, the Wyoming Legislature, pushed by a new Freedom Caucus, joined a dozen other states in passing a trigger law that would ban abortion as soon as the U.S. Supreme Court overturned Roe v. Wade.
After the court ruled, other abortion providers in states with trigger bans moved their clinics to safe havens in Illinois, Maryland or Minnesota. Burkhart, rather than leave the front lines of the abortion wars, pushed on in Wyoming, making her the only person in America to open an abortion clinic in a state that bans abortion.
“I really reject the notion of putting facilities only in the safe states, because the only way we’re going to preserve rights in this country is to go to these really uncomfortable places,” she said in an interview on the 3 1/2 drive from her home near Denver to the clinic in Casper. “For us to say we’re going to concede in certain areas, I don’t think we’re living up to our words and what we say when we say we support the rights of everyone.”
Instead of finding only resistance in a Trump-voting state, she has encountered the nation’s complex politics of abortion post-Roe.
For all the ways Wyoming is unusual — roughly 600,000 residents, spread across a vast expanse of mountains, high plains and moon-like outcroppings — its recent politics turn out to resemble other red and purple states. Republicans have fractured, between the Freedom Caucus pushing bans on books and abortion on one side and those who see themselves as defending the state’s more libertarian brand of conservatism on the other.
And as they have watched the consequences of banning abortion, many residents have discovered that their views on the issue are more complicated than they previously understood, that even if they would not choose an abortion themselves, there are situations where people need them. Most of all, they do not think it should be up to the government to decide.
“People, when it comes down to very deeply personal issues, and particularly health issues, they’re going to do what they think is right, even if it’s illegal,” said Ogden Driskill, the president of the state Senate.
A sixth-generation rancher in the shadow of the massive rock formation known as Devil’s Tower, Driskill describes himself as pro-life but opposes banning abortion, for the same reason he defends his use of ivermectin, a drug used to deworm horses, to try to fend off COVID, despite warnings that it is ineffective and unsafe. Most Wyomingites, he added, are like him.
“It’s what level of pro-life are you at,” he said. “If you’re using abortion as a form of birth control, probably a lot of people would say no. If it’s for a reason, probably most of them are willing to listen to what the reason is.”
Jeanette Ward, a state representative who moved to Casper in 2021 to escape what she called the “tyranny” of mask mandates in Illinois during the COVID pandemic, argued that Wyoming is still “overwhelmingly pro-life.”
“A loud minority would like to imply it is not so,” she added, but the Legislature overwhelmingly passed the abortion ban, and the governor signed it.
Burkhart is operating in that shifting space. Her clinic survives on an injunction from a judge, pending a trial in a lawsuit her clinic and other abortion rights supporters filed against the bans. Staking even a small claim in such a sparsely populated state, she argues, is a way to keep the conversation about abortion rights alive.
“I think it’s been proven time after time that you can’t make change without risk, right?” she said. “We owe it to ourselves to challenge these laws. Even if the clinic is only able to stay open four, 12, 24, 36 months, it’s how many people can you help in the meantime?”
The summers of mercy
For all her refusal to cede ground, Burkhart, now 58, does not come across as a firebrand. She speaks in even tones, her intonation barely changing as she lists the horrors that have shaped her career: “Arson, murder, flooding, stabbing, death threats.” (“Hmm,” she adds, quietly.) While others who knew and worked for Tiller refer to his murder or assassination, she talks about when “Dr. Tiller died.” And it is never George or Tiller, always Doctor Tiller.
She brushes off talk of the risks of her work almost passively: “I mean, you know, this is what I’ve decided to do with my life, or what my life decided to do with me.”
Burkhart was shaped in Wichita by one of the defining events of the nation’s long fight over abortion.
She had grown up there, after her earliest years on a farm in Oklahoma. Home on summer break from graduate school in 1991, she took a job answering phones and doing light lab work at the Wichita Women’s Center. She was unaware that anti-abortion demonstrators were about to descend on the city for what they called the Summer of Mercy.
For six weeks, thousands blockaded the city’s three clinics, mobbing sidewalks, throwing themselves in front of cars, handcuffing themselves to fences and screaming verses from Scripture. At the clinic where she worked, Burkhart watched one man bolt himself by the neck to the handles of the entrance with a bicycle U-Lock.
Wichita had become the nation’s central battleground on abortion, and the experience seared her. “Seeing the self-righteousness, the violence, the intimidation, the lack of respect for the women coming to the clinic,” she said, “how can you say we love and care for somebody and then spew hatred at the same time?”
The protesters chose Wichita because they wanted to shut down Tiller’s clinic, which was across town. Burkhart did not meet him for another 10 years. In the meantime, she went back to school in Seattle and prepared to go to medical school, then abandoned that plan after her stepsister was found murdered a week before the entrance exams. She managed political campaigns, but when her partner left her when she was pregnant, she moved home again, this time with her infant daughter.
She took a job as community affairs director at a Planned Parenthood clinic. It was 2001, and anti-abortion protesters were returning to Wichita for what they called the 10th anniversary revival of the Summer of Mercy. She met Tiller in meetings about security, and within months he insisted that she go work for him to start a new political action committee.
A longtime Republican and former Navy flight surgeon, Tiller had taken over his father’s primary care practice in the early 1970s after his parents died in a plane crash, and only when women began coming to him for abortions did he realize that his father had been providing them before Roe v. Wade made them legal nationwide.
Initially, Burkhart said, “He scared the crap out of me,” with his defiance in the face of death threats and a dry sense of humor that people sometimes mistook for brusqueness. But they were “simpatico,” she said. She didn’t mind that he called her at 1 in the morning, since she was up working too.
“He really understood, and I understood, that this work is risky, you have to take risks, you have to think outside the box and sometimes you have to make big, difficult, challenging decisions.”
Over the next eight years she became the public face of his clinic in state politics. She appreciated his approach to the Legislature, that he resisted efforts to enact even seemingly innocuous regulations on abortion providers — requiring that their procedure rooms be larger than those in other surgical practices, for example — because he believed those laws would only make it easier for opponents of abortion to push for more restrictions.
Tiller’s opponents accused him of running a “baby killing factory,” but Burkhart saw only deep commitment. “To his practice, and to people,” Burkhart said. “I really admired that, that he felt that everybody deserves forgiveness, redemption, that it’s part of life.”
In May 2009, an extremist who later testified that he had planned for many years to kill Tiller fatally shot him at his church. The funeral was standing room only. Burkhart recalls mostly her rage. The political action committee Tiller had started, ProKanDo, had been the state’s biggest donor to campaigns, yet she felt that the politicians it supported had been too timid to speak up for him, or abortion rights. “I remember people saying, ‘This is devastating, this is horrible, how can this happen?’” she said. “I was like, ‘How the hell do you think this happened?’”
A month later, a “maniacal mess” and compelled more by grief than good manners, she said, Burkhart visited Tiller’s widow, and, armed with a PowerPoint presentation, asked for her blessing to reopen the clinic. She did so in 2013, and named it “Trust Women,” after a slogan Tiller wore on a political button.
Anti-abortion groups worked hard to discourage her. They leafleted her neighborhood with a wanted-style poster that included her home address, and encouraged opponents of abortion to “bring her home to Jesus.” One protester, a pastor, stood outside her house with a sign asking, “Where is your church?” which she took as a hint that anti-abortion activists intended to kill her the same way they had Tiller.
In a recorded phone call from prison in 2013, Tiller’s killer mused to David Leach, of the anti-abortion group Army of God, that Burkhart might be the next provider to be killed — “She’s kind of painting a target on her,” he said in the recording, which Leach posted on YouTube.
Still, Trust Women was successful enough that in 2016 she opened another location in Oklahoma — the first new abortion clinic licensed in that state in 40 years.
The code of the West
The call from Wyoming in 2020 came from Christine Lichtenfels, a lawyer and the director of Chelsea’s Fund, a nonprofit that helps women seeking abortions. There was only one clinic in the state, and it provided only medication abortion, until 10 weeks of pregnancy, and it was in Jackson, on the western edge of the state. That clinic served nearly 100 people that year, but nearly 400 Wyoming residents traveled to Colorado for abortions. And Wyoming winters made travel difficult, with snow closing some roads for up to six months.
Lichtenfels proposed setting the new clinic in Casper, which is the center of gravity for the state’s population and just off highways that connect to four states that had passed trigger bans.
Proudly the “Equality State,” Wyoming was the first to give women the right to vote and the right to run for office, and the first to elect a woman as governor. The state’s voters had soundly rejected a ballot measure in 1994 that would have banned abortion by establishing fetal personhood. Its long libertarian tradition was codified in 2010 when the Legislature adopted the cowboy-inspired “Code of the West,” with its 10 commandments including “talk less, say more” and “remember that some things are not for sale.”
“If you could buck a bale of hay or pull someone out of a ditch in a blizzard, that’s what mattered,” Lichtenfels said in an interview. “Whatever you do in your own home, people weren’t going to go there.”
Most intriguing to Burkhart, the state’s voters had approved a constitutional amendment in 2012 declaring that adults have the right to make their own health care decisions. Republicans in the Legislature intended it as a shot against Obamacare, but Driskill, the state Senate president, said they recognized that it would be interpreted to protect abortion, too.
Burkhart had read up on Wyoming’s laws around abortion immediately after Tiller’s death, as she tried to help doctors who worked in his clinic find safer places to practice. “Surely it’s all gone to hell there,” she remembered thinking. Instead, she found, “not much had changed at all.”
Across the country, legislatures had swung to Republican control in 2010 and proceeded to break records for the number of abortion restrictions passed. Wyoming enacted just one, a relatively inconsequential requirement that women considering abortion get ultrasounds.
It was also time for Burkhart to leave Kansas. A younger generation of activists was pushing abortion rights groups to think more broadly, about reproductive justice. That concept had been developed by Black women in the South, and Trust Women, along with national reproductive rights groups, welcomed new leadership that reflected the diversity of that new movement. And Burkhart chafed with some staff members, who said that in her trench she had become too controlling, too insistent on doings things her own way.
“I frankly feel like I overstayed my welcome,” she said. “I mean, I had no friends.” An exaggeration, she added. Still, Wichita had become haunted: “All the negative was always kind of hanging around. There were always those reminders.”
In early 2022, Lichtenfels bought a one-story former medical building half a mile from the historic center of Casper, where the towering lighted marquee on a 105-year-old ranch outfitters store stands across the street from a coffee bar with stickers on tables urging customers to “Read Banned Books.”
Burkhart named the clinic Wellspring Health Access, and planned to see the first patients in June of that year, just as the Supreme Court was expected to rule on Roe.
“I thought it was an interesting time to be starting a new abortion clinic,” she said.
Overturning Roe would throw the question of how to regulate abortion back to the states. Wyoming law allowed the procedure until viability — around 24 weeks of pregnancy — in line with the laws in some of the bluest states.
“My God, this is serious”
The COVID pandemic made Wyoming’s live-and-let-live spirit appealing to many conservatives, like Ward, who saw the state as a haven from masks and vaccine mandates. In the Legislature, which meets for only 20 or 40 days depending on the year, a rambunctious Freedom Caucus was growing in influence — its membership increased to 26 members in 2023 from five in 2017. And sessions once devoted to little more than passing a budget now broke out into arguments over bills sponsored by new members to prohibit teaching critical race theory and transgender girls from competing in girls’ athletic events.
In March 2022, the caucus led the push for the trigger law banning abortion. “I thought, ‘Well, we’ll just sue the state,’ ” Burkhart said.
Then in May of that year, three weeks after the leak revealing that the Supreme Court intended to overturn Roe, Burkhart’s contractor called to tell her that the clinic was on fire. Surveillance video showed a woman whose face was obscured by a hoodie and surgical mask breaking in and dousing the floors with a gasoline can.
Burkhart watched firefighters and police officers from the bed of a truck across the street later that morning: “I remember thinking, ‘My God, this is serious. You’re going to get yourself or someone else killed.’”
To her surprise, the staff she had hired agreed to stick with her. Her contractor, a Trump voter, put in extra hours to rebuild the clinic — although he declined to put his sign out front.
In July 2022, Burkhart, Lichtenfels and other abortion rights advocates in Wyoming sued to overturn the trigger ban, arguing, among other claims, that it violated the state constitutional right allowing adults to make their own health care decisions. A judge issued a temporary block on the law, saying that they were likely to succeed at trial.
The Legislature responded by passing a new law in March 2023 that amended the constitution to say that abortion is not health care — along with another explicitly banning medication abortion. Again, the judge blocked the laws from taking effect.
That month, police arrested a suspect in the arson, a college student who said she’d had nightmares about the clinic opening. And in April, Wellspring did open, nearly a year and $300,000 in repair costs later.
Burkhart was still facing familiar opposition. Casper’s mayor, Bruce Knell, responded to an article about the clinic’s plan to open by posting a GIF of a man dancing in flames, an image he said he intended to warn those who provide abortions that they must repent or face hellfire.
Anti-abortion activists turned out to City Council meetings in June and July and begged officials to shut down the clinic. They worried it was attracting what one described as “prostitutes, sex traffickers, child molesters, pedophiles” to Casper.
Ward, who was among them, blamed the state’s Republican governor “who is not really pro-life” for appointing a “radical judge” who “gave the middle finger to the Legislature and We the People” by putting the abortion ban on hold.
“It’s funny how the court protects the so-called medical freedom right of women to kill their babies but did not protect our rights when we were being force-vaccinated or losing our jobs during the scamdemic,” she told the council.
A crisis pregnancy center run by anti-abortion activists in Casper opened a second location two blocks from the Wellspring clinic, and sent “sidewalk advocates” to the alley behind it to try to steer women away, offering roses, gift bags and the promise of free ultrasounds.
It’s easier not to take the opposition personally now, Burkhart said, perhaps because she has chosen not to live in Casper. That choice, too, has its stresses: The drive to the clinic from her home in Colorado can take more than three hours, depending on how much she speeds.
She had intended to be at the clinic once a week, on the day it sees patients, so she could sit in on every consultation. The doctors who perform the abortions also travel in from out of state. But Burkhart complained of trouble finding nursing and administrative staff who were local, qualified and as committed as she was.
In the administrative office at Wellspring, she frowned over medical records, worrying that the staff didn’t fully appreciate that the state could come after her if the paperwork was not filled out properly. She moved a marker over a whiteboard, trying to clarify the flow of patients from the waiting room to treatment and the recovery room.
Staff members described it as mission work.
“God, just to help these girls through these awful moments, that’s why I’m a nurse,” said Brittany Brown. Brown grew up in what she called Bible Belt Kansas, but came to appreciate the struggles women can face after her husband left her a single mother. She sought the job after seeing an article about the clinic on Facebook; she was working in what she described as a corporate-owned clinic, burned out from COVID and seeking to “do something useful.”
Behind the heavy curtains that separate the recovery room, she and Burkhart checked on Jade, a 22-year-old college student who called the clinic “my saving grace.” She and her partner had driven four hours from their home in Montana; clinics closer to home were so busy, Jade said, that they either didn’t return her call or offered her an appointment two months out.
Her parents were immigrants who had her when they were teenagers, and she and her sisters grew up in and out of foster care. “I don’t ever want to put a human being through what I had to go through as a child,” she said.
Jade had arrived at the clinic 11 weeks pregnant, and left a couple of hours later with a hug from a nurse and a paper bag containing recovery instructions and birth control. On the bag a staff member had written, “Live life to the absolute fullest!”
“It was just too much”
Burkhart’s frustrations grew over the fall. As she waited for reimbursements to come in from insurance companies and abortion funds, she worried about budgets, and struggled to keep her staff. She let some people go, suspecting they were “antis.” Others quit, frustrated that Burkhart seemed disorganized and impossible to please.
In late September, she drove to Cheyenne to witness the sentencing of the 22-year-old woman who pleaded guilty to setting the clinic on fire. Burkhart said she wanted to show her gratitude to law enforcement. “In a lot of cases, folks aren’t caught,” she said.
“This is also for Dr. Tiller,” she added. “Nobody caught the bomber. Nobody caught the person who drilled a hole in the roof and flooded the clinic.”
But her visits to Wyoming became less regular. Just before Thanksgiving, staff members said, Burkhart erupted during a videoconference and threatened to quit.
In late January, she told the staff that she would step back from her role running the clinic, though she would continue to lead Wellspring’s board.
“This work is relentless, and I’m simply trying to find some balance in my life here,” Burkhart said in a phone interview. She said it was not the local opposition that wore her down. “The arson aside, it is not the most hostile area I have worked at in this country,” she said.
She is also a part owner of a clinic in Illinois, and hoping to open more, and characterized herself as “more of a startup person.”
“It was just too much,” she said. “What I love is building things. I love taking something from scratch and giving it life and watching our patients come through the doors.”
Lichtenfels, who recruited Burkhart, said there was no question the arson had taken a toll on her: having to make sure donors and staff members did not give up, all the while not knowing who had committed the crime or what else they might be planning.
“She knew what the risks were, especially given her experience with Dr. Tiller’s murder,” Lichtenfels said. “Regardless, it’s emotionally and physically draining when it happens.”
Brown, the nurse, will run the clinic in Casper, overseen by a new executive director who lives in Arkansas, a former colleague of Burkhart’s from Trust Women in Wichita. Burkhart said she felt confident in the clinic’s future under them: “We didn’t work this hard to watch things fall apart.”
Demand seems to be increasing: The medication abortion clinic in Jackson closed in December, blaming high rent and other costs. That leaves Wellspring as the only abortion clinic in the state, and with a big hole to fill: Data from the Wyoming department of health shows that the number of abortions in the state doubled between 2021 and 2022.
Burkhart’s clinic remains a plaintiff in the lawsuits challenging Wyoming’s abortion law. A trial is set for April, but both the state and the abortion rights providers appeared in court in December to argue for a quicker judgment. The judge could rule any day.
This article originally appeared in The New York Times.
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