By Kate Zernike, The New York Times
CASPER, Wyo. — In 2020, a philanthropist emailed Julie Burkhart asking if she would open an abortion clinic in Wyoming, a conservative state that strongly supported Donald Trump.
More than ten years earlier, after an anti-abortion extremist killed her mentor George Tiller, who ran one of the nation’s few late-term abortion clinics in Wichita, Kansas, Burkhart had the same idea.
Tiller’s clinic had been targeted by anti-abortion groups, and after his death, the threats shifted to Burkhart, also known as Julie Darkheart.
Running a clinic in a conservative state had taken a toll on her, and she wanted to leave Wichita behind. Wyoming was even more conservative than Kansas, but she recognized that its conservatism was different, with less interest in regulating private matters.
She agreed to the proposal.
However, three months before the planned opening of her clinic in 2022, the Wyoming Legislature passed a trigger law, joining other states in banning abortion if the U.S. Supreme Court overturned Roe v. Wade.
Despite the court ruling, instead of moving her clinic to a safe state with no ban, Burkhart pressed on in Wyoming, becoming the only person to open an abortion clinic in a state that bans abortion.
She expressed her opposition to only placing facilities in safe states, believing that preserving rights requires confronting uncomfortable situations and not conceding certain areas.
In contrast to facing opposition in a state that supported Trump, she encountered the complex politics of abortion post-Roe.
Despite its unique characteristics, Wyoming's recent politics are similar to other red and purple states. Republicans are divided between those pushing for bans on books and abortion and those defending the state's more libertarian conservatism.
As the residents saw the consequences of the abortion ban, they realized that their views on the issue were more complex than they previously thought, believing that it should not be the government's decision.
Ogden Driskill, the president of the state Senate, said that when it comes to very personal and health issues, people will do what they believe is right, even if it's against the law.
Driskill, a rancher near Devil’s Tower, describes himself as pro-life but opposes banning abortion. He defends his use of ivermectin to try to fend off COVID, despite warnings that it is ineffective and unsafe. He believes most Wyomingites are like him.
Driskill questioned the level of being pro-life and mentioned that most people are willing to listen to the reason for abortion if it's not being used as a form of birth control.
Jeanette Ward, a state representative, argued that Wyoming is still overwhelmingly pro-life and mentioned moving to Casper to escape mask mandates in Illinois during the pandemic.
Ward added that although a loud minority would like to imply otherwise, the Legislature overwhelmingly passed the abortion ban, and the governor signed it.
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, and she believes it's a way to keep the conversation about abortion rights alive.
Burkhart believes challenging these laws is essential for making change, even if the clinic can only stay open for a limited time, as it's important to help as many people as possible in the meantime.
The summers of mercy
Despite experiencing numerous challenges, Burkhart does not come across as a firebrand. She speaks calmly while listing the horrors that have shaped her career. She brushes off talk of the risks of her work almost passively, saying it's what she has chosen to do with her life. Doctor Tiller.
Burkhart was influenced by one of the defining events of the nation’s long fight over abortion while in Wichita.
Growing up in Wichita and working at the Wichita Women’s Center during the Summer of Mercy shaped Burkhart.
During the Summer of Mercy in 1991, anti-abortion demonstrators descended on Wichita and blockaded the city’s three clinics for six weeks.
Burkhart witnessed numerous protests and demonstrations at the clinic where she worked during the Summer of Mercy.
Wichita had become the main battleground for abortion in the country, and it deeply affected her. She said she saw a lot of arrogance, violence, intimidation, and disrespect towards the women coming to the clinic. She questioned how one could claim to love and care for someone while also spreading hate.
The protesters selected Wichita because they wanted to close down Tiller’s clinic, which was in a different part of town. Burkhart did not meet him until 10 years later. In the meantime, she went back to school in Seattle and planned to attend medical school, but changed her mind after her stepsister was found murdered a week before the entrance exams. She worked on political campaigns, but when her partner left her while she was pregnant, she moved back home with her baby daughter.
She took on a role as community affairs director at a Planned Parenthood clinic. In 2001, when anti-abortion protesters returned to Wichita for what they called the 10th anniversary revival of the Summer of Mercy, she met Tiller in meetings about security. Within months, he urged her to work for him and start a new political action committee.
Tiller, a long-time Republican and former Navy flight surgeon, took over his father’s primary care practice in the early 1970s. 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.
At first, Burkhart said, “He really scared me,” with his defiant attitude in the face of death threats. She felt he had a dry sense of humor that some people misunderstood as being abrupt. But they had a deep connection, she said. She didn’t mind that he called her at 1 in the morning, as she was also up working.
“He truly understood, and I understood, that this work is risky, and you have to be bold, think outside the box, and sometimes make difficult decisions.”
Over the next eight years, she became the public spokesperson for his clinic in state politics. She admired his approach to the Legislature, as he resisted efforts to enact even seemingly harmless regulations on abortion providers, such as requiring that their procedure rooms be larger than those in other surgical practices, 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 strong dedication. “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 mostly remembers feeling angry. 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 hesitant to speak up for him or for 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?’
One month later, in a disorganized and impulsive way driven more by sorrow than politeness, she visited Tiller’s widow and, with a PowerPoint presentation, asked for her approval to reopen the clinic. In 2013, she did so and named it "Trust Women", after a slogan Tiller wore on a political button.
Groups against abortion put in a lot of effort to discourage her. They distributed flyers in her neighborhood with a wanted-style poster that included her home address, and urged opponents of abortion to "bring her home to Jesus." A protester, a pastor, stood outside her house with a sign asking, "Where is your church?" which she interpreted as a hint that anti-abortion activists intended to kill her in the same way they had Tiller.
In a recorded phone call from prison in 2013, Tiller’s killer speculated 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.
However, Trust Women was successful enough that she opened another location in Oklahoma in 2016 — 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 assists women seeking abortions. There was only one clinic in the state, providing 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 establishing 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 called 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 decisively rejected a ballot measure in 1994 that would have banned abortion by establishing fetal personhood. Its long libertarian tradition was formalized 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 interesting 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 researched 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."
Throughout the country, state legislatures had shifted to Republican control in 2010 and proceeded to set new records for the number of laws restricting abortion. Wyoming only passed one, which required women seeking abortion to get ultrasounds, but this was not very important.
It was time for Burkhart to leave Kansas. A younger group of activists was urging abortion rights groups to think more broadly about reproductive justice. This idea had been developed by Black women in the South, and Trust Women, along with national reproductive rights groups, embraced new leadership that reflected the diversity of this new movement. Burkhart clashed with some staff members, who felt that she had become too controlling and insistent on doing things her own way while in her position.
“I honestly feel like I stayed too long,” she said. “I mean, I had no friends.” She added that this was an exaggeration. Nonetheless, Wichita had become filled with negative feelings: “All the negative was always kind of hanging around. There were always those reminders.”
In early 2022, Lichtenfels purchased a one-story former medical building located 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 decided to call 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.
If Roe were to be overturned, the decision of how to regulate abortion would go back to the states. Wyoming law allowed the procedure until viability — around 24 weeks of pregnancy — which is similar to the laws in some of the most liberal states.
“My God, this is serious”
The COVID pandemic made Wyoming’s live-and-let-live attitude appealing to many conservatives, like Ward, who saw the state as a refuge from masks and vaccine mandates. In the Legislature, which meets for only 20 or 40 days depending on the year, a rowdy Freedom Caucus was gaining influence — its membership increased to 26 members in 2023 from five in 2017. And sessions once devoted mainly to passing a budget now turned into debates over bills sponsored by new members to ban teaching critical race theory and transgender girls from participating in girls’ athletic events.
In March 2022, the caucus led the effort to pass a 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 inform 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 observed 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.’”
Surprisingly, the employees she had hired agreed to stay with her. Her contractor, a Trump supporter, worked extra hours to rebuild the clinic — although he refused to display his sign out front.
In July 2022, Burkhart, Lichtenfels and other supporters of abortion rights in Wyoming filed a lawsuit to overturn the trigger ban, arguing, among other things, that it violated the state constitutional right allowing adults to make their own health care decisions. A judge temporarily stopped the law, saying they were likely to succeed at trial.
The Legislature responded by passing a new law in March 2023 that amended the constitution to state that abortion is not health care — along with another law explicitly banning medication abortion. Again, the judge prevented the laws from taking effect.
During that month, police arrested a suspect in the arson, a college student who said she 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.
Opponents of abortion turned out to City Council meetings in June and July and urged officials to close 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 terminate their pregnancies 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 opponents of abortion 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 planned 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.
Employees said it was like doing important work for a cause.
“My passion for being a nurse comes from helping these young women during difficult times,” said Brittany Brown. Brown, who grew up in a conservative Christian area, gained an understanding of the challenges women face after becoming a single mother. She found out about the clinic on Facebook while working at a corporate-owned clinic exhausted from the COVID situation and wanting to do something meaningful.
In a secluded room, she and Burkhart checked on Jade, a college student who called the clinic her lifeline. Jade and her partner had traveled four hours from their home in Montana because the nearby clinics were too busy to help her in a reasonable time.
Her parents were young immigrants, and she and her sisters had a tough childhood in and out of foster care. “I don’t want anyone to go through what I did as a child,” she said.
Jade arrived at the clinic 11 weeks pregnant and left a few hours later with recovery instructions and birth control. A staff member wrote “Live life to the absolute fullest!” on the bag she received.
“It was overwhelming”
Burkhart became more frustrated during the fall. Waiting for reimbursements from insurance companies and abortion funds, worrying about budgets, and struggling to retain her staff were all challenging. She suspected some of her employees were against her and had to let some go. Others quit because they found Burkhart disorganized and hard to please.
At the end of September, she traveled to Cheyenne to witness the sentencing of a 22-year-old woman who admitted to setting the clinic on fire. Burkhart wanted to express gratitude to law enforcement. “In many cases, the culprits aren’t caught,” she said.
“This is also for Dr. Tiller,” she added. “Nobody was caught for the bombing or for drilling a hole in the roof and flooding the clinic.”
However, her visits to Wyoming became less frequent. Shortly before Thanksgiving, staff members said, Burkhart exploded during a videoconference and threatened to resign.
At the end of January, she informed the staff that she would step back from running the clinic, but would remain the head of Wellspring’s board.
“This work is never-ending, and I’m just trying to find some balance in my life,” Burkhart said in a phone interview. She clarified that it was not the local opposition that wore her down. “Aside from the arson, it’s not the most hostile area I’ve worked in in this country,” she said.
She is also a part owner of a clinic in Illinois and hopes to open more, describing herself as “someone who enjoys starting new ventures.”
“It was overwhelming,” she said. “I love creating things. I enjoy building something from scratch and seeing our patients come through the doors.”
Lichtenfels, who recruited Burkhart, said there was no doubt that the arson had taken a toll on her: having to ensure donors and staff members didn’t give up, all the while not knowing who had committed the crime or what else they might be planning.
Lichtenfels said that the person was aware of the dangers, especially considering their past experience with Dr. Tiller’s killing. Nevertheless, it is exhausting both emotionally and physically when it happens.
Brown, the nurse, will manage the clinic in Casper, supervised by a new executive director who resides in Arkansas and was a former coworker of Burkhart's from Trust Women in Wichita. Burkhart expressed confidence in the clinic's future under their management, stating, “We didn’t work this hard to watch things fall apart.”
There is a growing demand: The medication abortion clinic in Jackson shut down in December, citing high rent and other expenses. This leaves Wellspring as the state's sole abortion clinic, with a significant gap to fill: Data from the Wyoming department of health indicates that the number of abortions in the state doubled between 2021 and 2022.
Burkhart’s clinic continues to be involved in the legal battles challenging Wyoming’s abortion law. A trial is scheduled for April, but both the state and the abortion rights providers appeared in court in December to argue for a faster judgment. The judge could make a ruling at any time.
This article was first published in The New York Times.
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