When Dr. Mila Means decided to begin offering abortions at her family practice in Wichita, Kansas -- the city where George Tiller practiced before he was murdered in 2009 by an anti-abortion crusader -- the clinic's landlord balked. Citing "a disruption and nuisance to other tenants and [the creation of] an unsafe environment," the company that owned the building brought a lawsuit against Means, seeking a temporary injunction to prohibit her from performing abortions. Dr. Means gave in and promised not to perform abortions.
There's no doubt that angry mobs and threats of violence make providing abortions a trying and often dangerous occupation. But angry citizens -- perhaps the most visible anti-abortion advocates -- aren't the only people making it difficult. The right-wing establishment intent on reining in women's constitutional right to reproductive health services extends far up the ranks of high-level public officials.
That's certainly true in Kansas. From 2003 to 2009, Phillip Kline, a former Kansas attorney general who later served as district attorney for Johnson County, carried out a long and dishonest inquisition into both a Planned Parenthood clinic and the late Dr. Tiller's abortion clinic. This week, the Kansas Board for Discipline of Attorneys held an ethics hearing to determine if Kline should be censured and disbarred for his egregious conduct as attorney general.
Kline's investigation, begun a few months after he became attorney general, was a crusade against abortion providers from the start. According to the complaint brought by the state's disciplinary office, Kline and his deputy attorneys had no evidence to go after either clinic, so they framed their investigation as a general inquiry into child abuse in order to get at the clinics. The attorney general knew he was on shaky ground: An internal office memo in 2003 conceded that "there potentially exists a legal obstacle to initiating a Judicial Inquisition due to the absence of a definite complaint or allegation that a medical provider knowingly failed to report a specific incident of sexual abuse." Kline used this pretense to obtain personal and confidential reports of child sexual abuse from two government departments.
But the worst allegations against Kline concern his attempts to discover the identities of women who obtained abortions at the clinics. Kline subpoenaed and received patient records from Dr. Tiller and the Planned Parenthood clinic. His office next subpoenaed the records of a hotel where many of Tiller's patients used to stay and compared those records to the reports obtained from the state's Health Department. While the state records were redacted so that the patients' names were protected, Kline's office was able to determine patient identities and names by comparing the two lists. The office identified 221 women (including adults who had accompanied children to the clinic) who had potentially visited Tiller's clinic. In addition, his office staked out Tiller's clinic, copying down the license plate numbers of workers and patients.
Kline was strangely obsessed with getting women's names and was shockingly cavalier with it. During this investigation, the records -- including women's names, phone numbers, addresses -- were often left in unprotected places; for example, for 40 days records were left sitting in an attorney's dining room in a Rubbermaid container, a move the Kansas Supreme Court later called "nothing short of grossly incompetent."
Of course, incompetence has little to do with it. The complaint against Kline details not a series of mistakes but instead a web of schemes, lies, and a total disregard for women's right to privacy. Kline, who ran for attorney general promising "to interpret the laws regulating abortion more strictly," went after abortion providers by any means possible. "It is plain that he is interested in the pursuit of justice only as he chooses to define it," the Kansas Supreme Court noted in reviewing Kline's conduct. Kline's hearing is expected to end next week, at which point the state Supreme Court will decide how to censure him if found guilty.
"Kline's actions are an anomaly in the sense that they are extreme," says Carole Joffe of the University of California, San Francisco's Bixby Center for Global Reproductive Health. "At the same time, you could say he's at the end of a spectrum."
Even without a hard-charging attorney general, state legislatures can disrupt clinics' ability to operate by increasing the number of regulatory hoops they have to go through. Next door to Kansas, in Nebraska, the legislature targeted Dr. LeRoy Carhart, another provider of late-term abortions. More subtle than Kline, Nebraska politicians outlawed abortion after 20 weeks on the scientifically dubious premise of "fetal pain." Carhart, who had endured harassment and threats for decades, no longer offers abortions past 20 weeks in Nebraska. In other states, providers were so fed up they tried to take matters into their own hands. The late Robin Rothrock, who ran an abortion clinic in Shreveport, Louisiana, sued the state some 30 times for "its capricious abortion regulations." At one point, the state passed a law allowing it to shut down any abortion clinic without prior warning and then promptly shut down Rothrock's. With the help of the pro-bono lawyers at the Center for Reproductive Rights, they managed to reopen it.
"Legislatures can really put people out of business," says Joffe. Just this week, the Virginia Legislature passed a bill that would require all abortion clinics to meet the same standards, including layout, equipment, and staffing requirements , as hospitals -- an impossibly high standard for small clinics to comply with. It was based on the recommendation of another star Republican attorney general, Ken Cuccinelli. "This is a bill meant to put people out of business, Joffe says. "These [types] of regulations are incredibly damaging."
Protests and harassment at abortion clinics have risen in recent years -- today 89 percent of large providers report some form of harassment. But so too has an unprecedented number of laws, regulations, and court cases meant to limit abortions and shut down the clinics that provide them. Since the murder of Tiller in May 2009, Wichita is still without an abortion provider. Dr. Means is still looking for a space where she can provide them. The protesters are her first obstacle, but with a Republican legislature and fiercely anti-abortion governor, Means can expect a host of laws and regulations to also stand in her way.