Opening an abortion clinic in the United States is never easy, and it's especially difficult in a state hostile to abortion rights. That's one of the reasons no one has attempted to open a clinic in Oklahoma since 1974 — at least, not until now. With the state down to just two clinics since the closure of Outpatient Services for Women in December 2014, Julie Burkhart decided to bring back abortion services to Oklahoma City, the largest metropolitan area in the country without a provider.
Just a month from opening her doors, Burkhart, CEO of Trust Women and owner of South Wind Women's Center in Wichita, Kansas (which faced its own contentious opening in 2013), now finds herself facing a state legislature that's not only anti-choice, but just approved a radical, headline-grabbing bill that would make the act of performing an abortion a felony.
Burkhart tells Rolling Stone about the challenges facing her and the doctors who've signed up to work at her clinic in Oklahoma, the barriers already in place for abortion providers, and how the 2016 election could change everything for abortion rights.
Why did you decide Oklahoma City would be your next site for opening a clinic?
It seemed like a natural progression — being in a neighboring state [to Kansas], the fact that Oklahoma has similar laws as those in Kansas, that it's a state where access is limited for people. After the physician in Oklahoma City went out of business, I felt like it was even more important. If you want abortion care in Oklahoma, currently you have to go to Tulsa or Norman. Our clinic will go further in terms of gestational limit, and it will be one more site for people to go to.
This will be the first clinic to open in Oklahoma in over 40 years. Why are there so few clinics in the state?
I think it's the fact that the laws are so restrictive. There's great stigma regarding abortion. It's a challenging environment. If you are a family physician or OB-GYN practicing in the state and you want to venture into abortion care, you are likely to find yourself ostracized from your medical community. People want to fit in and be accepted in their communities.
How long has the process taken?
From the time I started looking for a building until now, it's been a solid 24 or 25 months. We had to find a building, find a place that was suitable for a clinic. The financing was difficult. It was incredibly challenging finding a bank that would work with us. Here in Wichita, we paid cash for everything. It took me 18, 19 months to find a lender for the Oklahoma clinic. That set us back. After we closed on the mortgage and we submitted the initial application and revisions on that application for our license to the Oklahoma Department of Health, it kept denying us. I think it was a mixture of people not understanding or knowing exactly what to do — because no provider of abortion had wanted to open a clinic since the Seventies — and I think we had some obstructionists in the Department of Health who thought maybe we would just go away. So that took a period of time to get the green light to start construction. We are at least a year off-schedule. At this point the architect is still telling me that we should be able to move into the building on June 20th.
You have physicians already lined up for the new clinic. What does a physician have to do in order to provide abortion services in the state?
If you are an M.D., an allopathic physician, there is one application. If you are a D.O. [osteopathic physician], there is a different type of application. I can say that the application for D.O.s is more burdensome than the application for allopathic physicians, so there's that. Once the application is submitted for both, typically the board has 30 days to meet and say, “Yes, you can have your license” or not. We do have some of our doctors lined up who already have their licenses. We have other doctors who are still in the process of getting their license.
So with doctors still trying to obtain their licenses, this new bill that prohibits issuing or renewing licenses to doctors who perform abortions, and makes performing an abortion a felony, will affect you immediately. How do you recruit doctors to perform abortions in that type of environment?
It is something that we have been discussing internally. We are waiting to see what Gov. [Mary] Fallin does. She hasn't vetoed any anti-choice legislation that I know of. Even if she did veto it, the legislature can easily override it, so I don't see how it doesn't go into law. But our approach is to wait and see where this goes. If it does pass, we will start to put together our strategy. We might litigate, we might not. These are talks that we have to have internally and then with other people in the state of Oklahoma that care about this issue. It's a matter of assuring our doctors that we are going to do everything in our power. They have good hearts. They believe in equality and justice. So they are going to continue to practice for as long as they can.
This felony law essentially makes Oklahoma the most hostile state in the nation to abortion providers. It paints doctors who offer abortion services as corrupt or unscrupulous physicians. How does this affect patients seeking out abortions?
It might drive patients to physicians who aren't qualified to provide abortion care. People might think that abortion is illegal. In the end it becomes detrimental to women and their families because it paints them into a corner by ostracizing the physicians who would be helping them.
One thing we see here [in Wichita] all the time is people walk in the doors and say, “Oh, this is a nice facility,” or “Oh, this facility is clean.” I feel a number of women fully intend to walk into the doors of a clinic that is substandard in order to [get an abortion]. Women will also say to us, “Will it hurt when you cut me?” They think all of these horrible things are going to happen to them during the procedure. It says to me that women are willing to put themselves in harm's way in order to have an abortion and not be pregnant. That's why those of us who do provide high-quality care think it's important to fight this aura of inferring that doctors should be thrown into jail because they do provide abortion care, or that because they are providing care they must be horrible doctors.
A few months ago, Donald Trump said women should be punished for having abortions, then backtracked and said he didn't mean the women should be jailed, but that the doctors should. This Oklahoma bill is essentially that statement made into law. How do you see the 2016 election affecting the landscape for abortion providers?
This is an incredibly important election cycle. One thing that gives me some comfort having Donald Trump as a candidate is that as I understand it, based on his polling numbers, he has lost women, and it doesn't appear that women will be coming back to the Republican ticket to vote for him. I think that bodes well for whoever our Democratic candidate is going to be.
When he came out and said that, I thought, Well, that is what the anti-choice folks really believe. They're just afraid to say it. And he said it. Because by outlawing physicians from providing abortions, ultimately who does it hurt? It just hurts the women who need abortions. I felt like it was a breath of fresh air that he would say, “It is about the women. I want them punished.”
So do you think abortion rights altogether are on the line in this election?
I do. The composition of the Supreme Court is not one that I think a number of us feel comfortable with. Whoever is president is going to have an opportunity to appoint a new justice or justices, and it's incredibly frightening to think of what could happen in this country if we don't maintain the right to abortion care.
This interview has been edited for length and clarity.