Kansas navigates post-Dobbs world with state abortion restrictions in limbo

Johnson County District Court Judge Christopher Jayaram listens to closing arguments on Oct. 17, 2025, in a courtroom in Olathe, Kansas, as proceedings in a consequential abortion trial challenging state restrictions came to a close. (Photo by Anna Kaminski/Kansas Reflector)

OLATHE — The Kansas abortion trial with wide-reaching implications for state lawmakers and health care providers wrapped Friday with arguments over the two sides’ differing definitions of pain, humanity and consciousness.

“These are not easy issues,” Judge Christopher Jayaram said at the close of the day’s proceedings.

“I take this responsibility with understanding the gravity to which I am charged,” he said.

His comments were preceded by seven days of testimony from ethicists, doctors, researchers, people who have received abortions, an animal biologist and a neonatologist as each side of the case denounced or defended state abortion restrictions.

The rules date to 1997, when Kansas legislators passed the Women’s Right to Know Act with the stated motivation of fully informing women of the risks of abortion by mandating providers comply with a list of requirements, including a 24-hour waiting period to complete consent forms, specific typefaces and page colors for paperwork, large display signs in private offices with state-approved language, informing patients a fetus at 20 weeks can feel pain, which is disputed, and a 30-minute wait between first meeting with a physician and undergoing an abortion.

Providers and advocates argue that the law stigmatizes abortions and interferes with their ability to provide them. The case also includes more recent laws, House Bill 2749 from 2024 and House Bill 2264 from 2023, that never went into effect because a judge blocked them as part of the pending lawsuit. Sometimes called the reasons mandate, the 2024 law required providers to give patients the opportunity to select from a list of reasons for obtaining their abortion and report that data to the state. The 2023 law required doctors to tell patients their abortions were reversible, which has not been conclusively proven by science.

The defendants and plaintiffs represented the most prominent sides of a long-running national dispute, a confrontation brought into focus by the U.S. Supreme Court’s 2022 Dobbs decision eliminating the constitutional right to an abortion. Abortion in Kansas is allowed up to 22 weeks of gestation, and Kansas has some of the most permissive abortion policies among red states, in large part, due to the August 2022 statewide vote that affirmed abortion as a state constitutional right.

Farr Curlin, a professor at Duke University and a medical ethicist, testified on Oct. 16 for the state.

“Physicians are, like the public, divided about abortion,” Curlin said.

What has made abortion so controversial is the “arbitrary hostility toward one class of human beings,” he said, referring to fetuses. He argued the state’s laws advance an ethical interest in preserving the rights and life of a fetus while increasing oversight of abortion providers. He does not support abortion in most instances.

Curlin said that the scientific community doesn’t agree on when human life begins.

The state presented witnesses who supported its language classifying fetuses as “living, separate, whole and unique human beings” based on their clinical practices, research or other studies. Abortion providers and experts for the plaintiffs rebutted that language.

Experts and doctors also disputed claims regarding fetal pain and abortion pill reversal.

Steven Ralston, an OB-GYN and the director for maternal fetal medicine at George Washington University, testified that a difference exists between pain and reflex.

“Pain is an emotional response to some kind of unpleasant sensation,” he said.

He and other witnesses fielded questions about nociception, the body’s physiological response to stimuli that could cause tissue damage. Pain is the resulting subjective experience. The American College of Obstetricians and Gynecologists says science conclusively establishes that fetuses cannot experience pain until after 24-25 weeks. Nociception develops earlier, beginning at around 7 weeks. The state’s attorneys and witnesses used nociception as proof of fetal pain before 25 weeks. But the scientific community is not in agreement.

“It’s not an emotional response to what’s happening,” Ralston said. “It’s a reflexive response to what’s happening.”

Research into “abortion pill reversal,” which involves ingesting progesterone after taking mifepristone in an attempt to continue the pregnancy, is underdeveloped. In small studies, taking mifepristone alone, without the follow-up of misoprostol, the second step in a medication abortion, can prove dangerous.

Selina Sandoval, an OB-GYN for Planned Parenthood in Kansas, said in an Oct. 16 interview following brief testimony that the state mandating abortion providers to inform patients about abortion pill reversal requires doctors “to give misinformation” to patients. It’s not something she said she feels comfortable telling patients is an option, she said.

Being a part of the case was important to Sandoval. She said she has noticed how care has improved since the state’s restrictions were enjoined.

“I’ve personally seen the harms that the Women’s Right to Know Act has caused my patients,” she said.

A patient once told her she took buses for 19 hours to get to a Kansas clinic from Texas, she said. Affordability, work, child care and travel considerations all factor into the decision to get an abortion, Sandoval said. She called the state’s restrictions discriminatory.

“No other area of health care is under this amount of scrutiny,” Sandoval said.

 

An enormous case

Brittany Jones, the president of conservative Christian group Kansas Family Voice, sat in on much of the trial. She said in an interview it was one of the most unusual trials she has seen.

Jones took issue with the way the judge defined facets of evidence or objections in the case. The witness proceedings involved numerous objections from both sides that evoked differing reactions from the judge.

“From that standpoint, I mean, the judge appeared — I’m not going to assume anything — but he appeared very biased,” she said. “And appeared to be making rulings that were very biased and not based on the law. They were based on his opinions about abortion as a whole.”

The case at hand is a big one, Jones said.

“It started out as a big case when it included our entire informed consent law going back to 1997, that’s never been challenged, that has helped so many women in Kansas,” she said.

As the judge added more laws to the case, it grew in size and magnitude.

“We really don’t have a great idea of what strict scrutiny looks like in Kansas, how it’s applied in these cases, and so it has huge implications for how the Legislature can go about protecting women and life in the state,” Jones said.

She said Kansas has always been a leader, often at the center of the national conversation on abortion. It is one of the first states to try to figure out how to operate in the post-Dobbs era, she said.

Lynnette Ranney ran the front desk from 2018 to 2023 at the private Overland Park clinic that is a plaintiff in the suit. That was before and after Dobbs, but before Kansas’ restrictions were blocked. She was in charge of ensuring patients had filled out the correct paperwork and that they met all the state requirements. She described in court the anger, frustration and eye rolls from patients toward the state’s long list of requirements.

If patients brought in the required forms in the wrong color or the wrong forms altogether, the 24-hour waiting period would begin again.

“We would have to turn the patient away,” Ranney said. “We would print off new ones, give them their 24-hour timeframe, and try to reschedule them.”

One patient broke a door at the clinic after being turned away for blurry paperwork, Ranney testified

These issues arose at least 10 times a week, she estimated. She said she spent at least seven hours each workday on paperwork. In Ranney’s current role at a skin cancer center, she said, she spends about five minutes on similar tasks.

Once the paperwork and the 24-hour wait were completed, patients then waited an additional 30 minutes from the time they first saw their provider before they could proceed with an abortion. The clinic would set kitchen timers, Ranney said.

Ranney described to the court a patient who traveled to Kansas from Texas. She was seeking an abortion after being subject to sexual assault. When she showed up for the appointment, she brought the wrong consent forms, Ranney said. By the time the clinic could reschedule her appointment, she was too far along in her pregnancy to be seen, she said.

“It was devastating,” Ranney said. “It was so hard to be the person that says, ‘Hey, I know you’ve got a lot going on, but, sorry, we can’t help you.’”

 

National interest

A handful of national groups are involved in the case. On the plaintiff’s side, the Planned Parenthood Federation of America and the Center for Reproductive Rights argued on behalf of Traci Lynn Nauser, a Kansas OB-GYN, her clinic, and Comprehensive Health of Planned Parenthood Great Plains. On the state’s side, the conservative Christian advocacy firm Alliance Defending Freedom and Colorado-based firm First and Fourteenth.

Allison Pope, an attorney for the alliance and a native Kansan, said in a September press release that the state’s restrictions help women be fully informed about their pregnancies before choosing to get an abortion.

“Informed consent laws make this possible and reflect the longstanding will of the people of Kansas, but Planned Parenthood has made it clear that its goal is to withhold critical information from women,” she said.

Kansas Attorney General Kris Kobach, who is a defendant in the case, said in the alliance’s press release that the state restrictions provide the “best possible care” for Kansas women and children.

“Planned Parenthood has always cared more about its bottom line than women’s health and is actively working to hide important health information from women that could be a matter of life or death,” he said. “We are urging the court to uphold this commonsense protection that prioritizes the lives of women and their children in Kansas.”

Planned Parenthood and other medical organizations across the country have long recognized abortion as reproductive health care.

Both sides of the case rested on Friday, and a decision from Jayaram is pending.