Dr. Betsy Wickstrom, a high-risk obstetrician in the Kansas City metro area, has been a lifelong Republican. However, she became an outspoken advocate for Missouri’s Amendment 3, which lifted the state’s near-total abortion ban.
Wickstrom, who was once opposed to abortion, now understands where many who oppose it are coming from. She herself was once a part of that camp.
A Kansas City OB-GYN specializing in high-risk pregnancies, Wickstrom is both a Republican and a Christian. Yet, after over 30 years in maternal-fetal medicine, she shifted from supporting the “pro-life” movement to advocating for abortion rights. Her stance has only been solidified by her experiences practicing under Missouri’s abortion ban over the past two and a half years.
Wickstrom’s job has always been filled with both joyous and heartbreaking moments as she helps families through complex diagnoses. But now, when an expectant mother faces a nonviable pregnancy, new barriers to care can cause delays. In some cases, she is forced to send her patients to Kansas, where there is no abortion ban, and hospitals are more willing to perform second-trimester abortions. This led her to support Missouri’s abortion-rights amendment, which voters passed last month, effectively undoing the state’s near-total ban.
“The best possible outcome is that we will once again be able to care for people in the most compassionate way,” she said.
However, Wickstrom’s optimism is tempered by concerns over the future. Some state lawmakers are already aiming to overturn parts of Amendment 3, and the looming threat of a national abortion ban, should Republicans gain control of Congress and the White House, weighs heavily on her.
As she waits for guidance from Missouri hospitals on how to proceed after the amendment goes into effect on Dec. 5, Wickstrom remains cautious.
“Missourians want choice. They want personal freedoms, and they don’t want their civil rights restricted, and that gives me hope for the future,” Wickstrom said. “But I know we’re not even close to done yet.”
A Republican in the Abortion-Rights Movement
Wickstrom did not become “liberalized” while attending the University of Nebraska Omaha. When she began her medical residency in Missouri, she believed that the only “God-honoring and American patriotic” stance was to protect the fetus at all costs.
Although she voted for President Barack Obama because of her support for the Affordable Care Act, which she saw as essential for helping uninsured patients access prenatal care, Wickstrom still considers herself an Eisenhower Republican—focused on balancing fiscal responsibility with providing a basic safety net. But when it comes to abortion, she believes that choice is the only option.
In the early 1990s, shortly after completing her fellowship and entering medical practice, Wickstrom had to perform an abortion for a woman diagnosed with a partial molar pregnancy—a condition that is both nonviable and life-threatening. The patient was 15 weeks pregnant and severely ill. Although abortion was legal and Wickstrom would typically refer such cases to abortion clinics, this was an emergency. She performed a dilation and evacuation procedure, a second-trimester abortion, saving the woman’s life.
Over three decades in obstetrics, Wickstrom has seen countless patient stories that have shaped her views. One patient diagnosed with brain cancer at 14 weeks chose to terminate the pregnancy, while another, whose fetus had a serious brain abnormality, chose to continue the pregnancy to meet her child before their inevitable death. For Wickstrom, both decisions honored life. What mattered most, she said, was that the families had the ability to choose.
That choice became more complicated on June 24, 2022, when the U.S. Supreme Court overturned the constitutional right to an abortion, and Missouri became the first state to enact a trigger law banning the procedure except in medical emergencies.
Care Delayed and Care Denied
Wickstrom had just started a new position at a Kansas City-area hospital when the Supreme Court’s decision was announced.
“At 4 p.m. on June 24, 2022,” she recalled, “we were receiving emails from our hospital attorneys saying: ‘You cannot offer abortion. You cannot refer for abortion out of our hospital because we’re not going to take on that liability and responsibility.’”
She was instructed to email the hospital’s legal team if she had concerns about a pregnancy that could not continue. In urgent cases, a 24/7 legal hotline was available for guidance.
Since then, Wickstrom has encountered numerous obstacles in providing timely care. For example, when she diagnoses an ectopic pregnancy, a large red banner appears on her screen asking if she’s sure about the diagnosis. If the embryo or fetus has a heartbeat, she must consult an attorney. In critical cases, she sometimes has to refer patients to Kansas.
This is one example of “care delayed and care denied,” a reality Wickstrom says she’s faced since abortion became illegal in Missouri.
Some physicians across the state claim the abortion ban hasn’t changed their approach to treating nonviable pregnancies or miscarriages. Wickstrom believes that’s likely because many obstetricians can perform a dilation and curettage procedure for first-trimester miscarriages. However, more complex cases requiring second-trimester abortions are often referred to specialists like her—and now, she is prohibited from handling those cases.
When women arrive with ruptured membranes in the second trimester, months before their water should break, she must send them to Kansas for treatment.
“Bleeding, infection, labor—all of these things can happen with or without that heartbeat stopping inside the womb,” Wickstrom explained. “The answer is to stop the pregnancy and empty the uterus. You have to care for this woman, or she could die, potentially leaving her other children without a mother.”
Although she can still discuss evidence-based care with patients, once she mentions “termination,” she is required to hand them Missouri’s 23-page informed consent booklet, which begins with the statement, “The life of each human being begins at conception,” a claim Wickstrom finds medically inaccurate.
Dr. Betsy Wickstrom, who has worked tirelessly in the abortion-rights movement, now carries a water bottle with a Taylor Swift sticker and a list of national abortion hotlines, showing the words she feels she can no longer speak openly.
A few weeks ago, she added another tattoo to her forearm—three words that have been her mantra for over a decade: “Listen to women.” These words remain central to her work as she witnesses rising maternal mortality rates, hears the stories of women whose pain is ignored, and watches as abortion access continues to diminish.
“Listen to women.”
