TOPEKA, Kan. -- Opponents who have chipped away at abortion with state-level restrictions are facing a dilemma in some of the places where they have been most successful: Do they continue with that approach or seek more dramatic policies that risk court rulings that could undo previous gains?
For the last several decades, anti-abortion groups have focused on putting relatively small limits on the procedure state by state, especially in conservative places with Republican-dominated legislatures. Those efforts intensified in 2011 after the GOP made major election gains in state capitols across the country.
But as groups on both sides of the debate mark Wednesday's anniversary of the 1973 Supreme Court decision that legalized abortion, anti-abortion majorities in the GOP-controlled Kansas Legislature and elsewhere are under pressure to take bigger, broader steps.
"That debate is nationwide right now," said Jennifer Mason, communications director for Personhood USA, a Colorado-based group advocating state-level constitutional bans. "Many of my peers are frustrated with the past 40 years of an incremental approach."
Kansas was once an epicenter in the abortion debate, with protesters often targeting Dr. George Tiller, who performed late-term abortions at his Wichita clinic. He was gunned down in 2009 by an anti-abortion extremist now serving life in prison.
Kansas lawmakers have proposed more sweeping new measures that would ban most abortions as soon as a fetal heartbeat can be detected or declare that all persons have "inalienable rights" from the moment of conception. But influential anti-abortion leaders and veteran lawmakers are wary of those bills, fearing they could provoke damaging rulings from the Supreme Court or the state's own courts.
In their quest to raise money and build support, both sides have highlighted the successes that anti-abortion forces have achieved in the past three years.
Arkansas and North Dakota enacted fetal-heartbeat laws last year. North Dakota banned some procedures as early as the sixth week of pregnancy with a law that has been blocked by a federal judge.
Other bills passed in 2013 restricted women's access to abortion medication, restricted insurance coverage for abortion and imposed new requirements on abortion clinics and providers. A new law in Texas forced the closure of several clinics by requiring doctors who perform abortions to have admitting privileges at a nearby hospital. It is being appealed.
Kansas has tightened restrictions on late-term abortions, banned sex-selection procedures, strengthened a law requiring doctors to obtain parental consent before performing a minor's abortion and barred abortion providers from providing materials or instructors for public schools' sexuality courses.
Mary Kay Culp, executive director of Kansans for Life, compares the incremental approach favored by her group to a football team relying on a grind-it-out running game to score points.
"If you shoot that football into the end zone, over everybody's heads, things can happen," Culp said.
Abortion-rights supporters say either system — tightening restrictions little by little or pushing for broader bans even early in pregnancies — is harmful.
"Both strategies distract us, of course, from serving women," said Julie Burkhart, founder of the abortion-rights group Trust Women, who now operates a new clinic in Tiller's former building.
Whatever strategy is adopted may also depend on the views and clout of veteran anti-abortion leaders. In North Dakota, a legislative caucus that vetted anti-abortion bills lost its influence over time, giving individual lawmakers more latitude. In Kansas, Culp's group remains the most influential one on the anti-abortion side at the Statehouse.
"Where do you go next? That's the discussion, and that discussion may not be resolved in six months, a year or two years," said state Rep. Steve Brunk, a Wichita Republican and chairman of the Kansas House committee that handles abortion measures. "We want to move together."
Congress also could set national policy, but it's so bitterly divided between the Democratic-led Senate and the GOP-controlled House that abortion measures have had little chance of passage. House Republicans are trying nonetheless, with the Judiciary Committee approving a bill earlier this month aimed at permanently prohibiting taxpayer dollars from being used to pay for abortions.
Abortion-rights advocates have been pushing back.
California expanded abortion access last year with a measure that allowed nurse practitioners, certified nurse midwives and physician assistants to perform a type of early abortion. In Texas, the state senator who staged a marathon filibuster against the new law there, Wendy Davis, is now the Democratic candidate for governor in Texas, and abortion is likely to be a key campaign issue.
Burkhart said that she would rather have a "straight-up conversation" over banning most or all abortions. Less dramatic proposals, though harmful, do not inspire as much outrage, she said.
Abortion opponents "want to come at us from all these different angles in hopes people won't see it coming," she said.
Both sides are trying to read the Supreme Court, particularly Justice Anthony Kennedy, who is considered the swing vote on abortion issues.
Back in Kansas, Republican Gov. Sam Brownback recently compared the protests outside Tiller's clinic to efforts by abolitionists to end slavery before the Civil War. But even with the governor's support, Kansas abortion opponents face a more complicated situation at the state Supreme Court, where five of seven justices were appointed by Democratic governors who supported abortion rights.
"You have to take the public with you," Culp said. "Or you risk a backlash that puts you in a worse position than when you started."