“We will ensure that this community remains abortion free,” he said.

Indeed, the efforts to open new clinics face considerable obstacles. After enacting numerous pieces of anti-abortion legislation this year, the state recently denied licenses to two of the three remaining clinics in the state, down from 15 two decades ago. (A court has allowed the clinics to continue operating pending the outcome of a legal challenge to the new regulations.)

“It would have been difficult for Dr. Means to provide abortion care in Wichita, period,” said Peter B. Brownlie, the president of Planned Parenthood of Kansas and Mid-Missouri, which dropped plans to open an abortion clinic here after failing to find a local doctor willing to endure the expected harassment. “Now it’s doubly difficult.”

But Dr. Means decided last summer that she had little choice but to try.

She looked at the finances of her solo family practice and figured she might be the poorest doctor in the state. Though she lives modestly, she has had continuing problems managing money: her credit card companies have taken her to court, and her checks occasionally bounce. Determined to work alone, she did not have enough patients to cover the bills.

Offering abortions seemed the easiest way to keep the doors to her small office open, she said. The need was also there, she felt. The nearest provider was more than three hours away, and for the first time patients had been asking her where to go to end a pregnancy. (Statistics kept by the State of Kansas show that the number of women from the Wichita area who received abortions in the state dropped by nearly half.)

Having lived in Wichita since she was a young girl, including the “Summer of Mercy” two decades ago when thousands of protesters blockaded clinics, Dr. Means was aware that Dr. Tiller had endured several attacks as well as decades of protest and legal challenges before his death, efforts that also succeeded in closing the other clinics in the city. But she hoped — naïvely, she now says — that she would receive less attention by doing abortions part time and only early in the pregnancy.

She bought much of Dr. Tiller’s medical equipment and office furniture for $20,000. Her goal was to continue her family practice and also start performing abortions of fetuses up to 15 weeks.