Michelle Gutierrez pointed out pamphlets on the wall in the waiting room of the North West Health Care Center in Cody.
"There are pamphlets about things like birth control and STDs, what else do we have? How to talk to your parents. How to talk to your kids. Safe sex and then, like, violence, date rape, drugs, things like that," she said as she showed me.
Gutierrez is the executive director of the Title X clinic, which is located in a converted one-story house. It just has a couple of rooms. She opened the door to show me the exam room.
"This is the exam room. We really try…that was a thing that everyone loves when they come in is that it's not hospitally," she said.
Title X is a federal program that provides money for family planning and reproductive health care to low-income individuals. They do this by providing basic preventive care at a sliding fee scale.
"We provide things like annual exams, wellness exams, STD screenings. We provide birth control," Gutierrez told me.
Things that are able to prevent pregnancies. Gutierrez said all the services they provide are essential and vital services for the community. But it turns out, according to data from the Centers for Disease Control, in Wyoming, fewer women receive preventive care like breast exams annually than anywhere else in the country.
"We've had a few who were diagnosed with breast cancer after coming here and seeing our provider first. And to just come in and tell us 'Thank you for being here,' because they probably wouldn't have went and got that lump checked, because they couldn't afford it," said Gutierrez.
And here's the Catch-22. Wyoming, like many other more conservative states, has gotten more aggressive in trying to ban abortions. Dr. Giovannina Anthony is an OBGYN in Jackson whose practice is the only one in the state that provides medical abortions. At the moment, there is no practice in the state that offers surgical abortions. Anthony said when she first moved to Jackson 17 years ago, she encountered a state that didn't want government involvement in healthcare.
"Over time, that has changed," she said. "Honestly, the last legislative session was really, really disheartening."
In 2021, legislators were very combative towards doctors that testified against anti-abortion bills.
This current legislature is no different. Two bills are chugging along in this session. One would ban abortion if Roe vs. Wade is overturned and the other bans chemical or medical abortion.
The anti-abortion stance has even impacted basic preventive reproductive care by creating suspicion about what clinics provide.
"There's a degree to which you want to make sure the services are still provided and protected," said Rob Johnston, the executive director of the Title X clinics in Wyoming. "But at the same time, you're hesitant sometimes to draw too much attention to what you do because then you become the target."
The program has had problems over the years - mainly when politicians think that they are providing or encouraging abortions. This became a problem for a Title X clinic in Gillette.
"For years, they received money from the county commissioners and the city for services at that clinic. And then two years ago, those funds were cut," said Johnston.
Johnston said that's because of inaccurate information about what the clinic did. He says the cut came about when the clinic was asking for money to provide annual well-women exams.
Gail Wilson, the clinical director at Wyoming's Title X clinics, said it's frustrating when all they are trying to do is encourage women to get healthcare.
"In Wyoming, or any conservative state, access to reproductive health or asking for, or needing reproductive health services is somewhat taboo, like mental health," said Wilson. "And so people, it's like something to be ashamed of. And it's another body system that needs to be taken care of."
This confusion over what is reproductive healthcare could get worse. That's according to Sharon Breitweiser, the executive director of Pro-Choice Wyoming. She said if the bill that would ban chemical abortions passes, it could cause more stigma and confusion for women just trying to get contraceptives or Plan B, which is more commonly known as the morning after pill.
"There's this stigma that people don't know what's legal, people don't know what's abortion. There's all this conflation of emergency contraception with the early abortion pill when they're two very different things. [And] people not knowing where they can go," said Breitweiser.
Michelle Gutierrez with the Title X clinic in Cody agreed.
"I think people are misinformed on what services we do provide. And I think that's where a majority of it stems from," she said.
But she said no matter what, they are making a difference in many people's lives whether that's giving a life saving breast exam or contraceptives.
