By Dara Kam ©2024 The News Service of Florida
TALLAHASSEE — Florida abortion providers and activists are girding for a law that took effect Wednesday to prevent abortions after six weeks of pregnancy, severely limiting access to abortion for pregnant people in the state and across the Southeast.
“It’s been pretty chaotic,” Michelle Quesada, a spokesperson for Planned Parenthood of South, East, and North Florida, told The News Service of Florida on Monday.
Planned Parenthood clinics “have been packed” in the days leading up to the six-week limit, Quesada said.
While providers rushed to see as many patients as possible before Wednesday, abortion-rights supporters also were bolstering efforts to help women travel out-of-state to obtain the procedure.
The Republican-controlled Legislature and Gov. Ron DeSantis in 2023 approved the six-week limit, building on a 2022 law that banned abortions after 15 weeks. The Florida Supreme Court recently upheld the 2022 law, also clearing the way for the six-week limit to take effect.
The closest places for women in Florida to obtain abortions after six weeks will be at least a day’s travel by car. North Carolina allows abortions until 12 weeks of pregnancy but requires a 72-hour, in-person waiting period. In Illinois, abortions are allowed until “viability” of the fetus, which means the fetus can survive outside of the mother’s womb. Virginia bans abortions after 26 weeks and six days of pregnancy.
The 2023 Florida law includes exceptions for victims of rape, incest and human trafficking, with women needing to show documentation. The law also includes exceptions to save the life of the mother, requiring two doctors to certify in writing a “medical necessity” for abortion “to save the pregnant woman’s life or avert a serious risk of imminent substantial and irreversible physical impairment of a major bodily function of the pregnant woman.” An exception also exists for fatal fetal abnormalities, until the third trimester. The exception also requires certification by two doctors.
Abortion rights supporters maintain that the exceptions are impractical.
Rachel Humphrey, a high-risk pregnancy specialist who is a maternal-fetal medicine physician based in Orlando, said she recently saw a patient who was about 18 weeks pregnant and whose fetus was diagnosed with trisomy 18, a condition that carries multiple, severe birth anomalies. Trisomy 18 affects about one in 5,000 pregnancies, with the vast majority of babies not surviving beyond one month after delivery and fewer than 10 percent living about a year, Humphrey said.
“She got the diagnosis at the same time that most people get the diagnosis, which is 18 to 20 weeks, which is beyond the 15-week ban,” Humphrey said.
The doctor said she determined the patient was not eligible for an abortion because Humphrey could not say how long the baby would live after delivery and because the mother’s life was not in danger.
“She ended up carrying that pregnancy for about 10 more weeks and the baby died inside of her belly from the issues,” Humphrey said. “Staying pregnant really shouldn’t have been something that she was forced to do. It happened that she didn’t have the liberty to get the medical care that she needed.”
Amber Gavin, vice president of advocacy and operations for A Woman’s Choice, which has clinics in Jacksonville, North Carolina and Virginia, called the exceptions unworkable.
“If you are a victim of rape, you have to prove to us that you are a victim in order for there to be exception. Many people don’t report, so there’s no exception to be made if you don’t report it to the police,” she said.
The state also requires women to wait 24 hours after seeing doctors in person before they can obtain abortions, a law that passed in 2015 but was on hold until 2022 due to legal wrangling.
The waiting period coupled with the requirement for two physicians to certify the need for an abortion can result in potentially deadly delays, abortion-rights supporters contend.
“She has a 24-hour waiting period once she meets a doctor, and from there, she’s going to have to find two physicians to sign off, saying her health risk is substantial. That’s a delay in care, at which point, she could develop an infection, which could threaten her life or at least her ability to get pregnant in the future,” Daniel Noah Sacks, an obstetrician and gynecologist based in Palm Beach County, told the News Service.
Sacks pointed to a patient who is 15 weeks pregnant and whose water broke Monday but was unable to undergo the requisite examinations to trigger the 24-hour waiting period in time to receive an abortion before the new law goes into effect.
“Every situation from here forward has that problem,” Sacks said. “These laws really hurt women, especially women who have no means, but even women who have means, it affects negatively.”
The Legislature’s passage of the six-week limit — and the Supreme Court’s April 1 decision that allowed it to take effect — were major victories for abortion opponents. The 2023 law was titled the “Heartbeat Protection Act” because supporters said a fetal heartbeat can be detected at about six weeks.
Lawmakers also have provided money to centers across the state that offer services to pregnant women and try to prevent abortions.
“We are able to embrace them and help them,” Grazie Christie, medical director of the Pregnancy Help Centers of the Archdiocese of Miami, told the News Service. “Many times, all they need really is support, like the spiritual, psychological, and loving support of someone who says, ‘It’s hard, but we are here for you, and we can help you.’”
But critics of the six-week limit hope it will help galvanize support for a ballot proposal aimed at putting abortion rights in the state Constitution. Separately from the decision allowing the six-week limit to take effect, the Supreme Court on April 1 also ruled that the proposed constitutional amendment met legal requirements to be placed on the November ballot.
Despite a series of restrictions imposed by the Republican-controlled Legislature over the years, Florida — with about 50 abortion clinics statewide — has been what is known as a “receiving” state for people from other parts of the country with more stringent abortion laws, including other states in the Southeast.
In 2023, 84,052 abortions were performed in Florida, according to the state Agency for Health Care Administration. The vast majority — 76,422 were performed in the first trimester, or until 12 weeks of gestation, according to the state agency.
The number is expected to plummet. A similar South Carolina law resulted in a 71 percent decrease in abortions, according to Kimya Forouzan, principal state policy associate at the Guttmacher Institute, which collects abortion data.
The new law is intensifying pressure on organizations like Palm Beach County-based Emergency Medical Assistance, or EMA, which is part of a national network of about 100 groups collaborating to provide financial aid and other services to women seeking abortions. Funds are used to cover the costs of flights, hotels, transportation and meals, said Jessica Hatem, executive director of EMA.
Her group has sent people to North Carolina and coordinates with abortion providers in Illinois, the Baltimore-Washington, D.C. area and Virginia.
“This is kind of a we’re-all-holding-our-breath moment that we’re in,” Hatem said. “It’s going to be a huge lift. No one should have to leave their community to obtain an abortion, but it’s not as if people’s needs are going to go unmet.”
Mona Reis, the founder of Presidential Women’s Center in West Palm Beach, began working in Miami’s first outpatient abortion clinic in 1973, a day after the U.S. Supreme Court’s Roe v. Wade decision. Reis, who recently held a fundraiser for EMA at her home, told the News Service she “can’t cut it out of my heart.”
“It’s just everything that I believe in as far as women having equality and opportunity, it starts with being able to control when or whether you want to be a parent. That’s paramount for me. And I want women to have every affordable opportunity and you are not able to when you don’t have the ability to do this, and to have it with dignity and respect,” Reis said.
— News Service Assignment Manager Tom Urban contributed to this story.
