Should a proposed 15-week abortion limit making its way through the Legislature go into effect in July, Floridians can expect a dramatic fallout.
That could look like a burst of activity at clinics, increased travel to other states for procedures, an intensification of legal challenges and a heavier burden on the poor.
Florida has 56 clinics, with 43 of them licensed to do the second trimester abortions that would become illegal should the proposed measures go into effect, according to the Florida AHCA.
Only a sliver of Florida counties — 17 of Florida’s 67 — have abortion clinics and their administrators are preparing for a law change that would reduce the cutoff for abortions from 24 weeks.
The Florida House voted for a significant limit on abortion, with no exceptions for rape or incest. The Senate could send the measure to Gov. Ron DeSantis’ desk as early as next week.
In Mississippi, where a newly passed law banning abortion after 15 weeks of pregnancy is being challenged in the U.S. Supreme Court, the only abortion clinic in the state has never been busier. The patient load has nearly doubled and the clinic has expanded its hours of operation, according to a New York Times report.
“We already are looking at how it could affect everything from staffing to scheduling to how much medication to order,” said the director of a Florida abortion center who asked not to be named. “We know who this will affect. People who can afford it will always get an abortion even if they have to travel. It’s the poorest who will be affected the most.”
The bill’s short-term effect
Almost 5,000 women in Florida terminated their pregnancies in 2021 starting 12 weeks after their pregnancy began, which is equivalent to about 14 weeks after the first day of their last period, according to the Florida Agency for Health Care Administration. They did so for a number of reasons — from the discovery of a fetal abnormality to a delay from challenges saving up money and arranging travel for the procedure, to a pure lack of knowledge or fear of admitting they were pregnant.
Now, Florida appears poised to join other states, including Texas, with more restrictive abortion laws. As the bill goes to the Senate next week, Florida women’s health providers are bracing for the immediate repercussions: Angst. Confusion. Misinformation.
“Not everyone comes to the table understanding how or when they got pregnant,” said Dr. Maureen Whelihan, an obstetrician-gynecologist with Elite GYN Care of the Palm Beaches. “For our patients, this is going to generate a lot more angst, a lot of anxiety about what this means for them and for their daughters.”
Miscalculation is increasingly more common, she said. Some women have irregular periods, while others have medical conditions or contraceptive methods that give them irregular periods. “Patients are not as savvy about their reproductive health as one might think they should be. Now there will be a burden on them to be smarter earlier on, and I think that’s the wrong direction.”
Whelihan said she would like to see more obstetricians/gynecologists consulted about how changes will affect women and babies. “Any time that legislation happens that restricts our ability to discuss options with a patient is never good. Ultimately it’s the female patient that suffers.”
Rep. Erin Grall, the abortion bill’s sponsor, said she thinks the debate over restrictions involves more than just a woman’s choice to have an abortion.
“Once a woman becomes pregnant, two uniquely independent human beings exist,” the Vero Beach Republican said during the House debate. “I’ve never understood the ‘my body, my choice’ rhetoric when it comes to terminating a life.”
Dr. Samantha Deans, associate medical director of Planned Parenthood of Southeast and North Florida, said the legislation ? if passed into law ? is certain to bring initial confusion.
“I already hear people who say, ‘abortion is going to be illegal soon,'” and that type of rhetoric leads to patients not knowing they have options,” Deans said. “Even doctors can feel confused about what they can realistically offer their patients, depending on how close they are to the cutoff.”
Women’s health providers say the 15-week ban on abortions won’t stop those who can afford to go outside the state for procedures. It will affect women who barely scrape together enough for the procedure and can’t afford time off from work, child care and travel expenses. Unlike states such as Mississippi, leaving Florida could require traveling hundreds, if not thousands, of miles.
Florida’s Planned Parenthood branches already are preparing to help with costs to fly patients to other states to get abortion care and have begun to strengthen relationships with abortion providers in states such as North Carolina, Washington, D.C., Illinois and New York.
The bill’s long-term effect
Patients seeking abortions after 15 weeks will have three options if the bill goes into effect: travel to another state to get an abortion if they can afford it, continue with an unwanted or unhealthy pregnancy, or seek second-trimester abortions from someone who isn’t a qualified practitioner.
“People who are under 50, which is a lot of the population, they don’t know what it actually means to be in a time where abortion is unsafe and difficult to access,” said Dr. Sujatha Prabhakaran, a practicing OB-GYN in Sarasota. “They don’t remember or know people who suffered severe medical consequences or died trying to get the care that we can do in a really safe way.”
Prabhakaran also worries the 15-week cutoff won’t give patients enough time to fully consider whether an abortion is right for them. “Most of the patients that come to see us are very firm in their decision,” Prabhakaran said. “But some of them need to talk with us about the process and procedure, and then need time to talk with their families … or just to consider it for themselves.”
Obstetricians say they have seen patients in their second trimester who believe their pregnancy is viable and are planning their futures with their potential child when they get a devastating diagnosis. Having fewer options could affect an entire family.
“When a woman cannot access abortion care, you are changing the trajectory of her life,” said Elizabeth Nash, state policy analyst for The Guttmacher Institute, a reproductive health research and advocacy organization.
Kevin Cho Tipton, a critical care nurse in Miami public hospitals, said he’s seen plenty of patients who arrive at the ER in a state of emergency from trying any number of methods to terminate their pregnancy.
“When you put people in situations where they don’t have access to care, they’re forced to seek care outside of what would normally be safe.”
The health risks involved
Women in their second trimester are more likely to get an abortion due to a serious fetal abnormality, according to data from the Florida Agency for Health Care Administration.
Under the Florida bill, if a fetal abnormality is discovered after 15 weeks, two doctors would need to certify the baby wouldn’t survive long after birth before an abortion would be allowed.
“What concerns me is that there are abnormalities that are non-lethal but life-altering,” said Orlando perinatologist Dr. Cole Greves, who specializes in treating complex prenatal disorders.
Greves said 90% of his patients who come to him because of a fetal abnormality are more than 15 weeks pregnant, mostly because amniocentesis, ultrasounds and blood tests that reveal that type of information are done later in gestation. The women come seeking information on how and if those abnormalities can be treated.
“I present the options but it’s not for me to decide or for government officials to decide, it’s for families to decide. That is what’s most upsetting to me about restricting choices and access to care.”
Greves, who is chair-elect for his district for the American College of Obstetricians and Gynecologists, said the impact of the bill would be felt immediately in his practice. “It would change the counseling I would give patients and restrict the options that I present to mothers.”
The breadth of the effect
Florida’s 15-week abortion cutoff will have a more dramatic impact than the same law in states such as Mississippi.
Along with women from Florida, state clinics perform abortions on women from nearby southern states, such as Georgia, which limits abortions after 20 weeks, or Mississippi, where there is only one overwhelmed abortion clinic. Women also come to Florida from the Caribbean Islands and Latin America, where abortion is illegal in some countries or territories.
“Florida has been important for abortion access for a long time,” said Nash, of The Guttmacher Institute. “Continuing that access is important, even for those who live in Florida because traveling outside the state can be difficult.”
For islanders who come from outside the U.S., particularly where the quality of health care lags, the more stringent time frame can become formidable.
Elena Senises, the administrator at the Miramar Women’s Center, said women come to South Florida because of its proximity and they have family here to stay with. However, by the time they get an appointment, book a flight and arrive in South Florida, they often are further along in the pregnancy than 15 weeks. She worries about their options going forward. “When you put more obstacles on these women, it will have repercussions.”
Legal challenges ahead
Even if the Florida governor signs the 15-week abortion ban bill into law in March, Florida attorneys foresee legal challenges that could create a temporary hold on it taking effect in July.
In Mississippi, legal challenges to a 15-week abortion ban have placed a hold for four years on that state’s law. However, similar legal challenges in Texas did not result in a delay in their newly passed six-week ban that took effect in September 2021.
Abortion advocates and opponents closely are watching the outcome of a challenge to Mississippi’s 15-week ban in the U.S. Supreme Court that could overturn the court’s landmark 1973 Roe v. Wade. A decision in the abortion case is expected in late June or early July.
If the Supreme Court were to overturn Roe v. Wade, advocates could still challenge Florida’s 15-week ban or other bans on the basis that these restrictions violate Florida’s state constitution and the right to privacy in medical decisions, said Kait Thomson, director of government relations and community engagement at Planned Parenthood of Southwest and Central Florida.
Similar abortion measures to Florida’s 15-week ban also passed this week in West Virginia’s House and the Arizona Senate.
