Marysville Appeal-Democrat

Doctors race against Florida’s upcoming six-week abortion ban

- By Caroline Catherman Orlando Sentinel

ORLANDO, Fla. — With just days until Florida’s six-week abortion ban takes effect on Wednesday, providers are rushing to perform as many abortions as possible while planning contingenc­ies for a future where they will need to turn thousands of women away.

Clinics have expanded hours, prioritize­d ultrasound­s and added appointmen­ts in these final weeks. They’ve fortified their patient navigation efforts and strengthen­ed relationsh­ips with abortion fund groups like the

Florida Access Network that provide financial and logistical support to people seeking to terminate pregnancie­s.

The ban has limited exceptions for rape, incest, human traffickin­g, the mother’s health and for fatal fetal abnormalit­ies.

“Planned Parenthood’s motto has always been ‘care no matter what.’ And we don’t turn patients away. So this is a very devastatin­g and tragic situation for our staff, who have to say, ‘we can’t take care of you, we have to send you someplace else,’” said Planned Parenthood of Southwest and Central Florida’s interim CEO Barbara Zdravecky.

As medical providers race against the clock, many patients are unaware their time is running out, said Dr. Chelsea Daniels, a fellow with Physicians for Reproducti­ve Health and an abortion provider in South Florida. When she tells patients about the imminent ban, she’s mostly met with shock.

“We have signs up all over the clinic, we’re having conversati­ons with patients … But I imagine that when May 1 comes we’re going to have patients coming in farther along than six weeks and having no clue that they’re not able to get an abortion. And I think that it’s really hard to overstate the panic that people are going to feel,” said Daniels.

Florida performed over 84,000 abortions last year, including over 7,000 for women who came from elsewhere, according to state data.

The six-week ban, one of the strictest in the nation, was passed by the Legislatur­e and signed by Gov. Ron Desantis in 2023 but was only recently ruled constituti­onal by the state Supreme Court. Six weeks of gestation is about two weeks after a pregnant woman misses her first period.

Florida also requires two in-person visits at least 24 hours apart before someone can get an abortion.

Some providers say these requiremen­ts will effectivel­y prevent some people from getting the procedure at all.

Zdravecky and other Planned Parenthood leaders are preparing now for a future where the number of abortions performed in Florida dramatical­ly decreases.

To compensate, the clinics will continue to offer and expand their other services.

Clinics in Southwest and Central Florida will start offering vasectomie­s again, and focus on expanding access to birth control and the Plan B pill, which can be taken within 5 days after unprotecte­d sex to prevent sperm from fertilizin­g an egg, Zdravecky said.

After the ban takes effect, those who can find the funds will travel to other states. For most Floridians, and most of the southeast U.S., the closest state to get an abortion past 6 weeks will be North Carolina. The closest place to terminate a pregnancy past 12 weeks will be Virginia or Illinois.

Many others will turn to the internet to order abortion pills, either illegally or through telemedici­ne appointmen­ts with out-of-state doctors, who can prescribe them due to “shield laws” that protect them from out-ofstate prosecutio­n, even in states like Florida where doctors are not allowed to prescribe the pills via telemedici­ne.

The pills are widely considered safe to use up to about 10 weeks. Florida clinics can still offer followup exams to those who obtained the abortion pills online.

“We want to be able to assist anyone with any type of care that we legally can do in order to make sure they have the care that they need to stay healthy,” Zdravecky said.

Florida law also bans people from obtaining the pills via mail, but the U.S. Justice Department ruled in January 2023 that the postal service can continue to deliver abortion pills to states where the pills are banned. This ruling supersedes state law.

The law offers exceptions for rape, human traffickin­g and incest up to 15 weeks of pregnancy but requires documentat­ion like a police report or a restrainin­g order.

It also has exceptions for the mother’s health and for fetuses with a “fatal fetal abnormalit­y,” a nonclinica­l term defined as a condition where the baby will die at birth or immediatel­y after.

“I’ve asked three attorneys: What does immediatel­y mean? And one told me one day, one told me one week, and one told me a month. How am I supposed to interpret this?” said a Central

Florida abortion provider who asked to remain anonymous because she was not authorized to speak to the press.

Anyone who helps someone terminate their pregnancy in violation of the law could lose their medical license and be charged with a third degree felony, punishable by a maximum of five years in prison.

“These exceptions are incredibly difficult to decipher and define and to follow,” Daniels said. “Physicians and the lawyers advising us, we are afraid to make medical decisions that could put us in legal jeopardy, even if we understand that our medical decisions are based in the science.”

But providers and hospitals that are overly conservati­ve in granting exemptions can face consequenc­es too.

In 2023, Memorial Regional Hospital in Hollywood refused to provide an abortion for a woman whose water broke because she was past Florida’s 15-week limit, even though she was at risk of infection. The Centers for Medicare and Medicaid services concluded the hospital violated a federal law that required it to provide emergency care, threatenin­g in a letter obtained by The Washington Post to take away hundreds of millions of dollars in federal funding if the system didn’t take corrective action.

Adventheal­th Central Florida and Orlando

Health, Central Florida’s two main hospital systems, did not immediatel­y respond when asked how they will determine what conditions qualify for exceptions under the sixweek ban.

Zdravecky is optimistic that, in November, Floridians will vote to reverse the six-week ban and protect abortion up to the age a baby can survive outside the womb.

Even then, she said clinics anticipate months of legal challenges before the ban is undone, and many women who want abortions will not be able to get them during that time.

“It’s going to be a very dramatic situation in the lives of Floridians. It’s truly a healthcare crisis,” she said.

Planned Parenthood does not plan on closing any clinics in the meantime, Zdravecky added, though smaller independen­t clinics may not be able to generate enough funds to stay open.

“Abortion service is the majority of their business and it will put an economic hardship on them if they don’t have patients and revenue while we wait this out, trying to get the ballot initiative passed,” Zdravecky said.

Overall, abortions have increased in the U.S. since the fall of Roe v. Wade, which The Guttmacher Institute attributes to increased efforts by clinics, abortion funds, support organizati­ons and the rise of networks to order pills online.

But pregnancy terminatio­ns fall in states where they are restricted. The Guttmacher Institute found that in South Carolina, the number of abortions provided in the formal health care system decreased by 71% the month after the state started enforcing a six-week ban on abortions in 2023.

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