A six-week abortion ban proposed by Florida Republicans earlier this month threatens to reverberate across the American south.
Following the supreme court’s decision in Dobbs v Jackson Women’s Health Organization to overturn the federal right to abortion, Florida became a strategic refuge for women seeking to access reproductive healthcare from states that banned abortion – places as varied as Louisiana, Mississippi, Tennessee, Alabama and Texas.
“In the last six months since Dobbs, the number of out-of-state patients coming to [us] for abortion care has quadrupled,” Damien Filer, a representative of Planned Parenthood of South, East, and North Florida (PPSEN), told the Guardian. “In Jacksonville and Tallahassee, our health centers on the state’s northern border, our general patient load has more than doubled, with the majority being from out of state.”
According to data from Florida’s agency for health care administration, 82,192 abortions were performed in the state in 2022 – 7,324 more than the number performed in 2020 when Roe v Wade was still standing. The number of out-of-state abortion patients in Florida grew from 3,988 in 2020 to 6,708 in 2022 – a 68% increase that probably obscures the full year-on-year impact, since Roe only fell toward the second half of 2022.
Dr Robyn Schickler, the chief medical officer of Planned Parenthood of south-west and central Florida, says she often sees out-of-state patients forced to go to great lengths to get the reproductive healthcare they need. She recalled a patient in her early 20s who came in from Texas to Orlando last year around 13 weeks pregnant.
“Hurricane Ian came through, we had to close the center, cancel and reschedule a bunch of patients, and she ended up having to stay and ride out the hurricane,” Schickler said. “We got her in as soon as we reopened so that she could go back home, but instead of just coming in and getting the healthcare she needed, she had to ride out a hurricane away from her home – that was really wild.”
Schickler says the sheer volume of out-of-state patients has also created wait times that, in turn, have pushed Floridians from the northern part of the state further south for care.
The proposed bill introduced earlier this month is expected to pass the Republican-controlled legislature and be signed by the governor, Ron DeSantis. It would go into effect only if the Florida supreme court upholds the current 15-week ban in a case it will decide at some point this year.
The six-week ban would include exceptions to save a woman’s life, and the limit would remain at 15 weeks in the case of rape or incest. However, women seeking an abortion under the rape and incest exception would be forced to prove their victim status with documents such as restraining orders, police reports or hospital records –often rendering these exceptions meaningless, advocates say, given the barriers to reporting assault.
DeSantis – who is widely expected to run for president in 2024 – publicly stated he plans to sign the bill into law. “We’re for pro-life … I urged the legislature to work, produce good stuff, and we will sign,” he said.
A report published by Pew Research Center in 2022 revealed 62% of American adults believe abortions should be legal in “all or most cases”, while a mere 37% believe it should be illegal. A 2020 Ipsos/Reuters poll found that 56% of likely voters in Florida believe abortion should be legal in most cases, and a similar number disagreed with the supreme court decision overturning Roe, according to a 2022 University of South Florida poll.
Dr Shelly Tien, a board-certified obstetrician-gynecologist and abortion provider in north-east Florida, believes the proposed bill is bound to have a profound effect on already marginalized patients.
“Many of the patients I see that are coming from out-of-state are driving because it’s cheaper, and many patients are driving through the night,” Tien said. “We’ve had patients show up that are very hungry. I’ve cared for patients that have to miss and reschedule appointments because their childcare falls through or they’ve been unable to find someone to care for their children. I’ve had patients in relationships with active intimate partner violence trying to find a time when their partner, who is also the perpetrator, is out of town so they can sneak away and have an abortion,” she added.
“Six weeks is only two weeks after a missed period, and by that point, many women haven’t realized they’re pregnant. Women have irregular periods all the time for many reasons, so to prevent them from seeking abortion care after six weeks is, for all intents and purposes, a total ban. Essentially, a ban like this completely robs women, girls and their families of having any say in their own health,” Tien said.
Providers are bracing for the need to send a growing number of Floridians elsewhere for care.
“Already with a 15-week abortion ban, there are many patients we have to refer out of state,” said Amber Gavin, vice-president of Advocacy and Operations at A Woman’s Choice.
“A six-week ban is unbelievably cruel. It narrows the window of when folks can access care and makes it so much harder,” she said.
“Obviously, we will continue referring patients out-of-state to get their care elsewhere, whether that’s North Carolina, Virginia or other places.”
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