Florida’s Impending Abortion Ban to Leave Care Vacuum in South

Abortion care beyond six weeks into a pregnancy will be largely unavailable in the southeastern US starting next month after the Florida high court ruled Monday that the state constitution’s right to privacy doesn’t protect abortion.

The Florida Supreme Court in a 6-1 decision allowed state officials to enforce a 15-week ban, setting the stage for a prohibition on most abortions after six weeks to go into effect May 1.

The ruling came the same day justices approved a ballot measure to go before voters in November that would establish a right to abortion before fetal viability—roughly 24 weeks of gestation—or when the procedure is “necessary to protect the patient’s health, as determined by the patient’s healthcare provider.”

Reproductive health groups and petition circulators praised the decision allowing voters to decide on the proposed amendment, which would need approval from at least 60% of Florida voters to be adopted. But until that vote, and depending on its outcome, abortion providers and policy analysts say the six-week ban will be detrimental to abortion access and maternal health, both for patients in Florida and those from surroundings states like Georgia and Alabama who have flocked to Florida in the wake of near-total or complete abortion bans enacted after the US Supreme Court overturned Roe v. Wade in 2022.

National and local abortion provider groups and politicians are sounding the alarm on the immediate impact of the six-week ban to mobilize voters in support of approving the ballot initiative in Florida and similar ones that could appear on the ballot in more than a dozen other states across the country.

The Florida law “really does cut off abortion across the entire southeast region of the United States,” said Amita Vyas, an associate professor of public health at the George Washington University.

“Having this on the ballot for November will really elevate the discussion and conversation not just in Florida, but also across the country,” Vyas said in an interview.

Abortion providers say the ruling from the Florida Supreme Court doesn’t line up with medical practice and is already having ramifications for health practices in the state.

The new law “will have a tremendous impact on people’s reproductive health and their lives,” said Brittany Fonteno, president and CEO of the National Abortion Federation, which represents individuals and health centers across the country providing abortion care.

Southern Access

Florida’s six-week ban would put it in line with the laws in nearby Georgia and South Carolina, and is less restrictive than the total bans in states like Alabama, Louisiana, and Mississippi. But health providers have repeatedly criticized six-week limits, noting many patients don’t know they are pregnant at that point.

“When we look at this six-week ban, we’re really talking about basically a near-total ban on abortion,” Vyas said.

Chelsea Daniels, a fellow at Physicians for Reproductive Health and a family physician at Planned Parenthood’s affiliate in Miami, said the decision on the six-week ban caused immediate “fear and confusion and stress” for “the whole Planned Parenthood affiliate.” Daniels said the majority of patients she sees seeking an abortion are further along than six weeks.

Planned Parenthood has received funding from Bloomberg Philanthropies, the charitable organization founded by Michael Bloomberg. Bloomberg Law is operated by entities controlled by Michael Bloomberg.

The national anti-abortion group SBA Pro-Life America called the state high court’s ruling on the abortion ban a “victory for unborn children.”

“Gov. Ron DeSantis must be at the forefront of protecting Florida from Big Abortion’s attempt to eliminate the rights of unborn children, parents, women, and girls,” Katie Daniel, SBA’s state policy director, said in an emailed statement.

But the impending abortion law in Florida means many patients in the Southeast will have to travel further than before, at a time when health professionals and analysts say maternal health outcomes continue to worsen.

After the June 2022 Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization that overturned a constitutional right to abortion, Florida “has really been a beacon of hope for many people and has served as a place for many people to escape to in order to get access to the abortion care that they need,” Fonteno said.

The number of reported out-of-state abortion patients in Florida nearly doubled between 2021 and 2023—from 4,873 to 7,736, according to data from the Florida Agency for Health Care Administration.

NAF, which operates a national abortion hotline to assist patients seeking abortions, provided more financial support to patients in Florida in 2023 than any other state, Fonteno said.

North Carolina Gov. Roy Cooper (D) said in a Biden-Harris 2024 press call Tuesday that he expects “even more women will travel to North Carolina,” where abortion is legal until 12 weeks into gestation. But he added abortion clinics in the state are already “stretched thin as it is.”

Daniels, who also travels to Maryland and Virginia to provide second-trimester care, said she’s already seeing a “higher percentage of out-of-state people” in those states, and she only expects this to grow after May 1.

Maternal health is also expected to worsen across the Southeast—where maternal mortality rates are well above the national average, according to the Centers for Disease Control and Prevention.

“Abortion bans only widen the gaps in health-care outcomes that various communities are facing,” Fonteno said.

Abortion on the Ballot

In the face of the ban, providers and advocates say they are glad voters will have a chance to weigh in on the Florida abortion law.

The campaign Floridians Protecting Freedom collected roughly 100,000 more than the 891,523 required by the state of Florida to get a spot on the ballot. Lauren Brenzel, director of the Yes on 4 campaign, said in a press call Monday that Amendment 4 is needed “to keep the government out of exam rooms.”

Even if voters approve the amendment, advocates on both sides of the issue predict future legal battles attempting to limit the amendment’s reach.

A majority of the court indicated it could find fetal personhood rights inside of the state’s existing constitutional provisions. This comes after a February Alabama Supreme Court ruling recognizing unimplanted human embryos as children gave a boost to the anti-abortion movement’s efforts to build legal support for fetal and embryonic personhood.

Votes in support of abortion rights in other states also haven’t gone unchallenged. Michigan officials are currently asking a federal court to dismiss a lawsuit led by Right to Life of Michigan that seeks to undo abortion protections approved by a majority of the state’s voters in November 2022.

Daniels said that while the abortion ban and future litigation may prompt some abortion providers to leave the state, she feels “impassioned to stay here and see this out.”

“Blood, sweat, and tears have gone into this ballot initiative for all of us, and I would be remiss to not see it through and give Floridians, give my patient community who I have come to work with and love, my best shot,” Daniels said.