In spring 2022, just months before the US Supreme Court overturned Roe v. Wade, Republicans in Florida passed a law banning abortion after 15 weeks of pregnancy, down from the previous legal threshold of 24 weeks. It took effect that summer, but advocates for reproductive rights challenged it in state court as unconstitutional.
One year later, Republicans in Florida took even more aggressive action against reproductive freedom: Gov. Ron DeSantis signed a new bill to restrict abortion at six weeks of pregnancy. But the fate of that law rested on what the court would decide about the 15-week ban. If it decided that ban was legal, the six-week ban would be, too.
This week, nearly two years after challengers first filed their lawsuit, the Florida Supreme Court finally issued its ruling: The 15-week ban is constitutional under state law, and therefore the six-week ban will take effect in 30 days, on May 1.
In practical terms, six weeks is a total ban. Many people do not even know they’re pregnant by then. Even if they are aware, Florida requires patients seeking abortions to complete two in-person doctor visits with a 24-hour waiting period in between, a challenging logistical burden to meet before 15 weeks and a nearly impossible one before six.
Not only will the six-week ban decimate abortion access for Florida residents, but it will also significantly curtail care for people across the South, who have been traveling to Florida from more restrictive states since Roe was overturned. According to the Guttmacher Institute, a reproductive health research group, there were 8,940 more abortions in Florida in 2023 compared to 2020—a 12 percent increase that researchers attribute largely to travel from out-of-state patients. Residents of Florida’s bordering states face either a total ban (Alabama) or a six-week ban (Georgia).
More broadly, the Guttmacher Institute has found that six-week bans have massive impacts on the provision of abortion. In South Carolina, the number of abortions provided in the formal health care system decreased by 71 percent the month after the state started enforcing a six-week ban on abortions in 2023. Prior research found declines of close to 50 percent in abortion caseloads in Georgia and in Texas after their six-week bans went into effect.
Florida’s six-week abortion ban is particularly restrictive
When the six-week ban takes effect next month, Florida will become one of the most restrictive states in the country on abortion access.
Florida’s law not only bans abortion after six weeks but also bans abortion by telemedicine and requires any medication abortion to be dispensed in person, which effectively outlaws mail orders of the pills. (Researchers have affirmed there is no medical need for abortion pills to be administered in the physical presence of a health care provider.) At the time it was passed, no other state had a six-week ban with a requirement for two in-person doctor visits and no option for telehealth.
While the law includes exceptions for rape and incest, it requires anyone claiming those exceptions to provide a copy of a police report, medical record, or court order — even though victims often do not involve law enforcement. The executive director of the Florida Council Against Sexual Violence has called these exceptions “meaningless” and “harmful.”
Six weeks is simply not enough time for the vast majority of people to get abortion care, especially if remote options are off the table. In medical terms, pregnancy is measured from the date of the last menstrual period, not from the date of conception, and up to 25 percent of women don’t have regular menstrual cycles, meaning a missed period wouldn’t signal anything unusual. It can take at least three weeks for a pregnancy hormone to appear on a home pregnancy test, and while blood tests can also confirm pregnancies, Florida health care professionals testified that it can take weeks to months to get an appointment with an OB-GYN, with wait times particularly long for low-income and Black Floridians.
Once a pregnancy is confirmed, a patient, under Florida law, would need to schedule an ultrasound with an abortion provider. Scheduling these appointments takes even more time. Annie Filkowski, the policy director of Florida Alliance of Planned Parenthood Affiliates, told Vox in 2023 that wait times at their clinics average about 20 days.
These barriers would prove virtually insurmountable for most people, and even harder for minors in Florida, who are required by law to either get parental consent to end a pregnancy or petition a judge to bypass their parents.
The Republican state senator who sponsored the six-week ban, Erin Grall, conceded a teenager would be unlikely to go through that legal process within six weeks. “I think the purpose of this bill is to say that when there is life, we are going to protect it,” Grall said.
“There are 4.6 million women of reproductive age in Florida, along with trans and nonbinary people who may need an abortion,” said Kelly Baden, the vice president of public policy at the Guttmacher Institute. “With the regional clustering of bans in neighboring and nearby states, Floridians will have to travel across at least two state lines to get care after six weeks.”
Kris Lawler, the board president of the Tampa Bay Abortion Fund, announced Monday that their network stands ready to help people access care in the wake of this decision. “Abortion is essential healthcare, and while they might make it significantly harder to do so, no politician can stop us from accessing our basic right to abortion,” they said.
Florida provides critical reproductive health care for people throughout the South
The abortion bans in Florida will add strain to an already restrictive landscape that people in neighboring states like Louisiana, Mississippi, and Alabama have been contending with since the overturn of Roe.
When the six-week ban takes effect, people in the South will need to travel even farther for care. In 2023, North Carolina reduced access to legal abortion from 20 weeks down to 12, and also passed rules requiring patients to make two in-person doctor visits, with a 72-hour break in between. The only Southern state that allows abortion past the first trimester is Virginia, and beyond that the closest options are Washington, DC, and Illinois.
Total incidence of abortion has actually gone up since the overturn of Roe v. Wade, but an underlying reason is because travel out of state for abortion has also gone up, offsetting some of the newer restrictions in states with bans. Yet such travel is difficult and expensive, and it’s no guarantee that every patient looking to end a pregnancy will all be able to make a trip that’s hundreds of miles longer than before.
Florida voters could overturn the bans in November
One glimmer of hope for people in Florida and the entire South is a second ruling the Florida Supreme Court issued on Monday: A ballot measure to protect abortion access in the state can move forward.
The measure, which would require support from at least 60 percent of Florida voters to pass, would amend Florida’s constitution to protect abortion rights up to the point of fetal viability, or typically between 22 and 24 weeks of a pregnancy. Voters will have the opportunity to weigh in on this question in November.
Past polling indicates extreme abortion restrictions are not supported by the Florida public. In one survey conducted by Florida Atlantic University, 67 percent of Floridians said abortion should be legal in all or most cases, while just 12 percent supported a total ban. Another survey from 2023, led by the Public Religion Research Institute, found 64 percent of Americans backed abortion in all or most cases.
All seven ballot measures that have been advanced to protect abortion rights since the fall of Roe have passed. But those in red and purple states like Montana, Kentucky, Kansas, and Ohio did not have to reach a 60 percent threshold, receiving backing between 52 and 59 percent. Advocates for abortion rights expect the Florida campaign to be particularly expensive, running upwards of $100 million.
“It has never been more essential that the right to abortion be enshrined in the state constitution to protect access for Floridians and that we elect federal champions to protect the right to abortion at the national level,” said Reproductive Freedom for All President Mini Timmaraju. “We’re committed to working beside our partners on the ground to ensure that happens.”
Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates, said the Supreme Court’s decision “paves the way for Florida voters to stop these ridiculous abortion bans once and for all.”
Update, April 2, 2024, 3:35 pm: This story was originally published on April 5, 2023, and has been updated multiple times. Most recently, significant changes were made following the Florida Supreme Court’s ruling that the 15-week abortion ban is constitutional.
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