Florida: A reflection of the ‘chaos and confusion’ surrounding abortion rules in the US

Alejandra is 32 years old and has a tense expression. She is waiting for her appointment to have an abortion at the Planned Parenthood Golden Glades clinic in Miami. She sits in a room with four other women separated by hospital curtains. “I’m desperate, it’s a matter of life and death,” she says impatiently. Because of her epilepsy, the gynecologist has warned her that her “wanted” pregnancy is dangerous. That she should not “carry it to term.” She is eight weeks along but doesn’t want to risk it: she fears that if she leaves it any longer, the new law signed by Florida Governor Ron DeSantis, which will lower the legal limit for abortion in the state from 15 to six weeks, will take effect.

“I’ve been told I could die,” she continues. “It’s not about me anymore, it’s that I have a six-year-old daughter, and, frankly, I don’t trust my mother to take care of her.” She makes the gesture of caressing her belly with her hands and adds: “There are days when I wake up with this joy, but then I remember that I simply can’t.” She came to the clinic alone. Hardly anyone knows she’s there. That is why Alejandra is pseudonym.

June 24 will mark one year since a conservative-majority Supreme Court struck down federal protection for abortion in the United States. The ruling overturned the half-century-old precedent set by Roe vs Wade (1973), restored the states’ ability to legislate on the issue, and pierced the lives of women like Alejandra. The decision has also unleashed a multi-front war between two irreconcilable sides.

It has been 12 months of referendums, angry parliamentary discussions and judicial appeals. There is also a lot of misinformation and uncertainty, and it is often not easy to discern what is legal from what is not. Thirteen states have already banned abortion completely. In six others, laws were ready to go into effect as soon as Roe fell and although they have been challenged in the courts, they are well on their way to doing so. Six other states, with Republican majorities, have passed restrictive rules during this legislative session that, when they go into effect, promise to leave large regions of the country, mainly in the south and midwest, without access to abortion. The result is a map of “chaos and confusion,” as defined by Kelly Barden of the Guttmacher Institute, an independent organization that works at the intersection of politics and reproductive health.

That map changes almost daily. The latest change happened just last Friday in Iowa, where Supreme Court voted to block the reinstatement of a rule pushed by Governor Kim Reynolds that outlawed abortion after the sixth week and amounted to a near-total ban.

Few places better embody the ever-changing landscape of post-Roe America than Florida, where this time last year it was legal to terminate a pregnancy up to the 24th week of gestation. Shortly after the Supreme Court overturned Roe, Governor DeSantis signed a law lowering the limit to 15 weeks and six days, with no exceptions for cases of rape, incest, or human trafficking: abortion is only permitted if the mother’s life is in danger. The governor stated: “Life is a sacred gift worthy of our protection, and I am proud to sign this great piece of legislation which represents the most significant protections for life in the state’s modern history.”

Emboldened by their overwhelming electoral triumph last November, the Sunshine State’s Republicans, with a majority in both houses in Tallahassee, did not miss the opportunity and approved the six-week rule. The law is called the Heartbeat Protection Act as as fetal vitals are felt at about six weeks, although viability is not until the 22nd week at the earliest, according to the World Health Organization. This time the law includes the exceptions of rape or incest up to the 15th week, although it places the burden of proof on the rape victim, who must provide a medical report and a police report. If the mother’s health were in danger, two physicians would have to certify it.

The Planned Parenthood case

The governor has signed the law, but the rule will not go into effect until the Supreme Court rules on Planned Parenthood v. Florida — which could be any day now. Planned Parenthood, which is comprised of around half of the abortion clinics in the country, challenged the 15-week law on the grounds of the right to privacy recognized by the State Constitution. If, as appears likely, the justices decide in favor of DeSantis’ interests, Florida will automatically be at the forefront of anti-abortion restrictions. The southeast of the United States will become a gigantic desert for freedom of choice.

“The polls say 75% are against that law,” Nikki Fried, the only member of the Democratic Party who was part of DeSantis’ cabinet until the November defeat, explained to EL PAÍS. Fried ended up being arrested in April along with her party’s minority leader in Congress for protesting the rule. “[The governor] has done so because he believes that such extremist policies will help him gain support among the more radical base of his party.”

Fried believes, however, that it will take a toll on his White House aspirations, which is why he signed the bill “at night and behind closed doors.” DeSantis launched his White House bid in May, with a program based on fighting the progressive agenda of so-called “woke ideology” on issues such as education and the rights of trans people. He summed up this program with the slogan: “Make America Florida” — promising to make the whole of the United States become like Florida. “If he gets elected, he will try to ban abortion nationwide,” Fried warns.

The issue has become a hot potato for Republican presidential candidates, who seem to have understood, as demonstrated in last year’s midterm elections, that policies that are too radical can lose them votes. Without going any farther, the other two Florida-based hopefuls in the crowded race for the conservative party’s nomination — former president and clear front-runner Donald Trump and Miami Mayor Francis Suarez — have openly criticized DeSantis’ bill.

In addition to the new abortion legislation, Planned Parenthood’s Golden Glades clinic in Miami, is adapting to Florida’s new rules on gender-affirming care, which is banned for minors and restricted for adults. Christopher Pettaway, a patient coordinator at the clinic, says the six-week limit on abortion is “catastrophic.” “Many women can’t tell by then if they are pregnant, it’s only been two weeks since they missed their period. Fifteen weeks, on the other hand, seems to me to be a reasonable middle ground between the two camps,” he says. Pettaway explains that an abortion at the health center (one of Planned Parenthood’s 18 in Florida) costs between $600 and $900 depending on how far along the pregnancy is. It is also an expense that the state’s Medicaid program expressly does not cover. In addition, patients are required to make two visits separated by at least 24 hours. They are given an ultrasound and informed of the various options available to them, as well as assistance if they opt for adoption.

“Many opt for the abortion pill, but that method is also threatened in the courts. If they take mifepristone off the market, it would be disastrous,” says Lucy Estrada, director of Planned Parenthood’s Miami health center. She is referring to attempts by an ultraconservative Texas judge to ban the drug (along with misoprostol) that is used in about half of all pregnancy terminations in the United States. The case is still in the hands of a New Orleans appeals court.

Estrada confirms that being surrounded by anti-abortion states, Florida receives many patients from Georgia, Alabama, Mississippi, Louisiana, and Texas to whom Planned Parenthood and other organizations provide assistance, if they need it for travel: bus, lodging or travel in the city, thanks to an agreement with Uber.

If the Heartbeat Protection Act finally goes into effect, the state will cease to be a receiver and become a sender, which will increase the pressure on other places. To the west, it would be necessary to travel to New Mexico — Miami and Santa Fe are 3,200 kilometers (1,988 miles) apart. To the north, the Carolinas await. In South Carolina, a law with a six-week limit is blocked by a judge and awaiting review by a conservative five-man Supreme Court. In North Carolina, a rule prohibiting the termination of a pregnancy after 12 weeks is scheduled to come into force on July 1. Beyond that, there is Virginia: between Miami and its capital, Richmond, there are more than 1,500 kilometers (932 miles).

“A lot of people forget the effect these bans have for complicated pregnancies,” explains Dr. Shelly Tien. The expert in at-risk gestations, who also used to provide her services in Oklahoma and Alabama, now works only at a Jacksonville, Florida, clinic. “It happens even with healthy patients. Most of these mishaps occur after six weeks. These prohibitions affect not only women, but also their families and the communities in which they live. They also prohibit conversations between patients and doctors, who are unable to provide the necessary care before it is too late, and the situation becomes critical.”

That is precisely what Alejandra, the woman with epilepsy in the waiting room, wanted to avoid at all costs. The day after the procedure, she described the experience as “horrible” and said he still did not understand why “[politicians] are putting the lives of many women and children in danger. I don’t know why they think they have the right to control us.”

To change that, an association called Floridians for Freedom has started a petition to force a separate vote in the 2024 presidential election. They want to introduce an amendment to the state constitution that says: “No law shall prohibit, criminalize, delay or restrict abortion prior to its viability or when necessary to protect the health of the patient if deemed necessary by her physician,” such as Michigan and Kansas have already done in the year since the Supreme Court ruling. At the moment, they have 130,000 signatures. They need 800,000 signatures before February 2023.

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