Shock, frustration, anger, desperation: The real-life toll of Florida’s six-week abortion ban

On a Wednesday afternoon in a Tamarac abortion clinic, Eileen Diamond delivers the same news to the fourth patient in a row: “I am unable to help you here.”

She tells the woman her ultrasound confirms she is more than six weeks into the pregnancy, and in Florida, the services the patient seeks are no longer a legal option.

The woman stares at Diamond. “No, you have to help me,” she pleads, “I can’t afford another child.”  Diamond, director of Benjamin Surgical Services International, knows the panic will soon turn to tears, and anger will follow.

In a calm voice, Diamond offers the same information she has provided dozens of times to patients since May 1, when Florida’s six-week abortion ban took effect.

“If you want to continue with your abortion, you have to go to a state in which a clinic is going to be able to provide it safely and legally,” she says.

Outside in the waiting room, people occupy nearly every seat: a teenager with acne and braids who stares at the floor, a mother with her infant son using her foot to rock him in his baby carrier, a heavy-set woman clad in blue scrubs and a hair net nervously fiddling with her phone.

“We’re still seeing the same amount of patients,” Diamond says. “We’re just not able to perform abortion care for all of them.”

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Across the state, women, and sometimes the men in their lives, fill the waiting rooms of abortion clinics only to confront Florida’s newest abortion restrictions if they are further along than five weeks and six days pregnant and unable to squeeze in two visits at least 24 hours apart. Sometimes in Spanish, sometimes in Creole, and sometimes in straightforward English, clinic workers tell women they can’t have what they came for. As of May 1, Florida bans abortion after six weeks, only two weeks after a missed period.  The state also requires a 24-hour waiting period after an initial consent visit before a medication or surgical abortion can happen.

The reality of the law leaves little wiggle room. Many women don’t get regular periods, and those with unintended pregnancies often tend to recognize the symptoms — nausea, tender breasts, weight gain — at seven weeks or later. Often, patients call or arrive at a clinic unaware of Florida’s six-week ban, still trying to fathom that their birth control has failed.

“There is so much emotion to begin with just coming to the clinic,” said Betty, a volunteer at an Orlando abortion clinic who does not disclose her last name to anyone. “I consoled a woman today who was six weeks and two days. She broke down and dropped to the floor crying. I told her you are not the only one in Florida in this situation. We will help you. It will be okay.”

For the panicked Orlando woman, the nearest abortion clinic legally able to help her is now a nine-hour drive away in North Carolina, where the procedure is allowed through 12 weeks and six days of pregnancy. Because the woman can’t afford to travel, national and Florida-specific funds will work together to help with costs and arrangements. Many Florida women now fly to D.C., Virginia, or Illinois, where clinics are struggling to care for the thousands of patients from abortion-restricted states across the Southeast.

However, not every woman wishing to end a pregnancy can manage to leave Florida for the services.

At a South Florida clinic, a Guatemalan farmworker recently learned she is eight weeks pregnant and too far along for an abortion in Florida. She doesn’t have a driver’s license, a credit card, money to travel, or the ability to take time off. Nor does she earn enough to feed and care for another child. She tells the clinic worker she thought she was being careful, but her pregnancy test and ultrasound results confirmed otherwise. With her face buried in her hands, she repeats “no” over and over. Through sobs and in Spanish, she says she can’t have the baby, can’t miss work, and can’t let her boss know her situation. She leaves distraught.

When it all started

Florida’s abortion restrictions began in July 2022 when a 15-week ban went into effect soon after Roe v. Wade fell. In 2023, more than 84,000 women received an abortion in Florida, which drew travelers from places with stricter laws, including nearby Southern states as well as Latin America and the Caribbean. This year, the six-week ban replaced the earlier restriction.

Those numbers are certain to shift downward this year , with Florida now being one of the most restrictive states in the U.S.

Abortion rights advocates are hoping voters will approve a measure in November that would lift the ban in January 2025 and restore abortion access in Florida until roughly 24 weeks of pregnancy. Regardless, thousands of women must deal each week with the consequences of the existing law.

At Planned Parenthood Health Center in Miami, Dr. Chelsea Daniels wishes all Floridians could sit in her office to witness what unfolds.

“I wish they could see how devastated and panicked people are when you have to give them that news,” Daniels says. “You can’t possibly understand the complexity of their lives. It runs the gamut from ‘My last pregnancy nearly killed me,’ to ‘I was so sick I lost my job, I can’t do this again,’ to ‘I am a single mom and I am barely making ends meet,’ to people who say they want to be pregnant but have a complicated medical condition.”

Daniels says she has had patients tell her they don’t support abortion and then say, “But I need this abortion.”

“I think that goes to show you don’t know what someone else is going through,”  Daniels says, adding that the circumstances that lead women to the clinic often are misunderstood. “Lots of people are on birth control that has worked for them for years, but nothing is 100%. Even if you are taking every precaution, you can become pregnant.”

Since May 1, the Miami Planned Parenthood clinic has turned away more than 350 women, sending them to other states.

Sammy, who asked that her full name not be used, nearly became one of them.

On a hot August day, when every seat in the clinic’s waiting room is filled, Sammy sits at a desk opposite Daniels. First, Sammy swallows a mifepristone pill that stops the pregnancy from growing. Then the doctor hands her bottles with pills of misoprostol to take the next day at home. They will empty her uterus. Sammy breathes a sigh of relief as she puts the bottles in her purse. She has made the six-week cutoff without a day to spare.

Just 10 days earlier, Sammy, 30, went to the emergency room with complications from COVID and a throat infection. A blood test revealed her pregnancy. Had she not learned of it in the ER, she says, she would be in the same desperate situation as others in the clinic. Divorced since 2021, Sammy says she didn’t think it was possible for her to get pregnant, noting her litany of health issues.

“I have epilepsy, asthma, anxiety, and depression,” she says.  “I have no income, and mental healthwise, I can’t take care of a child.”

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Florida’s law has given rise to self-managed abortions

With 22 states enacting some type of abortion ban or restriction, desperation has led more women to choose to end pregnancies themselves, according to a study published in the Journal of the American Medical Association Network Open.

Self-managed abortion typically includes any action taken to end a pregnancy without medical supervision. It includes self-sourcing medications mifepristone and misoprostol, ingesting herbs, alcohol, or other substances, or using physical methods like a woman who punches herself in the stomach.

In Florida and other states with bans, telehealth appointments with out-of-state physicians and mail-order abortion pills play an increasingly greater role in how women opt to end their pregnancies. State law requires women to get pills in person. However, many providers in other parts of the U.S. are protected by state shield laws that allow them to ship medication to Florida.

Undergoing a medication abortion at home without a local doctor involved comes with risks and reasonable questions:  Are the pills authentic? What happens if there’s a complication?

Organizations in Florida, called abortion funds, will help with costs for travel but not with the cost of medication purchased online.

“We won’t pay for that, and those providers require payment upfront,” says Kamila Przytula, executive director of Women’s Emergency Network, a Miami-based abortion fund. “That’s a barrier for some women. A credit card is not something everyone has access to.”

With a medication abortion, the process is similar to an early miscarriage with cramping and bleeding. Typically, medication abortions are safe and overall effective, but rare complications can happen, such as an incomplete abortion. Clinic directors recommend anyone see a doctor who still has pregnancy symptoms after medication.

“I want them to feel empowered to come talk to us about their question, concerns or complications,” Daniels said.

So far, in 2024, doctors have performed 40,500 abortions in Florida, with the largest number of them, 8,422, in Miami-Dade County. It’s too early to know how much the six-week ban will reduce abortions in the state for the full year. However, clinics do report that women no longer travel to Florida from other states for abortion care, and July 1 and Aug. 1 state reports offer a two-month window showing reduced numbers of abortions.

Reproductive rights advocates say the abortion referendum that will be put before Florida voters in November has turned the Sunshine State into one of the most critical battlegrounds for women’s reproductive rights since the fall of Roe v. Wade. Voters will decide whether to enshrine a right to abortion through viability in the state constitution. At least 60% of voters must vote yes for the amendment to pass .

At her clinic, Diamond tells the angry women denied abortion care to vote and take back some power over the laws that impact their lives. “I try to redirect their hopelessness,” she says.

Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com .