Women are bypassing Florida’s 6-week abortion ban by using telehealth, mail and travel

ORLANDO, Fla. >> In the month since Florida implemented a six-week abortion ban, Lana’e Hernandez has helped nearly 200 women learn how to end a later pregnancy, which sometimes means securing airfare, hotel rooms and money to pay for clinics in places as far away as Illinois .

Her clients include mothers who decided to terminate their pregnancies for the first time due to serious fetal health defects and a single mother of five children who is unable to support another child. She said some of her clients had never left the state or flown before.

“This may be one of the most difficult decisions our patients have faced in their lives, and our government has put them in a position where they must leave their support system and travel across the country at great expense,” Hernandez said. “I just wish I could be at the airport and walk them to the gate.”

Hernandez’s experience highlights how Florida’s new abortion laws have made it more difficult for women and health care providers to grapple with the question of how to end a pregnancy.

While some women travel, others use telehealth with out-of-state doctors to obtain abortion-inducing drugs. Their decisions involve emotions and logistical difficulties – it is unclear how long these options can be maintained in the face of financial and legal challenges.

Hernandez has insight into this issue as a patient navigator at Planned Parenthood in Southwest and Central Florida, a job that has become increasingly common since the U.S. Supreme Court struck down the constitutional right to abortion in 2022. Currently, fourteen states prohibits it completely, with limited restrictions. exceptions. Three states, including Florida, ban it six weeks after the first day of a pregnant woman’s last period, with limited exceptions.

Florida has a 15-week abortion ban in place since 2022, and previously allowed it up to the 24th week.

Since Florida’s new ban went into effect May 1, some women have been able to get abortions within state borders, providers say, and others who don’t know they are pregnant until six weeks have chosen to continue with unwanted or unsafe pregnancies.

State abortion data for May is not yet complete, so the exact impact of the new rule is unclear.

The November elections may also change access to abortion. Residents will be asked to vote on Amendment 4, which would make abortion constitutionally protected in Florida until it is enforceable – about 24 weeks – if 60% of voters say yes.

Supporters of Florida’s six-week ban say they are confident it will significantly reduce the number of abortions performed by state residents, despite efforts to circumvent it.

“So far, in the vast majority of cases, it will have a big impact, just like in other states,” said Mat Staver, founder of pro-life Liberty Counsel. “Florida will not be an abortion hotspot as it was before this law was introduced.”

Last year, medical facilities in Florida performed more than 84,000 abortions, including nearly 8,000 for people who traveled from out of state.

The goal of organizations called abortion funds is to help women circumvent state bans. According to the National Abortion Fund Network, in 2023, these funds provided more than $36 million for abortions and more than $10 million in logistical support across the country.

But rising costs have made it impossible to fully meet the need, Stephanie Loraine Pineiro, executive director of the Florida Access Network abortion fund, said at a Monday news conference hosted by the national network.

“Florida’s ban forces Floridians and residents throughout the Southeast to travel further, depleting travel and practical support funds even faster,” Pineiro said.

Pineiro said her fund has helped 150 people over the past month, but can only cover about 50% of requested expenses on average.

Dr. Ushma Upadhyay, a professor at the University of California, San Francisco, believes that because of the new restrictions, many women in Florida have obtained or will obtain abortion pills online.

Under current law, this is a viable option, but overlapping regulations complicate the situation. Although the state prohibits telehealth and the prescription of abortion drugs, this prohibition applies to doctors, not women themselves.

Some states have passed “shield laws” designed to protect licensed clinicians in that state from prosecution for prescribing abortion pills to people in states where it is illegal. Online pharmacies then fill and ship these prescriptions.

Nearly 8,000 people a month in states with abortion bans or restrictions are prescribed and mailed abortion pills under contraceptive shield laws, according to estimates from the Family Planning Society’s #WeCount project, a nationwide abortion reporting effort.. One of the largest providers, Aid Access, charges $150 or less.

“Telehealth really removes a lot of barriers to abortion,” said Upadhyay, who is also co-chair of #WeCount. “Patients don’t even have to take time off work or seek child care.”

Currently, neither Florida women who end their pregnancies in this way nor those who help them face criminal penalties. Gov. Ron DeSantis has previously said that pregnant women who had abortions in violation of Florida law would not face criminal charges, in line with a previous state Supreme Court ruling.

However, the telehealth movement worries people who support abortion bans. Liberty Counsel’s Staver is “optimistic” that the practice will be banned in the future.

“I think it’s a serious problem,” Staver said. “It makes no sense for…Florida to pass a law regulating the operation of inpatient facilities, and at the same time someone is intentionally shipping drugs to Florida that are intended to violate the law.”

The U.S. Supreme Court issued a ruling Thursday preserving access to the drug mifepristone, used in many abortions, but other legal challenges are expected.

Dr. William Lile – a North Florida obstetrician and gynecologist who calls himself “Doctor ProLife” and believes that life begins at conception – expressed concerns about the health of women who take the pill without in-person testing to confirm advanced stage of pregnancy and to rule out such conditions , such as ectopic pregnancy.

The condition in which a fertilized egg develops outside the uterus is rare but can be life-threatening. A ruptured ectopic pregnancy causes symptoms similar to an abortion, so women on the pill may not realize what’s really happening, he said.

“We have already had cases of women who have suffered harm,” Lile said. “They thought they were taking the pill for an abortion, but actually they were in the 1% who had an ectopic pregnancy, which delays them from seeking health care.”

According to the U.S. Food and Drug Administration, these pills are generally safe for use up to week 10 of pregnancy, stating that while side effects are common, serious side reactions are rare.

However, not everyone can travel or obtain the pills. The ban hit some women hard.

Researchers at Middlebury College estimate that the average Floridian now lives nearly 900 miles from the nearest clinic offering abortions after six weeks, compared to an average distance of 20 miles before the ban. Wait times for appointments have increased at about 30% of clinics in North Carolina, Virginia, Maryland and Washington, the closest states where abortion is legal after six weeks of pregnancy.

“I hear people say, ‘Well, yes, I had (an abortion), but I went to Georgia first and then to Ohio and I’m not paying part of the rent, and I don’t know. where I will live,” Jenice Fountain, executive director of the Yellowhammer Fund in Alabama, said during a press conference on Monday. “It’s not a victory.”

Dr. Robyn Schickler, Planned Parenthood’s medical director for Southwest and Central Florida, says some women, aware of the new law, are quickly making appointments and getting abortions under the new legal framework. Others may take the time and cover at least some of the costs of moving out of state.

But she is haunted by patients she cannot help.

“No matter how hard you try to help, some patients cannot leave for various reasons. These are the most disadvantaged and vulnerable people who are forced to continue their pregnancy,” Schickler said.

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