Four and a half months of one of the most severe abortion restrictions in the country have brought many traumas in Florida. Dr. Jerry Goodman has seen and heard it over and over again since the law that limits access to abortion until just the sixth week of gestation went into effect in May, before many women even know they are pregnant. “It is not unusual to see a patient come in at 12 weeks with hemorrhage, a ruptured membrane, and a pregnancy that cannot continue.
The situation leads to infection, fever, and sepsis, but because there is still a fetal heartbeat, professionals are restricted from offering care. Even when we know that the fetus cannot survive outside the uterus, we are forced to wait,” said this obstetrician-gynecologist with more than 50 years of experience this Wednesday at a virtual press conference organized by Yes on 4, the official campaign in favor of the protection of the right to abortion in the State of Florida.
On November 5, a plebiscite will be held that puts voters in front of the choice of maintaining the current ban or approving Amendment 4, which, if supported by at least 60%, would guarantee under the state constitution the right of women to end a pregnancy before viability.
In this campaign context, in which the state government of Ron DeSantis has deployed a multiple strategy to torpedo abortion protection at the polls , the organization Physicians for Human Rights has published a report detailing how the current rule criminalizes basic care and endangers patients.
According to the report, the six-week restriction is unclear in its provisions and introduces barriers to care, delays in emergency services, and deviations from standard medical practice. It also notes how the vagueness of the law and the heavy penalties have created confusion and fear among health care providers who do not know in which cases they can provide a clinically necessary abortion, straining relationships with patients and, in some cases, forcing them to move out of state.
According to testimonies from doctors and health care personnel, they have also received warnings from hospital administrators, legislators, and others saying that they could be the target of criminal investigations for providing essential care.
The report includes examples of delays and denials of reproductive health care, including abortion care and management of miscarriages, but also deviations from standard medical care, poor training of new physicians, and an exodus of health care providers from the state — which it says worsens Florida’s already severe shortage of health care providers. Patient care is hampered even in “cases of ectopic pregnancy, molar pregnancy, and premature rupture of membranes, despite state health agency rules stating that these conditions should not be considered abortion.”
Dr. Cecilia Grande, who has been practicing medicine in Miami for 30 years, also spoke in favor of Amendment 4, feeling bound and forced to be in conflict with her training and ethical responsibility. “It is unacceptable to have to tell a woman who needs medical attention that her doctor cannot help her until she is on the verge of death. […] Decisions must be based on medical ethics and patient autonomy,” she said with conviction in the video conference.
For Grande, the “exceptions” are merely false promises. In practice, she explains, as does the Physicians for Human Rights report, legal, regulatory and logistical obstacles make it nearly impossible for women to get the care they need. They also especially affect Latinas, who “already have limited health insurance, language barriers and economic barriers.”
“I have had rape victims, and it is cruel that the State of Florida forces them to obtain a police report or a court order. This makes these poor victims re-victimize themselves. We have to be very clear that the women of the State of Florida and gynecologists are not asking for this restriction. Our daughters, our sisters, have fewer rights in Florida today than our mothers,” said Dr. Grande.
In Florida, the third most populous state in the country, there are 4.6 million women of reproductive age: 4.6 million people with fewer rights than they had just a few years ago. The law, known as the Heartbeat Law, was approved by Florida’s Republican-majority legislators in April 2023, by a vote of 70-40, and went into effect on May 1 of this year.
It is one of the most restrictive laws in the country, which after the Supreme Court’s historic ruling in 2022 against Roe vs. Wade, the legal precedent that guaranteed access to abortion nationwide, gave states the power to legislate on the matter. In Florida, the ban means that anyone who “deliberately performs or actively participates in an interruption of pregnancy” is committing a third-degree felony, punishable by up to five years in prison, a fine of up to $5,000, loss of medical license, or all of the above. Unlike many other states, Florida’s ban does not clearly exempt pregnant people themselves from criminal prosecution.
Current law provides for limited exceptions in situations of medical necessity to save the life of a pregnant person; to “avoid a serious risk of imminent, substantial, and irreversible physical impairment of a major bodily function… other than a psychological condition”; in cases of fatal fetal malformation when the pregnancy has not reached the third trimester; and in pregnancies resulting from rape, incest, or human trafficking before 15 weeks, only if the patient presents “a copy of a restraining order, police report, medical records, or other court order or documentation showing” that she is requesting the termination of the pregnancy because she is a victim of one of these cases.
The drama in Florida regarding abortion is taking place in parallel with others in other states. This week, for example, the media outlet ProPublica published two investigations about women who died in Georgia directly due to the lack of care that these restrictions imply.
This Wednesday, speaking at an event with the Latino community in Washington, presidential candidate Kamala Harris referred to this case and recalled that “40% of Latinas live in a state where abortion is prohibited.” Although the vote on Amendment 4 that would seal the right to abortion is in Florida, the situation permeates the national campaign.