FORT LAUDERDALE, Fla. — Would Florida’s proposed six-week abortion ban be a total ban in practicality?
For a woman to terminate a pregnancy in the six-week time frame under the currently proposed law, numerous steps would need to happen. Here’s a look at the process a woman would face if Florida were to adopt one of the strictest abortion laws in the nation.
Confirming a pregnancy is the first step
Missing a period may be the first sign for some, but as many as 25% of women don’t have regular menstrual cycles, according to the National Institutes of Health.
“The majority of people don’t know they are pregnant at the six-week mark,” said Dr. Shelly Tien, who works at Planned Parenthood Southeast in Jacksonville as well as traveling to many other locations to work in women’s health care.
If a woman is regular and misses a period, she has only two weeks to act.
“It’s a very narrow window to recognize you are pregnant, confirm a pregnancy, make a decision on what you want to do, and get in to a provider to get care,” Tien said. “That’s an extremely narrow window to navigate the health care system and make decisions.”
The first step to confirm pregnancy is relatively easy, but timing matters.
Home tests — simply peeing on a stick — can confirm a pregnancy, but it can take about three weeks to have enough of the pregnancy hormone (hCG) in a woman’s body for the result to show positive.
Blood tests can confirm pregnancy a few days earlier than a urine test but must be ordered and interpreted by a doctor. For a woman who doesn’t already have an established OB-GYN, getting an appointment can take weeks, or even months.
Getting an abortion provider
The next step — getting to an abortion provider — can take time as well.
If a test shows positive, and a woman wants to terminate her pregnancy, she would need to go to an abortion clinic to get a sonogram. An OB-GYN can do a sonogram but it would need to be repeated at an abortion clinic, which is required by state law to do its own.
Getting in to a clinic can be a challenge in Florida, says Stephanie Loraine Pineiro, executive director of the Florida Access Network. The number of abortion clinics in the state have been declining and could drop further if the law becomes more restrictive than the 15-week ban now in effect. Pineiro said in Texas, which bans abortions at all stages of pregnancy, some clinics have relocated outside the state.
As it is, 73% of Florida counties don’t have abortion clinics, Pineiro said, referencing a Guttmacher Institute report on abortion.
Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates, said the current wait time at Florida’s Planned Parenthood clinics averages 20 days.
During a first visit to an abortion clinic, a woman seeking an abortion would get lab work, an ultrasound, education and options information, and a meeting with a physician to discuss the procedure. Florida mandates that a patient must have an ultrasound before an abortion and the option to view the image.
But what exactly does a sonogram show at such an early stage in pregnancy?
Doctors say the sonogram would only show a gestational sac, a fluid-filled structure surrounding an embryo visible during the first few weeks of embryonic development. The image shows up on an ultrasound at 4.5 to 5 weeks of gestational age.
“If we can’t see a sac, we will tell the patient to return in 7 to 10 days,” said Elena Senises, the administrator at the Miramar Women’s Center. “Even if a urine test is positive, we don’t do abortion if we don’t see anything. We need to rule out a tubal pregnancy.”
Senises said it’s unclear how the state will measure six weeks. Health officials could use the fertilization date, which for a woman with a regular period is about 11-21 days after the first day of the last period, or they could use the sonogram.
The 24-hour rule
In Florida, any woman seeking an abortion needs two visits to an abortion provider. She must sign consent forms, and then wait at least 24 hours to have the procedure. After seven years of court holdups, the 24-hour rule became mandatory in the state in April 2022, doubling the demand on abortion clinics for appointments.
“As much as possible, we try to give women both appointments when they make the first one,” Goodhue of Planned Parenthood said.
Pineiro said the navigating two appointments and other hurdles in Florida will put women way beyond six weeks.
“You are considering the best of circumstances for somebody,” she said. “That somebody is going to be able to not only find out that they are pregnant within that time frame, take the day off from work, coordinate childcare for two separate days and find an appointment in their area. It’s just not possible.”
For a woman who returns after 24 hours, a licensed doctor can complete an abortion surgically, or by medication.
Dr. Tien explains that a medication abortion involves providing one pill in person, and a second set of pills to take a home most commonly 24 to 48 hours later. “It’s usually very safe and effective, “ she said. “Half of the abortions nationwide are by medication. Women are counseled extensively on pain and discomfort and when to call with questions or concern.”
With medication abortions, Tien said, a follow-up appointment is made to ensure it worked. Failures have been reported in just 1.1% of patients.
How it applies to minors
The proposed six-week ban with its short time frame would be particularly onerous on minors.
In Florida, the parent of a minor must be notified and give consent before she can get an abortion. State law allows minors to petition a judge for a bypass to let them get an abortion without parental consent by convincing a judge she is “sufficiently mature” to choose an abortion.
The judge also can grant a petition for an abortion without parental consent if they find the child is a victim of sexual abuse inflicted by a parent or guardian.
Judges are supposed to rule within three business days after a petition is filed by a female under 18 seeking an abortion. If the court does not grant her the right to have an abortion, she can appeal, and that appellate court must rule within seven days.
Pineiro said the legal process isn’t set up to work quickly enough for minors.
During a Senate committee hearing Tuesday on the proposed six-week ban, Sen. Erin Grall, R-Lake Placid, the bill’s sponsor, acknowledged it would be very difficult for a teenager to go through the judicial bypass 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.
When the six-week ban would go into effect
Florida went from allowing abortion up to 24 weeks, to restricting it to 15 weeks in 2022.
Now lawmakers will decide whether they will restrict it further to six weeks and add an exception for pregnancies as the result of rape or incest, but only up until 15 weeks and with documentation. A fierce debate is expected Monday when the full state Senate takes up the bill; the House version of the bill cleared its last committee Thursday and is ready to go to the full House.
If passed by the Legislature and signed by Gov. Ron Desantis, Florida’s six-week abortion law would take effect if the state Supreme Court rules in favor of the current law that created a 15-week ban. That law is currently being challenged as unconstitutional by abortion providers and the American Civil Liberties Union of Florida. The state filed its briefing in the case on Wednesday.
Whitney White, an attorney, ACLU Reproductive Freedom Project, said the court hasn’t yet set a date for oral arguments. “We believe there are decades of precedents that render the abortion law blatantly unconstitutional,” she said.
“The court has some dates on its website, when they are scheduled to hear arguments, generally in May and June, but that’s not binding,” she said.
Pineiro said if a six-week ban were to go into effect, her organization will help women with travel costs who are further along in pregnancy. North Carolina, which allows abortion up to 21 weeks, would be the closest state with less restrictive laws.
“We’re committed to supporting our community and getting women the abortion care they need, even if that means leaving the state,” she said.
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