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Women are circumventing Florida’s six-week abortion ban through telehealth, mail and travel

ORLANDO, Fla. >> In the month since Florida imposed a six-week abortion ban, Lana’e Hernandez has helped nearly 200 women figure out how to end later pregnancies, work that sometimes means securing plane tickets, hotel rooms and money to pay for clinics in places as far away as Illinois.

Her clients included a first-time mother who terminated a pregnancy due to serious fetal health problems, and a single mother of five who was unable to support another baby. She said some of her clients have never left the state or flown on an airplane before.

“This could be one of the most difficult decisions our patients have ever had to make in their lives, and our government has put them in a position where they have to leave their support system and travel across the country and incur enormous costs. Hernández said. “I wish I could just be at the airport and take them to their gate.”

Hernandez’s experiences underscore the many ways Florida’s new abortion rules have made it more difficult for women and health care providers struggling with how to end a pregnancy.

While some women are traveling, others are using telehealth appointments with out-of-state doctors to obtain abortion-inducing medications. Their decisions are fraught with emotional and logistical issues – and it is unclear how long these options can hold up in the face of financial and legal challenges.

Hernandez has a perspective on the issue as a patient navigator for Planned Parenthood of 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. Fourteen states now ban it outright, with limited options. exceptions. Three states, including Florida, ban it six weeks from the first day of a pregnant woman’s last menstrual period, with some exceptions.

Florida had a ban on 15-week abortions since 2022 and before that it was allowed up to 24 weeks.

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

The state abortion data for May is not yet complete, so the exact impact of the new rule is not clear.

The November election could also change access to abortion. Residents will be asked to vote on Amendment 4, which would make abortion constitutionally protected in Florida until a viability period — about 24 weeks — if 60% of voters say yes.

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

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

Medical providers in Florida performed more than 84,000 abortions last year, including nearly 8,000 on people who came from out of state.

Organizations called abortion funds aim to help women circumvent state bans. According to the National Network of Abortion Funds, these funds provided more than $36 million for abortions and more than $10 million for logistics support across the country in 2023.

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

“Florida’s ban forces Floridians and people in the Southeast to travel further, depleting resources for travel and practical support even faster,” Pineiro said.

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

Dr. Ushma Upadhyay, a professor at the University of California San Francisco’s Advancing New Standards in Reproductive Health, believes that because of the new restrictions, many women in Florida have been or will be getting abortion-inducing pills online.

This is a viable option under current legislation, but overlapping rules complicate the situation. Although the state prohibits prescribing abortion medications via telehealth, the ban applies to doctors and not the women themselves.

Certain states have passed “shield laws” that aim to protect doctors licensed in that state from prosecution for prescribing abortion pills to people in states where it is illegal. Online pharmacies then fill these prescriptions and send them by mail.

According to estimates from The Society of Family Planning’s #WeCount project, a national report on abortion, nearly 8,000 people in states that ban or restrict abortion are prescribed and mailed abortion pills each month under shield laws.. One of the largest providers, Aid Access, charges $150 or less.

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

Currently, Florida women who end their pregnancies this way are not prosecuted, nor are the people who help them. Governor Ron DeSantis has previously said that pregnant women who undergo abortions in violation of Florida law would not face criminal charges, in line with an earlier Supreme Court ruling.

However, the telehealth prescribing movement is alarming people who support abortion bans. Staver of Liberty Counsel is “optimistic” that this practice will be banned in the future.

“I think it’s a big concern,” Staver said. “It makes no sense for Florida to pass a law regulating brick-and-mortar facilities while at the same time someone is intentionally sending drugs into Florida that are specifically intended to violate the law.”

The U.S. Supreme Court ruled Thursday that safeguards access to the drug mifepristone, which is used in many abortions, but other legal challenges are also expected.

Dr. William Lile — a North Florida obstetrician and gynecologist who calls himself the “ProLife Doc” and believes life begins at conception — said he’s concerned about the health of women who are given pills without personal testing to confirm how far their pregnancy is. and to rule out conditions such as ectopic pregnancy.

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

“We’ve already had cases of women being harmed,” Lile said. “They thought they were taking the pill for an abortion, but in reality they were among the 1% who had an ectopic pregnancy and it delayed them from seeking health care.”

According to the U.S. Food and Drug Administration, these pills are generally safe to take up to ten weeks into pregnancy. She notes that while side effects are common, serious side effects are rare.

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

Researchers at Middlebury College estimate that the average Florida resident now lives nearly 600 miles from the nearest clinic that offers abortions after six weeks, compared to an average of 20 miles before the ban. Wait times for appointments have increased at about 30% of clinics in North Carolina, Virginia, Maryland and Washington, D.C., the closest states where abortion is legal after six weeks of pregnancy.

“I hear people say, ‘Well, I had an abortion, but I went to Georgia, and then to Ohio, and some of my rent hasn’t been paid, and I don’t know.’ where I’m going to live,” Jenice Fountain, executive director of the Yellowhammer Fund of Alabama, said during Monday’s press conference. “That’s not a victory.”

Dr. Robyn Schickler, chief medical officer for Planned Parenthood of Southwest and Central Florida, said some women, aware of the new law, are quickly making appointments and having abortions within the new legal time frame. Others may take the time and pay at least some of the costs for an out-of-state trip.

But she is haunted by the patients she cannot help.

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

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Distributed by Tribune Content Agency