Florida’s six-week abortion ban harms the health and safety of Florida patients while obstructing clinicians from providing basic reproductive and maternal medical care, according to a new research brief published today by Physicians for Human Rights (PHR).
“Delayed and Denied: How Florida’s Abortion Ban Criminalizes Medical Care” is the first study to document the consequences of Florida’s abortion ban on health care workers’ experiences of patient care since the state’s six-week ban went into effect in May 2024.
The research brief demonstrates the damage to reproductive health care and rights in Florida as clinicians struggle to provide care to pregnant patients while navigating the extremely restrictive and opaque new law. PHR’s qualitative research is informed by in-depth, semi-structured interviews conducted in July and August 2024 with 25 reproductive health care clinicians in Florida about their experiences caring for pregnant patients under the six-week ban.
“Florida clinicians shared harrowing accounts of how routine medical care has been delayed, denied, and deviated from standards of care. Not only abortion care but miscarriage and broader maternal health care have suffered gravely due to the state’s ban. Our research brief sheds new light on the health and rights crisis fueled by Florida’s abortion ban – on patients, providers, and the medical system as a whole,” said Michele Heisler, MD, MPA, research brief co-author, PHR medical director, and professor of internal medicine and public health at the University of Michigan. “Under the state’s abortion ban, Floridians have lost their reproductive autonomy.”
Findings from the in-depth interviews with Florida clinicians reveal:
- Florida’s six-week criminal abortion ban poses insurmountable barriers to abortion care for many patients, harming pregnant patients’ health and impairing clinicians’ ability to meet their professional obligations to provide high-quality reproductive health care.
- Many patients do not know they are pregnant before the six-week time limit or cannot get an abortion before six weeks due to the 24-hour waiting period for abortion care.
- The ban’s narrow and vague exceptions are unworkable in practice leading to numerous cases of delays and denials of care for medical emergencies and severe fetal anomalies.
- The state’s Florida Agency for Health Care Administration (AHCA) emergency rule – which states that procedures to treat PPROM (premature rupture of membranes), ectopic pregnancy, and trophoblastic tumors would not be considered abortions for state reporting purposes – has not eliminated delays caused by the ban in care in cases of PPROM and ectopic pregnancy, causing suffering and serious health risks.
- The ban’s exception for “fatal fetal abnormality” is defined to only include those that are “imminently lethal;” clinicians reported that the interpretation of this provision in Florida at some hospitals means that people are denied care if the condition will not be immediately fatal upon delivery, limiting conditions for which clinicians can provide care to patients.
- The ban has led to the disruption of the patient-clinician relationship and deviations from standard medical care including maternal health care. Many clinicians spoke of how the ban caused delays in miscarriage care.
- The ban is leading health care providers to leave or consider leaving the state, as well as impairing the training of new clinicians, worsening Florida’s already severe health care provider shortages.
Following the US Supreme Court’s overturn of Roe v. Wade, in July 2022 Florida enacted a criminal ban on abortion care after 15 weeks of gestation from the first day of a pregnant person’s last menstrual period, with only limited exceptions. After an April 2024 decision by the Florida Supreme Court, a far more restrictive six-week abortion ban was implemented in May 2024. This latest ban cut the legal limit for abortion from 15 weeks to six weeks from the first day of a pregnant person’s last menstrual period and included only very narrow exceptions.
Those found to be performing or participating in a pregnancy termination in violation of the ban face up to five years in prison, fines, and loss of medical licenses. In November 2024, voters in Florida will consider a ballot initiative (Amendment 4) that would enshrine abortion rights in the state constitution.
The AHCA, the state’s health agency, also continues to assert that the six-week abortion ban protects women’s safety and health. However, evidence documented by PHR shows that despite AHCA statements, the six-week ban is clearly resulting in delays and denials of medical care that severely harm Floridians.
For example, clinicians told PHR that the six-week ban is unclear in its guidelines and the steep penalties create fear and confusion among health care providers, who do not know in what cases they legally can or cannot provide abortion care. Clinicians reported receiving warnings from hospital administrators, legislators, and others that they may be targeted for providing necessary abortions and that these laws are being strictly enforced. This has led to an overall chilling effect on the provision of health care and has hindered access to abortion care for pregnant people, many of whom have a medical necessity for the procedure.
The 25 Florida clinicians and clinicians in training who were interviewed by PHR describe how the state’s abortion ban has led to routine medical care being delayed, denied, and deviated from standards of care. For example, one clinician highlighted how abortion criminalization has impeded health care: “I am being told I cannot be a doctor, and if I want to be a doctor, I will go to prison for five years.”
An obstetrician-gynecologists told PHR about being referred miscarriage cases for non-medical reasons from nearby emergency rooms:
Another Florida obstetrician-gynecologist told PHR about having to wait weeks until a patient’s “kidneys [were] about to fail” until they could offer pregnancy termination under the state’s previous 15-week ban:
“I strongly remember a patient who had severe kidney disease … She was getting sicker and sicker….[We] had to bring it to the head people of the hospital and be like, ‘What are we allowed to do?’ And they were like, ‘She’s not sick enough yet.’ … …I think it took over two weeks for us to get an answer from the hospital administrators. …So that hit very strongly, because it was kind of insane that we had to wait for her to become sicker. We had to wait for her creatinine to bump and her kidneys to be about to fail before we were allowed to even offer her [termination]. Then we had to jump through so many hoops to be able to do it. It really changed everything that we did in our practice.”
“The findings of PHR’s research brief demonstrate the need to remove Florida’s extreme abortion ban and restore access to comprehensive reproductive health care in the state,” said Payal Shah, JD, research brief co-author and PHR’s director of advocacy, legal, and research. “Both patients and providers are trapped in an unworkable legal landscape. Despite state health agency statements to the contrary, the state’s abortion ban is an egregious intrusion on patient autonomy that is causing medical harm. The ban’s criminal penalties and narrow, vague exceptions have compelled clinicians to deviate from established standards of care and medical ethics. These impacts constitute violations of Floridians’ human rights.”
Florida is currently rated 49th out of 50 U.S. states for the provision of prenatal care, leading to serious risks for pregnant people. The burdens of Florida’s maternal health care crisis and abortion ban fall disproportionately on already marginalized communities.
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.