Florida accounts for 8% of U.S. abortions. With a forthcoming ban, where will patients go?

Abortion access organizations say they are confronting an imminent crisis with Florida’s forthcoming six-week ban on abortion. The state, whose neighboring states also have imposed abortion restrictions, was home to more than 84,000 abortions last year, a little over 8% of the estimated total abortions across the U.S. in 2023.

Most of those abortions were for Florida residents, but thousands also were performed on patients who came from nearby states that already restricted abortions after the U.S. Supreme Court overturned Roe v. Wade in 2022. Several reproductive health organizations said there simply isn’t the capacity elsewhere to see so many patients.

“We see this as a public health catastrophe. We’re the second largest abortion-providing state after California,” said Amy Weintraub, the reproductive rights program director at Progress Florida, a nonprofit advocacy group for progressive causes. “Even if all these people were able to get appointments, pay for transportation, [have] childcare arranged, and all the rest, there’s no way clinics in other states could provide the load that providers in Florida currently do.”

The state Supreme Court laid the legal groundwork on Monday for the six-week ban to go into effect as of May 1, while it also approved a November ballot measure that will give Floridians the chance to enshrine abortion protections in the state constitution. The decisions mean that, for at least the six months ahead of the vote, most Floridians wanting abortions will have to either continue their unwanted pregnancies or leave the state for medical care.

The two closest states where abortion remains broadly available, Virginia and North Carolina, performed significantly fewer abortions combined last year than Florida alone. “They can’t absorb 84,000 patient visits, there’s just no way,” said Lauren Brenzel, campaign director for Floridians Protecting Freedom, which campaigned for the November abortion referendum.

She expects large numbers will have to shoulder the expenses of traveling to Illinois and New York, where there is more capacity. There’s no obvious place where Floridians can easily drive to access care. “People will turn to not necessarily the closest geographically, but the cheapest airline ticket,” said Weintraub. Major metropolitan areas like Washington, D.C., Philadelphia, New York, and Chicago are obvious sites.

“It’s an unimaginable, devastating reality that I don’t have coherent words for,” said Chelsea Daniels, an abortion provider at a Planned Parenthood clinic based in Miami. Six weeks is “much too early for most people to know they’re pregnant,” she said. Pregnancy is calculated based on the last menstrual cycle, meaning that conception doesn’t happen until the second week, and the first indication of pregnancy comes with a missed period at four weeks. That leaves just two weeks for patients to find and travel to an appointment — “and that’s if on day one you realize you’re pregnant,” said Daniels.

She and others in the clinic are planning to work overtime to try and see as many people as possible within the legal limit. Tens of thousands, though, will not be able to access appointments in time.

“We know who these bans are targeting,” said Daniels. “It’s not targeting people who have the access and resources to take a three-hour flight to D.C. It’s people who are uninsured, undocumented, racial and ethnic minorities, socioeconomically disadvantaged, these are the people who are going to be forced to make an impossible decision.”

Anyone under 18 will be effectively denied care, said Laura Goodhue, vice president of public policy at Planned Parenthood of South, East and North Florida, as getting a judicial bypass if they don’t have parental consent will be impossible within the six-week timeframe. “You will definitely see young people who aren’t ready by any means forced to give birth.”

Funds that subsidize abortion costs, and help coordinate travel, are already stretched, even with the current 15-week ban. Florida Access Network has existed since 1996 to help support both Floridians and those from out-of-state traveling to Florida for an abortion. After a 235% increase in requests in 2022, after the fall of Roe, the fund decided to limit services to Florida residents. It has a monthly cap of how much they can spend and, in March, had to stop taking new applications in the second week of the month, said executive director Stephanie Loraine Piñeiro.

The decision to help only Floridians reflects the huge demand from locals, not the lack of need from elsewhere, said Loraine Piñeiro: “There’s obviously still people who’ve been traveling from as far as Louisiana to get abortion care in Florida.” Of abortions performed in Florida last year, around 7,736, or 9% of the total, came from out of state.

As the only southeast state with abortion access, Florida has been a destination for those across the region who need abortions. Planned Parenthood has spent up to $20,000 a month on hotels for people from other states, said Goodhue, while Daniels said she saw several patients on Tuesday who traveled from Texas, which is a daily norm.

“Our out-of-state numbers since Dobbs have quadrupled,” said Daniels. “The overall problem is that it’s this never-ending domino effect.” Just as Florida absorbed abortions from Mississippi, Georgia, Louisiana, and elsewhere, those patients, like Floridians, will now have to travel elsewhere.

“My general reaction is, ‘oh f—’ because I think it’s going to impact my organization and the whole country,” said Alison Dreith, director of strategic partnerships at Midwest Access Coalition, which helps patients access abortion across the midwest. “Florida is a giant stopgap measure,” she said, seeing patients from across the region. As more states enact restrictions and patients head to Florida for care, Floridians are then pushed to travel elsewhere. Her organization is already feeling the pressure, having seen the same number of Florida patients in the past three months as they did in the whole of 2023.

The November ballot question would protect abortion in the constitution and prohibit any bans before fetal viability, currently around 24 weeks of pregnancy. The measure needs support of at least 60% of voters, but similar referendums in other states have received strong support, and those who are campaigning for the measure are optimistic. “We in Florida have a massive opportunity in November,” said Daniels. “All hope is definitely not yet lost.”

Meanwhile, abortion providers in the state will struggle to adapt to several months where the vast majority of abortions are prohibited. Daniels, who came to Florida from North Carolina and has colleagues who arrived in the state from Tennessee, said providers are used to having to move as states change their laws. Although she’s able to stay in Florida and provide other reproductive health services, others may not. “People don’t stay in a state where they can’t provide [care],” agreed Goodhue.

Daniels said she hopes Floridians are aware they can turn to telehealth services and abortion pills, which are safe to use at home, instead of resorting to risky methods. “I always worry people are going to feel so compelled to end a pregnancy they do so unsafely at home, and that would be a direct result of these bans,” she added.

This story is part of ongoing coverage of reproductive health care supported by a grant from the Commonwealth Fund.