Nation/World

East Coast abortion clinics have seen surge in clients since Florida’s abortion law took effect

Clinics up the East Coast have seen a surge in patient traffic since a law banning most abortions in Florida went into effect on May 1 — but so far they have not experienced the collapse in care that many providers had feared before the new restrictions began in the country’s third most populous state, according to new data collected by a research team at Middlebury College.

Wait times for abortion appointments have increased at approximately 30% of clinics across North Carolina, Virginia, Maryland and Washington, D.C., the areas closest to Florida where abortion remains legal after six weeks of pregnancy, according to the data, which is based on a survey of clinics before and after the law went into effect. North Carolina experienced the sharpest increases, with wait times rising in half of the state’s 16 clinics.

The average Florida resident now lives about 590 miles from the nearest clinic that offers abortions after six weeks and will need to wait nearly 14 days to end her pregnancy past that point — up from an average 20-mile drive and five-day wait before the ban, the data shows.

The study is a first-of-its-kind look at the practical impact of the new law in a state where 80,000 abortions had taken place each year. The survey was conducted by Caitlin Myers, a professor of economics at Middlebury College in Vermont and a team of undergraduate students, who systematically collected data from 130 clinics in six states and D.C. for the date of their next available appointment for an abortion after the six-week mark.

Although the survey offers only one window into the effect of the law, clinic directors and staff said it matched their own observations in the weeks since Florida banned most abortions on May 1.

Many said fewer Florida women appeared to be leaving the state for abortion care than was widely expected — a finding they largely attributed to increasing availability of telemedicine and abortion pills, in addition to long driving distances that may leave some women feeling they have no choice but to carry their unwanted pregnancy. At least 8,000 women every month are now obtaining abortion pills through the mail in states with strict abortion bans or significant restrictions in place, according to a recent study by the Society of Family Planning.

“Driving distance and appointment availability remain salient components of abortion access, but less so than they were three years ago,” said Myers, who has spent years quantifying the changing landscape of abortion access.

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“Telehealth is really a game changer for abortion access,” she said. “But it might be a fragile one.”

Abortion pills have become a major target for many antiabortion advocates frustrated that studies show abortion numbers have continued to rise since Roe v Wade was overturned. A court challenge seeking to restrict access to the pills, brought by a major antiabortion group, is currently pending before the Supreme Court, with a decision expected by late June.

Eileen Diamond, who runs an abortion clinic in Florida in the Fort Lauderdale area, said patients she has seen since the ban took effect have been extremely reluctant to leave the state if they are still within the 10-week window for taking abortion pills recommended by the U.S. Food and Drug Administration. Especially relatively early in pregnancy, she said, many experience “this feeling of disbelief” when they’re told they have to travel at least three states away to get an abortion.

“It’s very daunting for them,” said Diamond. “We are seeing a lot of patients turning to finding alternate ways to get pills by mail.”

Myers began conducting surveys of wait times at regular intervals at over 700 clinics across the United States in March 2022, anticipating that Roe would fall that summer. The results have helped illustrate the changing landscape of abortion access in the two years since.

As soon as Texas enacted its six-week “heartbeat ban” in the fall of 2021 — outlawing most abortions nine months before the fall of Roe — Texas patients quickly overwhelmed clinics in Oklahoma, Kansas and New Mexico, many of which had wait times of several weeks or ran out of appointments altogether, Myers said.

Before the Texas law, approximately 50,000 abortions occurred in the state every year — significantly fewer than had been performed annually in Florida. Despite those numbers, Myers said, “we’re not seeing that level of shock to access with the Florida ban.”

The reason, she said: “a general awareness” of medication and telehealth abortion.

“There are many more options to obtain the pills quickly and cheaply than there used to be,” Myers said.

Since last summer, U.S.-based doctors have been mailing thousands of pills into antiabortion states under “shield laws” recently enacted in a handful of blue states, designed to protect doctors from prosecution. Women in antiabortion states are also accessing pills through at least 25 nonmedical websites and several community-based networks that distribute the pills free.

Amy Hagstrom Miller, who leads Whole Woman’s Health, a national network of abortion clinics, opened a new clinic in New Mexico after she was forced to shutter several clinics in Texas when Roe was overturned. The deluge of patients she expected from antiabortion states at that clinic, along with other clinics elsewhere, has yet to materialize, she said.

“We prepared for more of a surge than we’ve seen in any of our clinics,” she said. At her new clinic in New Mexico, which borders Texas, she said, “we’re not even close to capacity.”

With the help of state and national abortion funds, which provide financial support to people seeking abortions, advocates have been able to book flights for patients who want to leave the state for an abortion, Diamond said. Some have been able to fly to D.C. in the morning, have their procedure and return home that night.

For others, travel is more difficult. Several patients she has seen since the ban took effect have not been able to fly because they don’t have valid identification, Diamond said. Others can’t leave because they can’t miss work or don’t have anyone to help with child care.

A Washington Post analysis found that, in total, about 7 million women of reproductive age in Florida and surrounding states will now have to travel longer to receive abortions after six weeks of pregnancy. The average affected woman saw a drive time increase of more than seven hours, analysis using data from OpenStreetMap shows. The group includes an outsize number of Black women and poor women, compared with the United States as a whole.

Diamond recounted that one of her patients recently arrived in Fort Lauderdale after driving 18 hours from Houston. She had not heard about the new six-week ban, Diamond said, and was already nine weeks pregnant.

“This woman was desperate,” Diamond said. “She had used everything she had to come to us.”

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In the end, she drove on for at least 12 hours from Fort Lauderdale to Virginia, Diamond said — and was planning to drive another 17 hours home after the procedure.

North Carolina, where abortion is legal until 12 weeks of pregnancy, is the closest state that offers abortions beyond Florida’s six-week limit. But another law, which requires patients to wait at least 72 hours between an initial in-person consultation with a doctor and the procedure, can make traveling there logistically difficult.

One Florida patient recently traveled 23 hours on a Greyhound bus for a consultation appointment at A Woman’s Choice in Charlotte, according to Lakeynn Huffman, the clinic manager — returning home that night because she could not find child care to cover the full 72 hours she had to wait between appointments.

The woman made the same trip two days later, Huffman said — traveling for a total of 92 hours to get an abortion.

Ordering pills online can be a nerve-racking experience for some patients, Diamond said.

“They’re worried the pills won’t get there, worried they don’t have a clinic to back them up,” she said.

Nearly three weeks since the new ban took effect, Diamond said she has started hearing from far fewer patients in the second trimester, which begins at 13 weeks of pregnancy, beyond the FDA’s 10-week limit for taking abortion pills.

“They’re not coming to clinic. They’re not calling about travel,” she said.

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Many, she said, may now assume there is nothing they can do in the face of a six-week ban.

“I think they are carrying these pregnancies,” she said.

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About this story

The Post used the most recent survey data collected by Caitlin Myers, a professor of economics at Middlebury College, and a team of undergraduate students.

The survey collected data from 130 clinics representing all providers in six states–Florida, Georgia, South Carolina, North Carolina, Virginia, and Maryland–as well as Washington, D.C. These locations were surveyed in April 2024, prior to the Florida ban and then again on May 13, 2024. The survey involved calling each facility to ask (1) about the availability of medication and procedural (surgical) abortions, and (2) for the date of the next available appointment for each type of abortion.

The analysis for this story relied on comparisons between the April and May survey data. If appointments were available at a facility, the team calculated the “wait time” as the minimum number of weekdays until the next available appointment for an abortion, of any type.

Students conducting the May 13th survey were: Isabelle Cone, Georgia Crosby, Emma Dobson, Avery Goldstein, Kate Goodman, Angel Gurung, Sarah Holmes, Julia Joy, Emily Kuperstein, Sascha Leidecker, Awa-Victoria Morel, Grace Mumford, Audrey Peiker, Emily Ribeiro, Grace Sokolow, Shay Soodak, Claire Vermillion.

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Clara Ence Morse contributed to this report.

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