In a small abortion clinic in San Juan, Puerto Rico, the phone rings continuously, women flood the waiting room, and cruise ship staff come looking for care. Darlington Medical Associates, a 10-minute drive from the island’s airport, is experiencing the impact of Florida’s six-week abortion ban. “We are the only clinic in Puerto Rico and the Caribbean that provides abortion service up to 24 weeks,” says Johana Molina, social worker/office manager for Darlington Medical Associates.
“After Roe v. Wade was overturned, our travel patients increased a lot, but after May 1, when the six-week ban went into effect, we started to receive many more patients from Florida.” Several times a day, Molina fields phone calls from patient navigators and organizations in Florida called abortion funds, scrambling to help women secure appointments.
“A lot of organizations send women here because it’s cheaper, it’s more friendly,” Molina says. Florida was once a safe haven for abortion care, even in the year after the Supreme Court’s Dobbs decision that overturned Roe v. Wade.
But nearly half of the country has abortion restrictions in place now, and as of May 1, Florida has one of the most limiting — a six-week ban and a 24-hour waiting period between a consent visit and a procedure. Florida abortion providers say a regular part of their daily routine has become turning away patients too far along in pregnancy to get care in the state and connecting them to resources to travel to end their pregnancies. In the two months after Florida’s ban went into effect, the state saw a 575% increase in people looking to travel out of state for abortions, according to National Abortion Federation data .
Florida women join thousands of others nationwide each month from states with bans or restrictions, desperate for appointments at the same overburdened clinics in less restrictive states like Virginia, Illinois, and North Carolina. In 2023, more than 166,000 U.S.
abortion patients traveled to other states to obtain care, double the number who did so in 2020 before multiple state abortion bans went into effect, according to the Guttmacher Institute, a sexual and reproductive health and rights organization. The demand has created a ripple effect: The cost of abortion care is rising, wait times for out-of-state appointments are longer, and organizations that pitch in to help cover travel costs must divvy their funding among more women. “Last year, we were able to help with 50% of appointment costs for eligible clients, and now that’s dropped to 30%,” says Kamila Przytuła, executive director of Women’s Emergency Network in Miami.
“We have had to cap our support per person at $1,000 max. So now we partner with other funds in our state. One will pay for hotel costs, another for child care or airfare, and another for clinic services.
There’s a collective effort in pooling resources.” Often, abortion seekers can’t afford to pay the travel costs themselves, barely scraping up enough to pay for the actual procedure. An estimated 73% of abortion seekers in 2022 had incomes under the poverty line, according to a recent Guttmacher Institute study.
Related Articles When her birth control method failed, Marie, a fast-food worker, emptied her bank account and then borrowed from a friend to get an abortion. But by the time she collected the $600 fee, she arrived at a Broward abortion clinic too late. A sonogram showed she had surpassed her sixth week of pregnancy by just a few days.
Already struggling to keep her job and take community college classes, she would need to travel to a state where the legal limits extend beyond Florida’s six-week limit, lose a day’s pay and incur travel costs. “I can’t pay for that,” she told a clinic assistant. The South Florida Sun Sentinel is identifying Marie by only her first name to protect her.
Five Florida-based organizations — and a few national funds — have jumped in to help women like Marie afford travel. They pay for plane tickets, gas money, meals and hotel costs, rides to and from the airport or bus station, and child care when a mother travels. Getting each woman’s costs covered takes much more coordination and cooperation among organizations than it did just a year ago.
State and national abortion funds received an initial outpouring of donations after the Dobbs decision ended federal abortion rights, but contributions have since tapered off while demand is at an all-time high. “There is not a single organization that’s not strained for resources because of how massive the need is in Florida,” Przytuła said. Meanwhile, the finances of abortion services have become increasingly complicated: The price of an abortion and the risk for complications rise by trimester and number of weeks of pregnancy.
With so many people traveling hundreds or thousands of miles to seek abortion care, it can take a week or more to get an appointment at an out-of-state clinic, which means pregnancies may progress to a more advanced stage and the cost balloons further. The total cost to travel for an abortion could be as high as $20,000 for someone in the third trimester. “Every clinic has its own price structure,” says Elizabeth Londono, a patient navigator for Planned Parenthood of South, East and North Florida .
“Some are much more expensive than others.” The rising cost of airfare, hotel stays, and meals must be considered, too. The Brigid Alliance , which provides logistical support to people seeking abortion care, estimates that the average cost of traveling for care has increased 41% since the first half of 2022, when it was just over $1,000.
At the same time, the price of surgical and medication abortions in Florida, particularly at independent clinics, also has increased as they struggle to pay their bills and stay open. Most Florida clinics charge on average $700 to $800, up from $500. A smaller clinic in West Palm Beach now charges $1,100.
“That’s a big financial ask on such a short timeline,” notes McKenna Kelley with the Tampa Bay Abortion Fund . Shock, frustration, anger, desperation: The real-life toll of Florida’s six-week abortion ban In the rural and urban areas of Florida, the challenges to getting an abortion are more than just monetary. Life circumstances often put women in a difficult position as they contemplate options.
At a Miami abortion clinic recently, a doctor told Maria that her ultrasound showed she was seven weeks, two days into her pregnancy. “You are going to need to leave Florida if you want to end the pregnancy,” the doctor explains in Spanish. Nicaraguan-born, Maria replies that she has no family in the U.
S. She has two children, 7 and 14, and lives with a friend. Two months ago, she lost her job.
She tells the doctor she is upset and scared. “I need to make this go away as soon as possible,” she says. The Sun Sentinel agreed to Maria’s request to withhold her last name.
Later that day, Maria spoke with a patient navigator and learned about the lengthy wait list for appointments at out-of-state clinics. The navigator said she would work on getting Maria an appointment in North Carolina and making travel arrangements, setting in motion the same scramble going on in nearly half the states in the country. Some women are waiting up to four weeks for an appointment, says Serra Sippel, interim executive director of The Brigid Alliance , a national organization that helps more than 130 clients a month with travel costs for abortion care.
“Delayed care is a serious impact of bans.” It’s that scramble that has led more Floridians to Puerto Rico. Molina at Darlington Medical Associates said her clinic has become a draw for Florida women, particularly Spanish-speaking ones.
It is one of four clinics on the island and the only one that offers services in the second trimester. Molina said Florida women often travel roundtrip to her clinic on the same day. “Yesterday, we received three patients from Florida,” Molina says.
“One was very anxious because she had just started a new job and thought she could lose her job if she missed work. She was desperate to return to Florida, and we counseled her that we strongly recommended that she stay one night after her procedure, but some people can’t take so much time off.” Molina said Darlington also draws cruise workers who previously may have gone to a Florida clinic while in port.
They typically make a telemedicine appointment and then pick up the abortion medication at Darlington when their ship docks in the Puerto Rico port. In Palm Beach County, Jessica Hatem, executive director of Emergency Medical Assistance, says some of her clients have never flown before or even left the state and are anxious about it. That makes Puerto Rico an appealing option, Hatem says: “A direct flight is key so there is not a second airport to navigate.
Puerto Rico is only two hours away, and there is no layover,” Hatem said the amount of coordination required is staggering. “These women don’t work jobs that give paid time off. They don’t have childcare .
.. It’s much more than just the financial piece,” she says.
When thousands of flights were canceled or delayed last month because of a global tech outage, Przytuła worked the phones at the Women’s Emergency Network. A fear-stricken yet desperate South Florida woman choosing to travel for abortion care had boarded a plane for the first time in her life. Her child care, rideshare, and hotel costs were covered by abortion fund organizations that serve Florida women.
The pooled monies were enough for a one-night hotel stay, not two or three. Stuck in Atlanta on a layover, the woman repeatedly asked Pryztula: “Who’s going to stay with my kids?” Pryztula urged the woman to stay calm, assuring her she was working to get the woman back to Florida. It took her four days to get home.
The woman’s plight illustrates the challenge of requiring women to travel for health care, Prztula said. “If one thing goes wrong for these women, it can create a negative domino effect.” In lieu of travel, some Florida women opt for telemedicine appointments with out-of-state doctors who will prescribe and mail abortion pills.
Others will turn to online vendors. Taking pills at home is medically safe, but legally risky in Florida, which explicitly bans abortion by telemedicine. In November, Floridians will weigh in on whether to amend the state constitution to protect abortion rights, a measure that requires 60% voter approval .
If approved, women would have the right to an abortion in Florida up until viability, which is about 24 weeks. “Fewer people would need to leave the state,” Hatem says. “It would be much less disruption to their lives.
” South Florida Sun Sentinel health reporter Cindy Goodman can be reached at [email protected]..
