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Some doctors say Florida's abortion ban exceptions aren't enough

Doctors with Planned Parenthood of Southwest and Central Florida say despite state health officials' attempts to clarify exceptions to the six-week abortion ban, they're still worried for patients.
Stephanie Colombini
Doctors with Planned Parenthood of Southwest and Central Florida say despite state health officials' attempts to clarify exceptions to the six-week abortion ban, they're still worried for patients.

The Agency for Health Care Administration issued emergency rules outlining some medical exceptions to the state's six-week abortion ban. But doctors are still left with questions and frustration.

Opponents of Florida’s six-week abortion ban say the emergency rules issued by state health officials this week to clarify some medical exceptions don’t go far enough.

The rules outline some life-threatening conditions a woman could experience that would allow doctors to perform an abortion after six weeks, including ectopic pregnancy or her water breaking early.

But some doctors who provide abortion care say there are other circumstances where pregnancy could endanger people's health.

Dr. Robyn Schickler recalled a patient she recently treated at a health center run by Planned Parenthood of Southwest and Central Florida.

The woman was about eight weeks along in her fourth pregnancy. During the previous three, she'd developed a condition known as preeclampsia. It's a form of high blood pressure that usually occurs after 20 weeks and can cause serious complications.

“Each pregnancy she got sicker and sicker, and she had to deliver earlier and earlier,” said Schickler, the organization’s chief medical officer. “Not only did it lead to poorer health outcomes for her, but it meant earlier and earlier pre-term births for her children. She didn't want to take that risk again.”

Schickler performed the abortion then, but doubts she could now that the six-week ban is in effect.

That law that established the ban states a pregnancy can be terminated after six weeks if “two physicians certify in writing that, in reasonable medical judgment, the termination of the pregnancy is necessary to save the pregnant woman’s life or avert a serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman other than a psychological condition.”

Schickler’s patient was trying to protect her health, but she wasn't in life-threatening danger yet.

“As a doctor, as an OB-GYN, I know that she was at an increased risk of preeclampsia again, of getting worse preeclampsia and of getting it earlier in the pregnancy, but would she have qualified for an exception? Her blood pressure was fine when she saw me,” said Schickler, speaking at a press conference at a Planned Parenthood health center in Sarasota on May 1, the day the ban went into effect.

WUSF followed up with her after AHCA published the emergency rules to find out if they provided sufficient clarity to alleviate her concerns. They did not.

The rules don't mention preeclampsia or some other complications.

Dr. Robyn Schickler if chief medical officer at Planned Parenthood of Southwest and Central Florida and treats patients as an OB-GYN.
Stephanie Colombini
Dr. Robyn Schickler is chief medical officer at Planned Parenthood of Southwest and Central Florida and treats patients as an OB-GYN.

Instead, Schickler maintains that the ban forces doctors like her to choose between caring for patients to the best of their abilities and following the law.

“Our hands are tied by the politicians that made these laws and my patients hands are tied, they can't make decisions about their own bodies,” she said.

Another physician in Orlando echoed Schickler's sentiments.

"The law's exemptions and these proposed rules may sound good in theory, but politicians do not understand how health care works," Dr. Rachel Humphrey, a maternal fetal medicine specialist, said in a statement.

"Doctors do not have a crystal ball to know whose life may be in danger from a pregnancy. The law is not clear, leading to confusion, and these rules only make it worse, leaving questions about other pregnancy complications open and forcing us to ask how close to death a patient must be to intervene."

Officials with the Agency for Health Care Administration argue the law's exceptions are clear and accuse abortion rights advocates of spreading "disinformation."

In the rule language, the agency wrote it “finds there is an immediate danger to the health, safety, and welfare of pregnant women and babies due to a deeply dishonest scare campaign and disinformation being perpetuated by the media, the Biden Administration, and advocacy groups to misrepresent the Heartbeat Protection Act and the State’s efforts to protect life, moms, and families.”

The “Heartbeat Protection Act” is the name of the law establishing the six-week ban, a reference to the point at which, the law says, a “fetal heartbeat” can be detected. Experts say that’s a medically inaccurate and misleading term, as what’s really happening during that time is the embryo can generate electrical impulses.

The conditions outlined in the rules as exceptions to the ban include “premature rupture of membranes (PROM),” commonly known as a pregnant person’s water breaking prematurely; ectopic pregnancies; and trophoblastic tumors, sometimes known as molar pregnancy.

The rules also include information about how hospitals and medical providers should keep records and report about the treatments.

Advocates for abortion rights like Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates, questioned the timing of the the rules.

“The fact is, if the State of Florida had these concerns they should have acted on them two years ago when the Legislature passed a 15-week abortion ban,” she said in a statement. “Announcing these rules the day after Florida’s six-week ban went into effect makes it clear that the motivation is political cover for the State, and not protecting public health.”

The law includes some other exceptions to the six-week abortion ban. Patients can terminate the pregnancy until the third trimester if a fatal fetal abnormality is detected.

Survivors of rape, incest or human trafficking can get abortions until 15 weeks. But they must provide documentation including police reports, restraining orders or other records and treatment providers may be required to report the crime.
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Stephanie Colombini joined WUSF Public Media in December 2016 as Producer of Florida Matters, WUSF’s public affairs show. She’s also a reporter for WUSF’s Health News Florida project.