‘This is life and death’: inside a Florida clinic after the six-week abortion ban

Rose hadn’t even missed her period when the thought hit her: “I need to take a test.”

The Florida resident, who has two kids, had given birth just three months ago. She thought that she and her husband were being careful. But the pregnancy test confirmed her suspicion: she was pregnant and, she realized, didn’t want to be.

“It would just be a very big financial, physical, emotional strain,” said Rose, who asked to be identified by a nickname. Her last two pregnancies were enormously difficult and she feared for her health. She wants to be a tattoo artist, but she’s not working at the moment. Her husband has only recently started a new job. Rose continued: “I want to start a career and go to school and learn new things and it’s a lot harder with more kids. It’s already more difficult with the kids that I have.”

Related: ‘Resist the state’: activists teach Floridians to ‘self-manage’ abortions in wake of ban

By the time she took a pregnancy test, Rose estimates that she was maybe four weeks into her pregnancy. She was lucky: many people don’t realize they’re pregnant that early. Rose also moved swiftly to secure an appointment at a Florida abortion clinic. Still, by Tuesday, when Rose sat in a dimly lit room decorated with butterfly collages and a doctor pressed a white pill into her hand to start a medication abortion, Rose was six weeks and four days into her pregnancy.

Had Rose arrived at the clinic a single day later, she would not have been able to get an abortion in Florida. On Wednesday, Florida banned abortion past six weeks of pregnancy.

“There’s still a lot I can do at my age, and that I want to do at my age and that I’m not really gonna get a chance to do if I’m continuing to be pregnant and have more kids,” she said.

Rose is 19 years old.

For nearly two years after the US supreme court overturned Roe v Wade, Florida stood as the last bastion of abortion access in the US deep south. Even though the state had a 15-week abortion ban, providers there performed more than 84,000 abortions in 2023, including almost 9,000 on out-of-state patients. But on 1 April, the Florida supreme court ruled to uphold the 15-week ban – and, due to legislative maneuvering by Florida’s Republican-controlled state legislature, that decision paved the way for the six-week ban to take effect on Wednesday.

The impact of the ban will ripple across the US. Women who are past six weeks – about 60% of Florida abortions take place after that point in pregnancy – will have to travel at least several states away for abortions, further burdening the relatively few abortion clinics that have survived Roe’s fall. Women who can’t afford to travel may self-manage their abortions, a process that, if undertaken early enough in pregnancy, is medically safe but legally fraught.

Women may also be forced to remain pregnant against their will.

The phone rang off the hook on Tuesday, the last day before the ban took effect, at the abortion clinic that performed Rose’s abortion, Bread and Roses Women’s Health Center in swampy Gainesville, Florida. A squat building nearly hidden behind a lush wall of ivy, Bread and Roses’s walls are decorated in butterfly motifs and motivational posters. One small, framed poster featured a uterus-shaped American flag under the stark word: “vote”.

Bread and Roses normally sees somewhere between 20 and 30 patients a day, but throughout April, as the ban neared, the clinic added extra hours and started to see closer to 40 patients a day. Desperate to squeeze in as many patients as possible on Tuesday, staffers barely had time to even eat. The doctor who was performing abortions kept attempting to heat up her pasta lunch, only to be repeatedly interrupted. Kristin, the clinic director, made toast but was pulled away to do ultrasounds; by the time she remembered to return to it, hours later, the bread had hardened into a hockey puck. (Kristin asked to be identified by her first name due to safety concerns.)

Almost every phone call seemed to include some version of the same conversation, as clinic staffers asked would-be patients: do you know about the six-week abortion ban? When was your last menstrual period? Do you think you’re less than six weeks along?

If a caller seemed like they were past that limit, staffers steered them towards resources to help them find an abortion clinic in another state. One woman, pregnant from her husband’s repeated sexual assaults, cried on the phone on Wednesday as a staffer told her that she likely couldn’t get an abortion in Florida. The woman, who lived in a state with a near-total abortion ban, was confused by Florida’s ban and overwhelmed by the difficulty of having to travel even farther than she had imagined.

“This law is changing everything,” a Bread and Roses staffer told another, baffled caller. “If you are over six weeks, we just would not be able to move forward with an abortion.

“It’s horrible,” the staffer added. “It’s not fair at all.”

Yet another woman who called Bread and Roses on Wednesday had accidentally gone to a crisis pregnancy center, an anti-abortion facility that aims to convince people to continue their pregnancies. They’re often located close enough to abortion clinics to confuse people. (A similar facility was located just two doors down from Bread and Roses.) People at the crisis pregnancy center told the woman that taking abortion pills could lead her to give birth on the toilet, according to a Bread and Roses staffer, who was enraged by the sheer misinformation. How could this be legal, but an abortion past six weeks was not?

Complicating everything is the fact that Florida also requires patients to go to an abortion clinic for a consultation at least 24 hours before they actually get the procedure or pills. That restriction further cuts down on the amount of time that women have to recognize they are pregnant, realize they want an abortion and get to a clinic.

Floridians past six weeks of pregnancy may have to venture to clinics in states like New Mexico, Kansas and Illinois. North Carolina is a closer option for many Floridians – but that state only permits abortions until 12 weeks of pregnancy and its waiting period is also even more onerous than Florida’s. It requires people to show up at a clinic for an initial consultation at least 72 hours before their abortion.

Related: Kamala Harris invokes ‘fight for our freedom’ as Florida six-week abortion ban takes effect

One patient at Bread and Roses on Tuesday, who asked to be identified by her initial A, was little more than five weeks into her pregnancy. A new mom with a months-old baby at home, A had always opposed abortion, but she had developed heart failure during her last pregnancy. Then she had a seizure about a week after giving birth.

“After my condition after my last pregnancy, I realized it’s something people should have a right to if need be,” A said of abortion. “I feel like women should have rights to their bodies. I think it’s cruel, honestly, for people with health conditions, like myself.”

A, who isn’t working right now, didn’t know what she would do if she had been unable to get an abortion in Florida. With a sigh, she suggested: “I would have been stressed out and delivered the baby.”

Rose already knows what it’s like to be denied an abortion. When she got pregnant with her son at 16, she considered having an abortion, but her deeply conservative mom refused to let her get one, she said. Then, due to an injury sustained at birth, Rose’s son was born with severe disabilities.

“I was a 17-year-old kid taking care of a heavily disabled child,” Rose said. “I love my son very much. I don’t regret him.”

But, she added: “It’s not okay to force somebody to do that with their body.”

Most minors involve parents in their decision to get an abortion, but minors in Florida who cannot or will not do so must, instead, go to court to convince a judge that they are mature enough to get an abortion. (The default assumption is that they are mature enough to give birth.) Their victory is far from guaranteed: in the two years before Roe’s demise, Florida judges denied more than 12% of 200-plus minors’ requests. Even if a minor succeeds, the court process can also take days, if not weeks.

Under a six-week ban, minors will likely be unable to surmount these legal hurdles in time. But even if they can secure a parent’s permission for an abortion, minors are especially likely to be denied them under Florida’s six-week ban. Two in three 15- to 19-year-olds realize they are pregnant after six weeks.

Because Bread and Roses staffers prioritized patients who seemed like they were less than six weeks into their pregnancy, all of the patients who showed up for consultations on Tuesday could legally get an abortion by Wednesday. But on Wednesday, the clinic had to tell three or four people that they were past Florida’s legal limit, according to the doctor performing abortions on Wednesday.

The clinic did not track how many people called but seemed beyond the six-week limit already. Kristin, the clinic director, estimated that about half of callers were not able to be scheduled.

Kristin suspects that, in the coming days, Bread and Roses will be forced to turn away even more. As the ban made headlines so much in April, she thinks people might be paying more attention than normal to their periods and pregnancies; if the ban falls out of headlines, people may forget about it until it’s too late. On Wednesday afternoon, Kristin sat in the clinic’s parking lot, clad in black scrubs, and scrunched her knees to her chest.

“I feel exhausted today. I feel incredibly sad and angry. I’m so angry,” Kristin said. “I’m so naive. I want to think that people have the best intentions and this law is just so harmful. I don’t understand how somebody can’t see how harmful this law is. This is life and death for some people.

“In the deep places of my heart, I don’t understand it,” she repeated.

There is a sliver of hope for Bread and Roses staffers: in November, Florida is set to vote on a ballot measure that would enshrine abortion rights in the state constitution, making the six-week ban unconstitutional. Similar measures have already triumphed in states across the country, including Republican strongholds like Kansas and Ohio.

Notably, ballot measures in increasingly red Florida must garner 60% of the vote to pass. Even if abortion rights supporters do win in November, Florida’s abortion laws would not officially change until January. Floridians will have to live under the six-week ban for months.

Clinics may also not survive the ban. Unable to perform most abortions, they’re facing a devastating financial hit – but it’s impossible to map its exact blast radius.

“How do you plan for it, when you don’t know what to expect?” Kristin said. “We’ll be fine. We’re not closing. We’ll figure it out.”

Like many other patients at Bread and Roses, Rose had never heard of the ballot measure before her abortion appointment. She is not registered to vote, but she does want to vote for the ballot measure.

The six-week ban, she said, is “evil”.

“Florida, along with the United States, is going downhill,” Rose said. “I used to like living here, but I’m planning on moving out as soon as I can.”