Getting an abortion was already hard. Then the hurricanes arrived

The ability to travel, financial barriers, and wait times are exacerbated by natural disasters, tacking on time and constraints to an already-restricted procedure, writes Kelly Rissman

Debris and damage from Hurricane Milton as US President Joe Biden visits the area, in St. Pete Beach, Florida, on October 13, 2024. Hurricanes have created more hurdles for patients to seek bortion access in the southeastern US, a region already plagued with barriers to abortion care (AFP via Getty Images)

A Florida woman seeking an abortion had visited Planned Parenthood North Tampa, just one day before Hurricane Milton barrelled through the region. Amid evacuations, floods, and power outages, she needed to wait at least a day before she could return to the clinic for her second appointment, due to the state’s mandatory 24-hour waiting period for abortions.

But the Planned Parenthood clinic lost power in the storm, and couldn’t open. The woman was forced to go to another clinic, restarting the 24-hour clock and pushing her one day closer to the point of illegality, which, in Florida, is just six weeks pregnant.

“In cases like this, that’s no longer a six-week ban, that’s a five-week five-day ban, because the law allows for absolutely no wiggle room for events that are not in anyone’s control,” said Dr Chelsea Daniels, who practices at Planned Parenthood of South, East and North Florida.

Two hurricanes rampaged the southeastern US in a two-week span, upending abortion care in a region that already boasts some of the most restrictive bans in the country.

Hurricane Helene made landfall in Florida on September 26 before barrelling through Georgia and spiraling out to Tennessee, North Carolina and South Carolina. Aside from North Carolina, all of these states ban abortions after six weeks — with no exceptions for natural disasters. That means those who want one usually only have a few days to get a termination once they’ve discovered they’re pregnant (and one third of people only learn they’re pregnant after six weeks).

By the time Hurricane Milton slammed Florida’s west coast on October 10, clinics in nearby states were still reeling from Helene. The hurricanes and floods caused delays in care, impacting the ability travel, and tacking on additional costs to an already expensive, time-sensitive procedure.

“The state has made it continually difficult for our patients to access abortion care any way they can, and during a storm like this, it’s just magnified immensely,” Barbara Zdravecky, CEO of Planned Parenthood Southwest and Central Florida told The Independent.

All nine of the affiliate’s clinics closed after Milton devastated the state. After being closed for three days, seven of them reopened on Monday while two others — the St Petersburg and North Tampa locations — remain shuttered due to lack of power.

Planned Parenthood directed patients to other health centers in less-impacted areas of the state, but the 24-hour waiting period continued to be a barrier.

Debris and damage from Hurricane Milton as US President Joe Biden visits the area, in St. Pete Beach, Florida, on October 13, 2024. Hurricanes have created more hurdles for patients to seek bortion access in the southeastern US, a region already plagued with barriers to abortion care (AFP via Getty Images)

National and statewide disasters “make it extremely obvious that the abortion ban that we’re living under…is so arbitrary and ridiculous because if we’re unable to provide care due to weather events, it makes patients’ ability to access care even more challenging,” said Dr Daniels.

Dr Daniels estimated that upward of 90 per cent of her patients are more than five weeks pregnant, meaning under the state’s ban, they have only days to get the procedure.

Floridians have an opportunity to change the law in November, because Amendment 4, which would enshrine the right to abortion in the state, is on the ballot.

In North Carolina, that wait period is even longer: 72 hours. The state is often considered a refuge for many patients in the southeast because it offers a 12-week abortion ban in a sea of states with tighter restrictions. But care at one crucial facility, Planned Parenthood South Atlantic’s Asheville, North Carolina clinic, came to a screeching halt when Helene ravaged the state.

The facility, the only clinic west of Charlotte to offer abortion care in the state, has been closed since September 27.

The Asheville clinic typically sees hundreds of patients per month, half of whom come from out of state, Julia Walker, a communications strategist for the affiliate told The Independent. Abortion care is “further complicated by that key access point being taken out and having to redirect those people even further than they were already anticipating traveling,” she said.

Traveling, especially last minute, can be costly. Many patients already faced financial barriers to getting abortions — and a storm only made that barrier even steeper for some.

Milton put one Florida pregnant woman seeking an abortion out of work for days. She used what she had to cover the cost of her bills, leaving her with nothing left to pay for a medication abortion, which tends to cost around $600.

So she reached out to Tampa Bay Abortion Fund (TBAF) for assistance, which provided 70 per cent of the funding, while National Abortion Federation covered the rest, Bree Wallace, director of case management for TBAF told The Independent.

Wallace predicted an uptick in demand for funding requests in the next two weeks once people realize they missed a period. “A lot of people have been out of work so now they’re struggling to even make ends meet, or lost their house, or they’re still misplaced,” she said. “I think pregnancy and everything around it are probably a lot of people’s last thoughts at the moment.”

Abortion care often isn’t covered by health insurance; Walker estimated that upwards of 95 per cent of patients pay out-of-pocket. “It reaches a point where, for some people, these burdens become insurmountable,” she said.

In other cases, some patients who had already planned to obtain out-of-state abortions were trapped in those states due to the storms. One woman was stranded in Washington, DC after getting care; another was stuck in Texas. As Milton neared, flights to Florida were canceled meaning people had to racking up extra days worth of costs for housing, transportation and food.

People hold up signs during a pro-abortion rights rally on the second anniversary of the Supreme Court ruling to overturn Roe v. Wade, in West Palm Beach, Florida, on June 24, 2024. (AFP via Getty Images)

“Many of our clients had to stay overnight an extra day or two and the impact of that is especially [felt by] those who are have child care needs, those who are missing work,” said Serra Sippel, the executive director of Brigid Alliance, a nonprofit that provides logistical support for those in need of abortion care. Natural disasters “just exacerbate all of the barriers and stresses that people who are having to flee their states for abortion care.”

In North Carolina, because of its lengthier time frame to get abortion care, even before Helene hit, the state was already getting backed up because patients were flocking there. After Helene, abortion clinics in the state have become even more limited, prompting many Florida patients to travel even farther for care, like Virginia, Maryland, New York, or even the Midwest, Dr Daniels said.

But traveling isn’t an option for everyone.

“Unfortunately, the restrictions on abortion care across the entire Midwest and southern part of our country have disproportionately impacted people with lower incomes, also people living in rural communities and BIPOC folks who are already oftentimes cut off from access to all kinds of healthcare,” Melissa Grant, the chief operating officer of carafem, a nonprofit which provides virtual and in-person reproductive health care, told The Independent.

“When you add a catastrophic emergency, like a storm… It just takes an already very difficult situation, and compounds it,” Grant added.

Carafem also offers mailed abortion pills. One of its pharmacies is located in North Carolina, so after Helene wreaked havoc in the area, those medications were delayed by four or five days.

A few days doesn’t sound too bad, Grant said, but for patients who were planning on taking the pill over a weekend, it can disrupt their entire schedule, including childcare arrangements and taking time off work. This delay could also push people beyond the medical limit for taking abortion pills.

In-person visits were impacted too. Milton “set off another patchwork of people” to the Atlanta clinic, causing delayed appointment times. Delays decrease patients’ options, Grant explained, as it “pushes them further into their pregnancy” and often results in more expensive, complex procedures. In the wake of Milton, carafem’s Atlanta center’s patient load increased significantly. In one 24-hour span, the number of patients doubled.

Abortion rights protesters rally near the Georgia state Capitol in Atlanta, on May 14 (AP)

However, it’s impossible to decipher whether the uptick in patients was due to the effects of Milton or to the state’s return to a six-week abortion ban on October 7. A Georgia judge had ruled that the six-week ban was unconstitutional on September 30, meaning for a week, the laws had shifted entirely.

Advocates emphasized that these disruptions often don’t just impact an individual, but their families too. Most Brigid Alliance clients have children already, Sippel said. So when a hurricane disrupts this stigmatized health care, it sets off a whole chain of other disruptions: childcare, schooling, time off work, and finances.

“Any other procedure, you might be able to tell your employer that. But in these states, there’s not a sense of security that they can tell their employer where they’re going and what they’re doing,” Sippel pointed out.

The southeast may be impacted now, but earthquakes, floods, hurricanes, and tornadoes could happen all across the country.

One in four women are expected to have an abortion in their lifetime, according to Guttmacher Institute.

“Whether you live in Mississippi or you live in California, it doesn’t matter. The lottery in terms of your potentially being one of the ones facing an unintended pregnancy, the odds are the same,” Grant said. “Is this how we really want our sisters and our daughters and our loved ones to have to navigate their lives?”