Owner Leda Lanza poked her head out of her office at the East Cypress Women’s Center, an abortion clinic in a Fort Lauderdale strip mall. All of the chairs in the carpeted waiting room were filled.
“Gentlemen, I am going to have to ask you to leave to make space for the ladies,” Lanza said.
The men — boyfriends, husbands, fathers — dutifully stood up and filed out of the small, gray room, decorated with thank-you notes, pro-abortion-rights newspaper op-eds and a postcard featuring a photo of Barack and Michelle Obama. The women remained.
As Florida lawmakers have ratcheted ever tighter the restrictions on abortion, including a just-passed six-week abortion ban aimed at emptying clinics like this one, a Miami Herald investigation found clinic waiting rooms as crowded as ever and maybe more so. That may have something to do with the overall number of clinics being reduced, but it is also likely a result of expatriates coming to Florida from other states that have restricted abortion access even more.
Now, with the state’s newly adopted six-week abortion limit — before many women even know they are pregnant — operators like Lanza wonder what’s next.
Much has been written about the abortion-related wrangling in Tallahassee, including the law’s impact on the political ambitions of Gov. Ron DeSantis, who signed it surrounded by supporters at a ceremony in the middle of the night. Less publicized are the thoughts and fears of the people whose lives, livelihoods and futures will be directly affected.
The six-week ban is not currently being implemented because a previously adopted 15-week ban is awaiting a ruling by the Florida Supreme Court, dominated by DeSantis appointees. The state was allowed to enforce that restriction while legal challenges worked their way through the court system. If upheld, that 15-week cutoff would be replaced by the six-week threshold.
A different kind of choice
Four miles and a world away from East Cypress, Respect Life Ministry’s Pregnancy Help Center also has gray walls and the feel of a medical office, which it is not. Its mission is to convince pregnant women to carry their pregnancy to term.
While the abortion clinic’s decor emphasizes body autonomy and celebrates politicians who want abortion to remain legal, the iconography at Respect Life is vastly different. Respect Life is adorned with models of fetal development — posters with images of fetuses, fetal models in cardboard boxes and models that show a fetus inside a cervix.
Angela Curatalo runs three pregnancy centers that amount to anti-abortion centers, assisting women who want to go through with their pregnancies, beckoning those on the fence.
If abortion clinics are angry over the Legislature’s action, Curatalo is overjoyed.
The three Respect Life locations are known as crisis pregnancy centers. Florida has nearly 160 such centers, many affiliated with the Catholic Church. Yet the six-week ban isn’t all they are celebrating. The crisis centers are enjoying a fresh infusion of taxpayer dollars — as much as $25 million per year among them — courtesy of staunchly anti-abortion lawmakers, who are firmly in control of the Legislature.
“There are so many babies that are going to come into our world, and do wonderful things. Who are we to say that one life is more valuable than another?” said Curatalo. As she spoke, she held a small black velvet box. Inside, plastic models of fetuses at seven, eight, nine and 10 weeks gestation were nestled in black foam.
While abortion clinics like East Cypress say women deserve a choice, Curatalo and her allies say women do have a choice: between raising their child or giving him or her up for adoption.
Curatalo’s definition of “choice” is in vogue politically in Florida, at least for now. The number of abortion clinics is shrinking. As of May 2023, there are 51 licensed abortion facilities in Florida, according to the Florida Agency for Health Care Administration. In 2014, there were 71. Since 2010, according to the same data, 31 abortion clinics have either closed or had their licenses revoked.
The number of crisis pregnancy centers is growing. Remaining abortion clinics, meanwhile, have struggled to cope with what they say are increasingly aggressive laws and sidewalk protesters seeking to dissuade women from entering the clinics, including a group called Sidewalk Advocates for Life, whose self-proclaimed objective is to “transform the sidewalk in front of every abortion and abortion-referral facility in America.”
Linda Freire is a programs manager for Sidewalk Advocates For Life and lives in Miami. When she was in college, she had an abortion that ended with her sitting in her car in pain as she bled. She said the experience was traumatizing — and led her to dedicate her life to helping women choose other pathways besides abortion. She says the new six-week ban is necessary and helps women understand the consequences of sex, and to know their dignity as women.
“Chemical abortion [pills] are given out like candy, yet It’s nothing to mess around with,” she said. “It not only harms you physically, but it harms you mentally, emotionally and psychologically.”
Conversely, a decade-long study of 1,000 women by a University of California San Francisco-based group found that, in general, carrying an unwanted pregnancy to term harms women physically and psychologically more than having an abortion.
Curatalo, seizing the moment, hopes to deploy mobile pregnancy help centers, which will allow the organization to meet women where they are.
In other parts of Florida, including Palm Beach County, Catholic Charities already has two such units. They offer pregnancy tests, sonograms and counseling in places like church parking lots.
A website says the mobile units have surround sound and a large screen monitor “so that the mother will have an enlarged, clear view of the baby and hear the baby’s heartbeat.”
Political winds can shift, even in Florida, where polling suggests the political class may be out of step with the voting public. A July 2022 survey of 600 Floridians conducted by researchers at the University of South Florida and Florida International University found that 57% disagreed with last June’s U.S. Supreme Court decision overturning Roe v. Wade, while 44% “strongly disagreed.” Forty-four percent were in favor of some level of restrictions on abortion in the state, differing, however, on what those restrictions should look like.
‘I am here for you’
Women come to the East Cypress Women’s Center having made up their mind that they do not want to carry their pregnancy to term.
On a day a Miami Herald reporter visited, a 16-year-old who arrived in bright pink sparkly crocs was getting an abortion as her mother stepped into the bagel shop next door to grab a cup of coffee. It was not a happy day, but the mom said she reminded her daughter: “I am here for you.”
The boyfriend of a woman who was inside the clinic hung out by the curb of the strip mall parking lot, holding his son’s hand.
Bonded together, perhaps in part by the Legislature’s determination to put them out of business, staffers operate more like family members, joking with each other in a sassy tone as they go about their day.
“We fight, we laugh, but we get the job done,” said Sherri Loss, an LPN who works at East Cypress.
“It took me like a couple weeks to get here,” said a woman there to terminate a pregnancy. She leaned against the back counter of the office area where women filled out paperwork, handed over cash, booked follow-up appointments, and sometimes exchanged hugs with a staffer before leaving. For those fewer than nine weeks along, the cost at East Cypress Women’s Center is $380 for ending a pregnancy surgically, $440 for women nine to 11 weeks pregnant.
Abortion by medication — actually a series of two medications, Mifepristone followed by Misoprostol — is considered safe up to 10 weeks into a pregnancy and is priced at $480 at East Cypress. An effort to ban Mifepristone is heading to the U.S. Supreme Court.
At the abortion clinic on a recent Monday, a pregnant woman who came to Florida from Jamaica a year earlier was waiting her turn. She was wearing a T-shirt from the bar and Mexican restaurant where she works to support her 6- and 8-year-old children.
Also in the waiting room, which features a humming fish tank and big-screen TV, was a 21-year-old senior from Florida Atlantic University, emotionally drained not only from getting the abortion pill, but from trying to convince the man who had impregnated her to help pay for her abortion. She said he demanded a blood test after she sent him a photo of the bill from the clinic. He never paid.
Nearby, a woman was lying on her back with her hands on her stomach across two chairs.
What six weeks really means
Planned Parenthood, the largest abortion provider in the state, estimates that around 30-40% of women who come in are already past the six-week benchmark, making it effectively a ban if it goes into effect.
“If it was banned, I guess I would have to carry,” the mom of two from Jamaica said, explaining that she would not have the money to go to New York or another state where abortion is legal and then come back to Florida.
Mariangel Moya is 20 years old, and was wearing a floral sundress as she waited in the hallway of a Miami Planned Parenthood. She was seven weeks pregnant, soon to be issued Mifepristone.
Her boyfriend passed time one floor below. Just two months earlier, the pair arrived alone in Miami from Spain, where they had been living after fleeing Cuba.
Moya is taking an online course and working at a jewelry store, and says she is just not able to take on having a child right now. She was unaware of the looming six-week ban or of dueling lower-court rulings of judges in Texas and Washington state — one saying that the pill should be outlawed, the other saying the opposite.
“I don’t want to do it, but I don’t have a choice,” she said in Spanish of terminating her pregnancy. “Not everyone can bring a baby into the world. It depends upon whether you can afford to have a baby.”
On this day she will take the first pill then she will go home with four Misoprostol pills that she will take on her own. She will also go home with a pack of birth control pills, given to her by Planned Parenthood.
Her original appointment was in the middle of April, but Planned Parenthood called to tell her there had been a cancellation, so she took the opportunity to come in earlier and get her abortion.
Little did she know that had she come to Planned Parenthood just a day later, she may not have been able to receive the pills, because of the Texas court ruling, later stayed by the U.S. Supreme Court in April while the legal challenges play out.
“I feel like we’re on a see-saw with this,” said Sherri Loss, the East Cypress LPN whose husband is Dr. Michael Loss, one of the abortion providers at the clinic.
The majority of the clients at the anti-abortion pregnancy help centers have their own life challenges. They are what the center calls “abortion vulnerable,” meaning they are likely to terminate their pregnancies.
At Respect Life, a crucifix hangs on the wall above the front desk and a Mother Mary statue is displayed in the stockroom. In a small chapel in the back office a wooden kneeler enables staff and volunteers to pray. The center manager answers the phone in Spanish, booking an appointment.
The mission is to show support and convince women that they are capable of raising a child, in part by highlighting the community resources that are available.
Although they celebrate the six-week ban adopted during the recent Legislative Session, ultimately, they believe abortion should be 100% illegal, a position shared by Miami Archbishop Thomas Wenski, who said it is “unfortunate” that the procedure remains limited but legal.
Many crisis pregnancy centers do not flaunt their religious affiliations, or at least do so selectively.
Respect Life Ministry has two websites. One, respectlifemiami.org, makes clear its connection to the archdiocese. The other, pregnancyhelpsfl.org, does not.
Those who stop in are a reflection of South Florida’s kaleidoscope of races and ethnicities. Just under half of the women are Hispanic and Spanish-speaking, said Curatalo, with the next largest group (20%) being Haitians. Around 12% are African Americans, while 3% are white and non-Hispanic, Curatalo said.
Many are recent immigrants and have very little in the way of resources, Curatalo said.
She said she has seen women in her center who cite lack of money, a diagnosis from a doctor saying their pregnancy is high-risk, or stories of already struggling to raise a 6-month-old baby.
Some have little clothing for themselves, much less a newborn. The counseling room of the Fort Lauderdale Center has a wooden armoire brimming with donated maternity clothes.
One woman who came to the center was living with her three children in a car.
The standard method at Respect Life is for counselors to bring a woman alone into the counseling room to listen to her concerns, leaving family members and partners in the waiting area.
After hearing all of her initial apprehensions, the counselors will ask: “What are you most afraid of when it comes to having your baby?”
And then staffers will address those items. They will sometimes mention Medicaid, food stamps and similar programs.
If the woman is open to receiving prayer, counselors would pray for her — but not during official counseling hours, as the state-funded program that subsidizes the crisis centers bars religious content during those hours.
After finishing the initial counseling, the counselor will invite the pregnant woman into the ultrasound room, where the technician will lay the pregnant client down on the exam table and use an ultrasound machine to show the fetus on a TV monitor, and let them listen to the heartbeat.
Critics point out that the same public officials who have sought to restrict abortion out of existence have also opposed providing adequate funding to those very social services that crisis pregnancy centers tout.
Christopher Pettaway, a clinical coordinator at Miami-Dade’s Golden Glades Planned Parenthood in Miami, says he has heard repeatedly from patients who can’t find a prenatal OB-GYN who will accept Medicaid and its less-than-generous reimbursements.
The father of a 7-month-old, who sometimes encounters women who aren’t sure whether they want to go ahead with an abortion, has recommended OB-GYNs he knows personally to women who are struggling to find someone who will accept their insurance.
When asked about the lack of available prenatal physicians and long waits, Curatalo said pregnant women who are in urgent need of care can always go to the emergency room, whose costs are considerably higher than an OB-GYN’s and if Medicaid pays the bill, taxpayers fund it.
Nine ‘saves’ and counting
Curatalo says that this year alone the three Respect Life centers have had nine “saves” out of 750 clients. “Saves”, she said, is the term for women who “come in and were like, ‘I’m gonna have an abortion’, or ‘I think I’m gonna have an abortion’ and then change their minds.”
“I’m anticipating that those numbers are going to go up when we start seeing more and more women that are coming in earlier and earlier, once the [six-week] law is passed. We’re going to see more women who are abortion-minded and we’re going to have more saves,” Curatalo said.
For years, a knock on the crisis centers is that they tried to disguise themselves as abortion providers, hoping women would show up seeking an abortion only to be talked out of the procedure. Some crisis centers use terms like “Pregnancy Help” and “Medical Clinic” in their name and even incorporate the word “choice,” co-opting the word that has been synonymous with legal abortion.
And it is true that some crisis centers have strategically opened in close proximity to actual abortion clinics, even in the same shopping center.
In fact, Respect Life said it consciously opened its Fort Lauderdale location on East Commercial Boulevard in the building next door to the Fort Lauderdale Women’s Center, an abortion clinic. Planned Parenthood locations in Tallahassee, West Palm Beach and Gainesville all have anti-abortion pregnancy centers either next door or right nearby, according to Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates.
Annie Filkowski says she, for one, was fooled by a crisis center. Filkowski was 17 and seeking abortion services in her hometown of West Palm Beach when she claims she accidentally ended up at a crisis pregnancy center.
“What was really spooky is that at the time, just like everyone else, I fully walked in believing they were a medical center with medical professionals that would have to abide by HIPAA,” she said, referring to the federal law that guarantees privacy of medical information.
Instead, as she recalls it, the staff threatened to call her mother and her school. It was traumatizing, she said.
Today, she is the policy director for Florida Alliance of Planned Parenthood Affiliates, and credits her experience as a teen at a crisis pregnancy center as the fuel for her work fighting for women’s reproductive rights.
“For me, it painted the full picture of what it’s like to attempt to access reproductive healthcare in America.”
“I was completely lied to. I was tricked. I was shamed. They were asking me what my religion was,” said Filkowski, who this year went to Tallahassee to lobby against the six-week ban that passed.
At the pregnancy help centers run by the archdiocese, the staff says that is not how things work at all.
“It’s not an intention to trick them,” Curatalo said. She said when women call and ask whether the center offers abortions, she will let them know that they do not.
A 19-year-old who recently went to Mary’s Pregnancy Resource Center, a crisis pregnancy center in Davie, said when she was inside the pregnancy center a staff member wearing scrubs gave her a pregnancy test and asked her if she wanted to get an abortion. She did not know that the center was anti-abortion, but thought she could save money at Planned Parenthood by getting her pregnancy test and ultrasound at the resource center first.
“I was like, yeah, I’m pretty sure I do want to get an abortion,” she said. Then she went to the next staff member, also in scrubs, who did her ultrasound.
“She showed me the heartbeat, she showed me the embryo,” said the 19-year-old.
Again, the staff member doing the ultrasound asked: “Do you want to terminate the pregnancy or do you want to keep the baby?”
“And I was like, I’m very much seeking to terminate,” she said.
Next, a staff member showed her all the possible outcomes, and had her watch a video about the risks of abortion.
At the end, the 19-year-old said she could tell the staff member was getting ready to pray for her, and she said she would be happy to receive the prayer.
She said the staff member held her hands and asked God to “protect her and her baby no matter what decision she makes.”
She left the center still planning to go ahead with an abortion.
Abortion advocates say the tightening of abortion restrictions in other Southern states since the U.S. Supreme Court overturned Roe v. Wade on June 24, 2022, has led to an increase in abortions in Florida. There has also been an increase in the number of women accessing birth control, sexually transmitted disease testing and family planning services.
Between January and March 2023, the latest figures available, 10% of abortions performed in Florida involved women from out of state, according to the Florida Agency for Health Care Administration, which oversees the state’s abortion clinics. That’s a bigger percentage than 2022, when the number was 8%, and bigger still than 2021, when it was 6.1%.
The East Cypress center says women have been coming to the clinic from Texas (where performing abortions, with few exceptions, is a felony), Tennessee (illegal from fertilization, except to save a mother’s life), Kentucky (a ban on nearly all abortion) and Arkansas (where doctors who perform abortions face up to 10 years in prison), often booking a hotel room because Florida now requires a 24-hour wait period between the first visit to a clinic and the actual procedure.
Dr. Shelly Tien, an OB-GYN who performs abortions at Planned Parenthood, said the six-week ban — combined with the even tighter restrictions that have sent out-of-state residents flocking to Florida — “disproportionately affects women who are marginalized, who are struggling with poverty.”
“We have patients who drive 12, 16 hours through the night for their appointment. They wait four or five or six hours to see me to sign a consent form. Then they have to wait another 24 hours for their actual procedure. So it ends up being a very long process for women. And very, very stressful.”
A fresh start
On the morning of Valerie Bryant’s abortion, she put on her comfy hot pink velour track suit and got a ride from her sister from her apartment in Sunrise, where she lives with her 11-, 15- and 17-year-old children, to East Cypress Women’s Center. Since her sister didn’t like the idea of abortion, she stayed in the car during the procedure.
Everything went well, Bryan said. But, as she walked out of the abortion clinic that day, she told herself: “I am never going to do this again.”
Yet Bryant, 36, feels strongly that women should have the choice to get an abortion if it is what they need to do, and does not regret her decision.
“There’s gonna be people out in their garage trying to give abortions with hangers!” she said of the incoming six-week limit.
Bryant works at a post office, but says that each month after paying rent she doesn’t have enough money left over to pay for groceries and her electric bill.
“We buy what we need a little bit at a time,” said the single mom, sitting in the dark on the couch in her ground-floor apartment. The apartment is filled with her kids’ toys.
Bryant is desperate for a fresh start. She is planning to move to a place where she hopes necessities like car insurance, food, rent and electricity won’t be so expensive.
“I’m out of here,” she said, declaring herself “at peace.”
A week later, she was packing up her apartment and getting ready for the move. Destination: Texas, a state where the abortion she received could have landed her provider in prison.
Laura Morel of the nonprofit investigative news site Reveal contributed to this report.