Susan Maurer began working as an abortion clinician 40 years ago at a Philadelphia hospital. For the past 22 years, she's helped South Florida women through what might be an agonizing moment. The soft-spoken 63-year-old nurse administers anesthesia and assists doctors. At one point way back when, she recalls, abortions were a private matter for women.
But beginning in 2000, protesters began showing up outside A Choice for Women, a nondescript cement clinic on SW 117th Avenue in West Kendall, which Maurer cofounded. On Good Friday last year, 200 activists assembled not far from the front door, displaying graphic pictures and posters. And they just keep coming, making it harder for patients, many of whom are already traumatized.
Now she's angry about the latest incursion: a 24-hour mandated waiting period for abortions at Florida's 66 legal providers. It means women must make two trips to a clinic, one for a consultation and another to have the procedure.
Pro-life groups applaud the move, saying women should reflect more before making such an important decision. But in a state where abortions have been on the decline for years anyway, and where a series of nagging restrictions has had little effect, pro-choice groups say the new law is simply a way to erode women's right to choose. It's a new, potentially expensive headache for those whose lives are already overburdened.
"The Florida Legislature has put one rule after another, and up until now, most laws have not been total game-changers. Let's just be honest and call this what it is," Maurer says. "This is trying to erode abortion rights. No one would make men come back to have a colonoscopy."
Florida is now in the midst of a national push to make getting an abortion harder than it's been since Roe v. Wade made it a legal right in 1973. In 2011, the last year for which numbers are on record, 84,990 women had legal abortions in Florida — a rate of 23.7 per 1,000 women of reproductive age. That's a 26 percent drop since 2000. Experts say the decline is due largely to increased use of contraceptives and greater access to the morning-after pill.
In recent years, the Florida Legislature has passed laws requiring parental notification (2006) and restricting late-term abortions (2014). Florida law already requires doctors to provide "informed consent" for abortion, including giving patients lengthy information about how far along they are and possible medical effects of abortion.
"The law condescendingly implies women don't know what they're doing and can't make choices on their own," says Christopher M. Estes, the chief medical officer of Planned Parenthood of South, East and North Florida. "Women who are coming to have an abortion procedure have already been thinking about it — they didn't just find a center on the side of the road and decide to have it done."
Rep. Jennifer Sullivan, a Republican from Mount Dora, is the pro-life 23-year-old sponsor of the house bill. She thinks women are rushed and often "coerced into the decision." Sullivan, the daughter of North Lake Tea Party founder Patricia Sullivan, just finished her first legislative session. She campaigned last year on a platform of less government and more personal responsibility.
The youngest woman ever elected to the state's legislature, she's taking online classes in business management through Liberty University, an evangelical Christian school in Virginia.
"Women don't have time to realize the effect the procedure is going to have on them," she says, speaking over the phone from a birthday party in her hometown. "A waiting-period law is designed to empower women."
The Florida Senate approved the bill April 24, with all Republicans voting in favor and all Democrats opposed. Just two days earlier, the house passed the same bill, largely along party lines. Throughout the debate, lawmakers from both sides delivered impassioned speeches, and reporters called it one of the most emotional debates of the legislative session.
A last-minute amendment to the bill exempts women who can provide a copy of a restraining order or documentation proving they are victims of rape, incest, domestic violence, or human trafficking.
Pro-life Gov. Rick Scott is expected to sign the bill, which would take effect July 1 and make Florida the 27th state to pass a waiting-period law but the 11th for which the consultation must be in person. States began enacting waiting periods in the early '70s, but most were struck down in court. In 1992, the U.S. Supreme Court upheld Pennsylvania's 24-hour waiting period in Casey v. Planned Parenthood, opening the door for states to adopt myriad regulations for abortions.
In some states, a 24-hour wait has been the first step in broadening restrictions. In 2011, South Dakota became the first state to pass a law requiring women to wait 72 hours before accessing abortion services. Since then, Utah and Missouri have followed suit.
Waiting-period advocates argue they're just sticking up for women who ultimately regret having an abortion. The Senate sponsor of Florida's 24-hour-waiting-period bill, Anitere Flores, of Miami, says the law should be considered a success if even one woman changes her mind.
"Having done post-abortion counseling for almost 30 years, we see people who have made decisions in a state of fear, without knowing all the facts first," says Joan Crown, director of the Respect Life Ministry of the Archdiocese of Miami. "Providers have a vested interest in making money off these girls, so they're not going to worry about slowing down the process."
There is currently no data available on numbers of women who regret their abortions in Florida. According to a 2013 study by the University of California, San Francisco, 90 percent of abortion patients reported they felt relief. Even when women felt sadness or regret, more than 80 percent still said it was the right choice.
And a 2008 American Psychological Association study found no greater risk of mental health problems among women who have abortions than those who have babies.
Opponents of the new law say one thing is certain: It will complicate women's lives — especially in certain parts of the state. A woman who lives in Panama City seeking an abortion already has to travel more than two hours to Tallahassee or Pensacola to have the procedure. Beginning in July, she will have to make that trip twice, and likely face protesters each time.
Elizabeth Nash, who studies state policy at the Guttmacher Institute in Washington, D.C., says this makes it especially tricky for low-income women, who often can't take two days off work while having to come up with funds for the procedure. Sixty percent of women seeking an abortion already have children.
"That's potentially two days lost, where women have to figure out childcare, travel arrangements, maybe even a hotel room, and then the cost for the abortion," Nash says. "You've added in a lot of extra logistics and costs."
Diane Macias of Fort Lauderdale was 20 years old and already the single mother of a 3-year-old girl when she saw two lines appear on a pregnancy test in 2012. She knew immediately she wanted to have an abortion.
So the following day, amid work, school, and childcare demands, she went to a clinic in Broward to have the procedure. She was frustrated with herself for becoming pregnant again, but she had no doubts as the doctor performed an ultrasound and explained her options. She learned what would happen before and after the procedure, both physically and emotionally. She had lab work done to be sure it would be safe for her. The educational process lasted close to two hours before the procedure began.
"It's a big misconception that you're just going to be told to get an abortion," she says. "It's a thoughtful process."
In 2013, Macias graduated from Florida Atlantic University with a bachelor's degree in sociology. Now she's in a master's program in social work at FAU. "Women are mothers, volunteers, employees, students — we do so much," she says. "If a woman needs a waiting time, she'll take it for herself."
On a recent Saturday, pro-life activist Mary Salter stands outside A Choice for Women clinic in Kendall holding a poster-size sign that reads, "End the Pill." For ten years, Salter, a 67-year-old pro-life activist and member of St. John Neumann Catholic Church, has been the leader of weekly protests and prayer groups outside the clinic.
Salter admits her prayers in front of A Choice for Women are a last-ditch effort; she says most women who arrive have already made up their minds. But 24 more hours, she says, is another opportunity to let patients hear her prayers for life. With more time, a woman may be able to feel the unmistakable bond she has with her unborn child.
"Women are meant to have babies," she says while two women sing "Ave Maria" behind her. "When they go against their deepest conscience, it's not natural, not right, not good, no matter the age or the reason. It's not good to terminate a life that was given to them."
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Just a few feet away, Steve Williams eyes Salter and the other pro-life activists. The 69-year-old wears aviator sunglasses and a bright-orange shirt that reads, "Pro Choice," where the "o" in "Pro" is a tight fist — a feminist symbol. He and fellow volunteer Myk Arostegui have hung sheets between activists and the doors of the clinic and are recording Salter and her group of activists on a small camera — in case anything goes awry.
As long as protesters are here, Williams plans to return. Now retired, he says he doesn't have the money to contribute to women's-rights groups anymore, but he has the time.
Around 8:30 a.m., cars begin to enter the clinic gates at a slow but steady tick. Each time one pulls in, the protesters — about a dozen at their peak — raise rosary-filled hands and shake "Give Life" signs as their voices ignite in prayer in Spanish and English. As they do, Williams steps in front of the protesters, an intermediary between their signs and incoming patients.
"Women used to have full access, and now people want to backtrack on women's autonomy," he says. "Women's rights are under one of the worst attacks in history, and anything I can do to help I'm gonna do."