Dr. Cecilia Grande in South Miami said Florida’s lawmakers should know about all the things that can go wrong with a pregnancy — all the scenarios she's seen happen over more than two decades as an obstetrics-gynecologist. Like when a patient suffers an early rupture of membranes — commonly described as when their "water breaks" too soon.
"They’re 18 weeks or 19 weeks — you know that this pregnancy cannot continue," Grande said. "You know that the mom, if you don’t act, is going to get an infection and that infection may have her many days in the hospital. She might lose her uterus. She might even lose her life."
A doctor would induce labor in this case — and the fetus may not survive. Grande worries that might now be considered an illegal abortion in Florida.
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Florida's new state law banning most abortions after 15 weeks leaves health care providers with fewer options when treating pregnant patients. South Florida physicians like Grande say they're frustrated that state legislators are making abortion laws without medical expertise. The doctors argue these policies could harm patients and providers throughout the state.
The state’s new law bans abortions after 15 weeks with some exceptions — for instance, if two separate physicians sign off on a fatal fetal abnormality or if the patient could die. The legislation doesn’t explain how imminent that danger needs to be.
"We’re having people that are politicians, and have absolutely no qualifications make these determinations and impose for patients to continue pregnancies," Grande said.
One in 50 pregnancies is ectopic — that means the embryo starts growing outside the uterus, usually in a fallopian tube. These pregnancies never end in a birth. They can cause internal bleeding or even death without quick intervention.
"Do we wait until that ectopic pregnancy ruptures? Because now we are afraid that somebody is going to accuse us," Grande said. "So this creates a big moral crisis for the doctors who took an oath that they were not going to do any harm."
The American College of Obstetrics and Gynecologists wrote in a statement in May that state lawmakers are "taking it upon themselves to define complex medical concepts without reference to medical evidence."
Dr. Grande said her medical expertise guides her decisions — not politics or religion. Even though she’s Catholic and doesn’t perform abortions herself.
"Regardless of what your religious position is, if you have a patient who comes to your office and they want to seek a termination of pregnancy for whatever reason — medical, personal — even if you’re not a provider of abortions, you point the patient in the right direction," she added.
"I couldn’t inhale a full breath without wincing," said Alison Vicent, who lives in Davie. "I couldn’t stand up straight, I was hunched over from pain."
Vicent didn't know she was pregnant in 2019. She started to have cramps and light bleeding. Within a few days, the pain became intolerable. At a hospital in Margate, an ultrasound showed her abdominal cavity was filled with blood — possibly from a ruptured fallopian tube.
"At that point the choice for what to do next was sort of out of our hands," Vicent said. "It became a ‘oh you haven’t eaten in the last few hours, right? Cool, all right we need to get you in the [operating room] right now.’ From there I found out in fact it was in my tube. The tube had ruptured."
She was roughly eight weeks along in her pregnancy. The only treatment for a rupture is emergency surgery to remove the pregnancy.
"I was now 25 years old with one fallopian tube," Vicent said. "You know, does my other tube work correctly? Is there a blockage? It’s one of the most traumatic things I’ve ever been through."
Vicent and her husband wanted a baby. With one fallopian tube, Vicent later did give birth to a healthy daughter.
Rachel lives in the Florida Keys. In 2016, she went to get an ultrasound in Coral Gables to find out why she was feeling pain on her side, near her hip.
"I was prepared to hear that I had a cyst, that I had cancer, that something horrible was going on inside of my body," Rachel said. "I was not prepared to be told I was pregnant."
Rachel asked us not to use her last name.
"You get judged," she explained.
She got an abortion at about 10 weeks.
"I did what I was supposed to do. I was on birth control. I’ve never been off of it," Rachel said. "How dare my body betray me in this way?"
Women, trans men and non-binary people in Florida who get pregnant now have much tighter timing to make these decisions — 15 weeks instead of 24, under the new law.
A 24-hour waiting period went into effect earlier this year, and a minor needs parental consent or a judge to agree.
"The feeling of helplessness is just overwhelming," Rachel added. "Other than voting, I don’t know what else women can do at this point."
That's what Grande is now advising her patients to do.
"'Are you registered to vote?' I tell them, 'I’m not telling you who to vote for, but if you don’t like how things are, go out and vote,' " she said.
On June 24, 2022, the U.S. Supreme Court overturned Roe v. Wade. In the early evening after the decision, an abortion rights rally took place in Miami's Wynwood neighborhood.
"Listen to the chanting — we want to be proud," said an unidentified person at the event. "Use your voices. Everybody here is here because they care."
Some protesters were wearing T-shirts and jean shorts, while others had green scrubs and white coats on.
"I was so happy when Katrina told me this was happening," Dr. Sarah Stumbar said. "Somewhere to go and feel a sense of community."
Drs. Stumbar and Katrina Ciraldo said they felt compelled to protest not just because of how the SCOTUS decision would affect them as women, but as physicians.
"We’re telling people that they need to consider what state they’re going in to train," Stumbar said, adding that she’s telling medical school students that Florida might not be the right place to do a residency.
"Here in Florida you won’t be able to get later training for second trimester procedures — if that’s what you’re looking for," she added.
Florida is already facing a shortage of doctors and nurses. A lot of people left their jobs because COVID-19 care was so tough. Dr. Ciraldo says now she worries about losing more health care colleagues because of the cost of living and also because of these new government restrictions on their jobs.
"It’s too expensive to live here. People are not gonna come here to go to medical school, go into more debt," Ciraldo said. "We’re going to have a major crisis. Health care workers are leaving the field in droves, because we’re burnt out, unsupported, we have people who are not physicians, like these people on the Supreme Court, telling us what is right or wrong."
Ciraldo said she knows what's right medically as a doctor. Now she feels like lawmakers in Tallahassee are tying her hands.
She held up a white poster that had “Keep your bans out of my exam room” in capital purple letters on it as fellow protesters shouted out, "My body, my choice!"
WLRN's Kate Payne contributed reporting to this story.
