The group backing Amendment 4 in Florida, which would enshrine abortion access until viability and replace the state’s current six-week ban, launched its first statewide TV ad during the presidential debate.

Its message: Florida’s abortion law takes effect before many women know they are pregnant or have had their first doctor’s appointment.

“This is when government in Florida has banned abortion,” the narrator says. “An extreme ban with no real exceptions. Not for her health. Not even for rape.”

Florida’s abortion ban, in place since May 1, is considered one of the country’s strictest. But it does include exceptions for the pregnant woman’s health, and for cases of rape and incest up to 15 weeks of pregnancy.

Yes on 4 argues that the exceptions require burdensome paperwork and are difficult to obtain.

Yes on 4, Floridians Protecting Freedom is a campaign of groups, including Planned Parenthood, trying to expand abortion access. 

Meanwhile, Gov. Ron DeSantis, R-Fla., who signed the six-week law in April 2023, is leading a statewide effort to defeat Amendment 4. Within a day last week, Florida’s health care agency launched a website against the initiative, and DeSantis’ secretary of state ordered an investigation into thousands of the ballot measure’s verified signatures. 

The window for an abortion in Florida is tight: The law requires two in-person doctor visits at least 24 hours apart before the six-week cutoff for an abortion, with a few exceptions. 

The law allows for an abortion at any point of pregnancy if the pregnant woman’s health or life is “at serious risk of substantial and irreversible physical impairment.”

Abortions for cases involving rape or incest are allowed up to 15 weeks of pregnancy.

Laura Goodhue, vice president of public policy for Planned Parenthood of South, East and North Florida, said the law’s requirements for qualifying exceptions make it hard for patients to meet the letter of the law and get a legal abortion.

To meet the state’s health exception, a patient must get two physicians to verify that an abortion is necessary, something they aren’t always comfortable doing, Goodhue said.

“It’s hard to find a second physician,” she said. “First, their license is on the line, but it also has criminal penalties.”

For rape and incest, the woman must provide documentation, such as a restraining order or police report, to her provider.

Most rapes are not reported to the police. According to the Rape, Abuse & Incest National Network, 2 out of every 3 sexual assaults go unreported.

Although all states with abortion restrictions include some exceptions, attempts to apply them show they can be ineffective in practice. Doctors wrestle with laws’ vague language, making it difficult to determine whether a patient’s case qualifies.

In complicated cases, physicians weigh patients’ medical conditions against concerns about their own legal liability, abortion law experts said. In Florida, willfully performing or actively helping someone get an abortion outside of the six-week window, or outside of a qualified exception, is considered a third-degree felony, punishable by fines and up to five years imprisonment.

Florida’s government hasn’t reported how many abortions have been provided under one of the exceptions, but Mabel Felix, a women’s health policy analyst at health-policy research group KFF,  said reports from other states with similar laws show that few people were able to access abortion care under an exception.

A KFF review of abortion law exceptions found that several states have contradictory language within their own laws, worsening the confusion.

“Assessing how many people who qualify for abortion care under the exceptions are actually able to do so is difficult and the limited health exception leaves out conditions that threaten the health of a pregnant person, but do not pose a risk of substantial and irreversible physical impairment of a major bodily function,” Felix said. “Although the text of many bans contain exceptions, these can be unworkable in practice.”

There are reports from other states of women being unable to obtain abortions, despite the fact that their pregnancies were endangering their health. NPR interviewed Florida physicians who said the vagueness in the ban’s exceptions has a chilling effect.

In Idaho, which has a complete abortion ban with a similar health exception to Florida’s and also requires that the pregnant woman provide a copy of a police report to the provider, there were five documented abortions in 2023, with no specification of which exception the abortions were provided under, Felix said. 

A day after Florida’s six-week law took effect, state health regulators issued new emergency rules clarifying its exceptions. It specified treatments for ectopic pregnancies and trophoblastic tumors — a tumor that can form where the placenta attaches to the uterus — aren’t considered abortions. Regulators also said that if a physician tries to induce delivery to treat the premature rupture of membranes and the fetus doesn’t survive, it’s also not considered an abortion.

State regulators said they focused on medical conditions that could occur after six weeks and “can present an immediate danger to the health, safety and welfare of women and unborn children in hospitals and abortion clinics.” 

Yes on 4’s TV ad said Florida’s six-week abortion law has “no real exceptions. Not for her health. Not even for rape.”

Florida’s abortion ban does include exceptions for the pregnant woman’s health and life, and for rape and incest up to 15 weeks of pregnancy. 

The amendment’s backers argue the law’s exceptions aren’t “real,” because of the hurdles to qualify. The health exception, for example, requires sign-off from two doctors, and doctors may hesitate over fear of legal penalties and loss of license. To qualify for a rape or incest exception before 15 weeks, women must provide documentation from law enforcement.

But the ad’s words omit that the current law allows exceptions for the health and rape, leaving viewers with a misleading impression. We rate the claim Mostly False.