Full Answer Section

Despite these efforts, Florida faces challenges in ensuring widespread access. According to the Urban Institute, nearly 1.2 million women of reproductive age in Florida live in “contraceptive deserts,” indicating limited access to publicly supported contraceptive services. While the Affordable Care Act provides for $0-copay birth control under most health plans, this benefit doesn’t extend to the uninsured. Florida has not expanded Medicaid to cover all low-income adults, although it does cover family planning services for people not otherwise eligible for Medicaid with incomes up to 196% of the federal poverty level through the Medicaid Family Planning Waiver Program. This partial coverage still leaves a significant portion of uninsured women with limited options for comprehensive contraceptive care (Urban Institute, n.d.).

Abortion:

Access to abortion in Florida is severely restricted, regardless of insurance status. As of May 2024, Florida has a six-week abortion ban, with limited exceptions only for the preservation of the mother’s life or physical health, lethal fetal abnormalities, or certain cases of rape or incest. This ban means that many women, even those with health insurance, will be unable to access abortion care within the state if their pregnancy is past six weeks gestation. This effectively eliminates access for most women, as many do not even realize they are pregnant before six weeks (Frankel, n.d.; Urban Institute, n.d.).

For women with health insurance, most private insurance plans in Florida generally do not cover abortion, unless it is medically necessary to save the mother’s life. Florida also does not use state funds to cover abortion for Medicaid beneficiaries, even though it does cover family planning services. This means that uninsured women, who are already facing economic challenges, are particularly disadvantaged as they would need to pay out-of-pocket for any legally permissible abortion, which is highly limited in scope, or travel out of state for care, incurring significant financial and logistical burdens (Urban Institute, n.d.). The role of a nurse practitioner or nurse leader in Florida would involve navigating these restrictive laws, providing accurate information and support to patients, and advocating for policies that expand access to comprehensive reproductive healthcare.

Florida’s Infant and Maternal Mortality Rates and Their Relationship

Infant Mortality Rate (IMR):

As of 2023, Florida’s infant mortality rate was 6.0 deaths per 1,000 live births. This rate has remained relatively stable in recent years, oscillating slightly around 5.9-6.0 deaths per 1,000 live births (Florida Health Charts, n.d.-a). While this is lower than some states, it’s generally higher than many developed nations, indicating room for improvement in infant health outcomes.

Maternal Mortality Rate (MMR):

Florida’s maternal mortality rate was 18.5 deaths per 100,000 live births in 2023 (Florida Health Charts, n.d.-b; Florida Health Justice Project, 2024). This rate is concerning, as it places Florida’s MMR close to the national average, which is significantly higher than in many other high-income countries. Maternal mortality refers to deaths occurring during pregnancy, childbirth, or within 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.

Possible Relationship Between These Factors:

There is a significant and complex relationship between access to maternal health resources, including contraceptive care and abortion, and infant and maternal mortality rates. Limited access to comprehensive reproductive healthcare, including contraception, can lead to higher rates of unintended pregnancies. Unintended pregnancies are often associated with poorer maternal health outcomes due to delayed or inadequate prenatal care, increased stress, and potentially higher rates of complications (Howell & Zeitlin, 2017).

Furthermore, the restrictive abortion policies in Florida can exacerbate this relationship. When abortion is heavily restricted or effectively banned, women who might otherwise choose to terminate a pregnancy due to health risks, socioeconomic instability, or lack of support are forced to carry pregnancies to term. This can lead to increased maternal morbidity and mortality, especially for women with pre-existing conditions or those who lack adequate resources. Studies have shown a strong correlation between restrictive abortion policies and higher maternal mortality rates, as well as an increase in infant mortality due to factors like poverty, inadequate prenatal care, and lack of postpartum support among those who are unable to access desired reproductive healthcare (Stevenson et al., 2021). The lack of comprehensive maternal health resources, particularly for uninsured women, means that many do not receive timely and adequate care throughout their pregnancy, increasing the risk of adverse outcomes for both mother and infant. Nurse practitioners and nurse leaders in Florida, recognizing these critical links, must champion policies and practices that expand access to a full spectrum of maternal health services to improve these vital health indicators.