This op-ed first appeared in the Tallahassee Democrat.

According to the U.S. Department of Agriculture and the U.S. Census Bureau, some 1.8 million people live in rural areas of Florida. That is approximately one out of every 12 Floridians.

Residents in those rural areas have less access to health care in general. And according to the American College of Obstetricians and Gynecologists, people living in rural areas also have much more trouble finding reproductive medical care.

This problem recently got much worse. Florida’s House Bill 5, which became law in July, outlaws abortion after 15 weeks of pregnancy. While HB 5 adversely impacts women and people who can become pregnant, it also creates critical problems for people who live in rural areas.

Historically, gynecologists and obstetricians are scarce in rural areas. Medical experts say many physicians go into those specialties, but very few choose to practice in rural areas. Combine that with the fact that fewer general practitioners practice obstetrics than in the past, and you have a scarcity of care.

Since 2010, at least three Florida hospitals serving largely rural areas have closed. They were in Jackson, Levy and Columbia counties. Those closings are part of a national trend in rural areas where many hospitals have been shuttered. These closures have a disparate impact on Black, Hispanic and Indigenous communities.

People in rural areas are also less likely to have health insurance that will pay for care. They are less likely to have employers who offer insurance plans. Since Floridians in rural areas suffer higher rates of poverty than their urban counterparts—18.9 % compared to 12.2 %, according to the Department of Agriculture—they are also less likely to be able to afford to pay for health care on their own. The higher rate of poverty also makes it harder to reach cities where gynecological and obstetric care and abortion providers are more available.

Making matters even worse, a mandatory-delay law went into effect in Florida this year. This law makes it more difficult to access abortion care and requires that patients delay their abortion care until they can make a second trip to the doctor’s office. That means anyone who needs to have an abortion will now have to go to two appointments, not just one, creating double the burden of travel time, expense, childcare, and time off work.

HB 5 greatly increases the likelihood that people who need to access abortion care will be forced to carry a pregnancy against their will because they will not be able to obtain an abortion within the 15-week window. This is even more likely for underserved pregnant people in rural areas and will create unnecessary risks for them.

Forced pregnancy and childbirth not only deny pregnant people autonomy but also may pose significant risks to their health and safety. In America, Black women are about three times more likely than white women to die from childbirth or other pregnancy related complications. In rural areas of the state, where access to healthcare may be limited, this poses a threat to residents who will be forced to bear the risks of pregnancy against their will and may also lack access to routine medical care.

Access to abortion care shouldn’t depend on where you live or your income. All Floridians deserve equitable access to healthcare. We also should be able to make private medical decisions for ourselves, without political interference.

Natishia June is the former field director for the ACLU of Florida.