Republican leaders in North Carolina鈥檚 legislature want the state to start enforcing a 20-week abortion ban. The ban has been on the books since the early 1970鈥檚 but courts have previously blocked it from taking effect because of Roe v. Wade.
Only a small number of abortions in North Carolina are performed after 20 weeks 鈥� most are performed in the first trimester 鈥� but as it gets harder to obtain abortions in other states, experts say there may be more abortions later in pregnancy.
State data from 2020 48 North Carolina residents had an abortion at 21 weeks or later, or roughly .2% of all of the residents who had abortions. Thirty of those were performed in North Carolina and 18 were out-of-state. Most abortion providers in North Carolina don鈥檛 offer abortions after 20 weeks, even though abortion is currently legal up to viability, which is around 24 weeks.
According to the Centers for Disease Control and Prevention, of abortions across the U.S. in 2019 were performed at 21 weeks or later.
Why patients might seek abortions after 20 weeks
Though there are no specific data about why North Carolina patients had abortions after 20 weeks, in general, there are two primary reasons people get later abortions, according to Katrina Kimport. Kimport, a professor at the University of California San Francisco, has later-pregnancy abortions.
The first reason, she said, is that patients might learn new information about their pregnancies, like that they or the fetus have a health problem.
鈥淪ometimes this new information is absolutely unavailable earlier,鈥� Kimport said. 鈥淔or example, the way that fetal development of the brain takes place, you cannot know if there鈥檚 health development until somewhere between the 26th and 28th week of pregnancy.鈥�
With the new information, someone might decide they don鈥檛 want to continue the pregnancy or that it would be unsafe to do so. In North Carolina, even with the possible 20-week ban, there would be exceptions for medical emergencies.
In addition, people sometimes don鈥檛 know they are pregnant until after 20 weeks. It鈥檚 rare, according to Kimport, but people who are obese, have recently given birth, have other medical conditions, or have irregular menstrual cycles might not notice when they miss a period or experience other signs of pregnancy.
The second reason patients get later abortions is because of what Kimport calls 鈥渂arriers to care,鈥� or when someone knows they want an abortion but has trouble accessing one before 20 weeks. They might have trouble finding an available appointment, lack the money or transportation to travel to a provider, or face obstacles like an abusive partner or family member.
The stigma around an unplanned pregnancy and seeking an abortion can also act as a barrier, according to Kimport.
鈥淚 interviewed somebody who was 18 and living at home and was so ashamed of being pregnant and wanting an abortion that she felt like she couldn鈥檛 speak to anybody about it 鈥� and so couldn鈥檛 actually take any action toward having an abortion,鈥� Kimport said.
The number of later abortions could grow
While only a small number of people get abortions after 20 weeks, Kimport expects the number of later abortions to increase now that Roe has been overturned because there are more barriers to care. People who live in states like South Carolina or Tennessee, where abortion is banned or severely restricted, will have to travel farther. Residents of states with fewer restrictions will then compete with out-of-state residents for appointments.
鈥淓ven people living in states that have protected abortion rights today may see their wait times for appointments extending. So they, too, may be delayed after 20 weeks of pregnancy before they can get care,鈥� Kimport said.
North Carolina is already set to be a destination for people from surrounding states seeking abortions 鈥� so more restrictions, even at the 20-week level, would certainly have a ripple effect.
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