Understanding The Abortion Law: Nine-Month Limit And Its Implications

The topic of abortion laws is a highly debated and controversial issue, with varying regulations across different countries and states. The discussion often revolves around the gestational limits for legal abortions, with some states imposing bans as early as six weeks into pregnancy when cardiac activity is detected, while others allow abortions without any term restrictions. The debate becomes even more contentious when considering late-term abortions, which typically refer to terminations after 20 weeks of gestation. While rare, these abortions are often performed due to medical concerns, such as fetal anomalies or risks to the mother's health. The legality of late-term abortions varies, with some states banning the procedure entirely, while others permit it under specific circumstances. The shifting landscape of abortion policies, influenced by court rulings and public opinion, continues to impact how women access reproductive care.

Gestational limits on abortion

In Europe, abortion is only permitted after 10-14 weeks if specific circumstances are present, such as when the pregnancy poses a serious danger to the life or health of the woman, or when a serious fetal anomaly is diagnosed. Sweden and Iceland allow abortions up to 18 weeks, while the Netherlands and Great Britain permit them up to 24 weeks under certain conditions.

Within the United States, state laws and regulations on abortion have been in flux since the Supreme Court overturned Roe v. Wade, which previously allowed states to regulate abortion after viability. As of 2024, 14 states have laws banning abortions starting at fertilization, while six states and Washington, D.C., impose no term restrictions. Some states have implemented bans before the 24-week mark, with Nebraska and North Carolina banning abortions at the 12-week mark, and Arizona, Florida, and Utah banning abortions at 15, 15, and 18 weeks, respectively. Iowa, Kansas, Ohio, and Wisconsin ban abortions at 22 weeks, while four states prohibit abortions starting at 24 weeks. Virginia is the only state that bans abortions in the third trimester, which begins at around 25 weeks. It's important to note that most states with restrictions have exceptions, such as preserving a pregnant person's life or health, but these exceptions are often narrowly defined.

Third-trimester abortions

In the United States, third-trimester abortions can cost anywhere from a few thousand dollars to over $25,000, depending on gestation and clinical complexity. They typically take place over three days and can include laboring, which contributes to their high cost.

There are only four facilities that publicly advertise care after 24 weeks, and a total of 44 states generally prohibit abortion in the third trimester. Due to these scarcity issues, pregnant people must often travel, accruing travel costs for transportation, accommodations, and food, which can represent a substantial burden.

There are two pathways to needing a third-trimester abortion: new information and barriers to abortion before the third trimester. In the case of new information, the pregnant person learns something new about the pregnancy, such as an observed serious fetal health issue or that they are pregnant, that makes them realize that this is not, or is no longer, a pregnancy they want to continue. In the case of barriers to abortion, the pregnant person wants an abortion before the 24th week but is delayed by obstacles such as financial obstacles, difficulty finding a provider, and stigmatization.

Abortions later in pregnancy are highly regulated in the United States. Fourteen states currently ban abortion, and 11 have gestational bans that restrict abortion at a certain point in pregnancy. An additional 16 states ban abortion at or near "viability", the point where a fetus can survive outside the womb, generally between 24 and 26 weeks.

Abortions at or after 21 weeks are rare and represent only 1% of all abortions in the US. They are often difficult to obtain, as they are only available in a handful of states and performed by a small subset of abortion providers. They are also time-intensive and costly.

Despite the rarity of abortions later in pregnancy, they receive a disproportionate share of attention in the news, policy, and the law. This discussion is often fraught with misinformation, such as claims of abortions occurring "moments before birth" or even "after birth," which are false and do not occur in the United States.

Late termination of pregnancy

In the United States, late-term abortions are often related to fetal viability, or the ability of the fetus to survive outside the uterus. As of 2015, more than 90% of abortions in the US occurred before the 13th week, with 1.3% taking place after the 21st week, and less than 1% occurring after 24 weeks. Abortions at or after 21 weeks are uncommon and typically only performed by a small subset of abortion providers. They are expensive and often require travel and lost wages, as well as treatment over multiple days.

The reasons for late terminations of pregnancy include circumstances where a pregnant woman's health is at risk, or when birth defects or lethal fetal abnormalities are detected. A 2013 study found that women seeking late abortions often fit one of the following profiles: raising children alone, suffering from depression or substance abuse, experiencing domestic violence or conflict with a male partner, facing decision-making or access problems, or being young and nulliparous.

Partial-birth abortion

PBA is typically used during the middle and last months of pregnancy when dismembering the foetus becomes more difficult due to stronger bones and ligaments. The mother first undergoes two to three days of cervical dilation, increasing the risk of infection and subsequent preterm births. The doctor can then partially deliver the child "intact" before killing them and completing the delivery. This method is faster than the more commonly used dismemberment method, where the mother's cervix is dilated manually, enough to remove the foetus' severed body parts.

In 2003, the US Congress passed a law banning PBA, which was upheld by the US Supreme Court in a five-to-four ruling. The Supreme Court had previously overturned a state law banning PBA because it did not include an exception to protect women's health. The federal law states that PBA is never medically necessary, and the Supreme Court upheld this law despite its previous decisions requiring a health protection for women. The number of PBAs carried out each year in the US is estimated to be between 2,200 and 5,000, with most taking place during the second trimester.

Abortions at or after 21 weeks are uncommon and represent 1% of all abortions in the US. They are expensive, often requiring travel and lost wages, and they are only performed by a small subset of abortion providers. Abortions at this stage are subject to the same regulations that apply to earlier abortions, including mandatory waiting periods and physician and hospital requirements.

State abortion laws

Gestational Limits on Abortion

Some states have laws in place that ban abortions after a certain number of weeks, with cardiac activity usually being detected in an embryo at around six weeks. Florida, South Carolina, and Georgia are the only states that ban abortions at this stage. Nebraska and North Carolina ban abortions at 12 weeks, Arizona at 15 weeks, Utah at 18 weeks, Iowa at 20 weeks, and Kansas and Ohio at 22 weeks. Wisconsin also bans abortions at 20 or more weeks post-fertilization, which is 22 weeks after the last menstrual period.

Viability

More than a dozen states ban abortions after the fetus is considered viable, and some laws leave it up to the abortion provider to determine whether a fetus is viable. Virginia is the only state that prohibits abortions in the third trimester, which starts at around 25 weeks.

No Limit

Six states and Washington, D.C., do not impose any term restrictions on abortions. However, most states with restrictions have exceptions, including to preserve a pregnant person's life or health, though these are often narrowly defined.

Late-Term Abortion

Late-term abortion, or third-trimester abortion, is a politically charged topic and is more controversial than abortion in general. In the US, it is often related to fetal viability, or the ability of the fetus to survive outside the uterus. In 2015, more than 90% of abortions in the US occurred before the 13th week, 1.3% took place after the 21st week, and less than 1% occurred after 24 weeks. Reasons for late-term abortions include circumstances where a pregnant woman's health is at risk or when birth defects or lethal fetal abnormalities are detected.

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