Real-life statistics about late-term abortions paint a different picture than what most people believe. Public debates often center around late-pregnancy procedures, yet only 1% of all U.S. abortions happen at or after 21 weeks gestation. The annual number stands at roughly 4,100 procedures, which is much lower than common assumptions.
CDC data shows that 96% of abortions take place at or before 15 weeks gestation, while 3% occur between 16 and 20 weeks. Many people believe that full-term and 9-month abortions happen often, but the numbers tell a different story.
Medical professionals perform 9-month abortions rarely and usually because of severe health complications. The digital world of late-term abortion services has altered the map since the Dobbs decision. Now, just 60 clinics across the nation offer services at or after 24 weeks as of 2023.
As I wrote in this piece, we'll get into what current research reveals about late-term abortions in 2025. The focus will be on clearing up common myths and understanding the medical, legal, and personal reasons behind these choices.
What is considered a late-term abortion?
People need to understand pregnancy timing terminology when they talk about abortion procedures. The phrase "late-term abortion" shows up often in political talks, but many don't know what it really means.
Clarifying gestational age vs. fertilization age
Doctors use two main ways to calculate how long someone has been pregnant. This can make abortion timing discussions confusing:
- Gestational age (GA): Doctors count this from the first day of the last menstrual period (LMP). This happens about two weeks before conception. Medical practice uses this standard method.
- Post-fertilization or fertilization age: This counts time from when the egg and sperm joined. The date comes about two weeks after the gestational age calculation.
Healthcare providers stick to gestational age because patients can remember their last period more easily than the exact moment they conceived. But some anti-abortion groups and laws use "fertilization age" or "conceptional age." This creates a two-week difference when talking about the same pregnancy stage.
Why 'late-term' is not a medical term
The phrase "late-term abortion" has no real medical meaning. The American College of Obstetricians and Gynecologists (ACOG) makes this clear.
Doctors use "term" to describe specific pregnancy stages near delivery:
- Early term: 37-38 weeks and 6 days
- Full term: 39-40 weeks and 6 days
- Late term: 41-41 weeks and 6 days
- Postterm: 42+ weeks of gestation
Abortions don't happen during these periods, so "late-term abortion" isn't accurate medically. Medical experts say "abortions later in pregnancy" or give specific weeks, like "abortion at 21+ weeks gestation".
Medical literature defines later abortions as procedures that happen at or after 21 weeks gestation. Third-trimester abortions start at 24 weeks gestation.
Common misconceptions about 9 month abortion
The idea of "9-month abortions" or abortions right before birth doesn't exist in medical practice. This remains one of the biggest myths in abortion discussions.
Here's what the real numbers tell us:
- 91% of abortions happen in the first trimester (first 13 weeks)
- Only 1.3% of U.S. abortions happen at or after 21 weeks gestation
- Less than 1% take place in the third trimester
Later pregnancy abortions happen rarely and usually for two main reasons. Doctors might find fatal birth defects or genetic problems that would cause death, suffering, or serious disability. The pregnant person might face life-threatening medical or psychiatric conditions.
Later abortion procedures differ from what political rhetoric suggests. Doctors use dilation and evacuation (D&E) or dilation and extraction (D&X) procedures. Political terms like "partial birth abortion" lack medical meaning. People use these terms in debates to create graphic images that don't match the actual medical procedures.
The medical facts about later abortions show why doctors and medical groups push for accurate terms. They reject political language that distorts public understanding of these rare but needed medical procedures.
How often do late-term abortions happen in the U.S.?
Late-term abortions are often misunderstood in America's healthcare system. The numbers tell a clear story – these procedures make up a tiny fraction of all abortions performed each year.
CDC and Guttmacher data comparison
The CDC and Guttmacher Institute are the go-to sources for U.S. abortion statistics. They work differently though – CDC gets its numbers from state health departments that volunteer data, while Guttmacher reaches out to abortion providers directly.
The latest CDC data from 2022 shows 613,383 legal induced abortions from 48 reporting areas. This number doesn't tell the whole story since some big states like California don't share their data with CDC.
The timing patterns paint a clear picture. Most abortions happen early in pregnancy, and the numbers drop sharply for later gestational ages. This pattern hasn't changed much over the years, even as overall abortion rates go up and down.
Abortions at 21+ weeks: percentage and trends
The numbers for later-pregnancy abortions are crystal clear. The CDC's 2022 data shows:
- 92.8% of abortions happened at or before 13 weeks' gestation
- 6.1% took place between 14-20 weeks' gestation
- A mere 1.1% occurred at or after 21 weeks' gestation
These numbers are up slightly from 2021, which saw 0.9% of abortions at or after 21 weeks. This means about 4,100 abortions per year happen at or after 21 weeks gestation.
Most of these later procedures happen right after the 21-week mark. A study from 1992 found that just 0.02% of all abortions happened after 26 weeks – about 320 to 600 cases nationwide each year.
These percentages haven't changed much in decades. About 91-92% of abortions still happen at or before 13 weeks. More people now get abortions at or before 9 weeks, thanks to easier access to medication abortion.
Abortions at 9 months: myth vs. reality
Stories about "9-month abortions" or abortions "moments before birth" are flat-out wrong. These situations don't exist and aren't legal in the U.S. Data shows third-trimester procedures are incredibly rare.
Nine out of ten abortions happen in the first trimester (first 13 weeks), and almost all others take place before 26 weeks. Third-trimester procedures, starting at 24 weeks, are extremely uncommon.
The numbers back this up. Last year, researchers found just 60 clinics nationwide that provide abortions at or after 24 weeks, and only five that offer services at or after 28 weeks. This limited availability comes from legal limits and the specialized skills needed for later abortion care.
The Dobbs ruling has made getting abortion care harder. Early research shows patients in states with abortion bans face more delays. They need time to plan out-of-state travel and often struggle to find appointments where abortion remains legal.
The number of people traveling out-of-state for abortions doubled between early 2020 and early 2023. These delays can push procedures later into pregnancy. We don't have complete post-Dobbs data yet, but the percentage of later abortions might increase.
Public perception doesn't match reality when it comes to late-term abortions. This gap shows why we need fact-based conversations about abortion timing, as laws keep changing how people access care at different stages of pregnancy.
Why do people seek abortions later in pregnancy?
People need abortions later in pregnancy for complex reasons that are often medically necessary. Politicians might claim these procedures are optional, but the truth is more complicated. Medical needs, late diagnoses, and problems getting care all play a role.
Fetal anomalies found after 20 weeks
Doctors can't detect many severe fetal problems until the mid-pregnancy anatomy scan that happens between 20-24 weeks. This detailed ultrasound looks at how the baby is growing and checks for structural problems that aren't visible earlier.
The 20-week scan looks for signs of 11 different conditions. These include anencephaly, open spina bifida, cleft lip, diaphragmatic hernia, serious heart problems, and severe skeletal dysplasia.
Doctors can find about 60% of birth defects during this scan. England's National Congenital Anomaly and Rare Disease Registration Service reported 13,306 babies were born with birth defects in 2019. Doctors diagnosed 68% of these cases before birth.
Some conditions are rare but devastating. A diaphragmatic hernia affects 1 in 4,000 births, and half of these babies don't survive. Babies with bilateral renal agenesis can't live outside the womb. Families who get these heartbreaking diagnoses must make tough choices about pregnancies that can't result in a living child.
Some fetal problems only show up even later. The brain grows rapidly in late second and early third trimester. This means doctors can't diagnose certain brain problems any earlier. One patient explained it this way:
"Brain development happens so much in the last second trimester and early third trimester that they really could not confidently tell us more [at earlier scans]".
Health risks to the pregnant person
Life-threatening pregnancy complications can emerge later. These include severe preeclampsia, newly diagnosed cancer that needs immediate treatment, and serious infections.
Laws that limit abortion access force some people to stay pregnant despite serious health risks. This hits harder in communities that already struggle to get good healthcare. Black women die from pregnancy-related causes three times more often than white women.
The risk of dying from an abortion goes up from 0.3 per 100,000 at eight weeks or earlier to 6.7 per 100,000 at 18 weeks or later. Yet abortion remains safer than continuing a risky pregnancy.
After the Dobbs decision, pregnant people in states with abortion bans face uncertainty about health exceptions. Some patients went home despite worsening health conditions and later developed life-threatening problems. Several lawsuits now challenge the harm done to patients who couldn't get abortions despite serious pregnancy complications.
Delays due to access, cost, or legal barriers
Many patients try to get abortions earlier but run into obstacles. Research shows women seeking abortions after 20 weeks weren't doing so mainly because of fetal problems or life-threatening conditions. They faced barriers that pushed their care later.
In 2004, abortion patients waited 7-10 days between trying to schedule and getting care. Poor patients and those with two or more children waited 2-3 days longer than others.
Money creates a big barrier. About 75% of abortion patients are poor or have low income, but 51% must pay themselves. One patient shared her struggle: "My boyfriend was working odd jobs, and I don't have a job, and we were homeless on the street… there was no way that we could get a couple hundred [dollars], let alone a grand, if not more".
Legal restrictions add more delays. By May 2016, 27 states required waiting periods of 24-72 hours between counseling and the procedure. Research shows this leads to more second-trimester abortions. Mississippi saw pregnancy lengths increase by four days on average after requiring two visits.
State bans now force patients to travel further for care, which means longer waits for appointments. The number of people traveling out of state for abortions doubled in early 2023 compared to early 2020. These delays push pregnancies later, creating a cycle where restrictions meant to limit abortions actually lead to later procedures.
How state laws impact access to late-term abortion
A complex web of state laws across the US controls if and when someone can get abortion care. These rules matter even more for people who need procedures later in pregnancy.
States with full term abortion bans
Right now, 18 states have either banned abortion completely or put strict time limits on it. Twelve of these states have total bans, though almost all have some exceptions. These exceptions usually cover four situations: saving the pregnant person's life, protecting their health, cases of rape or incest, and fatal problems with the fetus.
These bans have harsh consequences. Alabama treats performing an abortion as a Class A felony that can land someone in prison for up to 99 years. Kentucky's laws are also tough – they classify it as a Class C felony with 5-10 years in prison and fines from $1,000 to $10,000.
Several states with total bans, like Alabama, Kentucky, and Louisiana, don't make any exceptions for rape or incest. This leaves survivors in these states with almost no options for care.
Late term abortion states with exceptions
Six states limit abortions between 6 and 12 weeks. Florida, South Carolina, and Georgia don't allow abortions once they can detect cardiac activity – usually around six weeks. Nebraska and North Carolina stop at 12 weeks, Arizona at 15 weeks, Utah at 18 weeks, and Iowa at 20 weeks after fertilization.
More than half of US states only restrict abortion at viability or don't have any time limits at all. Six states and Washington D.C. let people get abortions at any point. California only steps in at viability, when doctors determine the fetus could likely survive outside the uterus without extreme medical help.
Most states with limits do have exceptions, but they're usually quite specific. States like California let people get abortions after viability if staying pregnant would risk their life or health. Others, including Idaho, Michigan, and Rhode Island, only allow late-term procedures if the mother's life is at risk.
Travel requirements and lack of providers
People travel more across state lines now that abortion access is limited in many places. Before Dobbs, one in ten patients went to another state for care. Now it's one in five. During 2023, 171,300 people left states with total or six-week bans to get abortion care.
People from the biggest ban states face the heaviest burden. Last year, 35,500 Texans crossed state lines for abortion services – some went as far as Washington or Massachusetts.
States that allow abortions have seen huge jumps in out-of-state patients. Illinois had the biggest increase – out-of-state patients made up 41% of their 90,450 abortions in 2023. New Mexico's abortion numbers shot up 368% between 2019 and 2023. Out-of-state patients got 79% of all clinical abortions there in 2023.
Crossing state lines creates more problems – extra costs, taking time off work, finding childcare, and dealing with unfamiliar healthcare systems. These barriers often push abortions later into pregnancy. The restrictions meant to limit abortions actually lead to more later-term procedures.
What procedures are used in late-term abortions?
Late-term abortion procedures are quite different from those used in the first trimester. These differences reflect how pregnancy develops through the second and third trimesters.
Dilation and evacuation (D&E)
D&E stands as the most common procedure at or after 21 weeks. The numbers show that doctors use this method in 93-95% of these cases. This surgical approach combines two essential steps: doctors prepare the cervix and then remove pregnancy tissue.
Doctors typically start cervical preparation a day before the procedure using one of these methods:
- Osmotic dilators (laminaria or synthetic alternatives like Dilapan-S)
- Medications such as misoprostol
- Mechanical dilators
Patients receive conscious sedation or general anesthesia with pain management on the procedure day. The doctor then uses specialized instruments and suction to remove the pregnancy tissue. The whole ordeal takes about 10-20 minutes, and patients stay under observation afterward.
D&E remains the preferred choice through most of the second trimester. To name just one example, see U.S. statistics where doctors used D&E in 98.6% of abortions between 13-15 weeks, 95.4% between 16-20 weeks, and 85.1% at 21 weeks or later.
Labor induction and other methods
Labor induction abortion serves as the main alternative to D&E, especially in advanced pregnancies. Doctors turn to this method more often after 20 weeks gestation.
The procedure works this way:
The doctor may give medication to stop fetal cardiac activity first. Then, medications cause uterine contractions that ended up making the cervix dilate and expel the pregnancy. This process usually takes 12-24 hours.
Common medication protocols include:
- Mifepristone followed by misoprostol (most common)
- Prostaglandins alone
- Oxytocin to increase contractions
Doctors once commonly used intrauterine instillation with saline or urea, but safer and more effective methods have replaced these.
Labor induction works well when families need an intact fetus for diagnostic purposes or the grieving process. Notwithstanding that, D&E procedures happen faster and have fewer complications.
Safety and complication rates
The largest longitudinal study shows both major late-term procedures are exceptionally safe. Complications happen in fewer than 5% of cases. These complications include:
- Retained pregnancy tissue (less than 1% for D&E procedures)
- Infection (up to 4%, drops to less than 1% with preventive antibiotics)
- Hemorrhage (0-1% of cases)
- Cervical laceration (up to 3%)
- Uterine perforation (fewer than 1%)
Death rates stay extremely low. CDC data from 2004-2008 showed 0.64 deaths per 100,000 legal abortions. Risk factors that make complications more likely include advancing gestational age, cervical abnormalities, multiple previous births, and provider inexperience.
Proper cervical preparation before D&E reduces complications by a lot. Ultrasound guidance during procedures has also helped lower perforation rates.
Research on later pregnancies found no increased risk of preterm birth after D&E procedures. A review of 600 patients revealed that subsequent pregnancies had lower preterm birth rates than the general U.S. population (6.5% versus 12.5%).
Mental health outcomes after late-term abortion
Research that analyzed psychological outcomes after late-term abortions shows a picture that is different from what many people assume. Mental health plays a vital role in care if you have these procedures.
PTSD and emotional distress
Women who undergo late-term abortions show varying levels of Posttraumatic Stress Disorder (PTSD) symptoms. Studies reveal that women with second or third-trimester abortions had higher intrusion subscale scores.
They were more likely to experience disturbing dreams, relive the abortion experience, and face sleep issues compared to those who had first-trimester procedures.
This doesn't mean everyone faces psychological harm. A study showed that before late termination, 57.8% of women displayed above-average psychological distress (66.7% anxiety, 51.1% depression, 37.8% somatization). These numbers dropped to just 10% after 2-6 years.
PTSD affects about 13% of U.S. women in their lifetime. This helps us understand how abortions relate to trauma. About 12-20% of women with an abortion history meet full PTSD criteria. A higher percentage experience some trauma symptoms without meeting all criteria.
Depression stands out as the most common psychological effect. One study reported 60.5% of cases showed depression, while 53.6% worried about future pregnancy. Other research found reduced self-esteem (43.7%), nightmares (39.5%), guilt (37.5%), and regret (33.3%) among participants.
Factors increasing psychological risk
These factors often predict higher psychological distress after late-term abortions:
- Pre-existing mental health conditions: Women's history of mental illness makes them more vulnerable to post-abortion psychological difficulties.
- Young age: People under 25 show higher risk for mental health complications. Limited access to abortion care and higher unwanted pregnancy rates might explain this.
- Decision ambivalence: Uncertainty about the choice raises the risk.
- Social reasons for abortion: These showed higher PTSD symptoms across all subscales (Intrusion, Avoidance, and Hyperarousal).
- Timing considerations: Most mental disorders peak within five years after abortion. They gradually fade and mostly disappear 17 years after the procedure.
Women face higher risks of later abortions when their partner wanted the pregnancy, they felt pressured to abort, left their partner before the procedure, kept it secret from their partner, or had physical health concerns.
Support systems and counseling needs
Women need professional help especially when psychological distress follows late-term abortions. Those who delay their abortions into second or third trimesters often need more active professional support.
Good counseling includes:
- A space for emotional expression without judgment
- Help to reduce shame and guilt
- Support with grief when needed
- Learning specific coping skills
- Finding supportive relationships
Mental health deserves equal attention as physical health. Mental health conditions cause 23% of pregnancy-related deaths with known causes in the United States. Suicide remains a leading cause of maternal death. "Our health care system is not set up to detect these risk levels in women early enough in pregnancy".
Healthcare workers must listen actively and show empathy. They should know how their beliefs might affect interactions with patients seeking abortion care. Many women need ongoing support after abortion since their stories might point to other social or health issues.
Counselors who use cognitive-behavioral therapy (CBT) help patients understand their thoughts better. They learn to tell thoughts from facts, review evidence for their thoughts, and make helpful changes when needed.
How the Dobbs decision changed the landscape
The Supreme Court's Dobbs decision in June 2022 changed America's abortion rights landscape. This ruling ended federal constitutional protection that existed for almost 50 years. States now control their own abortion policies without any federal oversight.
Pre- vs. post-Dobbs access to care
Today, 14 states enforce near-total abortion bans, while 11 others limit procedures at different pregnancy stages. The ruling led 66 clinics across 15 states to stop providing abortion services within 100 days. Patients now spend more time traveling to clinics. The typical travel time to reach an abortion facility jumped from 10.9 minutes before Dobbs to 17 minutes after.
Increase in out-of-state travel
The number of people crossing state lines for abortion care has grown significantly. About 155,000 people traveled to other states for abortions in 2024—more than twice the number from 2019.
States next to those with bans saw the biggest increase in patients. Illinois treated over 35,000 out-of-state abortion patients in 2024, leading all other states. Most Texas residents went to New Mexico for care.
Impact on timing and availability
New barriers have pushed back abortion timing for many patients. A Washington state clinic network reported that average pregnancy duration rose by almost 7 days after Dobbs. Only 60 clinics nationwide offered abortions at or after 24 weeks in 2023. Just five of these provided services at or after 28 weeks.
Healthcare providers have adapted to these changes. Telehealth services grew substantially, handling about 25% of all abortions in 2024—up from 5% in 2022. Twenty-three states also created "shield laws" to protect doctors who treat patients from states with bans.
Total abortion numbers showed a slight increase after Dobbs. This figure hides sharp drops in states with bans and longer waiting times for many patients.
What recent research and data show in 2025
Recent studies from 2025 reveal unexpected patterns in abortion access after the groundbreaking Dobbs decision.
New trends in abortion timing
National data shows a slight upward trend in abortion numbers, which contradicts earlier predictions of decline post-Dobbs. States without total bans provided an estimated 1,038,000 abortions in 2024, showing a small increase from 2023 and a 12% rise from 2020.
People crossing state lines for abortion care reached approximately 155,000 throughout 2024, which represents 15% of all procedures – this is a big deal as it means that the number has doubled since 2020.
Medication abortion now dominates the landscape at 63% of all clinician-provided abortions in 2023, up from 53% in 2020. The digital world has expanded rapidly, and virtual clinics now handle 14% of all abortions in 2024.
Clinic availability and service expansion
While ban states saw traditional abortion access shrink, other regions adapted quickly. States that kept abortion access saw a 3% increase in brick-and-mortar clinics between 2020-2024. The number of facilities offering later procedures dropped significantly – those providing care at or after 24 weeks fell from 60 in 2021 to just 50 in 2023.
Virtual clinics have filled this gap with lower costs. The median price for medication abortion through virtual platforms dropped from $239 in 2021 to $150 in 2023, which is nowhere near the cost of in-person services.
Policy shifts and public health implications
States continue to move in opposite directions with their abortion policies. Twenty-three states now have shield laws that protect providers serving out-of-state patients. Ban states push forward with "fetal personhood" legislation and target abortion medications.
Ballot initiatives keep altering the map, with seven out of ten state measures protecting abortion access passing in November 2024. State-level action remains the key driver of abortion policy as we move into the latter half of 2025, despite federal uncertainty.
Conclusion
Data tells a different story about late-term abortions than what we often hear. These procedures make up just 1% of all abortions in America. Most cases involve severe medical complications or patients who face major barriers to access. People often talk about nine-month elective procedures, but the reality shows most happen just after 21 weeks. Less than 60 clinics nationwide provide services beyond 24 weeks.
Restrictions meant to limit abortions actually push them later into pregnancy. Patients must cross state lines and deal with many hurdles. They need to arrange travel, get time off work, find childcare, and raise money. All these factors delay their care. The Dobbs decision has made things worse, and interstate travel for abortion has doubled since 2020.
Most people misunderstand the mental health effects of late-term abortions. Some patients feel psychological distress, but studies show good recovery with proper support. Patients who end wanted pregnancies due to fetal problems usually feel grief rather than regret. This shows how personal these decisions are.
Medical terms play a vital role in these conversations. "Late-term abortion" has no clinical meaning, though politicians use it often. Medical experts say "abortions later in pregnancy" and make clear distinctions between gestational and fertilization age.
State-level policy changes will reshape abortion access more than federal actions. Virtual clinics, medication abortion, and interstate networks help people adapt to access challenges. Yet big gaps exist, especially for patients who need care later in pregnancy. Their options keep shrinking.
The gap between what people think and what statistics show makes evidence-based discussions about abortion timing essential. Late-term abortions involve complex medical situations. They need thoughtful discussion, not simple political talk.
FAQs
Q1. How common are late-term abortions in the United States?
Late-term abortions are extremely rare, accounting for only about 1% of all abortions performed in the U.S. Specifically, only 1.1% of abortions occur at or after 21 weeks gestation, with the vast majority (92.8%) taking place at or before 13 weeks.
Q2. What are the main reasons people seek abortions later in pregnancy?
People seek later abortions primarily due to severe fetal anomalies discovered after 20 weeks, health risks to the pregnant person, and delays caused by access barriers, costs, or legal restrictions. Many patients initially attempted to access care earlier but encountered obstacles.
Q3. How has the Dobbs decision affected abortion access in the U.S.?
The Dobbs decision has significantly altered the abortion landscape, leading to near-total bans in 14 states and increased restrictions in others. This has resulted in longer travel times to abortion facilities, a surge in out-of-state travel for care, and delays in obtaining abortions, pushing some procedures later into pregnancy.
Q4. What procedures are typically used for late-term abortions?
The most common procedure for abortions at or after 21 weeks is dilation and evacuation (D&E), accounting for 93-95% of these cases. Labor induction is an alternative method, becoming more common after 20 weeks gestation. Both procedures have strong safety profiles with complication rates below 5%.
Q5. How do late-term abortions impact mental health?
Mental health outcomes after late-term abortions vary. While some women experience psychological distress, including symptoms of PTSD and depression, studies show that most recover well with proper support. Factors such as pre-existing mental health conditions, young age, and decision ambivalence can increase the risk of psychological complications.
