What Are ‘Late-Term Abortions’?
Key takeaways:
“Late-term abortion” is an inaccurate phrase used to describe second-trimester abortions, between week 13 and 26 of pregnancy.
Second-trimester abortions make up fewer than 10% of abortions in the U.S.
Second-trimester abortions are always performed in a medical facility under the supervision of a trained provider.
Second-trimester abortions have been inaccurately called “late-term abortions.” But that’s a confusing term because the medical definition of “late term” refers to pregnancy — not abortion. Keep reading to learn about abortions that happen after the first trimester of pregnancy.
Is there a difference between late-term and second-term abortions?
“Late-term” and “second-term” abortions both refer to the same thing: abortions that happen after the first term, in the second trimester of a pregnancy.
Pregnancy is often described in three segments called trimesters:
First trimester: conception through week 12
Second trimester: week 13 to 26 of pregnancy
Third trimester: week 27 until the end of pregnancy, anywhere from 38 to 42 weeks for a full-term delivery
“Late-term” is a medical term used to describe the very end of a pregnancy, after it has reached “full term,” from week 41 onward. Abortions can’t and don’t happen in these late stages of pregnancy.
So, you can see how describing second-term abortions as “late-term” abortions is misleading and imprecise. In fact, the American College of Obstetrics and Gynecology (ACOG) has made it clear that a “late-term abortion” has no medical meaning.
What percentage of abortions are late-term (second-term) abortions?
According to data from the CDC, the vast majority, or 91%, of abortions take place during the first trimester of pregnancy. Of the remaining 9% of abortions that happen after the first trimester:
7.7% happen between weeks 14 and 20
1.2% happen at or after week 21
Second-term abortions require specialized care, and only 16% of abortion providers in the U.S. offer services up until week 24 of pregnancy. There are 43 states with laws that restrict how far into pregnancy an abortion can be provided. The latest point in pregnancy that you can have an abortion in the U.S. is 24 weeks.
Abortions in the third trimester are extremely rare and happen only in extreme circumstances, usually when there are fetal problems that aren’t compatible with life.
Why do people have second-term abortions?
Abortions in the second term may be considered under several circumstances.
Severe medical problems
Examples of serious medical problems include:
Fatal developmental abnormalities in the unborn child that mean it would not survive after birth
Severe complications in pregnancy that threaten the life and health of the pregnant parent, such as preeclampsia, persistent bleeding, or a diagnosis of cancer
Challenging life circumstances
Research shows that people having second-trimester abortions often fit into one of these five categories:
They were already a single parent.
They had depression or substance use disorder.
They were experiencing domestic violence or another type of relationship conflict.
They had delayed the decision about keeping or terminating the pregnancy and then struggled to find an abortion provider.
They were young and experiencing their first pregnancy.
Challenges accessing healthcare
Some people don’t know they’re pregnant until they’re close to the second trimester. The earliest you can detect a pregnancy is between weeks 5 and 6, and the first trimester only runs until 12 weeks. So, the later a person finds out they’re pregnant, the harder it is to access abortion care within the first trimester. Possible challenges include the following:
Many people need to save money to afford a termination procedure, and gathering those funds can take time.
Covering travel expenses, time off work, or childcare can present additional challenges to accessing an abortion in the first trimester.
People who live in areas with few or no accessible abortion providers may face challenges to finding a provider and getting the state-required approval to have an abortion. The longer this takes, the harder it becomes to have the abortion.
How and where are second-term abortions performed?
Most second-term abortions in the U.S. are performed in medical facilities. The procedure is called a dilation and evacuation, or a “D&E.” First, a medication is given that minimizes pain and discomfort during the procedure. Then, the cervix (the part of the uterus that connects it to the vagina), is opened (dilated) just enough to allow the healthcare provider to access the uterus, where the pregnancy has started. The pregnancy is then removed from the uterus using instruments and suction.
Second-term abortions can also be performed using medications (different from a medical abortion that uses an “abortion pill”). Medications that start contractions in the uterus are given through an intravenous (IV) line. Eventually, the contracting uterus expels the pregnancy. This can take as long as 12 to 24 hours. Pain medications help to minimize pain and discomfort.
Whichever method is used, a second-term abortion always takes place in a healthcare facility supervised by a trained healthcare provider. This is because terminating a pregnancy in the second trimester comes with a higher risk of too much bleeding. The hospital stay is usually 1 to 2 days long.
Does the ‘abortion pill’ work for second-trimester pregnancies?
No. While medical abortions are highly effective in terminating a pregnancy, they’re only approved for use in the first 10 weeks of pregnancy.
What risks are associated with late-term abortions?
Legal second-term abortions performed by a trained healthcare provider in a medical facility are safe. The risk of maternal death due to legal abortion is 0.58 in 100,000 reported legal abortions. For reference, that’s much lower than the 2019 U.S. risk of maternal death associated with pregnancy of 20 per 100,000 live births.
The bottom line
Second-trimester abortions are safe when performed in medical facilities and carried out with the oversight of a trained healthcare team. The decision to end a pregnancy in the second trimester is often complicated. The use of “late term” in reference to abortions has generated misunderstanding. “Late-term” is an established medical term that describes the very end of a pregnancy, from week 41 onward. But there’s no such thing as a “late-term abortion,” which actually refers to an abortion in the second trimester.
Why trust our experts?
References
American College of Obstetricians and Gynecologists Clinical. (2013). Definition of term pregnancy.
Foster, D. G., et al. (2013). Who seeks abortions at or after 20 weeks? Perspectives on Sexual and Reproductive Health.
Gemzell-Danielsson, K., et al. (2008). Second trimester medical abortion with mifepristone-misoprostol and misoprostol alone: A review of methods and management. Reproductive Health Matters.
Hoyert, D. L. (2021). Maternal mortality rates in the United States, 2019. Centers for Disease Control and Prevention.
Jatlaoui, T. C., et al. (2019). Abortion surveillance — United States, 2016.
Kaiser Family Foundation. (2019). Abortions later in pregnancy.
Kaiser Family Foundation. (2021). States with gestational limits for abortion.
Monti, M., et al. (2020). The use of misoprostol and mifepristone in second trimester interruption of pregnancy: State of art. Clinical Obstetrics, Gynecology and Reproductive Medicine.
Raymond, E. G., et al. (2012). The comparative safety of legal induced abortion and childbirth in the United States. Obstetrics & Gynecology.
If you’re concerned about an unplanned pregnancy and want to understand your options, help is available. You can call the National Abortion Federation hotline at 1-800-772-9100, the Repro Legal Helpline at 1-844-868-2812, or visit the Women's Reproductive Rights Assistance Project.
