Abortion is banned after 20 weeks in NC — but there are exceptions. Get the details here.
A federal judge ruled that North Carolina’s general ban on abortions after 20 weeks is no longer unconstitutional and the ban can be enforced. The ruling follows years of litigation. But the ban has caveats. We’ve created this Q&A using our previous and new reporting to help you better understand what this ban means.
Details may change as new laws are enacted or courts rule. But for now, here are some answers.
How did NC’s 20-week abortion ban get reinstated?
A timeline:
Up until 2019, under state law, North Carolina banned abortions performed after 20 weeks of pregnancy (N.C. General Statutes 14-44, 14-45, and provisions of 14-45.1) These laws permitted abortions up to 20 weeks with health condition exceptions if there was a “substantial risk that the continuance of the pregnancy would threaten the life or gravely impair the health of the woman.” The 20-week ban was not enforced, as Supreme Court precedent permitted abortions up until fetal viability, generally considered to be around 23 or 24 weeks of pregnancy.
In 2015, the Republican-controlled legislature amended the medical exemption to apply only to limited emergencies, defined as conditions that required immediate abortion to avert death or for which a delay would cause “serious risk of substantial and irreversible physical impairment of a major bodily function, not including any psychological or emotional conditions.” The law also made clear the exemption did not cover someone at risk of harming or killing themselves: “no condition shall be deemed a medical emergency if based on a claim or diagnosis that the woman will engage in conduct which would result in her death or in substantial and irreversible physical impairment.”
In 2016, following this amendment, the Center for Reproductive Rights, the ACLU and Planned Parenthood Federation of America filed a federal lawsuit. The defendants in Bryant v. Woodall were district attorneys, tasked with enforcement, and the N.C. Department of Health and Human Services, which regulates abortion in the state. Plaintiffs argued that the 20-week ban was unconstitutional as it was a month before fetal viability begins, the standard Roe v. Wade set.
In 2019, U.S. District Judge William Osteen ruled that the state’s abortion ban was unconstitutional as it prohibited abortions before fetal viability, as defined in the landmark decisions that made abortion a constitutional right, Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey. He ordered an injunction blocking the law from enforcement. His decision was affirmed by the 4th Circuit Court of Appeals in 2021.
This June, the U.S. Supreme Court overturned Roe and Casey, and Osteen asked plaintiffs and defendants to file motions with their position on whether the injunction should stand. All parties in the case wrote they did not want the injunction modified or overturned. Senate leader Phil Berger and House Speaker Tim Moore, Republicans who were not official parties in the lawsuit, filed a brief asking Osteen to reverse his 2019 ruling.
On Wednesday, Osteen ruled the 20-week ban can be enforced as the injunction was based on Supreme Court precedent that has since been reversed.
What abortion rules, exceptions and requirements currently exist in NC?
Abortion is legal up to 20 weeks of pregnancy.
After 20 weeks, North Carolina has a limited exception for medical emergencies, explained above. The law does not delineate an exception for rape and incest.
Parental consent is required for an abortion for anyone under 18.
Patients must receive state-directed counseling, which requires patients to talk to a doctor or other qualified professional 72 hours before having an abortion, unless there’s a medical emergency, as mandated in the 2015 law mentioned above.
State and federal laws prevent government insurance from covering abortion except in the case of life endangerment, rape or incest, The News & Observer previously reported.
The use of telemedicine to administer medication abortion is prohibited.
The state requires abortion clinics to undergo yearly inspections to meet standards related to their physical plant, equipment and staffing. It also requires abortion clinics and providers to provide statistical summary reports concerning the medical and demographic characteristics of the abortions provided.
Physicians, nurses, and other health care providers cannot be forced to perform an abortion if they have a moral, ethical or religious objection.
How many people get abortions in NC?
In 2020, just over 30,000 abortions were performed in North Carolina. More than 5,000 of those were performed on people traveling from outside the state. Only 30 abortions were performed at 21 or more weeks of pregnancy in North Carolina, according to state statistics, The N&O reported.
Who could the 20-week abortion ban affect?
The impacts of the 20-week ban, according to some advocacy groups that support abortion rights, will largely be faced by people seeking late-term abortions. These people may be forced to travel out of state for abortion care, face delays in accessing that care or dangerous complications with their pregnancy, or be forced to carry a pregnancy against their will, according to an email blast sent out by Planned Parenthood South Atlantic. “People seeking abortion later in pregnancy often do so because they face delays in accessing abortion care or dangerous complications with their pregnancy,” wrote Jenny Black, president & CEO of Planned Parenthood South Atlantic. “Many need time to secure funds, time off work, transportation, and childcare, and often encounter other barriers in obtaining care, including medically unnecessary, state-mandated restrictions like North Carolina’s 72-hour forced waiting period.”
Some have viewed North Carolina as one the South’s few remaining safe havens for abortion care. Now, out-of state travelers who sought abortions after 20 weeks may have to seek care elsewhere.
Additionally, multiple studies have underscored abortion restrictions disparately impact low-income patients and increase illegal and unsafe abortion. A 2016 study estimated that 70% of those seeking abortion in the United States pay for the procedure out-of-pocket and that expenses build as time goes on, with an abortion at 20 weeks costing about $1,500.
Where do people in NC stand on abortion?
A poll published by the left-leaning group Carolina Forward showed that 27% of people polled thought a 20-week ban was just about right, 28% supported fewer restrictions and 37% supported more restrictions. Along party lines, Democrats favored fewer restrictions while Republicans favored more. The poll was conducted Aug. 3 and 4 by Public Policy Polling for Carolina Forward with 656 registered North Carolina voters with a margin of error of 3.8%.
A poll taken in June before the Supreme Court ruling, conducted by SurveyUSA for WRAL, found support in North Carolina for a 20-week ban, 57% to 31%. It also found opposition to passing more restrictions, with 35% saying the state should leave laws as they are, 20% saying restrictions should be lower, and 34% wanting to pass more restrictions or outlaw abortion altogether. People were more divided on the idea of a ban at 6 weeks, with 45% support and 39% opposition. The poll reported a credibility interval of 3.8%.
Will new abortion laws be passed?
As of now, that remains to be seen.
As reported earlier by The N&O, Moore and Berger have indicated an interest in introducing new abortion laws. In news releases Wednesday, Berger and Moore lauded the ruling and criticized Attorney General Josh Stein, a Democrat, who is tasked with enforcing state laws, for not working to reinstate the ban.
This July, Moore said he believes if there is a heartbeat, there is a child, and that he’d want “an honest and full conversation” about it within the caucus. Moore also said he believes there should be exceptions for rape, incest and the life of the mother.
Berger told reporters in June that abortion is “a serious enough issue” that senators will take time and then “deal with any potential changes in the next legislative session” next year. He has encouraged them to “look at what they would see as what North Carolina’s rules should be if we were writing on a clear slate.”
Democrats, on the other hand, have expressed their support for abortion access. In a statement following the reinstatement of the ban, Gov. Roy Cooper said he disagreed with the ruling and that he’d continue to work to make abortion accessible. In a statement last month. Stein wrote on Twitter, “Women still have a legal right to an abortion in NC under state law until 20 weeks. If people want that right to continue to exist, they have to elect legislators who share that view.”
If new abortion laws are introduced, the passage of them depends largely on whether the makeup of the legislature changes this fall. Republicans hold the majority in both chambers of the General Assembly, but Cooper holds the power to veto laws. The chances of passing future abortion bills may come down to whether Republicans gain a supermajority, which allows them to override vetoes.
Who enforces NC abortion laws? What happens if you don’t follow the law?
District attorneys are tasked with prosecuting all criminal cases filed in district and superior courts.
The North Carolina attorney general’s office, without involvement from Stein who recused himself from the case, filed the brief representing defendants stating they did not want the injunction modified or overturned. They wrote, “the district-attorney defendants do not presently intend to bring criminal charges based on violations of the statute at issue regardless of whether an injunction is in place that prevents such prosecutions” and that the two DA defendants and other DAs with enforcement authority have indicated “no intention to exercise that enforcement authority.”
DAs involved in that brief were Jim Woodall, district attorney for Orange and Chatham counties, and Satana Deberry, district attorney for Durham.
Osteen wrote Wednesday that even if there is presently no “indication that any . . . district attorney with a reproductive health facility in his or her jurisdiction” would seek to enforce the statute, “district attorneys themselves change.” Defendants also wrote in their briefs that “lifting the injunction risks . . . enforcement from individual prosecutors within North Carolina,” he wrote.
Which DAs will take action, if any, and what enforcement will look like remains unclear.
State laws classify violations of the 20-week ban as either a Class H felony, which carries a maximum sentence of 39 months, or a class I felony, which carries a maximum punishment of 24 months.
For more North Carolina government and politics news, listen to the Under the Dome politics podcast from The News & Observer and the NC Insider. You can find it at https://campsite.bio/underthedome or wherever you get your podcasts.
