North Carolina’s 20 week abortion ban adds another barrier for influx of patients

What’s happening: Last week, U.S. District Judge William Osteen lifted the injunction on a state ban on abortions performed after 20 weeks, with some exceptions to protect the life of the mother.

• Since Roe v. Wade was overturned two months ago, neighboring states have moved to ban or limit abortion, and patients have flocked to North Carolina to receive care.
• Planned Parenthood’s clinics in North Carolina are no longer providing abortion care after 20 weeks, says Jillian Riley, North Carolina director of public affairs for Planned Parenthood South Atlantic.

Why it matters: This is the first abortion restriction to take effect in North Carolina since the ruling, in one of the few states in the South that still permits most abortions.

Context: Abortions that late into pregnancy are rare. There were about 30 abortions provided in the state in 2020 after 21 or more weeks, according to data from the North Carolina Department of Health and Human Services.

• Of the abortions provided in the state that year, 88% occurred in the first 12 weeks of a pregnancy, per the state figures.

Yes, but: Because of the logistics of having to travel, patients are being forced to wait longer to receive abortion care, providers say.

• A Preferred Women’s Health Center, which has a location in east Charlotte, is now scheduling patients as far as three to four weeks out, executive director Calla Hales tells Axios.

In the past, clinics like hers would have referred patients at 20 weeks or more to a hospital like UNC or Duke. Now she has to direct people to hospitals in Virginia.

• The closest place she can think of for care is Virginia Commonwealth University’s Medical Center in Richmond, more than four hours away.
• While previously the clinic may have been able to see patients at 17 to 19 weeks, with the influx of people they are seeing, and the additional time those later-term cases take, now they are primarily scheduling the procedure for those less than 16 weeks pregnant.

What they’re saying: “At least 10 times a week, I’ll get a patient coming from out of state coming thinking they’re going to be less than 12 weeks, they get here and they’re like 18, 19, 20, much further along than they thought… and that’s a huge delay, because now they have to find a way to get to another state to be seen,” Hales says.

• “The added logistics and the added time is definitely preventing people from accessing care in a timely manner. And it’s also, quite frankly, going to end up forcing people to carry pregnancies to term that they don’t want and can’t afford.”

The other side: Opponents of abortion celebrated the ruling. In a news release, the conservative North Carolina Values Coalition called it “just the beginning” of its efforts to limit access to abortion.

• Republican lawmakers are likely to move to restrict abortion further should they regain a veto-proof majority in November’s elections.
• Of note: Republicans need to gain just five seats to regain a veto-proof supermajority.

Who this impacts: People who receive abortions late in pregnancy often receive new medical information or face barriers that delay their care, says Riley of Planned Parenthood. There’s a 20-week ultrasound that will tell someone who is pregnant whether there is a fetal anomaly or whether the pregnancy is viable, for example.

• People may also find out they are pregnant late because of stress, inequitable access to health care, irregular menstrual cycles (particularly in young women) or other factors, Riley says.
• “The difference between an abortion that happens earlier in pregnancy and an abortion that happens later in pregnancy is just that these are the ones that are really incredibly time sensitive, even more so, and they’re life-threatening medical emergencies,” she says.