Omar Bennett
The topic of banning abortions after 20 weeks of pregnancy has been widely debated in the United States, with many state legislatures creating new abortion restrictions and bans. These bans are often pushed by anti-abortion politicians and have forced people into challenging situations, especially those needing to terminate a pregnancy for serious medical reasons. While a majority of abortions in the US occur before 21 weeks, it is crucial that patients and their doctors have every medical option available, as situations can arise where abortions after 20 weeks are necessary, such as severe fetal anomalies and serious risks to the pregnant person's health. The constitutionality of banning abortions after 20 weeks is questionable, as it infringes on a woman's right to make her own personal medical decisions and can put her health and safety at risk.
| Characteristics | Values |
|---|---|
| Public opinion | 61% of voters say abortion should be legal after 20 weeks |
| Political affiliation | Democrats (78%), Republicans (62%), and Independents (71%) oppose a 20-week ban |
| Medical opinion | Doctors oppose 20-week bans; Physicians for Reproductive Health and the American Congress of Obstetricians and Gynecologists condemn these bans |
| Legality | The Supreme Court has affirmed a woman's constitutional right to abortion prior to fetal viability; no gestational ban has survived judicial scrutiny |
| State-level legislation | Some states have passed 20-week bans, while others define pregnancy as starting from implantation, allowing abortion up to 24 weeks |
| Impact | Abortion bans disproportionately affect marginalized groups and people with low incomes |
| Rationale | Politicians argue that 20-week bans protect fetal life and promote their anti-abortion agenda |
| Exceptions | Bans may include health exceptions, but these do not ensure provider availability or willingness to perform the procedure |
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What You'll Learn
The impact on marginalised groups
Abortion bans and restrictions have a significant impact on marginalised groups, violating human rights and intensifying existing inequalities. The removal of constitutional protection for reproductive healthcare in the United States has resulted in restricted access to abortion care, with far-reaching consequences for those who are already vulnerable.
Marginalised communities, including Black, Indigenous, people of colour, people with disabilities, immigrants, and those living in poverty, are disproportionately affected by abortion bans. These groups often face multiple and intersecting forms of discrimination, and the inability to access abortion care only serves to exacerbate their marginalisation. For example, women from marginalised groups are more likely to experience domestic violence and are less likely to obtain an abortion if banned in their state, putting them at increased risk of harm.
Low-income individuals are particularly affected by abortion bans and restrictions. Financial barriers, such as the inability to afford travel costs or lodging, can make accessing abortion care extremely challenging. The Hyde Amendment further exacerbates these financial constraints by withholding federal Medicaid funding for abortion, impacting millions of people with low incomes. Additionally, abortion restrictions can lead to increased medical costs, as individuals may need to seek alternative, potentially more expensive, forms of care.
Abortion bans also infringe on the privacy and freedom of thought, conscience, and religious beliefs of both patients and healthcare practitioners. The expansion of digital surveillance to detect violations of new regulations poses a significant threat to privacy rights. Additionally, restrictions on abortion limit the ability of physicians to provide unbiased counselling to patients and of clergy to offer pastoral care to their congregants.
The impact of abortion bans extends beyond the inability to access abortion care. They also contribute to a culture of stigmatisation and the spread of false information, further complicating and hindering access to proper medical care. The lack of access to safe and legal abortion care can lead to increased health risks, including suicide, for pregnant individuals. Furthermore, abortion bans can force victims of intimate partner or domestic violence to remain in abusive relationships, as they may be unable to terminate an unwanted pregnancy resulting from abuse.
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Doctors' opinions
In some states, like Georgia, abortion bans are in place once cardiac activity is detected, which is generally around six weeks into pregnancy. However, there are exceptions to these bans if the pregnant person's life is at risk. For example, in the case of a brain-dead pregnant woman in Georgia, doctors were required to keep her on life support to comply with the state's abortion law, even though her family wanted to remove life support.
In North Carolina, licensed medical doctors can perform abortions during the first 20 weeks of pregnancy upon the request of the pregnant woman without needing to state a reason. After the twentieth week of pregnancy, abortions can be performed by a licensed physician in a hospital licensed by the Department of Human Resources if continuing the pregnancy poses a substantial risk to the life or health of the pregnant person.
Some medical experts argue that abortions after 20 weeks should be banned, citing scientific and medical advances that suggest fetal pain may be possible from the 15th week of gestation onward. They also point to the administration of analgesic drugs (anesthesia) during second-trimester fetal surgery as evidence that the fetus can feel pain. Ultrasound and 3-D imaging technologies have also shown fetal movements and detailed images of the unborn baby at five months.
On the other hand, scholars have contested claims of fetal pain, and abortion bans after 20 weeks have provoked little outcry. Abortions after 20 weeks are rare, with most abortions occurring before the 13th to 15th week of pregnancy. Structural fetal anomalies, which can be lethal, are often detected later in pregnancy during a fetal anatomy scan around 20 weeks. These anomalies can significantly impact the decision to seek an abortion, and individuals may need to travel significant distances to find providers for abortions later in pregnancy.
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State-level bans
Since the U.S. Supreme Court overturned Roe v. Wade in June 2022, abortion policies and reproductive rights have been in the hands of each state, with nearly half of the states likely to enact new laws restricting abortion or prohibiting it altogether. State-level attempts to ban abortion after 20 weeks are part of an agenda to ban all abortions. Politicians in Congress have repeatedly pushed bills that would impose a nationwide ban on abortion at 20 weeks of pregnancy.
State-level abortion bans after 20 weeks are opposed by doctors. Both Physicians for Reproductive Health and the American Congress of Obstetricians and Gynecologists condemn these bans. Doctors argue that such bans criminalize them and take away their right to inform patients about all their healthcare options. They also highlight that abortions after 20 weeks are often required in very complex circumstances, such as severe fetal anomalies and serious risks to the pregnant person's health.
The impact of state-level abortion bans is significant, particularly on marginalized groups and people with low incomes. For instance, Texas, which outlawed most abortions in 2021, has seen a rise in maternal death and sepsis among women experiencing miscarriage. Additionally, the state's obstetricians are increasingly reluctant to practice there. Similarly, Massachusetts, which had allowed abortion until 24 weeks, saw a total ban on abortion after its state supreme court's ruling in May 2025, despite a state constitutional amendment protecting abortion through viability.
State-level abortion bans often include mandatory ultrasounds, waiting periods, and biased counseling, requiring multiple trips to the provider. These restrictions can create significant challenges for people with low incomes, who may struggle to arrange transportation, lodging, and navigate other obstacles imposed by anti-abortion laws.
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Viability and health exceptions
The Supreme Court has repeatedly affirmed a woman's constitutional right to abortion prior to fetal viability. No gestational ban has ever survived this scrutiny. In Roe v. Wade, the Court decided that fetal viability would be the benchmark for the balance between a person's right to choose and the state's interest in "potential life". However, the Court left the determination of fetal viability up to doctors, and it is widely cited to occur around 23-24 weeks.
The constitutional principle of viability has been reaffirmed over the years, with the Supreme Court and lower federal courts consistently upholding it. For example, in 1976, in Planned Parenthood v. Danforth, the Court recognised that viability was a matter of medical judgment and preserved flexibility in the term. In Colautti v. Franklin, the Court reiterated that neither the legislature nor the courts could proclaim a single factor, such as weeks of gestation or fetal weight, as the determinant of when the state has a compelling interest in the fetus's life or health.
Despite this, some states have attempted to ban abortion at 20 weeks, arguing that viability occurs at this gestational age. In 1996, the Utah legislature passed such a ban, but it was ruled unconstitutional in Jane L. v. Bangerter as it prohibited pre-viability abortions. Similarly, the Nebraska legislature passed the Pain-Capable Unborn Child Protection Act in 2010, and within five years, 14 additional states had passed similar laws. These laws have been continuously challenged and blocked in court. For instance, in Isaacson v. Horne, a district court in Arizona tried to justify a 20-week ban as a strict regulation rather than a ban, but this was unsuccessful.
The push for 20-week abortion bans is part of a broader agenda to restrict and ultimately outlaw abortion completely. These bans are opposed by doctors and healthcare organisations such as Physicians for Reproductive Health and the American Congress of Obstetricians and Gynecologists. They criminalise doctors and restrict their ability to provide constitutionally protected care and inform patients about their healthcare options. In complex situations, such as severe fetal anomalies and serious risks to the pregnant person's health, a 20-week ban could have life-threatening consequences.
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Public opinion
Some politicians have repeatedly pushed for a nationwide ban on abortion at 20 weeks, or earlier, arguing that it is necessary to protect unborn children from pain. For instance, Senator Lindsey Graham reintroduced the Pain-Capable Unborn Child Protection Act, stating that abortion at this stage inflicts tremendous pain on the fetus. This legislation has been supported by other senators, who claim that abortion kills babies who could survive outside the womb and that the unborn child can feel pain.
On the other hand, many people oppose such bans, including doctors and medical professionals. They argue that these bans criminalize doctors, restrict access to safe and legal abortions, and take away a patient's deeply personal decision-making power. According to one source, 61% of voters say abortion should be legal after 20 weeks, and a majority of Democrats, Republicans, and Independents believe lawmakers should not spend time on this issue.
In Missouri, voters approved an abortion-rights amendment, which was later repealed by Republican lawmakers, sparking protests and accusations of overturning the will of the voters. Similarly, Massachusetts voters approved a constitutional amendment protecting abortion through viability, but a state supreme court ruling effectively reinstated a total ban on abortion, with ongoing litigation.
The debate over abortion rights and bans continues to be a highly contested issue in the United States, with states now having the power to restrict or prohibit abortion after the Supreme Court overturned Roe v. Wade.
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Frequently asked questions
The landscape of abortion access in the United States is rapidly changing. In June 2022, the Supreme Court overturned Roe v. Wade, eliminating the federal constitutional right to abortion. Since then, many states have created new abortion restrictions and bans, and abortion is now illegal in 13 states.
Abortion bans disproportionately affect people from marginalized groups and those with low incomes. For example, Texas, which outlawed most abortions in 2021, has seen increased rates of maternal death and sepsis among women experiencing miscarriage.
Nearly 99% of abortions occur before 21 weeks, but the small percentage that occurs after 20 weeks is often due to complex circumstances, such as severe fetal anomalies and serious risks to the pregnant person's health. A 20-week ban would restrict access to safe and legal abortions in these situations and criminalize doctors.
Increasing access to sex education and affordable birth control can help reduce the number of unintended pregnancies and, consequently, the need for abortions.
