Third trimester abortions are very rare. According to the most recent CDC surveillance data from 2022, just 1.1% of all abortions in the United States occur at or after 21 weeks of gestation. The vast majority, 92.8%, happen at 13 weeks or earlier, and 78.6% happen within the first nine weeks.
That 1.1% figure covers everything from 21 weeks onward, which means it includes procedures in both the second and third trimesters. Abortions that occur strictly in the third trimester (typically defined as 27 or 28 weeks and beyond) represent an even smaller fraction, though the CDC does not break out that specific number. Only about 50 facilities in the entire country provide abortion care at 24 weeks or later.
Why the Term “Late-Term” Is Misleading
The phrase “late-term abortion” appears constantly in public debate, but it has no medical meaning. In obstetrics, “term” refers to the period around a pregnancy’s due date. The American College of Obstetricians and Gynecologists defines “early term” as 37 to 38 weeks, “full term” as 39 to 40 weeks, and “late term” as 41 weeks. Abortions do not happen during this window. The accurate phrasing is “abortion later in pregnancy,” and clinicians describe these procedures by specific weeks of gestation rather than using a blanket label.
Who Gets Abortions Later in Pregnancy
The circumstances behind these procedures fall broadly into two categories: serious medical diagnoses and logistical barriers that delayed earlier care.
Many abortions later in pregnancy follow the discovery of severe fetal abnormalities. A large study of outpatient pregnancy terminations in the second and third trimesters found that the majority involved structural anomalies, chromosomal conditions, or genetic disorders. Neural tube defects and other central nervous system abnormalities were the single largest category, accounting for 252 cases in the study. These included conditions like anencephaly (where much of the brain never develops), severe hydrocephalus, and holoprosencephaly. Chromosomal abnormalities made up another 378 cases, with Down syndrome and Trisomy 18 being the most common. Heart defects, abdominal wall abnormalities, and kidney malformations also appeared frequently. Some pregnancies involved conditions incompatible with life after birth. Others involved conjoined twins, severe twin-to-twin transfusion syndrome, or fetal growth restriction so extreme that survival was unlikely.
The timing matters here: many of these conditions simply cannot be detected until the 20-week anatomy scan or later. Some require follow-up testing, genetic analysis, or specialist consultations that push a diagnosis further into pregnancy. A parent who receives devastating news at 22 or 24 weeks may still need days or weeks to get an appointment, travel to one of the few facilities that provide later care, and arrange funding.
How Barriers Push People Into Later Gestations
Not every abortion later in pregnancy involves a fetal diagnosis. Research examining third-trimester cases in the U.S. found that many patients had decided they wanted an abortion well before 24 weeks but were delayed by policy-driven obstacles. Forty-four states generally prohibit abortion in the third trimester, and those bans limit the number of providers willing or able to offer later care. The result is that patients often must travel long distances, sometimes across multiple state lines, to reach one of roughly 50 clinics nationwide.
Cost is another major factor. Federal law and 34 state-level policies prohibit public insurance from covering abortion, forcing most patients to pay out of pocket. Later procedures cost significantly more, creating a cycle where the time spent raising money pushes the pregnancy further along, which raises the price further. One patient studied by researchers faced a cascade of delays: her local clinic had closed due to state regulations, her state required two separate clinic visits before the procedure, and her insurance could not legally cover the cost. Each of these barriers added weeks.
Stigma also plays a role. Some people delay seeking care because of shame, fear of judgment, or difficulty disclosing the pregnancy to anyone who might help. While stigma is not a policy in the way that insurance bans or waiting periods are, it functions as a barrier with real consequences for timing.
What the Procedures Involve
There are two approaches to ending a pregnancy later in gestation. The surgical route involves gradual cervical preparation over one to two days, followed by removal of the pregnancy under ultrasound guidance. The medical route uses medications to induce labor. Patients typically receive one medication by mouth, then begin a second medication 24 to 48 hours later to trigger contractions. Most patients deliver within 24 hours of starting contractions, with a median time of 10 to 12 hours. As gestational age increases, the process generally takes longer because more cervical dilation is needed.
The Legal Landscape
Nine states and the District of Columbia place no gestational limit on abortion. In the remaining states, bans at various points in pregnancy are in effect, with most prohibiting abortion in the third trimester except under specific circumstances. The most common exception is a threat to the life of the pregnant person. Some states also allow exceptions for serious physical health risks or diagnoses of lethal fetal anomalies. A few states that ban abortion earlier in pregnancy still carve out exceptions for fatal fetal conditions up to the third trimester.
The practical effect of this patchwork is that access depends heavily on geography. A person in a state without gestational limits may be able to receive care locally, while someone in a restrictive state may need to travel thousands of miles, adding time and cost to an already difficult situation.
Viability and Why It Matters to This Discussion
Many state laws tie their abortion restrictions to fetal viability, the point at which a fetus could potentially survive outside the womb. This threshold has shifted over time as neonatal medicine has improved. Large studies have reported outcomes for infants born as early as 22 weeks, and survival rates at that gestational age have increased. A small number of specialized centers have begun offering resuscitation at 21 weeks in selected cases, with one case series reporting that 35% of resuscitated infants at 21 weeks survived to hospital discharge. These are outcomes at the very edge of medical capability, achieved in experienced centers under specific conditions, not a standard applicable to every hospital.
The shifting viability line complicates legal frameworks that depend on it, but it does not change the fundamental rarity of third-trimester procedures. The small number of patients who reach this point in pregnancy are overwhelmingly facing medical crises or have been delayed by systemic barriers, not making a casual decision.