How long you can wait depends on where you live, what method you choose, and what’s available near you. In the United States, medication abortion is approved through 10 weeks of pregnancy. Surgical options extend further, with some clinics offering care into the second trimester and a small number providing procedures at 24 weeks or beyond. State laws, not just medical limits, often determine the actual cutoff you’ll face.
Medication Abortion: Up to 10 Weeks
The FDA approves the two-pill medication abortion regimen (mifepristone followed by misoprostol) for use up to 70 days, or 10 weeks, from the first day of your last menstrual period. This is a firm cutoff. If it has been more than 70 days since your last period started, you are not a candidate for this method.
Medication abortion accounts for a large share of all abortions in the U.S., partly because it can be prescribed via telehealth in many states and taken at home. But the 10-week window is short, especially if you don’t realize you’re pregnant right away. Someone with irregular cycles might not suspect pregnancy until week 6 or 7, leaving only a few weeks to arrange care.
Surgical Abortion: First and Second Trimester
Suction aspiration (sometimes called vacuum aspiration) is the standard surgical method in the first trimester, typically available from about 5 or 6 weeks through 13 or 14 weeks of pregnancy. It’s an outpatient procedure that usually takes under 15 minutes.
After roughly 14 weeks, a different procedure called dilation and evacuation (D&E) is used. D&E is the most common method for second-trimester abortions and can be performed at 20 weeks and beyond. It requires more cervical preparation, often involving dilators placed a day or two before the procedure, and is done by physicians with specialized training.
Availability drops sharply as gestational age increases. In 2023, researchers found only 60 clinics in the entire country providing abortions at or after 24 weeks, and just five clinics offering care at or after 28 weeks. If you need a later procedure, you may have to travel significant distances, sometimes across multiple state lines.
What “Viability” Means in Practice
Many state laws tie their abortion limits to the concept of fetal viability, but there is no single medical definition of that term. The American College of Obstetricians and Gynecologists notes that viability cannot be determined by a test or predicted with certainty. Clinicians focus on the “periviable period,” which spans weeks 20 through 25 and 6 days of pregnancy.
Survival rates during this window vary dramatically. Births before 23 weeks have a 5 to 6 percent survival rate, and nearly all of those rare survivors experience severe health complications. At 23 weeks, survival to hospital discharge ranges from 23 to 27 percent. By 25 weeks, that figure rises to 67 to 76 percent. Factors beyond gestational age, including the baby’s weight, sex, genetics, and whether a neonatal specialist is present at delivery, all affect outcomes.
Because viability is a clinical judgment rather than a fixed number, states that use it as their legal threshold leave room for interpretation. In practice, many providers set their own limits at or before 24 weeks even where the law might allow later care.
State Laws Can Shorten Your Window
Since the Supreme Court’s 2022 Dobbs decision, state-level abortion laws vary enormously. Some states ban abortion entirely or after six weeks (before many people know they’re pregnant). Others allow it through 15, 20, or 24 weeks, or have no gestational limit at all. These laws change frequently, so the limit in your state today may not be the same as it was a year ago.
On top of gestational limits, 27 states require a mandatory waiting period of 18 to 72 hours between a counseling appointment and the actual procedure. Fourteen of those states require the counseling to happen in person, meaning you need at least two separate clinic visits. These requirements can push your effective deadline earlier, especially if clinic availability is limited and appointment slots are weeks out.
Travel time, cost, and childcare logistics add further delays. Studies consistently show that people who want abortions earlier are sometimes pushed into later gestational windows not by choice but by structural barriers.
How Your Pregnancy Is Dated
All gestational limits are counted from the first day of your last menstrual period (LMP), not from the date of conception. This means you are already considered “4 weeks pregnant” around the time you’d first miss a period. If your cycles are irregular or you don’t remember the exact date, a first-trimester ultrasound is the most accurate way to establish how far along you are.
Getting the dating right matters. In one study, 40 percent of women who received a first-trimester ultrasound had their estimated due date adjusted by more than five days compared to what their last period suggested. A discrepancy of even a few days can determine whether you fall within or outside a legal or clinical cutoff. If you’re unsure of your dates, an early ultrasound gives you the most reliable number to work with.
Later Abortions and Medical Exceptions
Abortions after 20 or 21 weeks are uncommon, making up a small fraction of all procedures. Many occur because of serious fetal anomalies detected on anatomy scans (typically done around 18 to 20 weeks) or because of maternal health conditions that make continuing the pregnancy dangerous.
Most states with gestational limits include exceptions for medical emergencies or conditions that threaten the pregnant person’s life. Some states define medical necessity narrowly, limited to situations where the person faces death. Others take a broader view, allowing physicians to consider physical, emotional, and psychological factors. The definition varies widely by state, and physicians sometimes hesitate to act even in emergencies because the legal language is vague.
People who receive a devastating fetal diagnosis at 20 weeks and live in a state with a ban may face the added burden of arranging travel and funding for care hundreds or thousands of miles away, all within a shrinking window of time. This is one reason advocacy organizations and clinic funds exist specifically to help people navigating later procedures.
Practical Steps if You’re Counting the Clock
If you think you might be pregnant and are considering abortion, the most useful thing you can do is confirm the pregnancy and establish your gestational age as soon as possible. A home pregnancy test is accurate from the first day of a missed period. From there, look up the current law in your state, because that determines your actual timeline more than any medical guideline.
If you’re early enough for medication abortion (under 10 weeks), telehealth services can sometimes get pills to you within days in states where it’s legal. If you’re further along, you’ll need to identify a clinic that offers surgical care at your gestational age, which may require travel. The earlier you start this process, the more options remain available and the simpler and less expensive the procedure tends to be.