Abortion is available up to 10 weeks of pregnancy using medication and through the second trimester using surgical procedures, though legal limits vary dramatically depending on where you live. These timelines are measured from the first day of your last menstrual period (LMP), which means you’re already considered about four weeks pregnant by the time you miss a period.
How Pregnancy Weeks Are Counted
Pregnancy dating starts from the first day of your last menstrual period, not from conception. Because ovulation typically happens around day 14 of a 28-day cycle, you’re already counted as two weeks pregnant before an egg is even fertilized. This matters because every gestational limit for abortion, whether medical or legal, uses this same clock.
Ultrasound in the first trimester is the most accurate way to confirm how far along a pregnancy is, with accuracy within five to seven days. About 40% of women who receive a first-trimester ultrasound have their estimated due date adjusted because it differs from their LMP-based calculation by more than five days. Only about half of women accurately recall the date of their last period, so ultrasound confirmation is common before any abortion procedure.
Medication Abortion: Up to 10 Weeks
The FDA has approved medication abortion through 10 weeks of pregnancy (70 days from the first day of your last period). This involves two medications taken one to two days apart. The first stops the pregnancy from progressing, and the second causes cramping and bleeding to empty the uterus, similar to a heavy miscarriage. The process typically completes at home over several hours to a few days.
Effectiveness is high across this window. A pooled analysis of clinical trials found that only about 2% of medication abortions were unsuccessful, and the success rate was essentially the same whether the pregnancy was under six weeks or between six and seven weeks. The World Health Organization recommends medication abortion up to 12 weeks, and some countries follow that broader guideline, though the U.S. approval stops at 10 weeks.
Surgical Abortion: First and Second Trimester
Surgical options extend further into pregnancy and are divided into two main types based on gestational age.
Vacuum Aspiration (Up to About 14 Weeks)
This is the standard first-trimester surgical method, using gentle suction to empty the uterus. It’s typically a short outpatient procedure, often completed in under 15 minutes. The WHO recommends it for pregnancies under 14 weeks, though there’s some flexibility between 12 and 16 weeks depending on the clinical setting.
Dilation and Evacuation (14 to 24 Weeks)
For second-trimester abortions, the procedure shifts to dilation and evacuation, or D&E. This involves softening and gradually opening the cervix over two to three days using medication or small dilating devices, followed by the procedure itself, which uses suction and instruments with ultrasound guidance. It does not require an overnight hospital stay. According to UCLA Health, this method covers pregnancies from 14 weeks through 23 weeks and 6 days.
As gestational age increases, the procedure becomes more complex. Cervical preparation becomes more involved: between 12 and 19 weeks, medication alone or an osmotic dilator with medication is recommended, while after 19 weeks, the WHO recommends using both an osmotic dilator and medication together.
How Risk Changes With Gestational Age
Abortion in the first trimester is one of the safest procedures in medicine. Risk increases as pregnancy progresses, though it remains low through the second trimester when performed by experienced providers. The most significant clinical shift happens after 20 weeks, when the complexity of the procedure and the potential for complications rise more sharply.
The American Medical Association’s position reflects this reality: it recommends against third-trimester abortions except in cases of serious fetal anomalies incompatible with life. The AMA notes that in the third trimester, when maternal health factors require ending a pregnancy, delivery rather than abortion is generally the appropriate path because the fetus is typically viable at that point.
Legal Limits Across U.S. States
Legal access varies enormously by state, and the gestational limit where you live may be well below the medical limits described above. As of 2025, several states ban most abortions entirely, while others set cutoffs at specific weeks.
- 6 weeks: Florida, Georgia, Iowa, and South Carolina all restrict abortion at approximately six weeks, which is roughly two weeks after a missed period, before many people know they’re pregnant.
- 12 weeks: Nebraska and North Carolina set the limit at 12 weeks.
- 18 to 22 weeks: Utah allows abortion through 18 weeks, Kansas through 22 weeks.
- 20 weeks: Ohio and Wisconsin restrict abortion at 20 weeks after fertilization.
- 24 weeks or viability: Massachusetts, Nevada, New York, and Pennsylvania allow abortion through approximately 24 weeks.
Some states have no gestational limit at all and allow abortion throughout pregnancy, while others have enacted near-total bans with narrow exceptions for life-threatening emergencies. These laws change frequently, so checking the current status in your state is essential.
Medical Exceptions After Standard Limits
Even in states with strict gestational limits, most laws include exceptions for serious threats to the pregnant person’s life. Some also allow exceptions for severe fetal abnormalities that are incompatible with survival. These diagnoses often cannot be detected until the 18-to-20-week anatomy scan, which is why later abortions, though rare, remain a necessary part of medical care. Later abortions make up a small fraction of all abortions performed: the vast majority happen in the first trimester.