What exactly are NC’s abortion laws? What the state allows for patients & physicians
After the Supreme Court overturned Roe v. Wade in 2022, many states — including North Carolina — began creating new abortion laws.
Changes to North Carolina’s statutes regarding abortion came in 2023, and since then, lawsuits challenging the laws have been brought.
Presidential candidates have campaigned on economic issues, such as housing affordability and grocery prices, but abortion remains in the conversation.
Ahead of the election, here’s where North Carolina’s abortion laws stand.
Is abortion legal in North Carolina?
Abortion is legal during the first 12 weeks of pregnancy In North Carolina when the procedure is performed by a qualified physician who is licensed to practice medicine in the state.
After the 12-week cutoff, an abortion may still occur, under certain conditions.
- If a pregnancy resulted from rape or incest, an abortion is lawful through the 20th week of pregnancy.
- If a qualified physician determines there is a “life-limiting anomaly,” an abortion is lawful through the first 24 weeks of pregnancy.
- If a qualified physician determines there is a “medical emergency,” an abortion is lawful.
A life-limiting anomaly is defined as a “diagnosis by a qualified physician of a physical or genetic condition” that is a “life-limiting disorder” and is “uniformly diagnosable.”
Dr. Beverly Gray, an associate professor of obstetrics and gynecology at Duke University, said creating a list of conditions that qualify as a medical emergency would not be possible, and those decisions are left to the discretion of physicians.
“I think there are many ways that pregnancy can endanger a person’s life,” Gray said.
Chapter 90 of the General Statutes defines a medical emergency as: “a condition which, in reasonable medical judgment, so complicates the medical condition of the pregnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial and irreversible physical impairment of a major bodily function, not including any psychological or emotional conditions.”
Removal of an ectopic pregnancy does not qualify as an abortion in North Carolina.
When is abortion illegal in NC?
According to state law, it is not legal to advise, procure or cause a miscarriage or abortion after the 12th week of pregnancy.
Partial-birth abortion is illegal. North Carolina’s statutes refer to the definition of partial-birth abortion as outlined in Title 18 of the United States Code.
Partial-birth abortion is defined as an abortion in which the person performing the procedure “kills the partially delivered living fetus.”
Performing or attempting to perform an abortion is prohibited at any time during a pregnancy if the person has knowledge that the pregnant person is seeking to end the pregnancy because of the fetus’ race or sex or the presence or presumed presence of Down syndrome, said Jill Moore, an associate professor of public law and government at UNC School of Government.
Where can abortions be performed in NC?
If an abortion is performed during the first 12 weeks of pregnancy, it may be performed in a hospital, ambulatory surgical center or clinic certified by the North Carolina Department of Health and Human Services by a physician licensed to practice medicine in North Carolina.
If a procedural abortion — which is referred to in state law as a “surgical abortion” — is performed after the 12-week cutoff, it must occur in a hospital, Gray said.
Mifepristone laws in North Carolina
Some parts of state law regulating medication abortion — called “medical abortion” in the statutes — have been challenged in lawsuits and are no longer in effect.
For example, in Bryant v. Stein, a federal court held that the abortion medication mifepristone no longer needs to be taken in a clinical setting, Moore said. The ruling means:
- Mifepristone can be taken in one’s own home.
- The pill can be provided by pharmacies and not solely by licensed physicians.
- A follow-up appointment is not required, but an advance consultation is.
Can minors get an abortion in NC?
Pregnant people who are under the age of 18 can get abortions in North Carolina. However, an adult must give consent.
Requirements before getting an abortion in NC
At least 72 hours before a procedural abortion, a qualified physician has to meet with the individual seeking the abortion in person to go over information contained in the consent form. The consent form includes information such as:
- The name of the physician performing the procedure
- The medical risks associated with the procedure
- The likely gestational age of the embryo or fetus at the time of the procedure
- The medical risks associated with carrying the fetus to term
- The pregnant person’s option to view the embryo or fetus and listen to its heartbeat
A physician must also meet the pregnant person face-to-face 72 hours before providing a medication abortion to discuss the items laid out in the consent form, which is similar to the one required for a procedural abortion.
People seeking the abortion have to sign and initial the forms, which include an acknowledgment of risks and consent statement.
What kind of reports do physicians have to complete?
Physicians are required to complete reports for each abortion they perform, whether its procedural or via medication, Gray said.
Reports must be sent to the Department of Health and Human Services and include information about:
- The physician who performed the abortion
- The location, date and type of procedural abortion or location of where the medication abortion was performed
- The county, state and country of residence of the person seeking the abortion, and their race and age
- The number of live births, previous pregnancies and previous abortions of the person who received the abortion
- The preexisting medical conditions of the person who received the abortion
- The probable gestational age of the embryo or fetus
- The medication used in the medication abortion, and when it was dispensed, administered and used
- Whether the person who received an abortion returned for a follow-up appointment or examination, and the results and date of the appointment
- If the person did not show up for the follow-up, the “reasonable efforts” of the physician to encourage the person to do so
- Any complications from the abortion
- The amount of money billed to cover the treatment for complications, and who was billed for the treatment
Additional reports must also be submitted if there were any adverse events or complications from a procedural or medication abortion, Gray said.
What are the consequences of performing an unlawful abortion?
Physicians, pharmacists and health care providers who violate the statute may be disciplined by their respective licensing agency or board.
There may also be criminal consequences, as outlined in Chapter 14 of the General Statutes, which deals with criminal law.
- It is a Class H felony to “willfully administer to any woman, either pregnant or quick with child, or prescribe for any such woman, or advise or procure any such woman to take any medicine, drug or other substance whatever, or shall use or employ any instrument or other means with intent thereby to destroy such child.” Courts have interpreted this law to apply only after “quickening,” Jeffrey Welty, a professor of public law and government at UNC School of Government, told The N&O in an email.
- It is a Class I felony to administer, prescribe for or advise and procure any pregnant person to take a medication, drug or another substance with the intent to cause a miscarriage, to injure or destroy the pregnant individual or to use any instrument or application for those purposes. This applies at any stage of a pregnancy, except for lawful abortions performed during the first 12 weeks of pregnancy or those otherwise permitted, Welty said.
Class H and Class I felonies are the lowest level felonies in the state, Welty said.
A Class I felony must be punished by probation for a person with no criminal record, and a Class H felony would typically be punished by probation, though a sentence of a few months of incarceration is possible.
Can a physician refuse to perform an abortion in NC?
Yes. Under state law, no physician, nurse or health care provider who objects to abortion on moral, ethical or religious grounds can be required to perform or assist in procedures that result in abortion.
Staff reporter Luciana Perez Uribe Guinassi contributed to this story.
This story was originally published October 18, 2024 at 1:23 PM with the headline "What exactly are NC’s abortion laws? What the state allows for patients & physicians."
