Fact Sheet: Third Trimester Abortion and “Abortion Up to Birth”

Executive Summary 

• “Abortion up to birth” is sometimes used to describe abortions in the seventh, eighth, and ninth months of pregnancy – in the third trimester – because these abortions occur in the same general timeframe in which babies are born.
• Since the United States does not have a national limit on when elective abortions may be performed, nine states plus the District of Columbia place no limits on how late an abortion can be performed. Two others have adopted extreme ballot amendments that will permit abortion throughout all nine months.
• While many abortion centers only perform abortions in early pregnancy, there are several abortion centers across the U.S. that advertise abortions in the third trimester for any reason.
• Although media coverage tends to focus on third trimester abortions performed because the unborn baby has a serious health condition or a threat exists to the mother’s life, research shows that many third trimester abortions are performed for the same reasons unrelated to serious maternal or fetal health concerns as earlier abortions, and some women have shared their experiences with elective third trimester abortion.
• Despite some who claim born-alive abortion survivors are a myth, some babies do survive late abortions. A 2024 Canadian study of 13,777 abortions in the second and early third trimesters between 15 and 29 weeks found that 11.2% resulted in a live birth.

What is third trimester abortion or “abortion up to birth”?

The third trimester begins around 28 weeks of gestation and lasts until birth (months seven, eight, and nine of a typical pregnancy). The phrase “abortion up to birth” is sometimes used to describe third trimester abortions because they occur in the same general timeframe in which babies are born. Before 28 weeks, the beginning of the third trimester, a baby would be considered extremely preterm.^[1] However, once the pregnancy has reached the third trimester, births are no longer “extremely” premature. Babies born between 28 and 32 weeks are considered very preterm, and babies born between 32 weeks and 37 weeks are considered moderate or late pre-term. A birth is considered “term” if it occurs between 37 and 42 weeks. The “due date” occurs at 40 weeks. A baby born at 28 weeks has an over 90% expected survival rate.^[2]

The U.S. Centers for Disease Control and Prevention (CDC) data shows that, in 2023, 78% of all live births occurred prior to 40 weeks of gestation.^[3] Two percent of babies were born between 28 and 33 weeks, 8% between 34 and 36 weeks, 30% between 37 and 38 weeks, and 38% at 39 weeks.

Is third trimester abortion legal in the United States?

There are no federal limits on how late an abortion can be performed or any restrictions on the reasons for abortion. After the Supreme Court’s decision in Dobbs v. Jackson overturned Roe v. Wade, states and the federal government regained the ability to protect life throughout pregnancy, but many states have chosen not to do so. Currently, nine states plus the District of Columbia place no limits on how late an abortion can be performed, while two others have adopted extreme ballot amendments that will permit abortion throughout all nine months.^[4] Additionally, a few states have actively removed protections for abortion survivors.^[5] Also, of the 193 U.N. member countries, the United States is one of only eight countries that has no national gestational limit for elective abortion.^[6]

Are most third trimester abortions performed because the unborn baby has an abnormality?

Media coverage of third trimester abortion often focuses on abortions performed because the unborn baby has a very serious health condition. However, research shows that many third trimester abortions are performed for the same reasons as abortions earlier in pregnancy.

A qualitative analysis of interviews with 28 women who obtained abortions between 24 and 35 weeks identified two “pathways” which led women to seek an abortion in the third trimester.^[7] One pathway was due to receiving new information, which included discovering that the unborn baby had a health condition, but also included women with healthy babies who did not discover their pregnancies until very late. The second pathway was barriers that prevented the woman from obtaining an abortion earlier, such as cost, among other things. Although a number of the women’s stories relayed in the paper did involve prenatal diagnosis of fetal abnormalities, the author clarified that “[t]he new information respondents received that led to their decision to obtain an abortion was not exclusively related to fetal health.” The author concluded that reasons for third trimester abortion are similar to reasons for earlier abortions, and that “despite the enumerated ways that third trimester abortion differs from earlier abortion—in clinical complexity, cost, logistics, and social support—there are clear consistencies in why people seek abortion care, regardless of gestation.”

A second study by the same author analyzed interviews of 30 women who obtained abortions between 24 and 35 weeks, focusing on their travel across state lines.^[8] The study found that some of the women who underwent extremely late abortions had intended to get them earlier but had encountered delays that prevented them from obtaining abortions until late in pregnancy. Additionally, similar to the previous study, other women sought out third trimester abortion because they only realized they were pregnant this late. Unfortunately, no further information regarding reasons for abortion was contained in this study.

These results are similar to findings from an earlier study by the same researcher that examined women’s experiences obtaining abortion after 20 weeks of gestation (in the late second and third trimesters). Although this study did not analyze abortions performed because of a poor prenatal diagnosis, it did find that many women delayed abortions due to finding out about the pregnancy late, logistical problems, trouble deciding, and disagreements with their male partner.^[9] Speaking to the prevalence of late-term abortion in the mid-second trimester and later, one of the authors made the argument that “[o]ne percent of [total abortions] is not nothing. It’s small from a data analysis or statistical perspective, but when you’re thinking about that as real people, that’s a pretty big number.”^[10]

Research published by a Colorado abortion center that specializes in second and third trimester abortions shows that abortions on babies with health conditions made up less than a third of all abortions the center performed between 2007-2012, suggesting that the majority were performed on healthy babies.^[11] Of the unborn babies aborted because of a prenatal diagnosis, the most common health condition was Down syndrome, a condition which in the large majority of cases does not present a lethal threat to the child, and with which those children go on to lead happy, fulfilling lives.^[12] While that study did not report the specific gestational ages at which abortions for reasons other than a prenatal diagnosis were performed, another study published by the same abortion center reported that of over a thousand abortions performed between 18 and 38 weeks, only a fifth were performed because the unborn baby had a poor prenatal diagnosis.^[13]

Are third trimester abortions medically necessary for pregnancy emergencies?

The procedures used during third trimester abortions are generally not medically necessary interventions to save the life of a pregnant woman during a medical emergency. In fact, a third trimester abortion may require several days for an abortionist to dilate the woman’s cervix, which makes this procedure not the preferred route for true pregnancy emergencies needing immediate treatment.^[14] By the third trimester, the pregnancy can instead be ended via labor induction, or if indicated, cesarean section, and the child is usually able to survive delivery. Intentionally and directly ending the unborn child’s life is never medically necessary.^[15]

Do abortion centers offer elective third trimester abortion?

While many abortion centers only perform abortions early in pregnancy, several centers across the country offer third trimester elective abortion. An abortion center in Washington, D.C., advertises abortion up to 31 weeks 6 days and, in a now-removed part of their website, has assured customers that “[i]f you are 26 weeks or later into your pregnancy, we can still see you, regardless of your medical history, background, or fetal indications. We do not require any particular ‘reason’ to be seen here – if you would like to terminate your pregnancy, we support you in that decision.”^[16] The center also currently states that “[w]e firmly believe that access to abortion is a right for all people regardless of the reason behind their decision.”^[17]

Shortly after the Dobbs decision, a new, “all trimester” abortion center opened in Maryland to perform abortions in the third trimester up to 34 weeks of gestation, in the eighth month of pregnancy.^[18] The abortionist explained her rationale for opening a third trimester abortion center: “Every time we draw a line and we say ‘no more abortions after this point,’ someone’s going to fall on the other side of that line, and they’re going to be harmed.”^[19]

The late-term abortion center in Colorado mentioned above performs abortions up to 32 weeks and on a case-by-case basis after that,^[20] with published research showing that the center has performed abortions at 38 and 39 weeks – in the ninth month of pregnancy.^[21] The abortionist who operates this center has been described as an “absolutist” in his willingness to perform elective late-term abortions.^[22] His abortion center no longer performs first trimester abortions, and at least half of the late-term abortions are performed on healthy women and healthy babies. According to a profile published by The Atlantic, “The reason doesn’t really matter to Hern.”^[23]

Do abortion centers actually perform elective third trimester abortions?

Some women have shared their experiences with very late elective abortion in the third trimester, demonstrating that these abortions do indeed occur. In Dobbs v. Jackson Women’s Health, an amicus brief was submitted on behalf of 375 women who had been harmed by abortions in the late second and third trimesters, including women who had obtained abortions at 28 weeks and one woman at 32 weeks.^[24] Additionally, an abortion advocate has described getting an elective third trimester abortion at 28 weeks.^[25] The woman, who suffers from polycystic ovary syndrome and irritable bowel syndrome, said she obtained her abortion “because I was too sick, not ready, and I simply couldn’t afford it.”

Several women have shared their experiences with elective third trimester abortion anonymously online. One woman who described getting an abortion in Oregon at 28 weeks of pregnancy explained that she was surprised to learn she was pregnant: “I took a pregnancy test randomly and it was positive, so I got an ultrasound and found out I was at 27-28 weeks.”^[26] She decided to pursue an abortion because “I had been drinking and smoking the entire pregnancy and cannot afford to take too much time off work so abortion was my only option.”

Another woman who underwent an abortion in Washington, D.C., at 30 weeks of gestation (in the seventh month) had a similar experience, sharing, “I found out I was pregnant at 24 weeks and it was a complete surprise.”^[27] Notably, this woman described the sense of grief she felt after the procedure was completed: “I did opt to see the fetus after the procedure which was very emotional for me, and I was allowed private time to grieve and take photos. They even took foot and hand prints for me to keep…”

A woman who underwent an abortion around 30 weeks of pregnancy in New Mexico said, “surprise, turns out I was pregnant! I was baffled and had no clue how long I could have been pregnant.”^[28] She shared the thought process behind her decision to undergo a third trimester abortion: “Since a lot of people have asked, I will share my rationale for my decision. Besides the fact that, simply, this is how I wanted to handle it(and that should honestly be reason enough)….I certainly wasn’t going to raise it, for a lot of reasons – not enough income, mental health issues, my partner was honest in that while they would not argue child support, they would not stay with me and would want nothing to do with the child, and if I wasn’t prepared emotionally or financially for a child as a couple, I certainly wasn’t prepared to be a single parent.”

Another woman in New Jersey who underwent an abortion in the seventh month, at 31 weeks, shared, “My periods are rare already thanks to PCOS [polycystic ovary syndrome] so I never once thought these things combined meant I was pregnant. I just really regret not catching this sooner so I could have saved myself a lot of anguish.”^[29] Another woman who obtained an abortion in New Mexico at 31 weeks similarly described, “i also did not know that i was pregnant. not until the quickening, that is. when i immediately went to my local abortion clinic, they informed me of how far along i was. 31 weeks.”^[30] She also described the difficult experience of late-term abortion, sharing that she had thought of abortion as “a ‘take two pills and wear a maxi pad for a couple weeks’ kind of situation. i never knew that i would have to euthanize, go into labor with, and fully deliver, a viable fetus. a baby. my baby.”

The same woman, tragically relaying her feelings on the euthanizing injection involved in the abortion, wrote: “that last bit was pretty upsetting. before it happened, i held my small protuberance and cried, and said over and over: ‘i’m so sorry baby. even though i’ll never hold you in my arms, i will hold you forever in my heart.’”

A woman who was scheduled for an abortion in D.C. in the eight month of pregnancy, at 35 weeks, but who ultimately changed her mind related, “I was suppose to get an induced abortion tomorrow. I’m 35 weeks and didn’t even find out i was pregnant until 2 weeks ago because i didn’t have any symptoms.”^[31] She decided against abortion because she felt she couldn’t go through the process without support: “I don’t think i could of done it alone considering it is literal labor and delivery.”

Is it possible for a baby to survive a third trimester abortion?

Although abortion advocates sometimes claim born-alive abortion survivors are a myth, some babies do survive abortions^[32] – what one abortionist labeled the “dreaded complication.”^[33] Most very late abortions are performed through labor induction, or sometimes a combination of labor induction and dismemberment. Often, at the start of a late-term abortion, the abortionist will kill the unborn baby (feticide) via methods such as a lethal intraamniotic or intracardiac (into the heart) injection of digoxin or potassium chloride.^[34] However, feticide is not always performed, and it does not always successfully kill the unborn baby. A European study documented that, among 241 babies with poor prenatal diagnoses who underwent induction abortion between 20 and 24 weeks without feticide at the Medical University of Vienna, more than half (50.6%) were born alive.^[35] Similarly, a 2024 Canadian study of 13,777 abortions in the second and early third trimesters between 15 and 29 weeks found that 11.2% resulted in a  live birth  (even though feticide and dilation & evacuation were performed in many of these abortions).^[36]

Many babies born after about 22 weeks of gestation could survive if given appropriate medical care,^[37] but the fate of most babies born alive after this gestational age is unknown. Although the federal Born-Alive Infants Protection Act of 2002 clarified that infants who survive abortion are persons under the law, it lacks enforcement mechanisms and many politicians have voted repeatedly against strengthening the law.^[38] Infamously, former Virginia governor and physician Ralph Northam stated in an interview that “the infant would be kept comfortable … and then a discussion would ensue” in response to the question of what would be done if an infant survived abortion.^[39] The Abortion Survivors Network has documented at least 700 people alive today who survived abortion.^[40]

Tessa Cox is senior research associate at Charlotte Lozier Institute

Ingrid Skop, M.D., FACOG, is vice president and director of medical affairs for Charlotte Lozier Institute

Editor’s Note: This paper was updated 10/10/24 to clarify the number of states without any limits on abortion.

[1] World Health Organization. Preterm birth. May 10, 2023. Accessed September 11, 2024. https://www.who.int/news-room/fact-sheets/detail/preterm-birth

[2] Bell EF, Hintz SR, Hansen NI, et al. Mortality, In-Hospital Morbidity, Care Practices, and 2-Year Outcomes for Extremely Preterm Infants in the US, 2013-2018. JAMA. 2022;327(3):248-263. doi:10.1001/jama.2021.23580

[3] Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Natality on CDC WONDER Online Database. Data are from the Natality Records 2016-2023, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed September 19, 2024, at https://wonder.cdc.gov/controller/saved/D149/D406F791

[4] Susan B. Anthony Pro-Life America. Pro-abortion laws. Accessed September 11, 2024. https://sbaprolife.org/lifesavinglaws

[5] Charlotte Lozier Institute, “Questions and Answers on Born-Alive Abortion Survivors,” Charlotte Lozier Institute, January 27, 2023, https://lozierinstitute.org/questions-and-answers-on-born-alive-abortion-survivors/; Matthew McDonald, “Tim Walz Removed Requirement to Try to Save Babies Born Alive After Abortion,” National Catholic Register, August 9, 2024, https://www.ncregister.com/news/tim-walz-born-alive-abortion.

[6] Mary E. Harned and Mia Steupert, “Gestational Limits on Abortion in the United States Compared to International Norms (April 2024),” Charlotte Lozier Institute, April 30, 2024, https://lozierinstitute.org/gestational-limits-on-abortion-in-the-united-states-compared-to-international-norms/.

[7] Kimport K. Is third-trimester abortion exceptional? Two pathways to abortion after 24 weeks of pregnancy in the United States. Perspect Sex Reprod Health. 2022;54(2):38-45. doi:10.1363/psrh.12190

[8] Kimport K. Reducing the burdens of forced abortion travel: Referrals, financial and emotional support, and opportunities for positive experiences in traveling for third-trimester abortion care. Soc Sci Med. 2022;293:114667. doi:10.1016/j.socscimed.2021.114667

[9] Foster DG, Kimport K. Who seeks abortions at or after 20 weeks? Perspect Sex Reprod Health. 2013;45(4):210-218. doi:10.1363/4521013

[10] Vagianos A. No one wants to talk about the people who get abortions later in pregnancy. HuffPost. May 22, 2024. Accessed September 19, 2024, https://www.huffpost.com/entry/people-who-get-abortions-later-in-pregnancy_n_664cecbee4b0f45dcbadc518.

[11] Hern WM. Fetal diagnostic indications for second and third trimester outpatient pregnancy termination. Prenat Diagn. 2014;34(5):438-444. doi:10.1002/pd.4324

[12] “The Voyage of Life: Down Syndrome,” Charlotte Lozier Institute, accessed September 18, 2024, https://lozierinstitute.org/dive-deeper/down-syndrome/.

[13] Hern WM. Misoprostol as an adjunctive medication in late surgical abortion. Int J Gynaecol Obstet. 2005;88(3):327-328. doi:10.1016/j.ijgo.2004.12.008

[14]  Ingrid Skop, “Fact Sheet: Medical Indications for Separating a Mother and Her Unborn Child,” Charlotte Lozier Institute, May 17, 2022, https://lozierinstitute.org/fact-sheet-medical-indications-for-separating-a-mother-and-her-unborn-child/.

[15] American Association of Pro-Life Obstetricians and Gynecologists. State restrictions on abortion: evidence-based guidance for policymakers. Committee Opinion 10. September 2022. https://aaplog.org/wp-content/uploads/2022/06/CO-10-State-Level-Restrictions-1.pdf

[16] Dupont Clinic. Abortion after 26 weeks in Washington D.C. Page saved June 3, 2023. Accessed September 11, 2024. https://web.archive.org/web/20230603051644/https:/dupontclinic.com/services/abortion-after-26-weeks/

[17] “About Us,” DuPont Clinic, accessed September 18, 2024, https://dupontclinic.com/.

[18] “Induction Abortion: (After 26 Weeks) – Third Trimester Abortion,” Partners in Abortion Care, accessed September 18, 2024, https://partnersclinic.com/induction-abortion/. Information on abortions up to 34 weeks obtained from https://www.abortionfinder.org/provider/111610.

[19] Block M. An all-trimester abortion clinic prepares to open in Maryland, one of few nationally. NPR. September 1, 2022. Accessed September 11, 2024. https://www.npr.org/2022/09/01/1120124723/an-all-trimester-abortion-clinic-prepares-to-open-in-maryland-one-of-few-nationa

[20] Boulder Abortion Clinic, P.C. Third trimester abortion. Accessed September 11, 2024. https://www.drhern.com/third-trimester-abortion/. Information on abortion up to 32 weeks obtained from https://www.abortionfinder.org/provider/109365.

[21] Hern WM. Fetal diagnostic indications for second and third trimester outpatient pregnancy termination. Prenat Diagn. 2014;34(5):438-444. doi:10.1002/pd.4324

[22] Godfrey E. The abortion absolutist. The Atlantic. May 12, 2023. Accessed September 11, 2024. https://www.theatlantic.com/politics/archive/2023/05/dr-warren-hern-abortion-post-roe/674000/

[23] Id.

[24] Dobbs v. Jackson Women’s Health Organization. Brief amici curiae of 375 Women Injured by Second and Third Trimester Late Term Abortions and Melinda Thybault, Individually and Acting on Behalf of 336,214 Signers of The Moral Outcry Petition filed. App. 1. 20 Jul 2020, https://www.supremecourt.gov/DocketPDF/19/19-1392/148153/20200720161158567_39927%20pdf%20Parker%20app.pdf.

[25] Vial B. What it was like to get a later abortion. Teen Vogue. February 8, 2019. Accessed September 11, 2024, https://www.teenvogue.com/story/what-it-was-like-to-get-a-later-abortion

[26] Abortion at 28 weeks. r/abortion. April 15, 2024. Accessed September 11, 2024. https://www.reddit.com/r/abortion/comments/1c56oje/abortion_at_28_weeks/

[27] My experience at 30 weeks (lengthy post). r/abortion. June 17, 2023. Accessed September 11, 2024. https://www.reddit.com/r/abortion/comments/14c326v/my_experience_at_30_weeks_lengthy_post/

[28] Abortion at 30 weeks, during covid, 2 years later. r/abortion. June 16, 2022. Accessed September 11, 2024, https://www.reddit.com/r/abortion/comments/vdfkgm/abortion_at_30_weeks_during_covid_2_years_later/.

[29] Getting abortion at 31 weeks. This sub has been a godsend. r/abortion. July 17, 2024. Accessed September 13, 2024, https://www.reddit.com/r/abortion/comments/1e5ycfg/getting_abortion_at_31_weeks_this_sub_has_been_a/

[30] No one to talk to about my induction abortion. r/abortion. September 25, 2019. Accessed September 13, 2024, https://www.reddit.com/r/abortion/comments/d9blz9/no_one_to_talk_to_about_my_induction_abortion/

[31] Changed my mind about my abortion. r/abortion. August 9, 2023. Accessed September 13, 2024, https://www.reddit.com/r/abortion/comments/15m6cqo/changed_my_mind_about_my_abortion/

[32] Questions and answers on born-alive abortion survivors. Charlotte Lozier Institute. January 27, 2023. Accessed September 13, 2024. https://lozierinstitute.org/questions-and-answers-on-born-alive-abortion-survivors/

[33] Jeffries L, Edmonds R. Abortion: the dreaded complication. The Philadelphia Inquirer. August 2, 1981. Accessed September 13, 2024, https://web.archive.org/web/20210712064915/https:/digitalcollections.library.cmu.edu/awweb/awarchive?type=file&item=693589

[34] Diedrich J, Drey E; Society of Family Planning. Induction of fetal demise before abortion. Contraception. 2010;81(6):462-473. doi:10.1016/j.contraception.2010.01.018

[35] Springer. Fetal survival in second trimester termination of pregnancy without feticide. Obstet Gynecol. 2018;131(3):575-579.

[36] Auger N, Brousseau E, Ayoub A, Fraser WD. Second-trimester abortion and risk of live birth. AJOG. 2024;230(6):679.

[37] Younge et al. Survival and neurodevelopmental outcomes among periviable infants. NEJM. 2017;376:617-628; Smith LK et al. Effect of national guidance on survival for babies born at 22 weeks’ gestation in England and Wales: population based cohort study. BMJ Medicine. 2023;2:e000579. doi:10.1136/bmjmed-2023-000579.

[38] SBA Pro-Life America. Fact-checking the Trump-Harris debate on abortion: five points. September 11, 2024. Accessed September 13, 2024, https://sbapla.substack.com/p/fact-checking-the-trump-harris-debate.

[39] Cole D. Virginia governor faces backlash over comments supporting late-term abortion bill. CNN. January 31, 2019. Accessed September 13, 2024,  https://www.cnn.com/2019/01/31/politics/ralph-northam-third-trimester-abortion/index.html

[40] The Abortion Survivors Network. It’s hard to grasp the impact of abortion – we know. Accessed September 13, 2024, https://abortionsurvivors.org.