Late-term abortion: what the term means and what happens
If you're further along in pregnancy and wondering what your choices are, or you've heard the term and want to know what it means, this page explains it plainly: how rare these abortions are, what happens, and what the law says.
The short answer: "late-term abortion" isn't a medical term. People usually mean an abortion after about 21 weeks. These are rare, about 1 in 100 abortions in CDC data. At this stage the pregnancy is ended with a procedure called D&E or with medicine that starts labor, often after an injection that stops the fetal heart. Partial-birth abortion has been banned nationwide since 2003.
What people mean by "late-term"
The American College of Obstetricians and Gynecologists (ACOG) says "late-term abortion" has no medical meaning. In pregnancy care, "late term" already means something else: 41 weeks, just past a due date, and abortions don't happen then. Doctors instead name the week of pregnancy, or say "abortion later in pregnancy."
In everyday talk, people use "late-term" or "third-trimester abortion" for abortions after about 21 weeks, around the middle of pregnancy and beyond. Weeks are counted from the first day of your last period. If you aren't sure how far along you are, an ultrasound is the most accurate way to know.
How rare abortions after 21 weeks are
The CDC's most recent report covers 2022 and counts abortions only in the states that report to it, so it isn't a full national count. In those states:
- About 93% of abortions happened at or before 13 weeks.
- About 6% happened between 14 and 20 weeks.
- About 1% (1.1%) happened at 21 weeks or later.
The CDC groups everything from 21 weeks on together, so its report doesn't show how many happen in the third trimester specifically.
What happens at this stage
Later in pregnancy, one of two methods is used. Both are described more fully on types of abortion.
Dilation and evacuation (D&E)
The cervix is opened over several hours or a day or more, using thin rods that slowly absorb fluid and swell, medicine, or both. Then, usually with sedation or anesthesia, the doctor removes the fetus and placenta using suction and instruments. ACOG notes this can mean the fetus is removed in parts.
Induction abortion
Medicines make the uterus contract and pass the pregnancy, much like labor. They can be given by mouth, in the vagina, by IV or by injection into the uterus. ACOG says this usually takes 12 to 24 hours and that pain medicine is usually given. A tear in the uterus or cervix is rare, under 1 in 1,000.
The injection beforehand
Before many later procedures, a doctor first injects medicine (digoxin, potassium chloride or lidocaine) into the fetus or the fluid around it to stop the fetal heart. The Society of Family Planning, a professional group of family planning clinicians and researchers, recommends this near and after viability, to avoid a live birth. It doesn't recommend it routinely before viability.
Partial-birth abortion: what it was and the federal ban
"Partial-birth abortion" is a legal term, not a medical one. It refers to a procedure doctors called intact dilation and extraction (D&X), or intact D&E, in which the fetus was delivered partway, intact, before the procedure was completed.
Congress banned it nationwide in the Partial-Birth Abortion Ban Act of 2003. In 2007, in Gonzales v. Carhart, the U.S. Supreme Court upheld the law in a 5 to 4 decision. The ban has an exception to save the mother's life but no separate exception for her health. The Court noted that the law doesn't ban the standard D&E procedure described above.
How developed the baby is at this stage
By 21 weeks and after, a lot has already formed. According to MedlinePlus, a service of the National Institutes of Health:
- Around 19 to 21 weeks, the baby can hear, and many mothers begin to feel movement. By 22 weeks, movement can usually be felt.
- All of the essential organs began forming months earlier, around 9 weeks, and keep maturing until birth.
Survival outside the womb becomes possible in what ACOG calls the periviable period, from about 20 to 25 weeks. The odds rise quickly each week. In the studies ACOG cites, survival to hospital discharge was:
| Born at | Survived to go home |
|---|---|
| Before 23 weeks | About 5 to 6 in 100 |
| 23 weeks | About 23 to 27 in 100 |
| 24 weeks | About 42 to 59 in 100 |
| 25 weeks | About 67 to 76 in 100 |
ACOG says there is no single medical definition of viability; it depends on each pregnancy. See fetal development week by week for more.
Where experts disagree
Can a fetus feel pain at this stage?
The major medical groups' view: ACOG says a fetus doesn't have the capacity to feel pain until at least 24 to 25 weeks. The UK's Royal College of Obstetricians and Gynaecologists reviewed the evidence in 2022 and concluded pain perception before 28 weeks is unlikely.
The other view: in a 2020 paper in the Journal of Medical Ethics, two researchers who hold opposing views on abortion argued the evidence points toward a basic pain experience that may be possible from as early as 12 weeks, and that pain relief during later abortions is reasonable to consider.
Pain can't be measured directly in a fetus, and this is still debated.
What the law says
Federal law: the partial-birth abortion ban applies in every state. Other abortion laws are set state by state and can change.
Michigan: voters approved Proposal 3 in 2022, which added a right to reproductive freedom to the state constitution (Article I, Section 28). It lets the state regulate abortion after fetal viability. It also says the state may not ban an abortion that a clinician judges necessary to protect the patient's life or physical or mental health. The constitution defines viability as the point when, in the attending clinician's judgment, the fetus has a significant likelihood of surviving outside the uterus without extraordinary medical measures.
This is general information, not legal advice.
If you're further along and not sure what to do
Being further along can make every choice feel urgent and heavy. You don't have to decide alone, and you have more options than it may seem:
- A free ultrasound at a pregnancy center can tell you exactly how far along you are and how the baby is doing.
- If you've had hard news about your health or your baby's, you can ask your doctor for a second opinion and time to talk it through.
- Adoption is possible at any point in pregnancy, and you can make a plan before or after birth.
- Michigan's Safe Delivery law lets a parent safely and anonymously hand over a newborn up to 3 days old.
- If money is the worry, see help paying for a baby.
Sources
- ACOG. Abortion language guide and Induced abortion (patient FAQ).
- CDC. Abortion Surveillance, United States, 2022.
- Society of Family Planning. Induction of fetal asystole before abortion (2024).
- Gonzales v. Carhart, 550 U.S. 124 (2007), upholding the Partial-Birth Abortion Ban Act of 2003, 18 U.S.C. §1531.
- MedlinePlus (NIH). Fetal development.
- ACOG. Understanding and navigating viability.
- ACOG. Gestational development and capacity for pain.
- Royal College of Obstetricians and Gynaecologists. Fetal awareness: evidence review (2022).
- Derbyshire SW, Bockmann JC. Reconsidering fetal pain. J Med Ethics 2020;46(1):3–6.
- Michigan Constitution. Article I, Section 28.
Common questions
What is considered a late-term abortion?
How common are abortions after 21 weeks?
Is partial-birth abortion legal?
Is late-term abortion legal in Michigan?
Can a baby survive if born at 22 to 25 weeks?
“Can a woman forget her sucking child, that she should not have compassion on the son of her womb? yea, they may forget, yet will I not forget thee.”