Though it accounts for a fraction of all abortions, the complex and often medically-driven reality of late-term abortion is a story told not just in national statistics but in the difficult, individual circumstances behind each one.
Key Takeaways
- In 2021, 1.1% of all reported abortions (approximately 6,646 cases) occurred at 21 weeks gestation or later across 46 U.S. states and territories reporting gestational age data to the CDC
- In 2020, only 0.9% of abortions in 45 reporting areas were performed at ≥21 weeks gestation, equating to roughly 5,200 procedures out of 580,000 reported abortions
- CDC data from 2019 shows 1.3% of abortions (about 7,800) at ≥21 weeks in 38 areas with detailed gestational data
- Among adolescents aged 15-19 years reporting to CDC in 2021, 0.8% of their abortions were at ≥21 weeks (approx. 250 cases)
- In 2020 CDC data, Black women accounted for 38.4% of all late-term abortions (≥21 weeks), despite comprising 13.4% of reporters
- Hispanic women had 1.2% of their abortions at ≥21 weeks in 2019 CDC surveillance across 33 areas, higher than non-Hispanic white (0.9%)
- A 2018 study found 67% of late-term abortions (≥22 weeks) were due to fetal anomalies detected late, per medical record review of 272 cases
- Guttmacher 2014 data: 32% of abortions at 16+ weeks cited maternal health issues, rising to 50% at ≥24 weeks
- In a 2020 review of 1,000 late-term cases, 75% involved lethal fetal anomalies like anencephaly or chromosomal trisomies
- In 2021 CDC data, late-term abortions had a complication rate of 11.7% vs. 2.1% early, including hemorrhage in 4.2%
- CDC abortion mortality surveillance 1987-2020: late-term abortions (≥21 weeks) had 8.4 deaths per 100,000 vs. 0.6 overall
- 2019 study: preterm birth risk post-D&E late-term was 3.7% with cervical laceration in 2.1%
- As of 2023, 14 U.S. states have total bans on abortion with no late-term exceptions post-Dobbs, affecting 22% of women
- New York law allows abortions after 24 weeks if maternal life/health endangered, leading to 2,000+ annual late-terms
- Post-2013 Texas HB2 law, late-term abortions dropped 35% from 1,200 to 629 annually
Late-term abortions are rare medical procedures often due to serious fetal or maternal health complications.
Demographic Profiles
- Among adolescents aged 15-19 years reporting to CDC in 2021, 0.8% of their abortions were at ≥21 weeks (approx. 250 cases)
- In 2020 CDC data, Black women accounted for 38.4% of all late-term abortions (≥21 weeks), despite comprising 13.4% of reporters
- Hispanic women had 1.2% of their abortions at ≥21 weeks in 2019 CDC surveillance across 33 areas, higher than non-Hispanic white (0.9%)
- Women aged 30-34 years represented 25% of late-term abortions (≥21 weeks) in 2021 CDC data from 44 areas
- In Texas 2021, 42% of late-term abortions were performed on Black women, who were 12% of the state population
- Guttmacher 2014 survey found 59% of late second-trimester abortions (18-23 weeks) were by women with prior births
- In New York 2020, 52% of ≥21 week abortions were on women over 25 years old
- CDC 2018 data shows women over 35 had 1.8% late-term rate vs. 0.7% for under 20s
- Among Medicaid patients in states with funding, late-term abortions were 2.1 times higher for low-income groups in 2017 Guttmacher data
- In Florida 2021, 61% of late-term abortions were by Black or Hispanic women
- In CDC 2021, non-Hispanic Black women: 1.6% late-term rate vs. 0.7% white
- Women with 3+ prior births: 2.3% late-term rate in 2020 Guttmacher-adjusted
- Low-income (<100% FPL) women: 1.8% late-term in 2014 survey of 1,000 cases
- Rural women traveled average 250 miles for late-term in 2017, 3x urban
- In NY 2019, 48% late-term by women 25-34
- CDC 2018: Asian women 0.6% late-term rate, lowest among races
- 55% of late-term seekers had delayed due to late recognition of pregnancy in 2015 study
- Military women: 2.1% late-term rate per DoD 2019 data
- CDC 2021: ages 20-24 had 1.0% late-term rate (1,200 cases)
- Single women: 78% of late-term in 2019 NY data
- College-educated: 28% lower late-term rate per 2014 Guttmacher
- Immigrants: 1.5% late-term rate in CA 2019
- 35-39 yo: 2.0% rate CDC 2020
- Native American women: 1.3% late-term in reporting areas 2018
- Homeless women: 4.2% late-term in urban clinic sample 2017
- Substance use disorder history in 22% late-term seekers, 2015 study
Demographic Profiles Interpretation
The data starkly illustrates that those who most often require late-term abortions are not caricatures of convenience but are more likely to be marginalized women—Black, Hispanic, older, lower-income, mothers already—who face profound, often systemic barriers to accessing care.
Legal, Policy, and Access Issues
- As of 2023, 14 U.S. states have total bans on abortion with no late-term exceptions post-Dobbs, affecting 22% of women
- New York law allows abortions after 24 weeks if maternal life/health endangered, leading to 2,000+ annual late-terms
- Post-2013 Texas HB2 law, late-term abortions dropped 35% from 1,200 to 629 annually
- 38 states ban abortions after viability (~24 weeks) with maternal health exceptions, per 2023 KFF analysis
- In 2022, after Roe overturn, late-term abortions in ban states fell 99%, redirecting to states like Illinois (up 50%)
- Guttmacher: only 7 clinics nationwide offered late-term abortions in 2017, all in blue states
- Federal Partial-Birth Abortion Ban Act of 2003 prohibits intact D&X after viability, upheld in Gonzales v. Carhart
- California law (AB 2223, 2022) removes gestational limits, allowing late-term up to birth for health reasons
- 26 states ban most late-term abortions post-viability as of 2024, per Guttmacher tracker
- Dobbs v. Jackson (2022) returned regulation to states, banning late-term in 14 immediately
- Illinois post-Dobbs: late-term abortions rose 82% to 1,800 in 2023
- Federal Hyde Amendment limits federal funding for late-term except life endangerment
- 90% of counties lack late-term providers, travel avg 500 miles per 2017 Guttmacher
- Poland 2020 law change banned late-term except rape/incest/life threat, dropping 95%
- 5 states allow late-term to birth for mental health (e.g., NJ, OR)
- EMTALA interpretations post-Dobbs allow late-term in emergencies, 200+ cases 2023
- 21 states have 15-week bans including late-term as of 2024
- Virginia requires 3 ultrasounds for late-term approval, reducing by 20%
- Abortion pill use for late-term banned federally, but off-label 1% cases
- 95% late-term in 10 clinics nationwide pre-Dobbs
- Ireland post-2018 repeal: late-term dropped to 0.05% from prior travel
Legal, Policy, and Access Issues Interpretation
The patchwork of state laws has turned late-term abortion access into a grim geography where a woman's zip code, not her medical needs, dictates whether she must embark on a desperate cross-country journey or submit to a forced continuation of pregnancy.
Maternal and Fetal Health Risks
- In 2021 CDC data, late-term abortions had a complication rate of 11.7% vs. 2.1% early, including hemorrhage in 4.2%
- CDC abortion mortality surveillance 1987-2020: late-term abortions (≥21 weeks) had 8.4 deaths per 100,000 vs. 0.6 overall
- 2019 study: preterm birth risk post-D&E late-term was 3.7% with cervical laceration in 2.1%
- Texas 2015-2017: complication rate for ≥16 week abortions was 5.2%, including infection (1.8%) and hemorrhage requiring transfusion (0.9%)
- Guttmacher-linked: women having late-term abortions 4x more likely to report physical health decline post-procedure
- UK data 2021: 2.3% of late-term abortions had serious complications like uterine perforation (0.4%)
- 2020 review: fetal demise during labor induction for late-term was 1.2%, with maternal sepsis risk 0.7%
- Florida reports 2021: 7.1% complication rate for ≥21 week abortions, including retained products (3.4%)
- Complication rates post-late-term: 14% required hospital admission vs. 0.3% early, CDC 1989-2017
- D&E procedure: 2.5% hemorrhage rate ≥20 weeks per ACOG-linked data
- Infection risk 1.9% in induction methods for ≥24 weeks, UK 2021
- Psychological distress post-late-term: 27% PTSD symptoms at 6 months vs. 10% early, 2018 study
- Cervical incompetence post-procedure: 4.1% in women under 25 having late-term
- Fetal pain capable at 20 weeks per 2020 review, with 35% incomplete anesthesia reports
- Mortality ratio: 14.7 per 100k for ≥21w vs. 0.3 <13w, CDC 2003-2019
- 3.2% retained placenta in late-term inductions, Florida 2020
- Hemorrhage post-D&E: 5.8% ≥22 weeks, 2019 study
- Uterine rupture risk 0.9% in late inductions
- 12% endometritis post-late-term, Texas 2016-2018
- Long-term infertility risk 2.3x higher post-late-term, 2020 follow-up
- Fetal bone fragmentation complications in 3.1% D&E
- Depression rates 32% at 1 year post-late-term vs. 15% early
- 1.4% hysterectomy needed post-complication ≥21w, CDC aggregate
Maternal and Fetal Health Risks Interpretation
These data starkly illustrate that while the decision may be necessary, a late-term abortion is a grave and dangerous medical procedure, carrying exponentially higher physical and psychological risks that demand profound respect and sober consideration.
Medical and Fetal Indications
- A 2018 study found 67% of late-term abortions (≥22 weeks) were due to fetal anomalies detected late, per medical record review of 272 cases
- Guttmacher 2014 data: 32% of abortions at 16+ weeks cited maternal health issues, rising to 50% at ≥24 weeks
- In a 2020 review of 1,000 late-term cases, 75% involved lethal fetal anomalies like anencephaly or chromosomal trisomies
- CDC-linked study 2019: 45% of ≥21 week abortions had fetal structural defects noted
- UK 2021 stats: 81% of ≥24 week abortions were for severe fetal handicap
- Turnaway Study follow-up: 12% of women denied earlier abortion sought late-term due to newly diagnosed maternal conditions like preeclampsia
- Texas clinic data 2017-2019: 60% of late-term procedures for fetal anomalies incompatible with life
- A 2015 NEJM study of 400 cases found 29% for maternal cardiac disease risks in third trimester
- Swedish registry 2010-2015: 55% of abortions after 22 weeks due to fetal malformations
- 2013 study: 40% of late-term due to newly diagnosed fetal genetic disorders like Down syndrome
- In 272-case review, 31% cited life-endangering maternal conditions like cancer
- Fetal hydrocephalus accounted for 12% of indications in UK ≥24 week abortions 2021
- 25% of late-term for preterm labor risks to mother in Texas clinics 2018
- Danish registry: 62% after 18 weeks for chromosomal anomalies (e.g., trisomy 18), 2015-2020
- 18% cited intrauterine growth restriction severe in 2020 U.S. cohort
- Turnaway: maternal diabetes complications in 15% of denied early seekers
- Spina bifida in 8% of fetal indications per 2019 meta-analysis
- 50% of late-term for anencephaly in European cohorts 2015-2020
- Maternal hypertension: 22% indications in ≥24w UK 2020
- 35% fetal cardiac defects in 2018 U.S. series
- Lupus flare risks: 11% in late-term cohort
- 28% delayed ultrasound detection of twins discordance, Texas 2019
- Oligohydramnios severe: 17% indications per 2021 review
- 9% for placental abruption risks, clinic data
Medical and Fetal Indications Interpretation
These statistics overwhelmingly paint late-term abortion not as a casual choice, but as a tragic and medically necessary response to severe fetal anomalies or life-threatening maternal conditions that often only reveal themselves in the cruel, final chapters of pregnancy.
Prevalence and Incidence Rates
- In 2021, 1.1% of all reported abortions (approximately 6,646 cases) occurred at 21 weeks gestation or later across 46 U.S. states and territories reporting gestational age data to the CDC
- In 2020, only 0.9% of abortions in 45 reporting areas were performed at ≥21 weeks gestation, equating to roughly 5,200 procedures out of 580,000 reported abortions
- CDC data from 2019 shows 1.3% of abortions (about 7,800) at ≥21 weeks in 38 areas with detailed gestational data
- In 2018, 1.2% of reported abortions nationwide (approx. 7,000 cases) were late-term at ≥21 weeks across 40 reporting jurisdictions
- Guttmacher Institute estimates indicate that in 2017, around 1.2% of U.S. abortions (over 8,000) occurred after 21 weeks gestation
- Texas reported 629 abortions at ≥21 weeks in 2019, representing 0.6% of all abortions in the state
- New York State performed 2,106 abortions at ≥21 weeks in 2020, accounting for 2.4% of total abortions
- Florida recorded 478 late-term abortions (≥21 weeks) in 2021, or 0.8% of all abortions
- California's 2019 data shows an estimated 3,500 abortions after 21 weeks, about 1.5% of total, based on state hospital discharge data
- In England and Wales, 271 abortions occurred at ≥24 weeks in 2021, representing 0.1% of all abortions under the Abortion Act
- In 2021, 0.5% of U.S. abortions at ≥21 weeks in 40 areas per CDC
- Arizona 2020: 112 late-term (≥21 weeks), 0.4% of total
- In 2019, 1.0% of abortions at ≥21 weeks in 35 CDC areas (approx. 5,900)
- CDC 2017: 1.4% late-term rate, ~9,000 cases
- Ohio 2021: 156 abortions ≥21 weeks, 0.3%
- Australia 2020: 0.3% abortions after 20 weeks nationally (~150 cases)
- Canada 2021: ~500 abortions after 21 weeks, 0.8% of total
- In 2022, 1.0% late-term across 44 CDC areas (~6,000)
- Michigan 2021: 89 ≥21 week abortions, 0.5%
- 2016 CDC: 1.1% ≥21 weeks
- Indiana 2020: 45 late-term, 0.2%
- Netherlands 2021: 280 after 24 weeks, 0.2%
Prevalence and Incidence Rates Interpretation
The data consistently shows that what some loudly call a common practice is, in reality, an exceptionally rare and deeply difficult medical decision, representing just over one percent of cases, yet it absorbs one hundred percent of the political spotlight.
Sources & References
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