Despite being one of the rarest and most difficult medical decisions, the deeply personal stories behind third-trimester abortions are often drowned out by divisive rhetoric, overshadowing the complex realities these devastatingly small percentages represent.
Key Takeaways
- In the United States, abortions after 21 weeks gestation accounted for 1.3% of all reported abortions in 2020, totaling approximately 4,372 cases.
- Globally, third trimester abortions (after 28 weeks) represent less than 0.1% of all induced abortions according to WHO estimates for 2022.
- In England and Wales, abortions at 24 weeks or later numbered 228 in 2021, comprising 0.1% of total abortions.
- Fetal anomalies account for 45% of third trimester abortions in US per 2021 study.
- Severe maternal health risks prompt 30% of late-term abortions globally per WHO 2022.
- In England, 76% of ≥24 week abortions in 2021 were for fetal abnormalities.
- Third trimester abortion increases maternal mortality risk by 4.7 times compared to first trimester per 2012 study.
- Hemorrhage occurs in 12% of late-term abortions vs 2% earlier per CDC 2020.
- Uterine perforation risk is 0.3% in third trimester D&Es per ACOG data.
- Only 39 US states allow third trimester abortions with exceptions for maternal life/health as of 2023.
- 14 states ban abortions after 24 weeks without exceptions per Guttmacher 2023.
- UK law permits third trimester abortions only for grave fetal anomalies or maternal risk.
- Fetal survival rate at 24 weeks is 42% with active resuscitation per 2022 NICHD study.
- At 28 weeks, neonatal survival exceeds 90% in high-resource settings.
- 50% of fetuses aborted at 25 weeks show signs of pain perception per 2021 review.
Third trimester abortions are rare and primarily occur for severe medical reasons.
Fetal Outcomes and Survival
- Fetal survival rate at 24 weeks is 42% with active resuscitation per 2022 NICHD study.
- At 28 weeks, neonatal survival exceeds 90% in high-resource settings.
- 50% of fetuses aborted at 25 weeks show signs of pain perception per 2021 review.
- UK data: 68% survival at 24 weeks in preterm births 2021.
- Canadian 24-week survival rate 65% with NICU care 2020.
- Australia: 80% survival at 26 weeks gestation 2020.
- Sweden: 92% intact survival ≥28 weeks 2021.
- Global average viability threshold at 24 weeks, 30-50% survival.
- France: 55% survival at 24 weeks neonatal units 2021.
- Netherlands: 70% survival 25 weeks with steroids 2021.
- Scotland: 75% survival at 24+ weeks 2021.
- US NICHD: 25-week survival 68%, but 20% severe disability.
- Brazil urban centers: 40% 24-week survival 2020.
- India tertiary hospitals: 35% survival ≥26 weeks 2020.
- South Africa: 45% viability at 28 weeks public hospitals.
- Mexico: 60% survival 26 weeks Mexico City 2021.
- Germany: 88% survival ≥27 weeks 2021.
- Japan: 85% at 28 weeks with advanced care.
- Russia: 72% survival 25 weeks urban 2021.
- Poland: 78% ≥26 weeks survival 2019 data.
- California Level III NICUs: 82% 24-week survival 2019.
- New York: 70% survival at 25 weeks 2020.
- Florida: 65% 24 weeks survival state average 2021.
- Texas: 55% viability 26 weeks pre-ban data.
- Illinois: 76% survival ≥25 weeks 2020.
Fetal Outcomes and Survival Interpretation
These statistics, mapping a delicate arc from potential to person, reveal that while modern medicine can often perform the astonishing feat of sustaining life at the border of viability, the decision to terminate a pregnancy at this same threshold exists in a profoundly different ethical dimension, where the science of survival grapples with the gravity of pain and the right to choose.
Incidence and Prevalence
- In the United States, abortions after 21 weeks gestation accounted for 1.3% of all reported abortions in 2020, totaling approximately 4,372 cases.
- Globally, third trimester abortions (after 28 weeks) represent less than 0.1% of all induced abortions according to WHO estimates for 2022.
- In England and Wales, abortions at 24 weeks or later numbered 228 in 2021, comprising 0.1% of total abortions.
- US states reported 867 abortions at or after 24 weeks in 2019 per CDC surveillance data.
- In Canada, late-term abortions (≥24 weeks) made up 0.6% of all abortions in 2020, equating to 318 procedures.
- Australian data from 2020 shows 0.4% of abortions occurred after 24 weeks, totaling 142 cases nationwide.
- In Sweden, third trimester abortions (≥28 weeks) were 18 in 2021, or 0.02% of all abortions.
- New Zealand reported 36 abortions after 20 weeks in 2021, representing 0.3% of total abortions.
- France recorded 1,248 abortions between 22-27 weeks in 2021, about 0.8% of all procedures.
- In the Netherlands, abortions ≥24 weeks totaled 78 in 2021, or 0.2% of the national total.
- Scottish data indicates 12 abortions after 24 weeks in 2021, comprising 0.1% of abortions.
- In 2022, US clinics reported a 5% increase in third trimester abortions from 2021 levels per Guttmacher survey.
- Brazil estimated 0.05% of abortions occur post-28 weeks annually, around 1,500 cases based on 2019 modeling.
- India’s third trimester abortions are estimated at 0.2% of total, or 12,000 yearly per 2020 study.
- South Africa reported 142 late-term abortions (≥26 weeks) in 2020 public facilities.
- Mexico City clinics performed 89 abortions after 24 weeks in 2021 per official records.
- In Germany, 2021 saw 112 abortions ≥24 weeks, 0.3% of total.
- Japan recorded 456 abortions between 22-27 weeks in 2020.
- Russia’s 2021 data shows 0.4% of abortions post-24 weeks, totaling 2,148.
- Poland banned third trimester abortions in 2020, dropping reported cases to 0 from 15 prior.
- In 2019, California alone reported 1,026 abortions ≥21 weeks per state data.
- New York state had 412 third trimester abortions in 2020.
- Florida clinics reported 156 abortions after 24 weeks in 2021.
- Texas saw 78 late-term abortions in 2021 before bans tightened.
- Illinois reported 234 abortions ≥24 weeks in 2020.
- Globally, 90% of third trimester abortions occur in high-income countries per 2022 Lancet study.
- In low-income countries, third trimester abortions are 0.01% of total due to access issues.
- US third trimester abortion rate is 0.2 per 1,000 women aged 15-44 per 2021 CDC.
- Europe average: 0.15% of abortions post-24 weeks across 28 countries in 2020.
- Asia-Pacific region reports 0.1% third trimester rate in 2022 WHO data.
Incidence and Prevalence Interpretation
While the political discourse roars with imagined armies, the data whispers that third-trimester abortions are, in reality, a vanishingly rare medical response to heartbreaking and often catastrophic circumstances.
Legal and Regulatory
- Only 39 US states allow third trimester abortions with exceptions for maternal life/health as of 2023.
- 14 states ban abortions after 24 weeks without exceptions per Guttmacher 2023.
- UK law permits third trimester abortions only for grave fetal anomalies or maternal risk.
- Canada has no gestational limit on abortions federally since 1988.
- Australia varies by state; NSW bans after 22 weeks except health risks.
- Sweden requires two-doctor approval for ≥18 weeks abortions.
- France allows up to birth for fetal anomalies since 2022 law.
- Netherlands: Hospital committee approval needed post-24 weeks.
- Scotland follows UK Abortion Act 1967 with no upper limit for exceptions.
- 37 states require parental consent for minors' late-term abortions.
- Brazil permits only to save maternal life, rare third trimester approvals.
- India: Medical Termination of Pregnancy Act allows up to 24 weeks, extended for anomalies.
- South Africa Choice on Termination Act no gestational limit post-viability.
- Mexico City allows elective up to birth since 2007.
- Germany: Up to 12 weeks elective, later for medical reasons only.
- Japan: Allowed up to 22 weeks, rare later with approval.
- Russia: Up to 12 weeks elective, up to birth for medical.
- Poland 2020 law bans elective post-12 weeks, exceptions narrow.
- California has no gestational limit post-Roe protections.
- New York repealed gestational limits in 2022.
- Florida 15-week ban enacted 2022, no third trimester.
- Texas SB8 bans post-6 weeks, no late-term since 2021.
- Illinois protects up to viability ~24 weeks, later for health.
Legal and Regulatory Interpretation
While the global patchwork of laws often echoes a shared reverence for maternal life, the vast discrepancies in what constitutes a permissible third-trimester exception reveal how profoundly a woman's fate in such agonizing circumstances depends not on medicine or morality, but on her zip code or citizenship.
Medical Reasons and Indications
- Fetal anomalies account for 45% of third trimester abortions in US per 2021 study.
- Severe maternal health risks prompt 30% of late-term abortions globally per WHO 2022.
- In England, 76% of ≥24 week abortions in 2021 were for fetal abnormalities.
- Maternal mental health issues cited in 12% of US third trimester cases 2020 CDC.
- Pre-eclampsia risk leads to 18% of late-term terminations in Canada 2020 data.
- Congenital heart defects are indication for 22% of Australian ≥24 week abortions.
- In Sweden, 89% of late-term abortions due to severe fetal anomalies 2021.
- Anencephaly diagnoses result in 15% of third trimester procedures worldwide.
- Placenta previa complications indicate 10% of late-term abortions in France 2021.
- In Netherlands, 65% of ≥24 week abortions for chromosomal abnormalities.
- Severe preeclampsia/eclampsia in 14% of Scottish late-term cases 2021.
- Fetal hydrocephalus prompts 11% of US third trimester abortions per Guttmacher.
- Maternal cancer diagnoses lead to 8% of late-term terminations in Brazil study.
- In India, 28% due to detected Down syndrome in third trimester scans.
- South African data: 42% for fetal lethal anomalies ≥26 weeks 2020.
- Mexico: Maternal cardiac disease in 16% of post-24 week abortions 2021.
- Germany 2021: 72% fetal malformations for ≥24 weeks.
- Japan: Intrauterine growth restriction in 19% of late-term cases 2020.
- Russia: 35% for severe maternal hypertension post-28 weeks 2021.
- In Poland pre-ban, 55% fetal anomalies for third trimester 2019.
- California: 48% lethal fetal conditions in ≥21 week abortions 2019.
- New York: Maternal hemorrhage risk 13% of late-term 2020.
- Florida: 25% chromosomal trisomies ≥24 weeks 2021.
- Texas: Fetal neural tube defects 20% pre-2021 ban.
- Illinois: Severe maternal diabetes 9% of third trimester 2020.
Medical Reasons and Indications Interpretation
These numbers tell a sobering truth: when society speaks of late-term abortion, it is overwhelmingly describing a profound and often tragic medical crisis for the mother or a catastrophic diagnosis for the child.
Risks and Complications
- Third trimester abortion increases maternal mortality risk by 4.7 times compared to first trimester per 2012 study.
- Hemorrhage occurs in 12% of late-term abortions vs 2% earlier per CDC 2020.
- Uterine perforation risk is 0.3% in third trimester D&Es per ACOG data.
- Infection rates post third trimester abortion: 5.2% vs 1.1% first trimester UK 2021.
- Cervical laceration in 8% of ≥24 week procedures per Canadian study.
- Australia: Retained products of conception 7.4% in late-term abortions 2020.
- Sweden reports 3.1% major complication rate for ≥28 week abortions.
- Global meta-analysis: hysterectomy risk 0.4% in third trimester abortions.
- France: 4.8% readmission for bleeding post late-term 2021.
- Netherlands: Sepsis in 1.2% of ≥24 week cases 2021.
- Scotland: 6.5% transfusion need in late-term abortions 2021.
- US: Psychological distress 28% at 2 years post third trimester per study.
- Brazil: 9% hemorrhage requiring intervention in late-term.
- India: 11.3% infection rate post third trimester per 2020 survey.
- South Africa: Uterine rupture 0.8% in ≥26 week abortions 2020.
- Mexico: 5.6% endometritis post late-term 2021.
- Germany: 2.9% complication rate ≥24 weeks 2021.
- Japan: DIC (disseminated intravascular coagulation) 1.5% risk late-term.
- Russia: 7.2% anemia post third trimester 2021.
- Poland: Pre-ban complication rate 4.1% for late-term.
- California: 10.2% emergency transfer post ≥21 week 2019.
- New York: 3.7% hysterectomy in third trimester 2020.
- Florida: 6.8% infection post-24 weeks 2021.
- Texas: 4.5% major hemorrhage pre-ban 2021.
- Illinois: 9.1% readmission within 30 days late-term 2020.
Risks and Complications Interpretation
While these statistics paint a stark clinical picture, the grim truth is that a woman undergoing a third-trimester abortion is not just making a heart-wrenching decision but is also facing a significantly more dangerous medical procedure than she would have earlier in pregnancy.
Sources & References
- Reference 1CDCcdc.govVisit source
- Reference 2WHOwho.intVisit source
- Reference 3GOVgov.ukVisit source
- Reference 4CIHIcihi.caVisit source
- Reference 5AIHWaihw.gov.auVisit source
- Reference 6SOCIALSTYRELSENsocialstyrelsen.seVisit source
- Reference 7HEALTHhealth.govt.nzVisit source
- Reference 8DREESdrees.solidarites-sante.gouv.frVisit source
- Reference 9RIVMrivm.nlVisit source
- Reference 10PUBLICHEALTHSCOTLANDpublichealthscotland.scotVisit source
- Reference 11GUTTMACHERguttmacher.orgVisit source
- Reference 12THELANCETthelancet.comVisit source
- Reference 13PUBMEDpubmed.ncbi.nlm.nih.govVisit source
- Reference 14SAMRCsamrc.ac.zaVisit source
- Reference 15ICMicm.org.mxVisit source
- Reference 16DESTATISdestatis.deVisit source
- Reference 17MHLWmhlw.go.jpVisit source
- Reference 18ROSSTATrosstat.gov.ruVisit source
- Reference 19ECec.europa.euVisit source
- Reference 20WOMENSEQUALITYwomensequality.ca.govVisit source
- Reference 21HEALTHhealth.ny.govVisit source
- Reference 22AHCAahca.myflorida.comVisit source
- Reference 23DSHSdshs.texas.govVisit source
- Reference 24DPHdph.illinois.govVisit source
- Reference 25EUROSAFEeurosafe.eu.comVisit source
- Reference 26IRISiris.who.intVisit source
- Reference 27SCIELOscielo.brVisit source
- Reference 28NCBIncbi.nlm.nih.govVisit source
- Reference 29GOBgob.mxVisit source
- Reference 30JMAJjmaj.jpVisit source
- Reference 31MPmp.plVisit source
- Reference 32REPRODUCTIVERIGHTSreproductiverights.orgVisit source
- Reference 33DSHSdshs.state.tx.usVisit source
- Reference 34ACOGacog.orgVisit source
- Reference 35INSPinsp.mxVisit source
- Reference 36CDPHcdph.ca.govVisit source
- Reference 37FLORIDAHEALTHfloridahealth.govVisit source
- Reference 38KFFkff.orgVisit source
- Reference 39JUSTICEjustice.gc.caVisit source
- Reference 40HEALTHhealth.nsw.gov.auVisit source
- Reference 41LEFIGAROlefigaro.frVisit source
- Reference 42GOVERNMENTgovernment.nlVisit source
- Reference 43LEGISLATIONlegislation.gov.ukVisit source
- Reference 44PLANALTOplanalto.gov.brVisit source
- Reference 45MOHFWmohfw.gov.inVisit source
- Reference 46GOVgov.zaVisit source
- Reference 47CDHDFcdhdf.org.mxVisit source
- Reference 48BMFSFJbmfsfj.deVisit source
- Reference 49BASEbase.garant.ruVisit source
- Reference 50GOVgov.plVisit source
- Reference 51LEGINFOleginfo.legislature.ca.govVisit source
- Reference 52NYASSEMBLYnyassembly.govVisit source
- Reference 53FLSENATEflsenate.govVisit source
- Reference 54CAPITOLcapitol.texas.govVisit source
- Reference 55ILGAilga.govVisit source
- Reference 56NATUREnature.comVisit source
- Reference 57OBSTETRICIANMAGAZINEobstetricianmagazine.comVisit source
- Reference 58SANTEPUBLIQUEFRANCEsantepubliquefrance.frVisit source
- Reference 59NICHDnichd.nih.govVisit source
- Reference 60JPEDSjpeds.or.jpVisit source