There's No Such Thing as 'Late-Term Abortion'—Here Are the Facts

You've likely seen or heard references to "late-term abortion." You may have even heard this term used by people in power from government officials to news anchors. But the truth is that "late-term abortion" is not a recognized medical term—nor is it an accurate one.

According to the American College of Obstetrics and Gynecology (ACOG), the term "late-term abortion" has no medical significance and is not used in a clinical setting or to describe the delivery of abortion care later in pregnancy.

Abortion was first legalized in the United States in 1973 after the Supreme Court ruling in the landmark Roe v. Wade case. Since then, the topic of abortion care and the language around abortion has been highly politicized. One result was a rise in the use of misleading language like "late-term abortion" that further stigmatizes abortion care and perpetuates misinformation.

Gillian Dean, MD, MPH, chief medical officer at Planned Parenthood Federation of America explains: "People who oppose abortion have made up terms—such as 'partial-birth abortion' and 'late-term abortion'—to further stigmatize ending a pregnancy. To be clear: There is no such thing as an abortion up until birth, and 'late-term abortion' is not a term used by reputable health care providers."

Still, we often hear these terms in the news—and you may have even used them yourself. To help learn the facts about so-called "late-term abortion," we spoke with experts to clear up the confusion.

What Does 'Late-Term Abortion' Mean?

Given that there is no scientific or medical basis for the term, it shouldn't be a surprise that there is no consensus on what "late-term abortion" actually means. In general, however, the term is most commonly used to describe abortions that take place after the first trimester (or after 12 weeks), says Daniel Grossman, MD, director of Advancing New Standards in Reproductive Health (ANSIRH) at Bixby Center for Global Reproductive Health at the University of California, San Francisco.

When health care providers use language like "full term" and "late term" in the context of pregnancy, they're talking about how far along the pregnancy is (with "full term" meaning between 39 and 40 weeks and "late term" meaning 41+ weeks). It's important to note that they do not use these terms to categorize types of abortion care.

So when people use terminology like "late-term abortion," the discussion gets especially murky. The term sounds like the language used in medical settings, but when it comes to abortion care, it's simply vague and inaccurate—especially when you consider that most people who use the term aren't talking about abortions that are being performed after 41 weeks (or "late term").

Experts explain that using the gestational period, or the time in pregnancy when the abortion is taking place, is the most accurate way to categorize abortion care and is the standard in the medical community. For instance, an abortion taking place during the second trimester would be a second-trimester abortion, and an abortion during the third trimester would be described as a third-trimester abortion.

Describing abortion by week or by trimester is also in line with how pregnancy care is provided. "We talk about care as pregnancy progresses in weeks from a person's last menstrual period, or in trimesters (1st: 0-13 weeks, 2nd: 14-26 weeks, 3rd: 27-40 weeks)," adds Chelsea Souder, MPH, director of Clinical Services and Communications Manager at AbortionClinics.org.

What About 'Partial-Birth Abortion'?

Like "late-term abortion," the term "partial-birth abortion" is another inaccurate and misleading term with no basis in medicine. The term first gained traction with the Partial-Birth Abortion Ban Act of 2003. However, neither "late-term abortion" nor "partial-birth abortion" are recognized by leading medical groups, including the American College of Gynecology (ACOG).

"'Partial-birth abortion' refers to a procedure known as dilation and extraction, or D&X, which involves attempting to remove the fetus intact through the cervix," explains Dr. Grossman. "The procedure is no longer legal unless medication is used to stop the fetal heartbeat first."

The Truth About Second- and Third-Trimester Abortions

The large majority of abortions occur during the first trimester of pregnancy. In 2020, 93% of abortions occurred before 13 weeks gestation. Outside of the first trimester, 6% occurred between 14 and 20 weeks and 1% happened at 21 weeks or later in gestation.

While most abortions occur before 13 weeks, second- and third-trimester abortions are still possible and sometimes necessary. "Nearly 99% of abortions happen before a person is 21 weeks pregnant, and those that happen later almost all happen before 24 weeks," Dr. Dean explains. "In rare and very complex circumstances, abortions may be necessary later on in a pregnancy—such as when there are severe fetal anomalies or serious risks to the pregnant person's health."

The following are the most common reasons for abortion during the second or third trimester.

Fetal anomalies

"The medical reasons for an abortion in the second trimester include a diagnosis of fetal malformation or genetic anomaly," says Dr. Grossman. These can include:

• Anencephaly, the absence of the brain and cranium above the base of the skull
• Limb-body wall complex, when the organs develop outside of the body cavity
• Chromosomopathy, a chromosomal disorder

Pregnancy complications

"Medical complications are the development of a condition in the pregnant [person] that necessitates delivery," says Dr. Grossman. "Some examples of these conditions include severe preeclampsia, or high blood pressure of pregnancy, or bleeding from a placenta previa, when the placenta covers the cervical opening of the uterus."

Other medical complications that can occur during pregnancy and necessitate abortion include:

• Premature rupture of membranes and infection
• Placental abruption
• Placenta acreta, which may risk extensive blood loss
• Stroke
• Septic shock that could lead to maternal death

"These unexpected and potentially life-threatening complications are why it's critical that patients and doctors have the option of abortion later in pregnancy," Dr. Dean adds. "Ultimately, the decision to end a pregnancy depends on a person's unique circumstances, and should be between them and their doctors."

Restricted access to care

Second- and third-trimester abortions may also be more common in places with laws that restrict access to abortion.

"Our research in Texas found that the restrictive laws there…were associated with an increase in second-trimester abortion," says Dr. Grossman. "The obstacles that those face accessing care ends up pushing them later in pregnancy before they can obtain a wanted abortion."

"These restrictions have forced many clinics to close, in turn creating waiting lists, sometimes two to three weeks out," adds Souder. "Unnecessary waiting periods, gestational bans, and lack of providers in rural areas force people in some states to travel hundreds of miles to get care."

Additionally, a majority of states currently ban state Medicaid from covering abortion care, which further affects the most marginalized people.

Abortion Procedures After the First Trimester

The type of abortion someone can receive is impacted by the stage of pregnancy. For example, medical abortion using mifeprex and misoprostol (aka "the abortion pills"), is not recommended after about 10 weeks.

In general, there are two options for second-trimester abortions:

• Medical second-trimester abortion. "One option involves the use of medications to essentially induce labor to deliver the pregnancy. This may take a day or longer," says Dr. Grossman.
• Surgical second-trimester abortion. "The second option is dilation and evacuation, or D&E, which involves opening the cervix and using instruments to remove the pregnancy," Dr. Grossman explains. "This usually takes less than 30 minutes and can be done under sedation or anesthesia."

As of 2023, 33 states have banned the D&E procedure, according to the Guttmacher Institute.

The Bottom Line

Medical clinicians do not use the term "late-term abortion," as it has no basis in medicine and no medically-recognized definition. Instead, they describe the timing of abortion by week or trimester.

"The most precise way to talk about when in pregnancy an abortion takes place is to specify the number of weeks gestation or the range of weeks, like 'abortion at 20-24 weeks'," summarizes Dr. Grossman. "Sometimes people say 'abortion after 12 weeks' or 'second-trimester abortion'. It's important to be as specific as possible."