On June 24, 2022, the United States Supreme Court overruled the nearly 50-year legal precedent of Roe v. Wade; a case that federally protected the right to an abortion for millions. After allocating abortion jurisdiction to individual states, Americans watched as state borders acted as both obstructions to autonomy and gateways to freedom; a landscape of assorted reproductive care deadlines in an increasingly polarized nation. Within the past two years, this decision has further restricted abortion access, forcing abortion seekers to navigate increasing barriers to care. In the wake of such upheavals, those seeking an abortion in the third trimester continue to be drowned out in campaign trails and talking points that either seek to condemn them as criminals, or deny their existence altogether. These individuals must traverse tricky abortion access deadlines present in 43 states, while juggling opposition interpersonally and on a systemic basis. In particular, those seeking an abortion in the third trimester of pregnancy are confronted with looming expenses, a select few clinics providing care, and continuous death threats towards abortion care providers that make obtaining this care an onerous feat. Given that only 13% of respondents in a 2018 Gallup poll believe abortion should be legal in the third trimester at all, I argue that the general public on both sides of the political aisle are widely misinformed about this procedure’s necessity and impact. By discussing personal and medical necessities, systemic barriers to access and resources for those seeking this care, it is my hope more people can garner a better understanding of the fight for extended abortion access.

Before diving into content, I feel it prudent to explain why I will not be using “late-term” when referring to abortions in the third trimester. The term “late-term” is entirely political, implying these procedures occur past an acceptable timetable. “Late-term” is not the medically used moniker (third term and third trimester are generally used), and many doctors and scientists actively avoid this misleading language. 

Approximately 1% of all abortion patients receive an abortion in the third trimester, and they do so for one of two reasons: barriers to prior access, or medical anomalies. According to author Katrina Kimport’s 2022 study published in the journal Perspectives on Sexual and Reproductive Health, some requesting an abortion in the third trimester previously aimed to receive the procedure in the first or second term, but encountered hurdles only surmounted after the 26-week term limit. As the advocacy group Who Not When argues, it is not uncommon for women to require more than two trimesters to earn the money required for the procedure, or to encounter stigmatization or isolation that would make obtaining care prior to week 27 a logistic impossibility. Monique, one of Kimport’s study participants, knows this struggle all too well. Immediately upon discovering she was pregnant, Monique and her recently unemployed boyfriend sought an abortion, but swiftly discovered her insurance prohibited coverage of abortion costs. Monique was forced to continue with the pregnancy until an employment signing bonus would provide enough capital for the procedure. 

Furthermore, some pregnant people discover problems with pregnancy well into their third trimester that would make a continuation of said pregnancy dangerous–for both parent and fetus. University of California San Francisco outlines that some fetal health conditions are only identifiable in the third trimester, such as preeclampsia (a pregnancy complication related to organ damage and high blood pressure) and placenta previa (the premature separation of the placenta and subsequent blocking of the cervix). Kara, a pseudonym for another participant in Kimport’s study, details that much of the brain’s development occurs in the late second trimester and early third trimester, preventing her from knowing the severity of the fetal health issue prior to the third trimester. For patient Erika Christensen, these issues would prove fatal if the fetus came to term. Abortion itself can be medically necessary for many patients with pre-existing medical conditions or who discover medical ailments during pregnancy, and is an important argument for receiving an abortion in the third term. Kimport concludes her study by arguing the dual societal and medical reasons for third-term abortion “make a strong case for a social conceptualization of abortion not in terms of trimesters but, instead, as an option throughout pregnancy.”

Alas, current options for abortion throughout pregnancy are heavily restricted–if not nearly nonexistent. Only seven states (Alaska, Oregon, Colorado, New Mexico, New Jersey, Vermont) and the District of Columbia have no limit on abortion procedures, and finding a clinic in one of these states willing to provide this service is a laborious feat. Upon writing this article, I discovered only 10 clinics across the United States willing to perform this procedure at 27 weeks (the start of the third trimester and legal cutoff for states like Virginia); the closest clinic from UT sitting almost seven hours away. However, the blame for such limited clinical options does not solely lie with those providing care. A large part of many clinic’s hesitancy to extend care into the third trimester is the colossal opposition third term healthcare providers confront. In May of 2009, third term abortion doctor Dr. George Tiller was serving as an usher at his church until Scott Roeder entered, shooting him at point-blank range and later claiming the assassination was necessary to save “preborn babies” from abortion. This danger is echoed by four third-term abortion doctors in the 2013 documentary After Tiller, who recall various death threats they and their families have received due to their profession. Two particularly chilling threats Dr. LeRoy Carhart encountered include the arson of his farm (including his 17 horses, cat and dog), and letters containing white powder sent to his clinic. Given ongoing danger to all abortion care providers, seen in one instance through the burned down abortion clinic in Wyoming hardly two years ago, those providing abortion care in the third trimester are forced to wield a scalpel with a target on their back. 

If and when a patient is able to seek out a clinic providing a third-term abortion, they must then cough up enough money to cover the procedure’s price. Third-trimester abortions are especially costly, jumping from charges of $644-$715 in the first term and $1,068 in the second term, to a whopping range of a few thousand dollars to over $25,000. Erika Christiansen, originally going by the pseudonym “Elizabeth”, reveals that she had to pay $10,000 for the procedural shot alone…with only cash. For those struggling to come up with the money in the first two terms, this increased cost could be the difference between an abortion and forced delivery. 

If a patient is able to bypass obstacles in both clinical options and cost, they are then confronted with hot-button legislation attempting to prevent the procedure as a whole. Anti-abortion group Due Date Too Late had urged constituents to vote ‘yes’ to failed Colorado proposition 115 legislation that would’ve heavily restricted abortions after 22 weeks. This group is not alone. Anti-abortion groups in Ohio rallied against 2023 legislation that granted the right to an abortion until “fetal viability”, known colloquially as Issue 1, by teaming up with national anti-abortion group Susan B. Anthony Pro-Life America. Luckily, Issue 1 passed in November, but current legislation banning all abortions in Texas, Alabama, and South Dakota indicates a long journey ahead before care can be extended to third-trimester patients across America. 

As abortion remains a controversial issue in nearly every corner of the US, it is important we remember the abortion seekers that consistently fall outside of our daily purview, and remind ourselves why their quest for reproductive freedom is no less valid or necessary than others’. If you or a loved one are seeking an abortion in the third-term, there are resources available to you. Throughout the research process for this article, I used www.noisefornow.org/map to find clinics willing to perform abortions in the third term, as well as www.whonotwhen.com for additional information regarding third-term abortion seekers. Additionally, https://abortionfunds.org/need-an-abortion/ guides abortion care seekers through the process of discovering ways to pay for care, and provides helpful information clarifying certain abortion or abortion justice terms, tips for contacting abortion funds, and available financial assistance. 

If you live in Austin and are willing to donate, but are unsure of ways to help in a state that has entirely banned abortion services, I recommend supporting the Austin Women’s Health Center. Found at ​​www.austinwomenshealth.com/donate/, the center assists with gynecological care, miscarriage management, family planning services, abortion care referral and follow-up services, as well as much more. Donations made to Planned Parenthood (www.plannedparenthood.org/) and Just The Pill (www.justthepill.com/donate/) also help the fight for reproductive freedom on a national scale. 

Even if monetary support isn’t possible for you, I urge you to push for extended abortion care access by getting political. Pressure your representatives to extend abortion care, and make an active effort to elect officials willing to do so. Change is never impossible, even in a state like Texas. Autonomy is a lifelong liberty, and it’s time it should be treated as such.