A look back at the year Republicans banned abortion in North Carolina

A look back at the year Republicans banned abortion in North Carolina

Reproductive-rights rally in North Carolina in 2022. (Photo by Jason Redmond / AFP)

By Michael McElroy

December 15, 2023

Republicans have said that if they win the governor’s race and expand their control in the legislature in 2024, a full ban is on the table. 

In one of the biggest stories of 2023, North Carolina joined the growing list of Southern states stripping women of their long established reproductive rights.

The Republican-controlled legislature passed its 12-week abortion ban because they had enough votes to override Gov. Roy Cooper’s veto. But they did not have the votes to pass the kind of full ban that many Republicans wanted. That could change if Republicans win the governor’s race in 2024 and expand their hold on the state legislature.

NC House speaker Tim Moore said as much this spring.

Here is a look back at the year in reproductive rights in North Carolina and a look ahead at what’s to come.

How did we get here? 

North Carolina’s 12-week abortion ban, which passed in May over the objections of nearly every medical association and a majority of North Carolinians, was a compromise, Republicans said at the time. 

Just look at what they could have done, they said.

A month before they passed the abortion bill on party lines, Republicans introduced separate legislation that would have enacted a complete ban, with only some exceptions for the life of the mother and none for rape or incest. 

Republican leadership pointed to their rejection of this most extreme version as evidence of a willingness to find common ground, even though the medical and voter consensus overwhelmingly shows that abortion restrictions are dangerous and oppressive.

The compromise was with themselves. 

The negotiations on the 12-week ban – Senate Bill 20 – took place only among Republicans and behind closed doors. But they had some help.

Republicans achieved their supermajority not through the election process but through Rep. Tricia Cotham. Cotham, who represents Mecklenburg County, won as a Democrat inNovember of 2022 with vows to protect abortion rights. She then switched to the Republican Party in April, giving them the decisive vote they needed to pass a ban.

On May 2, they released the 46-page bill at a nighttime press conference. And voted on it 48 hours later. 

The bill passed the House with limited debate and made its way to the Senate, where senators with objections were given only 10 minutes each to make their case. 

When Sen. Jay Chaudhuri, a Democrat, asked the bill sponsors questions about its details, they didn’t know the answers.  

“This is a 46-page bill,” Sen. Joyce Krawiec, said. “I read it yesterday just like you did, and I don’t remember all the parts of it.”

There was a lot to read.

Widespread opposition

The bill banned abortions after 12 weeks, allowing for exceptions for rape and incest up to 20 weeks, for “life-limiting” fetal anomalies up to 24 weeks, and to save the life of the mother throughout the pregnancy.

It also added several barriers to abortion care, including as many as three in-person office visits for medication abortions, and in-person counseling 72 hours before all abortions. These made it difficult for patients to successfully jump through all the extra hoops and still get an appointment before 12 weeks. 

Doctors said the in-person visits requirement would be especially onerous for women in rural communities and those with kids and jobs. 

“We only have nine counties in North Carolina that actually have access to abortion care currently,” Dr. Michaela McCuddy, a family medicine doctor in Chatham County, told Cardinal & Pine  ahead of the vote. “So our patients are traveling two to three hours just to get an appointment.”

“Imagine forcing that person to do that three separate times, without any evidence to justify the medical necessity for those appointments.”

The law also painted a dark and misleading picture of abortion as psychologically and physically unsafe, doctors told us. It requires doctors to inform a patient of potential abortion-related complications, but medical evidence shows that nearly all of the listed complications are far more common during pregnancy than abortion.

“Women are 14 times more likely to die from childbirth than from an abortion in the first trimester,” Dr. Erica Pettigrew, a family medicine doctor, told Cardinal & Pine this spring. 

For this and innumerable other reasons, nearly every major medical society in the world sees abortion bans as dangerous meddling in fundamental healthcare. More than 1,400 medical professionals in North Carolina wrote an open letter to lawmakers in February urging them to listen to doctors and leave the state’s previous laws, which then allowed abortion up to 20 weeks, in place.

Gov. Roy Cooper, a Democrat, vetoed the bill during a large rally on May 13, but the legislature—thanks to Cotham’s party switch—overrode the veto three days later. The bill became law and went into effect on July 1.

The next month, according to the Guttmacher Institute, abortions in North Carolina decreased by a third.

‘Dangerous restrictions on care’

Several medical groups filed lawsuits immediately after the law took effect, and in October, a federal judge temporarily blocked two provisions while leaving the ban itself in place. 

The judge, US District Judge Catherine Eagle, ruled that the medical groups were likely to succeed in arguing that at least these provisions were unconstitutional.

The lawsuit argues that several of the law’s specifics form a “tangled web of medically unnecessary, inconsistent, and dangerous restrictions on care.”

The first provision would prohibit doctors from prescribing medication abortion until they order and review an ultrasound. The second would require that anyone seeking an abortion after 12 weeks under exceptions for rape, incest, or to save the life of the mother, must have the procedure in a hospital, rather than an abortion clinic.

The medication abortion provision, Eagle wrote, was so vague as to leave doctors without a clear understanding of what was allowed or when. “The provision is open to differing interpretations,” she wrote, arguing the vagueness would subject doctors and other medical providers to “arbitrary accusations.”

Eagle, who was appointed by President Barack Obama, ruled that the medical groups had also “offered uncontradicted evidence” that the hospital provision lacked “any rational medical basis.”

An opening move, not the final say

The 12-week abortion ban, Republican leaders say, is only the beginning. 

Lt. Gov. Mark Robinson, who is likely to be the Republican nominee for governor next year, has called abortion “murder,” compared the procedure to slavery, and wrote in his  2022 memoir that supporters of abortion rights were “morally reprehensible.”

If elected governor, he says he would push for the legislature to follow through on a complete ban.

“Let’s say I was the governor and I had a willing legislature,” Robinson said in a recent radio interview. “We could pass a bill that says you can’t have an abortion in North Carolina for any reason.”

And if Republicans flip enough legislative seats in the 2024 election, they won’t need to worry about the members of their party who resisted a more severe ban.

A national rallying cry

Abortion was a huge factor in the 2023 elections as voters in Virginia, Ohio, and Kentucky protected abortion rights and beat back Republican efforts to gain full control over state governments. 

It could be North Carolina’s turn in 2024.

In addition to the governor’s race, Rep. Dan Bishop, another Republican who has called for a full ban, is running for state attorney general, an important post. And though neither of North Carolina’s US Senators are up for election next year, all 14 Congressional districts are.

Some national Republicans promised after Roe v. Wade was repealed that they would push for a national abortion ban, if they win control of both the House and Senate. They have since backed off of those threats after a slew of  election losses in 2022 and 2023, but the threat remains.

There are more registered Democrats in North Carolina than Republicans, and the current Congressional delegation’s split—7 Democrats and 7 Republicans—reflects the state’s political diversity. 

But the new congressional map drawn by Republicans in the state legislature is so severely gerrymandered that it makes it impossible for many Democratic incumbents to retain their seats. The maps mean that the 7-7 split will likely switch to a 10-4 Republican majority. 

Democrat Reps. Wiley Nickel, Kathy Manning and Jeff Jackson have already announced they will not seek re-election because of the new maps. The three Republicans who are now all but guaranteed to take their place could help ensure control over Congress and make a national abortion ban more likely. 


  • Michael McElroy

    Michael McElroy is Cardinal & Pine's political correspondent. He is an adjunct instructor at UNC-Chapel Hill's Hussman School of Journalism and Media, and a former editor at The New York Times.

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