Abortion Is Still Legal in North Carolina for Now—But There Are Restrictions

A guide to what the end of Roe means for our state.

Abortion is still safe and legal in North Carolina.

That was the message NC Democrats and abortion rights advocates repeated over and over after the US Supreme Court invalidated Roe v. Wade last week. 

The ruling wiped away federal protections that stood for 50 years and threatens the liberty and lives of millions of people across the country. Even as advocates expressed outrage and vowed to continue the fight, they made a point to say that as of now in North Carolina, nothing will change.

The court’s decision “sends a chilling message that our most fundamental rights are on the line,” Pro-Choice North Carolina, said in a news release on Friday, soon after the ruling was announced. But, the group said, “We want to be clear that abortion is still legal in North Carolina and this decision does not have an immediate legal impact on the availability of abortion in our state.”

If you need an abortion, you can still get one here.

There are, however, restrictions and state-imposed requirements for women seeking an abortion in North Carolina, and, health officials say, many people are unaware of them.

Plus, the political landscape that keeps abortion accessible could change drastically in the November election.

“Black women are 3-4 times more likely to die in childbirth than their white counterparts in the US,” US Rep. Alma Adams, who represents much of Mecklenburg County, said on Twitter last week. “People are going to die because of today’s reckless #SCOTUS decision.” 

Here is what you need to know about the abortion laws in North Carolina, what the Roe decision means for the state, and what it does not.

The Obstacles

The three biggest hurdles to obtaining abortion care  in the state are a ban after 24 weeks of pregnancy, a mandated counseling session for the patient, and a medically unnecessary three-day waiting period. Additionally, medication abortion—which accounts for more than half of all abortions in the US and is a two-dose regimen of pills, mifepristone and misoprostol—must be provided in person, as North Carolina prohibits the use of telehealth or mailing pills.

Abortions are banned in North Carolina after fetus viability, the point at which it can survive on its own outside the womb. Though every pregnancy is different, the current law sets that benchmark at 24 weeks. (There are exceptions in cases after 24 weeks for women whose health is in jeopardy)

A law passed in the General Assembly banning abortion after 20 weeks was ruled unconstitutional by a federal judge in 2019, but it is unclear what effect the Roe ruling will have on that decision. North Carolina Republicans have called for the 20-week ban to be reinstated.

For now, anyway, the 24-week line stands. 

Before anyone can get an appointment with an abortion provider, however, they must endure a counseling session with a doctor or nurse “that includes information designed to discourage the patient from having an abortion,” the Guttmacher Institute, a research and reproductive rights group, says. 

Then, in the final hoop, patients must wait 72 hours before they can obtain care. 

These delays are an emotional burden to any patient seeking an abortion, but they are especially dangerous for women whose health is at risk, health officials say.

The restrictions have caused some North Carolinians to seek care in other states, Dr. Jonas Swartz, an obstetrician with Duke Medical Center, said at a news conference on Monday afternoon.

“Putting that burden on people is horrible,” he said. 

The Next Two Elections Are Huge

Republican leaders of the NC General Assembly have said they would not try to pass an abortion ban in NC now because they don’t have enough votes to override the inevitable veto from Gov. Roy Cooper, a Democrat and strong supporter of a person’s right to make their own choices about their body.

But there are enough competitive state legislature seats at play in the 2022 election to give the GOP a veto-proof majority, and Republicans have said they would absolutely revisit the issue in January. If Republicans gain a supermajority in November, Gov. Cooper will no longer be able to prevent state lawmakers from following in the footsteps of much of the rest of the South. Virginia and Maryland are the only other Southern states without severe restrictions or outright bans.

Then there is the 2024 election, where Cooper cannot run again because of term limits. The leading contender to be the Republican nominee for governor, Lt. Gov. Mark Robinson, has called for an outright abortion ban with no exceptions for the health of the mother.

So the clock is ticking in North Carolina. 

Where to Get Help 

One of the biggest obstacles in North Carolina is financial.

Medication abortion can cost around $350 or more, doctors say. A surgical abortion can range significantly, depending on the type of procedure, from $300 to $1,400.

This does not include the costs associated with taking time off from work, recovery, day care, or transportation, which make an already onerous process even worse for women in rural areas. Most counties in North Carolina do not have abortion providers, so most people have to drive long distances to obtain care. 

“While fake women’s health centers operate all over the state,” Pro-Choice North Carolina says,  “abortion providers are only located in a few key cities.” (For a list of clinics and locations, click here.)

There are, however, several organizations that try to help patients make their appointments and can cover some of the costs. 

The Carolina Abortion Fund offers financial assistance to people needing abortions in North Carolina and South Carolina. They can help pay for lodging, child care, some transportation costs, and the procedure itself. You can call them at 855-518-4603 or find more information here.

Pro Choice North Carolina also offers a comprehensive guide for finding a clinic or legal help, and other resources, and Planned Parenthood South Atlantic has extensive resources and information, including a guide to volunteer as escorts at abortion clinics.