What Would a 12-Week Abortion Ban Mean in NC?

All abortion bans are dangerous, a Charlotte doctor told us, so Republican legislators would not get any points for passing a 12-week ban instead of a 6-week or outright ban like in other Southern states.

It’s been 10 months since the fall of Roe v Wade, and Republican-controlled legislatures across the country have spent that time imposing severe restrictions on abortion, with some states enacting full bans without exceptions for incest or the life of the mother and others banning abortion as early as six weeks. 

Now it could be North Carolina’s turn. 

While Gov. Roy Cooper’s veto threat had kept North Carolina from following these other state, the recent party switch State Rep. Tricia Cotham from Democrat to Republican, means the GOP-led legislature now has the votes to override his veto. 

In recent weeks, Republican leaders in the legislature have said they are close to agreement on a 12-week ban that does include several exceptions including rape, incest and the life of the mother. [UPDATE: Republicans filed their 12-week ban this week and it is expected to pass as soon as Thursday. Keep an eye on our Instagram and Twitter pages for breaking updates.]

The doctors who provide care for pregnant women and babies are nearly unanimous in their warnings about the dangers of both outright abortion bans and de facto bans like 6-week restrictions, a timeframe so short that many women don’t even realize they are pregnant. Such restrictions threaten the lives of pregnant women, create a chaotic health care system and leave doctors hesitant to render necessary care because of legal concerns. 

So what would the specific effects be of a 12-week ban in the state and region?

We asked Dr. Katherine Farris, the chief medical officer of Planned Parenthood South Atlantic and an abortion provider in Charlotte, to walk us through the potential consequences.

The conversation has been edited lightly for length and clarity:

Cardinal & Pine: Why are abortion restrictions dangerous in general?

Dr. Farris: We have to stop making the assumption that pregnancy is a benign condition. It is not. Pregnancy is inherently dangerous. A certain percentage of people will die in childbirth and people of color are four times more likely to die in childbirth. For people who are coming from a different or a lower socioeconomic status, who have less access to healthcare, the risks increase, and the more barriers you face to healthcare in general. You are 10 times more likely to die giving birth than you are during a first trimester abortion. 

No one should be forced to risk their life, and to add the complexity of an undesired pregnancy to that is just unforgivable.

Why do abortion bans make existing disparities in maternal health even worse?

Women of color are less likely to be able to access healthcare, so women of color are going to be less likely to access abortion care. And then we’re going to add some layers, right? Women of color who are also in poverty are much less likely to be able to access abortion. Because the simple reality is if you’ve got enough money, you can get an abortion. You can hop on a plane and go somewhere where it’s legal. So if you don’t have money, if you don’t have access to healthcare.

Many deeply conservative states have not included exceptions for incest, rape and the health of the mother in their abortion bans, but news reports show that North Carolina could have those exceptions. We’ve seen doctors say they are confused about who is judging the specifics of an exception and remain hesitant to grant an exception even in states that do account for them. So are exceptions effective in abortion restrictions?

No exception will make up for every individual patient’s circumstances. It is absurd. Where’s the exception for the patient who had a regular period and shows up thinking she’s 11 weeks, but she’s 25 weeks? I mean, I saw that patient last month. Where’s the exception for the patient who it’s taken two and a half months to get the time off from work, someone to watch her kids and the money together for the procedure, to navigate the morass and the confusion? 

And where’s the exception for the patient who goes to a crisis pregnancy center, which is unregulated, and gets lied to? She gets told, “Oh, you’re only two weeks. We’re going to schedule your abortion in three weeks.” And then when she’s about to go in for that abortion in three weeks, she gets called saying, “I’m sorry, the doctor can’t come in today. We’re going to reschedule you for a week from now.”

This is happening. This is happening to my patients. Then by the time they walk in the door, they’re over 12 weeks. Is the state going to make an exception for her because she was lied to by an organization that they funded with our taxpayer dollars?

That is horrific.

North Carolina already has restrictions, of course, like the 72-hour mandatory counseling and waiting period provisions. Have you seen your patients making that decision haphazardly without thought or consideration? 

No. No woman, no pregnant person needs to be told that they need to think about it. That assumes that people have not given any thought to their bodies and what’s going on from the minute they suspect that they might be pregnant, let alone from the minute they have that positive pregnancy test. The forced waiting periods provide absolutely zero benefit to patients. And they’re infantilizing pregnant people. That’s just insulting.

We’ve heard doctors virtually everywhere say that a six-week ban is effectively a full ban because so many women don’t even realize they’re pregnant at six weeks. What about a 12-week ban?  

With a 12-week ban, more people will be able to get into the clinic, this is true. But the question isn’t, “Oh, well we’re okay because more people can get in.” Everyone who can’t get that care is harmed and damaged by this. The fact that it’s a slightly higher number does not make it acceptable.

There are a million different factors that go in. We are seeing more and more people, North Carolinians, not being able to access abortion in our state until later in their pregnancies because there’s so much more demand with most of the South not allowing access to abortion at all, or barely. 

The people who are 11 weeks and six days along are not more deserving of this healthcare than people who are 12 weeks and one day. 

Several anti-abortion groups cite abortions later in pregnancy as the reasons we need abortion restrictions. How common were abortions later in pregnancy before the end of Roe? How common is it for a pregnant woman to just decide at seven months, “You know what? Nah.”?

That doesn’t happen. I was in an educational session with some legislators, and one of them said, “Well, if we don’t have a law that bans abortion, then is it just doctors refusing to do it? Wthat stops them from performing an abortion on a patient at 38 weeks?” 

And the answer to that is neither of those things. A pregnant person at 38 weeks doesn’t walk out of Starbucks with their coffee and say, ‘You know, never mind.’ 

Abortions that are later in pregnancy are really almost always associated with some kind of tragedy. Fetal diagnosis in maternal health are the most common causes of abortions later in pregnancy.

But I will say we are definitely seeing more of them now because the next most common cause of abortions later in pregnancy is legislators. If you make it harder for people to get an abortion, you will make them get an abortion later in their pregnancy. 

Any closing thoughts?

The reality is legislators shouldn’t be forcing people to continue that pregnancy. No one should be forcing a pregnant person who is carrying a fetus with a particular diagnosis to make any decision. The pregnant person should be given all of the options, all of the information, and then they should decide with information that is medically accurate, guided by a healthcare provider, talking to whoever they trust in their lives. 

No one wants the input of their legislators on this.