By John Mascolo, Esq. | Legally reviewed by John Mascolo, Esq. | Last reviewed August 08, 2024
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Abortion is legal in North Carolina through the first 12 weeks of pregnancy without conditions. In cases where a pregnancy resulted from rape or incest, abortion is legal through 20 weeks of pregnancy. In cases where the physician detects a life-limiting anomaly, abortion is legal through 24 weeks. After that, abortion is legal only in cases of a medical emergency.
In June 2022, the U.S. Supreme Court overruled Roe v. Wade in Dobbs v. Jackson Women's Health Organization. In Dobbs, the Supreme Court's 6-3 majority ruled that Roe was wrongly decided and that the federal constitutional right to privacy does not include a right to decide whether to have an abortion. The decision in Dobbs upended decades of legal precedent in America and restored the authority of state law to regulate and even prohibit abortion.
At the time of the Dobbs ruling, North Carolina law banned abortion at the 20th week of a woman's pregnancy, except in medical emergencies. But, a federal judge blocked that law while Roe was still the law of the land. With Roe's demise, the judge dismissed the injunction, reinstating the 20-week abortion ban.
In light of the Dobbs ruling, the North Carolina General Assembly tried to pass a more restrictive abortion law in 2023. Although Republican lawmakers had a majority in both the State Senate and the State House, they did not have the votes needed to override Democratic Gov. Roy Cooper's expected veto.
In early 2023, in a dramatic turn of events, Democratic state representative Tricia Cotham announced that she was leaving the Democratic party and becoming a Republican. Cotham's vote became key as it provided state Republicans with a veto-proof supermajority in both the State House and State Senate.
By May 2023, state lawmakers passed Senate Bill 20, the current 12-week ban. Although Cooper vetoed the law, the new supermajority was able to override the veto and put the new law into effect on July 1, 2023. Now, the law limits abortion access in North Carolina to the first 12 weeks of pregnancy. Exceptions only apply in the following cases:
North Carolina law has prohibited and restricted abortion access throughout the years. Whereas Dobbs permitted the passage of the 12-week ban now in place, the state has also placed restrictions to discourage or delay patients from seeking abortion. Since Dobbs, it has further tightened those laws.
North Carolina requires a 72-hour waiting period for any pregnant person seeking abortion services. The law mandates that patients have two appointments. In the first one, they sit for an in-person counseling session with the physician who will perform or administer the abortion. In the second appointment, the abortion procedure will take place. For those traveling for abortion care, this may cause hardship due to a need for extra time off work or lodging between the two appointments.
The patient must sign off on several provisions in the consent law. They include a discussion of medical risks associated with abortion and carrying a pregnancy to term. The physician must give information about the fetus's gestational age, allow the patient a "real-time view" of the fetus, and provide "heart tone monitoring." The physician must also provide information to the patient on medical assistance benefits, public assistance benefits, a father's obligations for child support, alternatives to abortion, and how to access printed materials and information offered by the state.
North Carolina law also requires that a minor person seeking an abortion get consent from a parent or guardian. An exception allows a minor to request a judicial waiver. A judge can grant a waiver when they find any of the following:
North Carolina law bans partial-birth abortion. It also prohibits anyone from performing an abortion based on sex, race, or Down syndrome. The ban on such eugenic abortions is only triggered when an abortion provider has knowledge that a pregnant person is seeking an abortion in whole or in part due to the actual or presumed race or sex of the fetus or the presence or presumed presence of Down syndrome in the fetus.
North Carolina has also placed restrictions on the provision of medication abortion services. A legal challenge caused a federal judge to block some of these regulations as improper state attempts to preempt federal law on safety in prescription drugs.
The following chart lists the main provisions of North Carolina's abortion laws, while a more detailed description follows. See FindLaw's Reproductive Rights section to learn more about abortion, contraception, and family planning.
| Relevant North Carolina abortion laws | North Carolina General Statutes Chapter 14 — Criminal Law
Chapter 90 — Medicine and Allied Occupations
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| When is abortion legal? | Abortion is legal in North Carolina through the first 12 weeks of pregnancy without conditions. In cases where a pregnancy resulted from rape or incest, abortion is legal through 20 weeks of pregnancy. In cases where the physician detects a life-limiting anomaly, abortion is legal through 24 weeks. After that, abortion is legal only in cases of a medical emergency.
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| Consent requirements | Adult: Except in cases of medical emergency, the pregnant patient must provide written consent at least 72 hours in advance of any abortion procedure or service. The physician must meet in person with the patient and provide access to state-produced materials and an ultrasound, discuss the gestational age of the fetus, and go over medical risks and alternatives to abortion. Minor: Except in a medical emergency, a minor patient (under 18) and their parent or guardian must provide written consent as described above. The law allows an exception in cases where a minor gets a waiver of parental consent from a judge. |
| Penalty for unlawful abortion | North Carolina's criminal abortion offenses say that unlawful conduct taken to destroy a fetus is a Class H felony, punishable by a fine and imprisonment. If the unlawful conduct is to cause a miscarriage or otherwise harm a pregnant woman, then the offense is a lesser degree Class I felony, punishable by a fine and imprisonment. If an abortion provider fails to follow the parental consent statutes related to an abortion on a minor, the violation will be a Class 1 misdemeanor, punishable by a fine and a jail sentence. North Carolina uses a structured sentencing system. Thus, any actual criminal sentence will vary based on several factors, including specific offenses, criminal history, and aggravating and mitigating circumstances. The state's abortion law also indicates that violations of the law by health care providers can lead to professional disciplinary actions. |
| Other abortion regulations | A physician may perform a surgical abortion in the first 12 weeks of pregnancy in a state-licensed abortion clinic, ambulatory surgical facility, or hospital. Surgical abortions after the 12th week of pregnancy must be in a hospital. See Section 90-21.82a. No state funds may be used to pay for abortion except in cases where the life of the mother would be endangered by carrying the pregnancy to term or in cases of rape or incest. See Section 143C-6-5.5. |
| Residency requirements for patients | None. |
| Physician licensing requirements | Only a licensed physician can provide abortion services under North Carolina law. Yet, a federal judge in North Carolina has held that non-physician health care providers who meet the FDA certification requirements can dispense drugs related to medication abortion. |
Note: State laws are subject to change through the passage of new legislation, rulings in the higher courts (including federal decisions), ballot initiatives, and other means. While we strive to provide the most current information available, please consult an attorney or conduct your own legal research to verify the status of any state law(s) you are reviewing.
The 12-week abortion ban in North Carolina is more restrictive than the abortion laws of most states.
North Carolina's law reflects the importance of anti-abortion legislation to the Republican majority in the state legislature. Over a dozen states, including nearby South Carolina, Georgia, and Florida, have severely restricted abortion access since Dobbs.
In contrast, the majority of states now allow abortion up to the time of fetal viability, including Virginia, where abortion is legal through the second trimester. After that, states vary what circumstances would still permit a legal abortion.
In 2000, the Food and Drug Administration (FDA) approved the use of mifepristone, one of two drugs commonly used in medication abortions. In the years since, the use of medication abortion has increased. A recent study by the Guttmacher Institute concluded that in 2023, medication abortion accounted for 63% of all abortions in the U.S.
Abortion opponents filed a legal challenge in federal court to the use of mifepristone in 2022. They claimed that the FDA was wrong to approve the drug and rule changes that later made it more accessible to the public.
In June 2024, the U.S. Supreme Court dismissed the challenge based on issues of legal standing. They concluded that the plaintiffs were physicians who did not perform abortions or prescribe abortion pills. So they suffered no injury by the FDA's approval and later rulings on mifepristone. The Court's decision allowed legal access to abortion medication to continue.
In most states, abortion regulations appear in a mixture of health care laws and criminal laws. A visit to an abortion clinic or a pro-life crisis pregnancy center may result in differing information about reproductive health care. This can lead to confusion.
If you are unsure of laws related to abortion in North Carolina, consider speaking with a qualified attorney. There are many experienced health care law attorneys throughout North Carolina. A consultation may help answer your legal questions and give you peace of mind.
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