North Carolina's 12-week abortion ban bill: What's at stake

The Tar Heel State saw the largest spike in abortions in the U.S. after Roe v. Wade was overturned, highlighting its status as a significant abortion access point in the region.

North Carolina Governor Roy Cooper stands at a podium as he speaks to a crowd of abortion rights supporters. A sign in front of him reads: Stop the bans.
Democratic Gov. Roy Cooper ignites a crowd of about 1,000 abortion rights supporters gathered in Raleigh, N.C., on Saturday before he vetoes legislation banning nearly all abortions after 12 weeks. (Hannah Schoenbaum/AP)

Pressure is mounting this week as abortion access in North Carolina could come down to one vote in the state legislature.

On Saturday, Democratic Gov. Roy Cooper vetoed legislation that would have banned most abortions after 12 weeks of pregnancy, down from the current 20-week restriction. But members of the state’s GOP-controlled General Assembly could override the veto as early as this week, having recently gained a majority in both chambers.

“If just one Republican in either the House or the Senate keeps a campaign promise to protect women’s reproductive health, we can stop this ban,” Cooper told a crowd of voters and abortion rights activists on Saturday in Raleigh.

After the Supreme Court’s Dobbs decision overturned Roe v. Wade in June 2022, North Carolina saw the largest spike in abortions in the U.S., according to a WeCount report by the Society of Family Planning.

Cooper has said the 12-week abortion ban bill would “effectively ban many abortions altogether” because of the restrictions and requirements within it.

Yahoo News spoke with Kelly Baden, vice president for public policy at the Guttmacher Institute, a research organization that supports abortion rights, to unpack what’s in the bill and what’s at stake for abortion access in the surrounding region if it goes into effect on July 1. Responses have been edited for length and clarity.

What’s included in North Carolina’s 12-week abortion ban?

“It’s much more than meets the eye,” Baden said.

“It would require patients to delay their abortion care by mandating in-person consultations 72 hours in advance of the abortion procedure. Consultations are currently able to be done by phone in North Carolina. If you have to take time off from work, if you have to arrange child care, if you have transportation issues or you live farther away from a clinic — all of those things mean that this additional restriction adds barriers to the abortion. You’re really putting patients in a bind because then they’re chasing after the appointment, which might push their pregnancies later into term.

“The bill would also require clinics to get an ambulatory surgical center license,” she continued. “We know abortion is very safe; we do not need to require abortion providers to go through lengthy and expensive processes to become ambulatory surgical centers. The impact of doing that means there will be fewer providers overall in North Carolina. That means reduced access for potentially anybody seeking abortion care in North Carolina, and because we’re talking about regional implications, this potentially impacts patients from all around the Southeast.”

Are there any exceptions included in the 12-week abortion ban?

“S.B. 20 allows abortion in cases of rape and incest through 20 weeks of pregnancy, and for ‘life-limiting’ fetal anomalies at 24 weeks,” Baden said.

However, “even when exceptions are written into abortion bans in a state, they are not meaningfully happening in real life,” she noted.

“We’ve heard about patients being told to wait until they’re bleeding more heavily than they currently are, or wait until they are in much more of an emergency health situation than they currently are in order to get care. Hospitals are not interested in testing the legal boundaries to see what is permissible under a hostile state abortion ban, and it’s pregnant women that will pay the price.”

Referring to the WeCount study, why do you think North Carolina saw an uptick in abortions after Roe v. Wade was overturned?

“Even before the Dobbs decision, traveling to other states to get abortion care was relatively common. Abortion access was already dependent on your state and your income, and this Dobbs decision has just made a difficult situation worse,” Baden said.

“If you look at the states surrounding and a little beyond North Carolina’s neighbors, they have all banned abortion with very limited exceptions: Tennessee, Kentucky, Alabama, Mississippi, West Virginia — there are patients there who now don’t have access to an abortion clinic in their state and are forced to travel. I think North Carolina is one place that has been able to receive those patients and treat them and meet their needs. It really has been an important access point in a region where most states have banned or severely limited abortion altogether.

“When you’re a state like North Carolina now in a post-Roe world, you have to know that your policy decisions have a cascading effect beyond the borders of your own state.”

If the 12-week abortion ban does take effect in North Carolina, what are some of the geographic implications for abortion access?

“People living in a state like Louisiana, for example, have to cross several state lines even to get to an abortion clinic,” Baden said. “If you are low-income, if you have children, if you don’t have paid leave from work, if you don’t have reliable transportation and you live in a rural area — those are all huge barriers to getting that care that you might need.

“We can just expect to see an exacerbation of the pain points that we’re already experiencing,” she added. “I think in the region, looking to Florida and what might happen there with the six-week abortion ban, and looking to South Carolina where legal abortion is hanging by a thread, all of that is going to continue to play a role in the state abortion access in the South and beyond.”