Providers are seeing more patients who need abortions later in pregnancy as bans and restrictions spread across US states, while insurance access declines.
These bans and restrictions have also increased later‑term abortion care in a few sanctuary states and cities over the past decade.
Patients are arriving “later and sicker” for reproductive health services, said Diane Horvath, cofounder of Partners in Abortion Care in Maryland, the only all‑trimester clinic in the United States owned and run by women.
Forty‑one states have abortion bans or major restrictions at some point in pregnancy. More than 20 million people have lost Medicaid since 2023, and 3‑5 million have dropped coverage through ACA exchanges in recent months.
“People are being dropped from Medicaid. Premiums are rising,” Horvath said. “Instead of seeking care early, they simply do not go in. There is nowhere to go.”
Later abortions, defined as those after the first trimester—when most abortions occur—become more expensive the farther along the pregnancy.
“Sometimes you need a $22,000 gap with only three days to raise the money,” said Alisha Dingus, executive director of the DC Abortion Fund, one of the nation’s largest abortion funds. “Rising costs and dwindling availability may create major barriers to later abortion care,” a recent Jama study reported.
Costs rise as pregnancy advances; provider numbers fall, and restrictions increase, noted Erika Christensen, cofounder of Patient Forward, which advocates for all‑trimester access.
The later‑term abortion population is overwhelmingly young people living below the poverty line in health‑care deserts, Christensen added. “They face a perfect storm: little time to gather money for the most costly care, with expenses that can exceed a year’s earnings.”
Access challenges grow with each week. Only clinics in four states and Washington, DC, provide all‑trimester services to every patient.
Despite the growing complexity, more providers are filling the gaps.
In Maryland, where the state constitution protects reproductive freedom and there is no viability limit, two all‑trimester clinics—Care Reproductive Health Clinic and Partners in Abortion Care—serve patients nationwide and abroad, and the DuPont Clinic operates in nearby Washington, DC.
Abortions in later pregnancy are sought for the same reasons as earlier ones, Horvath said.
Read next
Nepal Headteacher Rescues 900 Children from Deadly Flash Flood
A headteacher in Nepal ordered the evacuation of 900 pupils from his school just before a massive wave of water hit their town during the catastrophic flash floods that have claimed nearly 800 lives and left thousands unaccounted for.
Rajendra Dawadi, headteacher of Tribhuvan Trishuli secondary school in Nuwakot, which
"The river has taken everything": people return to the remains of their homes in Nepal
Since the catastrophic floods swept through the Himalayan valleys of Nepal and Tibet, the death count has kept climbing. Hundreds of bodies have emerged from the thick, tar‑like mud that remained after the waters receded, and the toll stood at 797 in Nepal and Tibet by Sunday.
Morgues across
Ten years later: a solitary Black woman stands defiant against Swedish neo‑Nazis
An iconic photograph captured a solitary Black woman, her fist raised, blocking a column of hundreds of uniformed neo‑Nazis marching in 2016, and the image splashed across headlines worldwide.
At the time the picture was celebrated as a emblem of resistance to the far right. A decade later, as