The North Carolina General Assembly recently voted to override Governor Cooper’s veto of Senate Bill 20, a bill that bans abortion after 12 weeks of pregnancy with narrow exceptions and implements harsh new restrictions on abortion even before 12 weeks. The bill will go into effect on July 1, 2023. Our team is working closely with community partners to fully understand the 43-page bill. Here are a few of the primary changes that will be made under the new law. 

Update, August 2023: This article explains the provisions of SB 20 as it was originally passed. Since then, the General Assembly passed House Bill 190, which amended some parts of the original bill. The ACLU of North Carolina and Planned Parenthood South Atlantic also filed a lawsuit and were awarded a Temporary Restraining Order on another of the bill's provisions. You can read about these updates here

Abortions after 12 weeks will only be allowed in cases of rape, incest, after the diagnosis of a “life-limiting” fetal anomaly, or when there is a “medical emergency.”  

Patients who meet one of these narrow exceptions must access care in a hospital, making it less accessible to people in rural areas. 20 counties in North Carolina do not have a hospital. This requirement also makes the procedure more expensive. There are also gestational limits for three of the exceptions — abortions in the case of rape or incest can only be performed up to 20 weeks, and in the case of fetal anomaly up to 24 weeks. 

In cases of rape or incest, patients must share their stories of assault and abuse with their doctors, whether or not they feel prepared to talk about it. If the patient is a minor, the doctor is required to report the incident to police, even if the patient does not want to pursue legal action.  

Medication abortion will only be allowed up to 70 days (or 10 weeks).  

Medical evidence demonstrates that medical providers may safely and effectively provide medication abortion for up to 77 days (11 weeks) in a pregnancy. Currently, doctors in the state routinely provide medication abortions up to 11 weeks of pregnancy. 

Patients will be required to make three in-person appointments to obtain an abortion. 

Patients accessing abortion at any stage of pregnancy must go to an in-person appointment, where they will be forced to listen to state-mandated, non-scientific, anti-abortion counseling and receive a medically unnecessary ultrasound. The patient must then wait 72 hours before coming in for the abortion. For medication abortions, the doctor must also schedule a follow-up appointment with the patient 7-14 days later. This appointment is medically unnecessary. Patients could simply take a pregnancy test at home to confirm the pregnancy has ended and call their doctor in the event of any complications. These requirements will be particularly onerous for patients who live in rural areas, who don’t have easy access to transportation, who don’t have childcare or paid time off work, and for those coming from out of state. 

The bill may force clinics to shut down. 

SB 20 allows the NC Medical Care Commission to adopt new rules to govern abortion clinics. which are already highly regulated. While we do not yet know what these new rules will be, several Senators have suggested that they will be in line with “ambulatory surgical facilities.” If that is the case, many of them would be unable to meet these new licensure requirements and would be forced to close. It is not medically necessary or recommended for clinics to meet the requirements of an ambulatory surgical center according to medical experts, so no abortion clinics in the state currently do.  

What now? 

We understand that these confusing, draconian new policies will present immeasurable obstacles for people in North Carolina and beyond trying to access abortion. Please know: you are not alone. Many organizations across the country are working hard to support and protect abortion access despite the new restrictions. If you need help understanding the options currently available, reach out to your closest abortion clinic (you can find them on We will also continue to update our abortion guide