The Landscape of Abortion Access in North Carolina if Roe vs. Wade is Overturned

The following blog post was written by our summer 2022 Masters of Public Health (MPH) intern Abigail O'Keefe

Every individual deserves the right to be able to make unrestricted decisions about their reproductive health, and access to abortion is an essential component of this right. However, with the possibility of Roe vs. Wade being overturned and states continuing to pass legislation that extremely restricts or outlaws the right to abortion1, it has raised questions about what does abortion access look like currently in North Carolina and what will happen to abortion access in North Carolina if the Supreme Court overturns Roe vs. Wade.

Currently in North Carolina, it is legal to have an abortion. There is no legislation enacted in North Carolina that will immediately ban all access to abortion if the Supreme Court overturns the protections in Roe vs. Wade later this month 2, meaning that abortion will still be legal immediately following the Supreme Court’s decision in Dobbs v Jackson Women’s Health Organization even if Roe is explictily overturned. However, while access to abortion is legal and will likely continue to be legal for the immediate future2, North Carolina is still considered a “hostile” state for abortion access due to the many restrictions that are currently in place for obtaining an abortion 2,3. Below is a summary of the major restrictions on abortion access in North Carolina that are important to be aware of as they impact your right to access abortion care in the state.

The Current Restrictions Impacting Abortion Access in North Carolina

  • If under the age of 18, you cannot have an abortion without receiving written consent from a parent or legal guardian 3-4.
    • Exemptions to this restriction are if the patient receives a judicial waiver 3-5 or if there is a medical emergency 6
    • Text Abby is a resource with information on how to access abortion services as a minor and resources for minors on obtaining a judicial waiver.
  • You can only obtain an abortion from a physician who has a license to provide care in North Carolina 3,7 and abortions can only be performed within a clinic that has received a license to provide abortion procedures or in a hospital 7.
    • This ban is a tactic to further restrict access to abortion services. There is no medical reason as to why other advanced care practitioners, like physician assistants, can’t perform abortions if it is in their scope of practice 8. This restriction is about reducing the number of health care providers who are legally able to provide abortion care in North Carolina, ultimately impacting a person’s ability to receive care 8.
  • You are prohibited from using telemedicine to obtain a medication abortion from a healthcare provider 3,9.
    • Obtaining a medication abortion using telemedicine is safe and telemedicine is an important resource for expanding access to abortion in North Carolina 10. This restriction is not based on medical science and only further limits access to abortion services in North Carolina10.
  • Before you can have an abortion, you are required to receive “biased counseling” either in person or over the phone from a healthcare provider 3,9.
    • The counseling consists of a medically-inaccurate and unnecessary script that the state mandated be read to every patient who is seeking an abortion 9. This is another politically-motivated restriction designed to shame and deter patients from receiving an abortion.
  • You are restricted from receiving an abortion until a minimum of 72 hours has passed since you have received the mandated counseling from a healthcare provider 3,9.
    • There should be no mandated wait period before having an abortion, as it is not medically necessary11, and it is the only procedure in North Carolina that requires a patient to unnecessarily and arbitrarily wait before they are able to receive care11. This is another restriction that stigmatizes abortion care and stereotypes people receiving care, with the main goal of reducing access to abortion for people in North Carolina.
  • The funding and coverage of abortions through different health plans in North Carolina are restricted in the following ways:
    • Abortion services are not covered if you are a state employee (including public school educators) who is insured through the state health insurance plan 12.
    • Abortion services are not covered if you are insured through state or federal Medicaid 13.
    • Abortion services are not covered if you work in the local and county governments 12. This restriction was put in place by the state legislature. 
    • Abortion care is not covered if you are covered by a health plan that was purchased through the “state’s health insurance exchange” 14. This restriction was also put in place by the state legislature. 
      • Restricting abortion from being covered under certain health plans further limits abortion access by not covering the cost associated with having an abortion15
      • While many of these prohibitions on insurance coverage contain exceptions 12-14, in practice those exceptions are often very difficult for providers and patients to obtain. 

While it is still legal to have an abortion in North Carolina despite the many restrictions, the fight to protect and expand access to abortion is critical. Currently, the governor of North Carolina is able veto any bans on abortion that anti-choice lawmakers in the House and Senate may try to pass, but this could all shift with the midterm elections coming up in November15,16. It is extremely important that we all use the power that we possess to make our voices heard and collectively take action to protect the reproductive rights of every individual who seeks out reproductive healthcare in North Carolina. Steps that we can all take in fighting to protect reproductive freedom in North Carolina today, tomorrow, and for the foreseeable future are:

  • Registering to vote in North Carolina, talking to candidates about the importance of abortion access,  and voting the whole ballot in upcoming elections.
  • Donating money to an abortion fund that will help people access abortions in North Carolina.
  • Talking with the people in your life about the threats to reproductive rights, advocating for policies that will protect reproductive rights, and challenging the beliefs and stigma people may have about abortion. 
  • Volunteering at North Carolina abortion clinics and organizations that fight to protect reproductive rights in North Carolina.
  • Advocating to your North Carolina lawmakers about the need to protect abortion access by calling them, talking directly with them, and sending emails and letters to them. 
  • Signing up to receive information, news, and resources about the fight for reproductive freedom in North Carolina from Pro-Choice North Carolina

References

1. Nash E. State Policy Trends 2021: The Worst Year for Abortion Rights in Almost Half a Century. Guttmacher Institute. Published December 16, 2021. Accessed May 27, 2022. https://www.guttmacher.org/article/2021/12/state-policy-trends-2021-worst-year-abortion-rights-almost-half-century

2. Nash E, Cross L. 26 States Are Certain or Likely to Ban Abortion Without Roe: Here’s Which Ones and Why. Guttmacher Institute. Published October 28, 2021. Accessed May 27, 2022. https://www.guttmacher.org/article/2021/10/26-states-are-certain-or-likely-ban-abortion-without-roe-heres-which-ones-and-why

3. North Carolina. Center for Reproductive Rights. Accessed May 27, 2022. https://reproductiverights.org/maps/state/north-carolina/

4. N.C. Gen. Stat. Ann. § 90-21.7 (Enacted 1995).

5. N.C. Gen. Stat. Ann. § 90-21.8 (Enacted 1995; Last Amended 2000).

6. N.C. Gen. Stat. Ann. § 90-21.9 (Enacted 1995).

7. N.C. Gen. Stat. Ann. § 14-45.1 (Enacted 1967; Last Amended 2015).

8. Health Worker Roles in Providing Safe Abortion Care and Post-Abortion Contraception. Geneva: World Health Organization; 2015.

9. N.C. Gen. Stat. Ann. § 90-21.82 (Enacted 2011; Amended 2015).

10. ACOG Statement Regarding Telemedicine Abortion. The American College of Obstetricians and Gynecologists. Published June 19, 2015. Accessed June 3, 2022. https://www.acog.org/en/news/news-releases/2015/06/acog-statement-regarding-telemedicine-abortion

11. Waiting Periods For Abortion. Guttmacher Institute. Published October 12, 2016. Accessed June 3, 2022. https://www.guttmacher.org/evidence-you-can-use/waiting-periods-abortion

12. N.C. Gen. Stat. Ann. § 143C-6-5.5 (Enacted 2011).

13. Fact Sheet: About the Hyde Amendment. All* Above All. Accessed June 3, 2022. https://allaboveall.org/resource/hyde-amendment-fact-sheet/

14. N.C. Gen. Stat. Ann. § 58-51-63 (Enacted 2013).

15. Regulating Insurance Coverage of Abortion. Guttmacher Institute. Published June 1, 2022. Accessed June 3, 2022. https://www.guttmacher.org/state-policy/explore/regulating-insurance-coverage-abortion

16. Friedman H. What a possible post-Roe future means for abortion access in North Carolina. The Chronicle. Published May 18, 2022. Accessed May 30, 2022. https://www.dukechronicle.com/article/2022/05/what-a-possible-post-roe-future-means-for-abortion-access-in-north-carolina

17. Donnelly C. Here’s how abortion laws in North and South Carolina could change if Roe is overturned. WFAE 90.7 - Charlotte’s NPR News Source. Published May 3, 2022. Accessed May 27, 2022. https://www.wfae.org/health/2022-05-03/overturning-roe-could-make-abortions-harder-to-access-in-the-carolinas

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