Cross-posted with permission from the ANSIRH blog.

While access to abortion is increasingly restricted in many states, options for women needing an abortion after 20 weeks have narrowed dramatically.

In April 2010, Nebraska became the first state in the country to pass a restriction on abortion after 20 weeks, based on an unscientific claim that fetuses feel pain after 20 weeks gestation. The Nebraska law banned abortions after 20 weeks for any reason except if the pregnant woman’s life is in danger.

Prior to the passage of this law in Nebraska, there were 21 states (plus the District of Columbia) where abortion was available after 20 weeks. Although in most of these states these services were dependent on one site and one physician, nonetheless the services existed. Since April 2010, legislation limiting abortions to 20 weeks has been signed into law in Alabama, Georgia, Idaho, Indiana, Louisiana, Kansas, Oklahoma, and North Carolina. Bills making access to later abortion more difficult were passed in Missouri and Ohio.

Arizona’s lawmakers have gone even further. Although the Roe v. Wade Supreme Court decision legalized abortion through the second trimester, generally understood as 24-26 weeks, Arizona has redefined biology and the right to abortion and banned abortion after 18 weeks LMP (from the last menstrual period). The trimester construction of Roe is becoming irrelevant in many states.

And perhaps it is time to move beyond the trimester construction established in Roe—but not for the reasons put forth by those opposed to abortion under all circumstances. We must expand our advocacy to include women who seek abortions later in pregnancy.

Studies show that many women who present at clinics after 20 weeks wanted an earlier abortion, but faced financial hurdles and legal barriers—barriers which have increased as states pass new waiting periods, facility regulations, and other laws that restrict access to care. Other women face a diagnosis of fetal anomaly later in pregnancy. For still other women, circumstances shift and a wanted pregnancy becomes untenable when a woman’s partner leaves, her young child develops a serious illness and needs her full attention, or someone in the family loses his/her job and/or health insurance.

These life situations do not fall neatly into a trimester construction. All of these women need to be able to make decisions about their futures, their lives, and their health.

The restrictions on later abortion are part of a broad attack on women’s fundamental right to abortion. We must come together to find new strategies to protect existing services, help women who need later abortion care to get to those states where the services are still provided, build understanding and compassion for every woman’s unique life situation, and stand up for the right of every woman to access the abortion she needs; as early as possible, and as late as necessary.