If you’re considering an abortion you might be wondering how to go about it, especially now that access to abortions in the US depends on which state you live in, even more than it did previously.
Around 1 in 4 women in the US are estimated to have an abortion – sometimes known as terminating a pregnancy – before the age of 40, so it’s a common experience. Figures from a 2020 report show that there were 930,160 legal abortions in the US. Reasons for wanting an abortion are individual and varied.
“The decision to have an abortion is entirely yours and it’s still legal in many US states, provided certain criteria are met,” says Dr Ann Nainan, doctor and Healthily expert. “It can be natural to have intense feelings or feel confused about what to do and where to get help.
“An abortion should always be done under the supervision of a licensed healthcare professional either in person in a clinic or via telemedicine – where you have a consultation remotely, such as by telephone – to ensure your safety. At Healthily we give you the medical facts about what options are available to you, depending on your stage of pregnancy, and where you can access abortion legally, safely and confidentially.”
Read more about the different types of abortion in
What are the abortion laws in the US?
Abortion is still legal in many states and currently it’s also legal to travel to another state to get an abortion, but the situation is still developing. Just to be clear – there is no nationwide ban. The federal government says that reproductive healthcare, including access to birth control and safe and legal abortion care, is an essential part of your health and wellbeing.
The American College of Obstetricians and Gynaecologists agrees, saying all people should be able to access the comprehensive and evidence-based healthcare they need, including abortion. Here are the key points:
- whether abortion is legal or not is now decided state by state. In 2022 the Supreme Court overturned the ruling of a landmark legal case called Roe v Wade, which made abortion a constitutional right in the US. Since the overturning, each state can make its own rules, so there is a varied picture across the country
- abortion is not available in at least 10 US states and others have imposed new restrictions, with more states set to follow
- how far you are into your pregnancy can also change what is legally available to you, state by state
- access to medical abortion (the abortion pill) has also been restricted, but the federal government’s website says that federal regulation generally permits medication abortion to be dispensed by telehealth, and sent by mail from certified prescribers, pharmacies, clinics, medical offices and hospitals. But you should always check local state laws because certain restrictions can apply
- travelling between states for an abortion is currently protected by law. It’s currently legal to travel to another state for an abortion, if it’s not legal in your state, but you should always check local state laws for any recent legal changes
- always check the most up-to-date legal situation in your state, the federal government’s Department of Health & Human Services website suggests visiting
How to get a legal abortion in the US
If you’re confused or worried about how to access an abortion (if it’s now illegal or restricted in your state) there are organisations that can give you information about the options available, which are legal and safe.
These include advocacy groups such as
, which can answer your questions, help you work out how far along your pregnancy is and direct you to get the help you need.
How to get the abortion pill legally
Medical abortion is where you take pills prescribed by a doctor to end a pregnancy. Medical abortion can take place in a medical consulting room, in a hospital or at home. Here are the key points on accessing the abortion pill legally:
- you should always arrange a medical abortion through a medical professional, either in person at a clinic or via telemedicine. They can check whether it’s the best method, explain what to expect and if the doctor is aware of any potential safety concerns. It’s not safe to pay for abortion pills online without a medical assessment and advice. They should be prescribed by a healthcare professional who can ensure you get the care you need
- call the on 1-800-722-9100, which operates the largest toll-free multi-lingual hotline for abortion referals and financial assistance in the US. You could also try contacting the not-for-profit organisation, , for advice on how to access the abortion pill
- clinics can also prescribe the abortion pill. But only a few Planned Parenthood centers can offer telehealth consultations for the abortion pill, where the pills are posted to you, or you arrange to pick them up from a local Planned Parenthood pharmacy. The charity has developed this for searching for the availability of the abortion pill in different locations
Read more about
Can you have an abortion at home?
During the COVID-19 pandemic medical abortions at home were permitted in the US by the FDA and have been allowed to continue – but again, it depends on where you live. In 19 states, the medical professional providing abortion medication must be physically present when you take the pills, which means you cannot take abortion medication at home.
The World Health Organisation has recently produced guidelines covering self-managed abortion at home.
Here’s what to consider:
- work out how advanced your pregnancy is. You can check your dates at . Your dates will be checked during your telemedicine consultation so it’s good to be prepared with this information
- check that you don’t have a medical condition that could make medical abortion at home more complicated, such as severe anaemia or a blood clotting disorder. You should also see a medical professional in person if you have an intrauterine device (IUD) fitted
- understand the medical abortion process so you know how much pain (cramping) and bleeding to expect, and how long it will last
- knowing where you can access medical care in the rare instance of developing complications
- support from family and friends during the abortion and after
When would you need a surgical abortion in the US?
Surgical abortions are usually recommended by doctors after 10 weeks of pregnancy. The pill used for medical abortions is not licensed after this time, but can still be offered in certain situations under close medical supervision. Your doctor will discuss the best method for you.
In the majority of states where abortion is still allowed, surgical abortion can take place up to between 20 and 24 weeks, but again this can vary, so check the legal picture in your
43 states have limits on abortion, according to how many weeks pregnant you are. There are some exceptions to these limits in some states, such as when the life of the mother is in danger.
In states where abortion is legal you can access surgical abortion through your doctor or a hospital or clinic. But if abortion is illegal in your state, you will have to travel to another state for a surgical abortion. For advice on how to find an abortion provider, the federal government’s Department of Health & Human Services website suggests using
, which has the details of registered and legal clinics.
How long does it take to get an abortion?
As it’s so complex and subject to rapid change, it’s best to check what the law says in your state before considering your next move. At the time of writing, these are the key things to know:
- how long it takes to get an abortion varies according to where you live. It depends on whether abortion is legal in your state, whether you have to travel to another state, or order abortion pills from a medical service outside of your state (this can sometimes take several weeks for pills to arrive by mail)
- the Guttmacher Institute, a policy and research organisation, says that waits for abortions vary between 24 to 72 hours. In some states you need to have counselling in person at a clinic and then wait for a specified time period afterwards. Some states insist women wait at least 24 hours between counselling and having an abortion
- several states also make it a legal requirement to have an ultrasound at a specified time and place before an abortion, which can cause delays
How much is it to get an abortion in the US?
This depends on the type of abortion and how far along in your pregnancy you are.
Abortions can cost up to $750, but often cost less. According to 2021 figures, the average cost for a medical abortion was $568 and $625 for a surgical abortion in the first 12 weeks of pregnancy, rising to $775 for a second trimester abortion.
Abortion funding in the US
Some government health insurance schemes, including Medicaid in some states, cover abortion but others don’t.
Even when some states cover abortion they only provide cover for cases of rape, incest or where the mother’s life is in danger.
One research study carried out before Roe v Wade was overturned found that 69% of people who had an abortion, including those with private medical insurance, ended up paying for abortions out of their own pockets, as it wasn’t covered in their plan.
If you can’t afford to pay, or your insurance plan doesn’t cover it, you may be able to get help from an abortion fund such as the
If you are under 18 do you have to tell your parents about your abortion?
In 36 states, there are laws which mean you have to tell your parent or guardian that you are getting an abortion, if you’re under 18.
There are circumstances where this can be avoided, but you would need to apply for a judicial bypass. This is where you get an order from a judge to get an abortion, without having to tell your parents. You can contact
for more information on how to apply for this.
How to deal with your emotions around abortion
You may experience a wide range of emotions at any point during the abortion process – fear, guilt, relief. Each person is unique and processes their feelings in their own way. There are lots of places to get support, such as through a doctor, counsellor or a support group. If you need help and support, read
If you're struggling with your mood or you’re feeling anxious, it’s important to speak to a doctor.
Find more useful information on abortion care with our .
When to see a doctor
See your doctor if you want to chat through any questions or concerns, such as checking how many weeks pregnant you are if you’re not sure, finding out what your options are, or if you’re experiencing anxiety or low mood.
Abortion clinics have specialist counsellors who can talk through your options and help you make the right decision for you. If you think you want to go ahead with the pregnancy but you're struggling with low mood or anxiety, your doctor can refer you for specialist counselling, or assess if you need medication for depression.