Mass. lawmakers push for abortion without trimester limits

A few short lines buried in Massachusetts’ laws have been debated time and again: the rules around when a person in the third trimester of their pregnancy is allowed to get an abortion. The option became available in Massachusetts five years ago, and lawmakers tweaked the language in 2022.

But a new bill would make abortion broadly legal at or after 24 weeks — leaving the decision to the judgment of health care providers. Advocates and lawmakers believe it’s the first time this has been formally proposed in Massachusetts. Some doctors say the update is necessary because the current language isn’t clear.

“None of us want to break the law,” said Dr. Chloe Zera, who treats patients with high-risk pregnancies in Boston and advocates for health policy with the Society for Maternal Fetal Medicine. “And it means that we are put in the position of having to interpret this wording and translate that into something that is meaningful in medical speak, which it just isn’t.”

Supporters argue the bill would allow more Massachusetts residents to get abortions here instead of traveling to other states — something dozens of people here do each year and can cost tens of thousands of dollars, one advocate estimated. The proposal could also help alleviate a crunch in providers who are willing to perform such procedures. It’s a change advocates see as all the more important under a Trump administration they view as hostile to reproductive rights.

If passed, it would put Massachusetts in a small group with nine other states, plus Washington, D.C., that have no gestational limits on abortions, according to the Guttmacher Institute.

Providers and advocates point to two reasons why someone might get an abortion later in their pregnancy: because of new information, or because of barriers to accessing an abortion earlier. That new information could include a life-threatening condition, or, it could simply mean the person finding out that they’re pregnant at all. Barriers could include having an abusive partner, or needing to travel to get care.

If it were broadly legal for Zera to provide abortions later in pregnancy, she says she would — where, right now, some of her patients leave the state.

That’s what Kate Dineen did in 2021, traveling to Maryland in order to end her wanted pregnancy after her the boy she was carrying suffered a stroke — paying thousands of dollars to make the trip across state lines. She publicly shared her story as the Supreme Court was considering whether to overturn Roe v. Wade, and she lobbied to expand Massachusetts’ carveouts in 2022.

At the time, she found that lawmakers were sympathetic to her plight, and many didn’t even realize anyone had to travel out of Massachusetts for an abortion.

But now she says the law needs another try. Providers and advocates told GBH News a small number of people have still traveled out of state to get an abortion since 2022.

“That ban has now more expansive exceptions — but it is still a ban with exceptions,” Dineen said. “And what we’ve learned, both here in Massachusetts and in other parts of the country, is that a ban with exceptions often just functions as a ban.

“I would say to lawmakers: First, thank you for all the work you’ve done so far and thank you for acting in 2022 to improve access,” she said, and paused. “It didn’t work. What we did didn’t work. ... The way to address this issue is not to tinker around the edges and to come up with more exceptions.”

Claire Teylouni, Reproductive Equity Now’s senior director of policy and programs, estimates the change would impact “dozens” of Massachusetts residents each year — an infinitesimally small number compared to the roughly 18,000 abortions Massachusetts residents received here in 2023.

“Abortions later in pregnancy are not done for convenience,” Teylouni said. “These are serious medical procedures often decided upon due to unexpected pregnancy complications.”

Abortions at or after 24 weeks are very rare, accounting for less than half a percent of all abortions in Massachusetts. There were 84 in total in 2023.

“What we’re seeing is, not hundreds, but a handful are still being told, ‘We’re so sorry, we can’t do that procedure here. But you can go to D.C., you can go to Maryland, you can travel to New Mexico, you can travel to Colorado to get care. And then you can come back to Massachusetts and we’ll handle the rest,’” said Rep. Lindsay Sabadosa, the bill’s co-lead sponsor in the House . “That is just unacceptable to me, personally, at this time.”

The lawmakers who back the bill say it would restore agency to patients and their providers.

“I really filed this bill because I believe these decisions should be made between a patient and the doctor — and that’s it,” said state Rep. Christine Barber, the other co-lead sponsor of the House bill.

“Right now, we’re asking doctors to also be lawyers,” echoed state Sen. Robyn Kennedy, the bill’s lead sponsor in the Senate.

It’s also an idea that’s unpopular, according to national polling. Fewer than one in four Americans believe abortion should be legal in the third trimester, according to a 2023 Gallup poll .

When asked about the public opinion, Zera said she understood the “knee-jerk” reaction — but that creating a list of exceptions doesn’t match reality.

“There’s endless ways that things can go sideways, unfortunately, in medicine,” she said. “The [patients] that I take care of are, generally speaking, people with incredibly highly desired pregnancies who are trying to think about: What’s the most compassionate way to deal with a horrible problem? The best of multiple terrible choices? And so while if you just say, ‘Well, could you have an abortion at 36 weeks?’ — is that something that anyone would choose? You should be so lucky to not have to be in that position.”

In response to questions about how this or other abortion rights bills might be addressed this session, spokespeople for Senate President Karen Spilka and House Speaker Ron Mariano said the bill would be reviewed after it went through the standard committee process.