North Carolina judge strikes down abortion restriction, upholds 12-week ban on medication abortion

RALEIGH, N.C. (CN) — A federal judge in North Carolina ruled that abortions performed after 12 weeks must be conducted in hospitals, while also striking down a documentation requirement on physicians in a final judgment issued Monday.

Pregnant women seeking abortions before the 12-week mark will still be able to get a medical or surgical abortion in a clinic or doctor’s office. After 12 weeks, a woman will only be allowed to get a surgical abortion in a hospital, and only if the pregnancy is due to rape or incest or if it endangers her life.

North Carolina is one of a few states in the South that hasn’t imposed a near-total ban on abortions and still allows abortions past six weeks. 

Last September, U.S. District Judge Catherine Eagles of the U.S. District Court for the Middle District of North Carolina ruled against requiring hospitalization, but she vacated that ruling in her Friday opinion, saying that the hospitalization requirement did not violate the plaintiffs’ constitutional or due process rights.

Eagles wrote that requiring surgical abortions to be performed in hospitals is problematic.

“The plaintiffs have offered credible and largely uncontroverted medical and scientific evidence that this requirement is unnecessary to protect maternal health and safety and will unnecessarily make such abortions more dangerous for many women and more expensive,” the Barack Obama appointee wrote. “But since the Supreme Court’s decision in Dobbs, there is no fundamental right to abortion.”

Molly Rivera, a spokesperson for Planned Parenthood South Atlantic, said that abortions in a clinic setting are extremely safe and have fewer complications than other outpatient procedures like vasectomies and colonoscopies.

"While we are relieved to be able to continue to provide medication abortion throughout the earliest stages of pregnancy, we are disappointed that the court allowed a new barrier to abortion care to take effect,” Rivera said. “This decision will fall hardest on survivors of sexual assault who need abortion care later in pregnancy as they are now forced to travel out of state or to a hospital for this care, resulting in much higher costs for patients.”

Eagles also ruled that lawmakers cannot require doctors to document the existence of an intrauterine pregnancy before approving a woman for a medication abortion. The lawmakers’ provision requiring documentation is vague, Eagles wrote, and could create problems with arbitrary enforcement by law enforcement and prosecutors, who may not fully understand the medical terminology. The provision would have had women undergo ultrasounds, screenings and blood tests — additional steps that Eagles said are unrelated to patient safety.

Eagles found the extra confirmation unnecessary, because doctors are required to rule out ectopic pregnancies before prescribing abortion pills. If a woman with an ectopic pregnancy was to take the two-step medication abortion, it would not end the pregnancy, but it also wouldn’t directly harm her, she wrote in her opinion.

The North Carolina legislature passed restrictions on abortion in May 2023, less than a year after the Supreme Court overturned Roe v. Wade in the landmark Dobbs v. Jackson Women’s Health Org. The restrictions —  which were vetoed by Democratic Governor Roy Cooper but passed into law by the Republican majority —  added regulatory requirements and imposed civil and criminal penalties on health care providers. The plaintiffs’ argued that the law also reduced access to abortion.   

The plaintiffs, Planned Parenthood South Atlantic and Dr. Beverly Gray, sued the attorney general and members of the North Carolina Medical Board in June 2023.

In their suit, the plaintiffs challenged two provisions in the state law that would require intrauterine pregnancies to be documented by physicians, and surgical abortions after 12 weeks to be performed in a hospital, which the plaintiffs said would harm sexual assault survivors. 

Intervenor defendants Speaker of the House Tim Moore and President Pro Tempore Phil Berger have argued that they have a legislative interest in protecting unborn life, promoting maternal health and safety and regulating the medical field, and are allowed to impose restrictions under state law. 

Eagles is also presiding over a similar case about North Carolina abortion pill access. She loosened lawmakers’ additional safety restrictions on doctors in May, after she said they created burdens on patient access and the health care system.

Representatives for Moore and Berger did not reply to requests for comment.

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