The Plot for Forced Childbearing

May 8, 2023


  • Senate Bill 20 is a wide-ranging ban on abortion in North Carolina
  • It would ban care for many fetal abnormalities and victims of rape and incest
  • SB 20 is the first step in activists’ goal to completely ban abortion


In the span of less than 48 hours, North Carolina Republicans introduced and passed a bill last week that would severely curtail access to abortion and reproductive healthcare for women all across our state. After unveiling the bill publicly at 11PM on a Tuesday, a state House vote was held the very next morning – before many members had even had time to read the bill. When a state Senate vote was held on Wednesday, even many Republicans admitted they had not had time to read it in full. Both chambers passed the bill on party-line votes anyway.

Senate Bill 20 is a massive, devastating assault on women’s bodily autonomy and basic reproductive freedom. It does this not only by curtailing the number of weeks (down to 12, from 20) that women are permitted to seek abortion care, but also by narrowing the few exceptions that exist; and in many other subtler, but very effective ways, some of which could eliminate abortion access completely.

Many of SB 20’s most vocal supporters have deliberately obfuscated and avoided mentioning what it actually does, because many of the bill’s provisions are deeply, extremely unpopular. In this piece, we will give a basic overview of what is actually in this bill.

A dramatic cut in eligibility

Most prominently, SB 20 would cut the number of weeks when women can legally access abortion care from the current 20 weeks to 12.

The “number of weeks” question is certainly the most visible aspect of abortion debates, but often not the most actually relevant to abortion healthcare. Women rely on abortion care for a wide variety of reasons, only some of which are elective. Many women do not know they are pregnant for several weeks after conception. As anyone knows who has been pregnant (or is close to someone who has been), any number of pregnancy complications can and do arise, at all points in a pregnancy. Many of those complications are manageable, and many are not.

It is for women and their medical professionals to decide how to navigate their own pregnancies – not politicians.

Narrowed exceptions for victims of rape and incest

One of the most appalling provisions of SB 20 is that it dramatically narrows exceptions for victims of rape and incest.

While the bill’s anti-abortion supporters are technically correct that those exceptions exist, what they don’t mention is that they only apply for the first 20 weeks of a victim’s unwanted pregnancy. As stated in the bill as ratified, under “When abortion is lawful:”

After the twelfth week and through the twentieth week of a woman’s pregnancy, when the procedure is performed by a qualified physician in a suitable facility in accordance with G.S. 90-21.82A when the woman’s pregnancy is a result of rape or incest. (90-21.81B, Section 3)

To be absolutely clear, SB 20 would prohibit victims of rape or incest from seeking abortion care from their 21st week onward.

There are any number of (mostly horrific) reasons why victims of rape or incest would not seek – or be unable to seek – abortion care for unwanted pregnancies within 20 weeks. SB 20 would sentence them to forced childbearing from their assault.

Narrows care for fetal abnormalities

Another section of the bill would prohibit abortion care even in cases of severe fetal abnormalities. As written, the bill only provides for abortion access until 24 weeks in cases of “life-limiting” fetal abnormalities (90-21.81B, Section 3). This means that patients who discover at 25 weeks that their fetus is developing without lungs or a brain, for example, would be forced to carry a non-viable fetus to term – an utterly barbaric barrier.

Moreover, for women who do encounter abnormalities before 25 weeks, SB 20 dictates a long series of condescending and moralistic requirements euphemistically termed “informed consent.” Section 90-21.81D of SB 20 stipulates that doctors must tell women about the “unpredictable and variable lengths of life” with the abnormalities at stake, even if this is not medical fact. The doctor must offer referrals to multiple forms of (expensive) care to encourage her to continue with the pregnancy. The doctor must make a full report to the state Department of Health and Human Services.

No exceptions for women’s health

Another particularly dramatic measure in SB 20 is that it excludes any exceptions for avoiding grievous, debilitating and even permanent injury to a pregnant woman – only for “medical emergencies” that amount to imminent dangers to her life.

The difference sounds small, but is actually very important. What this means is that unless a woman’s life is imminently in danger, she is prohibited from undergoing an abortion, even if her health – long-term or immediate – will be harmed. (The bill also specifically excludes “any psychological or emotional conditions” from permissible considerations. Mental health was not deemed important.) Even if an abortion patient is bleeding out, or faces serious injury, doctors would be unable to provide abortion care until she was at death’s door.

Eliminating exceptions for women’s health is a new and widespread tactic in the anti-abortion movement. It will not only force women into incredibly dangerous situations hazardous to their lives before doctors are legally allowed to intervene; it will also make doctors more wary of doing so at all, for fear of being targeted by ambitious anti-abortion prosecutors.

Invents new bureaucratic hurdles to stop abortion care

One of SB 20’s most devastating effects will be creating new, totally unnecessary bureaucratic hurdles that stop women from accessing abortion care. These were included to slow down and gum up medical practices with scheduling conflicts and regulatory licensing hurdles, all designed with one single purpose in mind: stopping women from getting help.

Among these provisions of SB 20 are:

  • Requiring a consultation with a physician 72 hours before an abortion to be in person, not over the phone or remote.
  • Requiring 3 separate visits to a doctor’s office for obtaining a medication abortion. Only 1 of these actually involves giving the medication.
  • Requiring any abortion after the 12th week of pregnancy to take place in a hospital, instead of any outpatient facility. (This involves much higher costs and additional staffing and scheduling issues.)
  • Inventing brand new licensure requirements for abortion facilities, with a long list of onerous fees, and a requirement that they be annually renewed. Those requirements will likely match those for ambulatory care centers, like emergency rooms, and would effectively close every abortion clinic in North Carolina.

This is Step One

Make no mistake –┬áSenate Bill 20 is the beginning of anti-abortion activists’ goal to ban abortion care, not the end. Radical Right and fundamentalist activists in North Carolina have praised SB 20, but acknowledge that it is a “first step” – not their ultimate goal. That goal is a total ban on any abortion care, whatsoever.

New abortion restrictions like those in SB 20 are deeply unpopular with North Carolina voters:

It is likely - though not a foregone conclusion - that Republican politicians have the votes to override Governor Cooper's veto of SB 20. In that case, it will be up to voters to hold SB 20's supporters accountable in future elections - particularly if they oppose the total prohibition of abortion healthcare in our state.

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