Most conversations about abortion focus on the first trimester. That makes sense — the majority of abortions happen early in pregnancy. But not everyone discovers a pregnancy at 4 or 6 weeks. Some people have irregular periods and do not realize they are pregnant until much later. Others face new medical information about fetal anomalies. Some wanted the pregnancy but experienced a devastating diagnosis. Others were prevented from seeking care earlier by abusive partners, financial barriers, or living in a state with restrictive laws. For these patients, later abortion — defined as abortion after 12 weeks — is a necessary and often lifesaving option. Illinois is one of the few states where later abortion remains legal, safe, and accessible. While Telehealth Abortion in Illinois is only available up to 12 weeks, telehealth providers can serve as a critical gateway to later abortion care by offering referrals, helping patients navigate logistics, and providing financial assistance. This guide explains everything you need to know about abortion beyond the first trimester.
Defining Later Abortion
There is no single medical definition of “later abortion.” Generally, the term refers to abortion after the first trimester — that is, after 12 weeks of pregnancy. Some researchers divide later abortion into two categories:
Second trimester abortion (13 to 27 weeks): Most later abortions occur in the second trimester. The procedure is typically called dilation and evacuation (D&E).
Third trimester abortion (28 weeks and beyond): Extremely rare. Represents less than 1 percent of all abortions. Usually performed only for severe fetal anomalies or life-threatening maternal health conditions.
It is important to understand that later abortion is not a casual choice. No one wakes up at 20 weeks pregnant and thinks, “I think I’ll have an abortion today.” Later abortions happen for serious, often heartbreaking reasons.
Why Do People Have Later Abortions?
The common myth is that people have later abortions because they were “lazy” or “changed their mind.” This is false. Research shows that later abortion patients face significant barriers to earlier care. Common reasons include:
Did not know they were pregnant: Irregular periods, contraception that masks pregnancy symptoms (like some IUDs), denial, or simply not recognizing early signs. Some people have pregnancy tests that show false negatives. Others have no symptoms at all.
Could not access care earlier: Living in a state with restrictive laws, no nearby clinic, financial barriers, transportation problems, or difficulty getting time off work or finding childcare.
Changes in relationship: A partner who was supportive becomes abusive. A relationship ends. A partner who promised to help abandons the patient.
Changes in health: New diagnosis of a medical condition that makes pregnancy dangerous. New information about how pregnancy will affect existing conditions.
Fetal diagnosis: Ultrasound or genetic testing reveals a severe fetal anomaly incompatible with life, such as anencephaly (missing parts of the brain and skull) or trisomy 18 (a condition causing severe intellectual disability and organ abnormalities). Many of these diagnoses cannot be made until 18 to 22 weeks.
Threat to the pregnant person’s life: Conditions like preeclampsia, placental abruption, or heart disease that make continuing the pregnancy life-threatening.
Pregnancy resulting from rape or incest: Trauma may delay disclosure and care seeking.
Age: Adolescents may not recognize pregnancy or may delay care due to fear of parental discovery.
These are not excuses. They are real, painful barriers that push care into the second trimester.
Is Later Abortion Safe?
Yes. Later abortion is very safe — significantly safer than continuing a pregnancy to term and giving birth. The risk of serious complications increases slightly with gestational age, but remains extremely low. For second trimester abortion, the risk of a major complication is less than 1 percent. For comparison, childbirth in the United States carries a maternal mortality rate of about 17 deaths per 100,000 live births. Later abortion is much safer than carrying a pregnancy to term.
That said, later abortion is a more complex medical procedure than first trimester abortion. It requires a specially trained provider, usually in a hospital or specialized clinic. It typically takes two days. It may involve cervical preparation (using medication or dilators to open the cervix) before the procedure itself.
What Is a D&E (Dilation and Evacuation)?
Dilation and evacuation (D&E) is the standard procedure for second trimester abortion. Here is how it works.
Day one (often): The patient receives medication or osmotic dilators (small sticks placed in the cervix) to begin opening the cervix. This preparation can take several hours or overnight. Some providers combine both steps into a single day for earlier second trimester abortions (13 to 16 weeks).
Day two (procedure day): The physician uses a combination of suction and medical instruments to remove the pregnancy tissue from the uterus. The procedure itself takes 10 to 30 minutes. Most patients receive sedation or anesthesia.
Recovery: Patients typically spend 1 to 2 hours in a recovery area before going home. Bleeding is similar to a heavy period and lasts 1 to 2 weeks. Most patients return to normal activities within a few days.
D&E is safe, effective, and performed by trained physicians every day in the United States.
What About Induction Abortion?
For very advanced pregnancies (typically 24 weeks and beyond), some providers use induction abortion instead of D&E. Induction abortion uses medication to induce labor, leading to the delivery of the pregnancy. This process can take 12 to 24 hours and is performed in a hospital. Induction abortion is rare and usually reserved for severe fetal anomalies or maternal health emergencies.
Where Can You Get a Later Abortion in Illinois?
Later abortion is available in Illinois, but options are more limited than for first trimester abortion. Major providers include:
Chicago area: Several hospitals and specialized clinics offer second trimester abortion services up to 24 weeks or later. These include Planned Parenthood of Illinois (select locations), the University of Illinois at Chicago, and other providers.
Downstate: Fewer options. Some clinics in Rockford, Peoria, and Carbondale offer second trimester abortion up to 16 to 18 weeks. Beyond that, patients usually need to travel to Chicago.
Out of state: Illinois is a destination for later abortion patients from surrounding states with bans or severe restrictions, including Indiana, Missouri, Kentucky, Wisconsin, and Iowa.
Your telehealth provider for first trimester services can refer you to later abortion providers. Do not delay reaching out. Later abortion appointments can be harder to schedule, and every week matters.
Cost of Later Abortion in Illinois
Later abortion is more expensive than first trimester abortion due to the complexity of the procedure, the need for sedation or anesthesia, and often the need for an overnight stay.
Cost range for uninsured patients:
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13 to 16 weeks: 800to1,500
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17 to 20 weeks: 1,500to2,500
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21 to 24 weeks: 2,500to4,000+
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25 weeks and beyond: 5,000to10,000+
Illinois Medicaid: Fully covers later abortion at zero cost to the patient. This is critically important because most later abortion patients cannot afford thousands of dollars out of pocket.
Private insurance: Coverage varies. Some plans cover later abortion. Others do not. Check your policy. Illinois law requires insurance plans regulated by the state to cover abortion, but many self-funded employer plans are exempt.
Financial assistance: Illinois abortion funds help patients pay for later abortion. The Chicago Abortion Fund, Midwest Access Coalition, and National Network of Abortion Funds all provide grants. These funds can cover travel, lodging, childcare, lost wages, and the procedure itself. Never assume you cannot afford care without first contacting a fund.
Travel and Lodging for Later Abortion
Later abortion often requires traveling to Chicago from other parts of Illinois or neighboring states. For patients who must stay overnight (most do), lodging is a major expense and logistical challenge.
Travel assistance: The Midwest Access Coalition helps patients with gas cards, bus tickets, flights, and other transportation.
Lodging assistance: Many abortion funds can pay for hotel rooms. Some clinics have relationships with local hotels that offer discounted rates. The Hope Clinic for Women in Granite City (near St. Louis) offers limited lodging assistance.
Practical support: Volunteers with the Chicago Abortion Fund and other organizations sometimes offer spare rooms, rides, meals, and childcare. Do not be afraid to ask for help.
If you are traveling to Illinois from a restrictive state, you will need to stay in Illinois for at least two days. Choose accommodations that are private, safe, and close to the clinic. Do not share your location with anyone you do not trust completely.
Legal Protections for Later Abortion in Illinois
Later abortion is fully legal in Illinois. There is no gestational limit. The Reproductive Health Act of 2019 codified the right to abortion at any stage of pregnancy. This means Illinois is one of the few states where a patient can access later abortion for any reason — not just life endangerment or severe fetal anomaly.
Illinois also has strong shield laws protecting patients and providers from out-of-state legal attacks. If you travel to Illinois from a state that bans abortion, you cannot be prosecuted in Illinois. The state will not cooperate with extradition or subpoenas. While your home state may try to punish you, Illinois will not help them.
That said, you should be aware of the laws in your home state. Some states have attempted to ban travel for abortion. These laws are likely unconstitutional but could still be used to harass patients. Speak with a lawyer or an abortion fund about your specific legal risks before traveling.
Emotional Realities of Later Abortion
Later abortion is often emotionally complex, especially when the decision is driven by a severe fetal anomaly or a threat to the patient’s health. Patients may grieve a wanted pregnancy while also knowing that ending the pregnancy is the right or only choice.
For fetal anomaly: Many patients wanted the baby. They chose names, bought clothes, and made plans. Learning that the pregnancy is not viable is devastating. The abortion is mourned as a loss. Grief counseling is strongly recommended.
For maternal health: A patient with a life-threatening condition may be terrified. The abortion is not a choice about the pregnancy but a choice between her life and the pregnancy’s continuation. Most people choose survival. That choice is valid and brave.
For other reasons: Patients who discover pregnancy later due to barriers or lack of knowledge may feel shame or guilt about “waiting too long.” None of that is their fault. Every barrier they faced was created by a system that makes abortion hard to access. They are not to blame.
Later abortion patients deserve the same compassion and non-judgmental care as first trimester patients. More, perhaps, because they have already endured so much.
How Telehealth Providers Can Help with Later Abortion
While telehealth abortion in Illinois is only available up to 12 weeks, telehealth providers can still be a critical resource for later abortion patients.
Referrals: Telehealth providers can refer you to trusted later abortion providers in Illinois. They know which clinics offer services at which gestational ages. Do not waste time calling around on your own.
Medical records transfer: If you have had any prenatal care — ultrasounds, blood work, genetic testing — your telehealth provider can help transfer those records to the later abortion provider. This saves time and reduces redundant testing.
Financial assistance navigation: Most telehealth providers have patient advocacy teams that can help you apply for Illinois abortion funds, even for later abortion. They submit the paperwork, make the calls, and coordinate with the later provider.
Emotional support: Telehealth providers can offer counseling referrals, abortion doula connections, and ongoing check-ins before and after the procedure.
Contraception planning: After a later abortion, you may want long-acting contraception. Telehealth providers can prescribe pills, patch, ring, or Depo, and refer you for IUD or implant placement.
Even if you are past 12 weeks, reach out to a telehealth provider. They can help. They will not turn you away.
A Note on Self-Managed Later Abortion
Self-managed abortion — ending a pregnancy without medical supervision — is extremely dangerous in the second trimester. The methods used are not safe. They can cause hemorrhage, infection, uterine rupture, organ damage, and death. Do not attempt self-managed abortion for a pregnancy beyond 12 weeks.
If you cannot access legal later abortion in your home state, travel to Illinois. There are funds to help you pay for travel, lodging, and the procedure. You do not have to risk your life. Help is available.
A Final Word
If you are pregnant beyond 12 weeks and need an abortion, you are not alone. You are not bad. You are not irresponsible. You are a person facing an incredibly difficult situation. The barriers that delayed your care are not your fault.
Later abortion in Illinois is legal, safe, and available. It is more expensive and more logistically challenging than first trimester abortion, but it is possible. Funds exist to help you. Providers are waiting to care for you. You do not have to carry an unwanted pregnancy to term.
The first step is reaching out. Contact a telehealth provider in illinois, even if you are past 12 weeks. They will refer you to a later abortion clinic. They will help with funding. They will support you. You have already been through so much. Let someone help carry the rest of the weight.
You deserve compassionate, non-judgmental care at any gestational age. In Illinois, you can get it.
