For the first time, a woman in Massachusetts can choose to end her pregnancy at any point, without a prosecutor looking over her doctor’s shoulder. On Aug. 10, Gov. Maura Healey signed the Prioritizing Patient Access to Care Act, decriminalizing abortion. By this Act, the commonwealth joins nine other states that trust patients and medical professionals to make abortion decisions throughout pregnancy — rather than politicians, police and prosecutors.
The co-lead sponsor of the bill was our very own state Rep. Lindsay Sabadosa, D-Northampton, who underscored the stakes for patients: “Massachusetts has reaffirmed a fundamental principle: medical decisions should be made by patients and their doctors, period. In a state with one of the strongest health care systems in the country, no one should be denied medically appropriate care because of arbitrary restrictions that cannot account for individual circumstances.”
Before this new law, Massachusetts had a 24-week gestational ban, with narrow exceptions. Rep. Sabadosa said the exceptions framework led hospital administrators and their attorneys to deny necessary medical care for fear of criminal or civil liability, forcing women to travel to Maryland, D.C. or New Mexico for care, resulting in delays, extra expenses and trauma for patients and their families.
“To ask someone to travel out of state in this political moment, it just feels wrong,” said Rep. Sabadosa. “By removing those barriers, we are ensuring that Massachusetts remains a place where people can access the care they need, when they need it, without being forced to leave the Commonwealth.”
The legislative hearings focused on women who experienced a severe fetal diagnosis or a threat to their own health and had to travel out of state for medical care, which are very sympathetic stories that were able to win over many supporters. In fact, there are many valid reasons why people might need abortion care later in pregnancy. According to the organization Patient Forward, which fights to destigmatize abortion later in pregnancy, people seeking later abortion care have often learned new information later in their pregnancy and then are delayed even further by barriers outside their control.
Sometimes women do not recognize they are pregnant because they are using contraceptives, their periods are absent or irregular, they are very young, they have no pregnancy symptoms, they are experiencing different symptoms from a past pregnancy or are subject to outside stressors. Sometimes their life is upended by a lost job, homelessness or the end of a relationship.
After they learn this information, they may experience barriers delaying access to abortion care, including obstructions to medical care caused by religious crisis pregnancy centers, difficulty finding providers offering later abortion care, conflicts with family members or partners, logistical obstacles like travel, child care or time off from work or school, language barriers, parental consent requirements that cause delays, immigration status or probation restrictions limiting travel out of state, and/or difficulty raising money for a deductible or costs of an abortion that insurance won’t cover.
The people most likely to need later care are the ones already pushed to the margins — young, low-income and racially marginalized — who have always faced the steepest barriers to sex education, contraception and abortion.
While it’s certainly important that we have made later abortion more accessible to people experiencing health emergencies, the Prioritizing Patient Access to Care Act is important for all people seeking later abortion care for whatever their reason.
Decriminalizing third trimester abortion care in Massachusetts caps a decade of activism that began in earnest after the election of Donald Trump in 2016. In 2018, the state adopted An Act Negating Archaic Statutes Targeting Young Women Act (the NASTY Women Act), repealing 19th century laws criminalizing abortion in the first 24 weeks of pregnancy. In 2020, the ROE Act created an affirmative right to abortion for the first time and lifted the parental-consent requirement for 16- and 17-year-olds. And in 2022, after Dobbs v. Jackson Women’s Health Organization overturned the constitutional right to abortion, Massachusetts adopted a groundbreaking law shielding providers from civil and criminal liability for treating patients from states that ban abortion, including by telehealth — a critical avenue of abortion access for people living in states with bans. Now Massachusetts has gone further still, decriminalizing third trimester abortion in the commonwealth, amidst skyrocketing criminalization of pregnancy in many states post-Dobbs.
Decriminalizing third-trimester abortions, eliminating parental consent for 16- and 17-year-olds and nationwide telehealth abortion access are surely not what the architects of Dobbs anticipated, but they have awoken a sleeping giant — the rage of women, whose creativity, determination and courage are transforming the abortion landscape by increasing access and destigmatizing abortion.
Until women have bodily autonomy at all times — even in the third trimester of pregnancy, no questions asked — we will be second class citizens, our lives, health and dignity endangered. Women are worthy of respect and honor as the decision makers of our own lives. So, we will keep fighting for nothing less than full control over our lives and bodies.
Carrie N. Baker is a professor in the Program for the Study of Women, Gender and Sexuality at Smith College and a regular contributor to Ms. Magazine.