Access to later abortion (defined as abortion occurring after the first trimester of pregnancy) is a critical reproductive health, rights, and justice issue. While abortion continues to be a politically contentious and divisive issue, later abortion is marginalized even among those who otherwise support abortion rights. Clients who need later abortions are younger and more economically vulnerable than those who seek first-trimester abortion care, yet polling indicates public support for later abortion is significantly lower than for earlier abortion. Legal restrictions, higher costs, and fewer providers mean that pregnant people who need later abortions must overcome many obstacles to access care. At later gestations, access to high-quality abortion services becomes more contested, restricted, and inaccessible.

The Later Abortion Initiative (LAI), a project of Ibis Reproductive Health, will change the conversation around later abortion and the pregnant people who need this service. LAI particularly focuses on the increased stigma, challenges and barriers for clients who need abortions after 18 weeks. LAI will support the development of innovative activities and new leadership on later abortion, and support efforts to preserve and expand access to later abortion care. Building on previous work by colleagues around the country and in collaboration with other organizations, including the Later Abortion Network, LAI will develop an ambitious program of work to:

• Improve referrals for later abortion care, including by collaborating with Maternal Fetal Medicine (MFM) colleagues and others to improve access to care
• Increase the number of sites where later abortion is available and create support for clinics that currently provide vital later abortion care
• Identify training resources to expand the number of physicians who can perform later abortion, especially at 20 weeks’ gestation and beyond
• Collaborate with reproductive justice and reproductive rights organizations to identify how and where later abortion fits into their work and to raise the visibility of the issue across the reproductive health, rights, and justice movement
• Develop an ambitious research agenda, including assessing the impact of later abortion restrictions and clinical best practices
• Work with communications, messaging and public relations experts to build support for later abortion and fight restrictions on later abortion at the state level
• Expand www.laterabortion.org to ensure that it is a resource to promote evidence-based information to all stakeholders working on or requiring information about later abortion
• Provide a range of venues to share information, ensure coordination of efforts and to catalyze collaboration among organizations working on later abortion issues

As we continue to respond to emerging issues around later abortion, we will consult with stakeholders in a wide range of organizations to ensure that people have access to regardless of when they decide that they need to terminate their pregnancy. 

History of the Initative 

The Later Abortion Initative (LAI) began as The Second Trimester Abortion Initiative in 2007, which was originally launched to promote a strategic vision for securing access to and provision of second-trimester abortion care in the United States. In September 2008, Advancing Standards in Reproductive Health, ANSIRH, hosted a national Summit on Securing Access to and Provision of Second Trimester Abortion. Summit participants included 45 experts and leaders from a diverse group of organizations. In preparation for the summit, ANSIRH produced a white paper summarizing what we know and don’t know about this issue. At the summit, participants reviewed the white paper and refined a set of recommendations for securing access to second-trimester abortion in the US. The Second Trimester Abortion Access Network (STAAN), under the leadership of Ibis Reproductive Health, was formed to promote these recommendations.

After the tragic murder of Dr. George Tiller in 2009, the scope of the Initiative at ANSIRH was expanded to include abortion after the second trimester. In 2010, Ibis expanded the scope of STAAN and changed the Network name to The Later Abortion Network (LAN). Building on previous work by colleagues around the country and in collaboration with other organizations, LAI was launched by Ibis Reproductive Health in 2015 to develop an ambitious agenda to preserve access to high-quality later abortion care and promote legislative and service delivery advances to improve pregnant people's access to care and to change the conversation around later abortion and the clients who need this service.