Abortion is not illegal in Pennsylvania. Under the state’s Abortion Control Act, abortion is legal through 24 weeks of pregnancy, and after 24 weeks it is permitted only when a physician reasonably believes it is necessary to prevent the pregnant person’s death or a substantial and irreversible impairment of a major bodily function.1Pennsylvania General Assembly. Pennsylvania Code Title 18 Chapter 32 – Section 3211 Legality comes with conditions: a 24-hour waiting period, informed consent, physician-only performance, and parental consent for minors.
The 24-Week Line
Before 24 weeks, abortion is legal as long as the other requirements in the Abortion Control Act are met. Performing an abortion after 24 weeks is a crime unless the life-or-serious-health exception applies.1Pennsylvania General Assembly. Pennsylvania Code Title 18 Chapter 32 – Section 3211
Past that point the rules tighten considerably. A second physician must independently examine the patient and confirm in writing that the abortion is medically necessary. The procedure has to take place in a hospital. The physician must use the method most likely to result in fetal survival, unless doing so would pose a significantly greater risk to the pregnant person. A second physician must also be present to care for any child born alive.1Pennsylvania General Assembly. Pennsylvania Code Title 18 Chapter 32 – Section 3211
What Has to Happen Before an Abortion
Every abortion in Pennsylvania must be performed by a licensed physician who has decided, based on clinical judgment, that the abortion is necessary. That judgment can weigh physical, emotional, psychological, familial, and age-related factors. A written referral from another physician who has made that determination will also work. An abortion sought solely because of the sex of the fetus does not qualify as necessary under the statute.2Pennsylvania General Assembly. Pennsylvania Code Title 18 Chapter 32 – Section 3204
Consent must be voluntary and informed. The physician or a qualified delegate has to walk the patient through the nature of the procedure, its medical risks, the probable gestational age of the fetus, and the available alternatives, and must offer printed materials on fetal development and agencies that provide alternatives.3Pennsylvania General Assembly. Pennsylvania Code Title 18 Chapter 32 – Section 3205
After that consultation, the patient waits at least 24 hours before the abortion can be performed. In practice, that means a minimum of two visits or contacts with the provider. The waiting period does not apply in a medical emergency.3Pennsylvania General Assembly. Pennsylvania Code Title 18 Chapter 32 – Section 3205
Rules for Patients Under 18
A patient under 18 who is not emancipated needs informed consent from at least one parent before a physician can perform an abortion. The same requirement applies for anyone who has been legally adjudged incapacitated, in which case the guardian gives consent. A medical emergency overrides the parental consent rule entirely.4Pennsylvania General Assembly. Pennsylvania Consolidated Statutes Title 18 Chapter 32 – Section 3206
A minor who cannot or does not want to involve a parent can petition a court of common pleas for a judicial bypass. The court will authorize the abortion if it finds the minor mature enough to give informed consent on her own, and has done so. Even where the court decides she is not mature enough, it can still authorize the procedure if it finds an abortion to be in her best interests. The proceedings are confidential, and the court must rule quickly.4Pennsylvania General Assembly. Pennsylvania Consolidated Statutes Title 18 Chapter 32 – Section 3206
Medication Abortion
Medication abortion using mifepristone is available in Pennsylvania through the first ten weeks of pregnancy. Mifepristone is subject to a federal Risk Evaluation and Mitigation Strategy (REMS) program, so only certified prescribers can prescribe it and only certified pharmacies can dispense it. The medication can be shipped from a certified pharmacy by mail.5U.S. Food and Drug Administration. Information About Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation
Pennsylvania allows mifepristone to be prescribed via telehealth, but only a physician can write the prescription. A certified pharmacy can then dispense it in person or by mail. Confirm that any pharmacy you plan to use holds the FDA certification. The FDA advises against buying mifepristone outside the REMS program, including from foreign online pharmacies, because it cannot verify the safety or quality of those medications.6Pennsylvania Office of Attorney General. The Status of Medication Abortion in PA – Questions and Answers
Paying for the Procedure
Pennsylvania law bars the use of state funds to pay for abortion except when the pregnant person’s life is endangered or the pregnancy resulted from rape or incest. That restriction covers Medicaid and health plans for state employees, and plans sold through the Affordable Care Act marketplace in Pennsylvania follow the same limitation.7Commonwealth of Pennsylvania Department of Health. Abortion The underlying statute prohibits any state or federally appropriated Commonwealth funds from covering abortion outside those exceptions.8Pennsylvania General Assembly. Pennsylvania Code Title 18 Chapter 32 – Section 3215
Some private insurance plans do cover abortion, so check the policy or call the insurer. For patients paying out of pocket, medication abortion typically runs several hundred dollars, and first-trimester surgical procedures fall in a similar range. Second-trimester costs climb significantly. Many clinics offer sliding-scale fees or can connect patients with financial assistance. Abortion also qualifies as a deductible medical expense on federal taxes when you itemize, subject to the 7.5%-of-adjusted-gross-income threshold, and can be reimbursed from a Health Savings Account or Flexible Spending Arrangement.9Internal Revenue Service. Publication 502, Medical and Dental Expenses
Emergency Care Cannot Be Refused
Federal law provides a backstop for pregnancy emergencies. Under the Emergency Medical Treatment and Labor Act (EMTALA), any hospital that accepts Medicare must screen and stabilize patients presenting with an emergency medical condition, including pregnancy complications such as ectopic pregnancies, severe infections, or hemorrhage.10Office of the Law Revision Counsel. 42 U.S. Code 1395dd – Examination and Treatment for Emergency Medical Conditions
A Pennsylvania hospital cannot turn away a patient in a pregnancy-related emergency. If it lacks the resources to provide the needed care, it must arrange transfer to a facility that can. EMTALA preempts any state or local law that directly conflicts with its stabilization requirements. Pennsylvania’s own statute already permits abortions to save the patient’s life or prevent serious harm, and EMTALA operates as a federal floor on top of that.10Office of the Law Revision Counsel. 42 U.S. Code 1395dd – Examination and Treatment for Emergency Medical Conditions
The Spousal Notification Provision Is Not Enforceable
The Abortion Control Act still contains a section requiring spousal notification before an abortion. The U.S. Supreme Court struck that provision down in its 1992 decision in Planned Parenthood v. Casey, finding it imposed an undue burden. The words remain in the statute but cannot be enforced. No one in Pennsylvania has to notify a spouse before obtaining an abortion.