Virginia abortion laws allow the procedure through the end of the second trimester, with rules that get stricter as pregnancy progresses. First-trimester abortions can be performed by a physician or a qualified advanced practice registered nurse in an outpatient setting. Second-trimester abortions require a physician and a licensed hospital. Third-trimester abortions are permitted only when a physician determines the pregnancy would likely cause the patient’s death or substantial and irremediable harm to their physical or mental health. Written informed consent is required, and unemancipated minors need parental consent or a court order.
Who Can Perform an Abortion and Where
During the first trimester, either a physician licensed by the Board of Medicine or an advanced practice registered nurse jointly licensed by the Boards of Medicine and Nursing may perform the procedure, provided the APRN acts within their scope of practice.1Virginia Code Commission. Virginia Code 18.2-72 – When Abortion Lawful During First Trimester of Pregnancy Until this provision took effect, only physicians could perform abortions at any stage. Qualified nurse practitioners can now handle first-trimester procedures independently.
Second-trimester rules are tighter. Only a licensed physician may perform the procedure, and it must take place in a hospital licensed by the Virginia Department of Health or operated by the Department of Behavioral Health and Developmental Services.2Virginia Code Commission. Virginia Code 18.2-73 – When Abortion Lawful During Second Trimester of Pregnancy Outpatient clinics are not authorized to perform second-trimester abortions.
Clinics that offer abortion services no longer sit in a separate licensing category. The 2011 regulations that treated them as a class of hospital were repealed. Facilities still have to meet general healthcare standards, including infection control, emergency preparedness, and staff credentialing, and the Virginia Department of Health can inspect them and act against those that fall short.3Virginia Register of Regulations. 12VAC5-412 Regulations for Licensure of Abortion Facilities
Gestational Limits and Third-Trimester Restrictions
Virginia does not set a single-week ban. The trimester framework does the limiting work. First-trimester procedures run roughly through 12 weeks. Second-trimester procedures run roughly from 13 through 26 weeks and require a hospital and a physician. As a practical matter, abortion services in Virginia are generally available through about 26 weeks and 6 days.
After that point, third-trimester restrictions apply. A physician must determine, in their medical judgment, that continuing the pregnancy would likely result in the patient’s death or substantially and irremediably impair the patient’s mental or physical health.2Virginia Code Commission. Virginia Code 18.2-73 – When Abortion Lawful During Second Trimester of Pregnancy Outside those circumstances, the procedure is not lawful in the third trimester.
Informed Consent
Every abortion in Virginia requires informed written consent. The physician (or the APRN, for first-trimester procedures) explains the procedure, its risks, and alternatives, and the patient signs a written acknowledgment.4Virginia Code Commission. Virginia Code 18.2-76 – Informed Written Consent Required
Older requirements that stacked on top of consent are gone. Virginia used to require a mandatory ultrasound and a 24-hour waiting period before the procedure could go forward. The General Assembly repealed both in 2020. There is no ultrasound requirement and no mandated delay between the consent conversation and the procedure.
If a patient has been adjudicated incapacitated by a court, written permission from a parent, guardian, or other person responsible for the patient’s care must be obtained before the abortion can proceed.4Virginia Code Commission. Virginia Code 18.2-76 – Informed Written Consent Required
Medication Abortion and Telehealth
Medication abortion using mifepristone and misoprostol is available in Virginia and can be prescribed through telehealth. Under the federal risk-management framework finalized in 2023, mifepristone does not require in-person dispensing and can be mailed to patients after a telehealth visit with a certified prescriber. Some Virginia clinics assess pregnancy dates and health history through a secure online portal and then send the pills by mail or through a local pharmacy.
Virginia imposes no additional state-level restrictions on medication abortion beyond those that apply to all abortions: provider qualifications, informed consent, and parental consent for minors.
Parental Consent for Minors
Virginia requires parental consent, not just notification, before a physician can perform an abortion on an unemancipated minor. The minor must deliver written authorization, signed by an authorized person and notarized, confirming that the authorized person knows about the intended abortion and consents to it.5Virginia Code Commission. Virginia Code 16.1-241 – Jurisdiction; Consent for Abortion
An authorized person includes a parent, legal guardian, custodian, or someone standing in a parental role. Before the written authorization is used, the physician or their agent must give the authorized person notice of the intent to perform the abortion. That notice can happen in person or by phone at least 24 hours before the procedure. If the physician cannot reach the authorized person after reasonable attempts, notice can go by certified mail with return receipt requested to the person’s usual address, at least 72 hours before the procedure.5Virginia Code Commission. Virginia Code 16.1-241 – Jurisdiction; Consent for Abortion
If an authorized person is physically present with the minor and gives written authorization witnessed by the physician or their agent, that satisfies the consent requirement without the advance notice step. Minors who are married or legally emancipated are not subject to these rules.
Judicial Bypass
A minor who cannot or does not wish to involve a parent can petition the juvenile and domestic relations district court for a judicial bypass. The court can authorize the abortion without any parental involvement if the judge finds either that the minor is mature and well-informed enough to decide independently, or that, even if she is not sufficiently mature, the abortion is in her best interest.5Virginia Code Commission. Virginia Code 16.1-241 – Jurisdiction; Consent for Abortion
The process is confidential and moves fast. A hearing must be held no later than four days after the petition is filed, and these cases get priority. If the judge denies the petition, the minor can file an expedited confidential appeal to the circuit court, which must decide within five days. The court will appoint an attorney for the minor on request. If bypass is granted on a best-interest basis, the judge may still order the physician to notify a parent, but that notice must be waived if the authorized persons in the household are abusive or neglectful or have refused to accept parental responsibility.
Cost, Insurance, and Public Funding
Virginia limits public funding for abortion but goes somewhat further than the federal baseline. Medicaid will pay for an abortion in two categories handled through the Virginia Department of Health: pregnancies resulting from rape or incest (with law-enforcement reporting requirements), and cases where a qualified physician certifies that the fetus has a severe incapacitating physical deformity or mental deficiency.6Virginia Department of Health. State Funding of Certain Abortions7Virginia Code Commission. Virginia Code 32.1-92.2 – Funding of Certain Abortions Where Fetus Is Believed to Have Incapacitating Physical Deformity or Mental Deficiency When the pregnancy threatens the life or health of the patient, funding is handled through the Virginia Department of Medical Assistance Services instead.
The fetal-abnormality category goes beyond the federal Hyde Amendment, which restricts federal Medicaid dollars to cases of rape, incest, or life endangerment. Virginia uses state funds to cover that extra category.
Private insurers operating outside the state health exchange generally decide for themselves whether to cover abortion, and employers offering group health plans do the same. Patients paying out of pocket for a first-trimester procedural abortion nationally tend to pay somewhere between $500 and over $2,000, depending on the provider and gestational age. Local abortion funds and the National Abortion Federation Hotline offer income-based discounts and help with procedure costs, travel, and lodging.
Criminal and Professional Penalties
Performing an abortion outside the bounds of Virginia law is a Class 4 felony. The statute reaches anyone who administers drugs or uses other means to end a pregnancy in violation of the trimester-based framework.8Virginia Code Commission. Virginia Code 18.2-71 – Producing Abortion or Miscarriage A Class 4 felony in Virginia carries a prison sentence of two to ten years. The criminal provision applies to the person performing the procedure, not to the patient.
Healthcare providers also face professional discipline. The Board of Medicine and the Board of Nursing can impose fines, practice restrictions, suspension, or revocation of a license. Facilities that fall out of compliance risk closure. A single violation can trigger both a criminal prosecution and a licensing proceeding.