If you’re considering an abortion in North Carolina, state law requires certain information to be provided before an abortion can take place. These requirements are called informed consent requirements.

Informed consent is about more than signing paperwork. It involves receiving information about the medical procedure or treatment, understanding potential risks and alternatives, having an opportunity to ask questions, and making a voluntary decision.

If you’d like to understand the broader reasons informed consent matters before an abortion, start with Part 1: Why Is Informed Consent Important Before an Abortion?

This article focuses specifically on what North Carolina law currently requires for informed consent before surgical and medication abortion.

Note: Laws can change. This article is for general educational purposes and isn’t legal advice. Check current North Carolina law and NCDHHS information for the latest requirements.

Does North Carolina Require Informed Consent Before an Abortion?

Yes.

North Carolina has separate informed-consent statutes for surgical abortion and medical abortion (also referred to as a medication abortion or the abortion pill).

Under N.C. General Statute §90-21.82, a surgical abortion cannot be performed in North Carolina without voluntary and informed consent as defined by the statute.^[1]

N.C. General Statute §90-21.83A establishes a separate set of informed-consent requirements for medical abortion (the abortion pill).^[2]

Except in a medical emergency, both statutes generally require specified information to be provided at least 72 hours before the abortion.^[1][2]

What Does NC Law Require Before a Surgical Abortion?

For a surgical abortion, North Carolina law generally requires a physician or qualified professional to provide the information contained in the State’s consent form orally and in person at least 72 hours before the abortion, except in a medical emergency.^[1]

The required information includes several categories.

Information About the Physician

The consent information includes the name of the physician who will perform the abortion, specified information concerning hospital admitting privileges, and whether the physician accepts the patient’s insurance.

The patient must also be told if the physician does not have malpractice liability insurance for performing abortions or does not have local hospital admitting privileges.^[1]

Information About the Pregnancy

The consent information must include the probable gestational age of the pregnancy at the time the surgical abortion is expected to take place.^[1] Since each stage of pregnancy is different, available abortion options can change over time, and an ultrasound is the most accurate means of determining how far along you are in your pregnancy.

Information About Risks

The statute requires disclosure of the particular medical risks associated with the surgical procedure being used.

When medically accurate, the statute identifies risks including:

Infection
Hemorrhage
Cervical tear
Uterine perforation
Potential effects on subsequent pregnancies, including the ability to carry a pregnancy to term
Adverse psychological effects associated with surgical abortion

The patient must also receive information about the medical risks associated with carrying the pregnancy to term.^[1]

Information About Alternatives

North Carolina’s acknowledgment of risks and consent statement also includes information about alternatives to abortion, including continuing the pregnancy and parenting or placing the child for adoption.^[1]

The consent process additionally addresses the potential availability of medical-assistance benefits for prenatal care, childbirth and neonatal care and public-assistance programs.^[1]

An Opportunity to Ask Questions

The required information isn’t supposed to be delivered simply through a recording.

Instead, the statute requires a consultation that allows questions to be asked, and the physician must ultimately sign a declaration stating that the surgical procedure was explained in person, the required information was provided, and the woman’s questions regarding the surgical abortion were answered.^[1]

What Does NC Law Require Before a Medication Abortion?

North Carolina has a separate informed-consent statute for medical abortion, commonly called the abortion pill.

Except in a medical emergency, §90-21.83A generally requires a qualified physician or qualified professional to provide the information in the State’s consent form orally and in person at least 72 hours before the medical abortion.^[2]

Gestational Age and Ultrasound

The statute requires the consent form to include the probable gestational age of the pregnancy as determined using both the patient’s history and ultrasound results used to confirm gestational age.^[2] Read more about why an ultrasound is important when you’re considering the abortion pill.

Information About the Medication-Abortion Process

The statute requires a detailed description of the steps involved in completing the medical abortion, as well as a detailed list of risks associated with the specific abortion-inducing drugs being used.^[2]

The risks specified in the statute include:

Hemorrhage
Failure to remove all pregnancy tissue, which may require an additional procedure
Sepsis
Sterility
Possible continuation of the pregnancy

The law also requires information about the medical risks associated with carrying the pregnancy to term.^[2]

Other Information Required by NC Law

The medical-abortion statute also requires information concerning Rh incompatibility, including information about Rh immunoglobulin for a patient with an Rh-negative blood type.

It requires information that complications from medical abortion, including incomplete abortion, increase with advancing gestational age. The statute also requires notice that the patient may see pregnancy remains during the process.^[2]

Follow-Up Care

The required acknowledgment and consent statement includes notice that the physician will then schedule an in-person follow-up visit approximately seven to 14 days after providing the abortion-inducing medication to confirm that the pregnancy has ended and assess bleeding and other complications.^[2]

The FDA’s current information for mifepristone also says patients should follow up with their healthcare provider approximately seven to 14 days after taking mifepristone to make sure the pregnancy has ended and the patient is well.^[4]

How Do the NC Requirements Compare?

Here is a simplified overview:

Requirement	Surgical Abortion	Medical Abortion
Voluntary informed consent required	Yes	Yes
Information generally provided at least 72 hours beforehand	Yes	Yes
Information provided orally and in person	Yes	Yes
Probable gestational age addressed	Yes	Yes
Procedure/treatment risks disclosed	Yes	Yes
Risks of continuing pregnancy addressed	Yes	Yes
Alternatives addressed	Yes	Yes
Opportunity to ask questions	Yes	Yes
Freedom from coercion addressed	Yes	Yes
State consent documentation required	Yes	Yes

This table is only a summary; the statutes contain additional requirements.^[1][2]

Does North Carolina Address Pressure or Coercion?

Yes.

The consent statements for both types of abortion address whether the woman is being forced to have an abortion and state that she has a choice not to have one.^[1][2]

North Carolina also has a separate statute, §90-21.90, requiring the informed-consent information to be presented to the woman individually, in her physical presence, and in a language she understands. The statute says this is intended to provide an adequate opportunity to ask questions and help ensure she is not the victim of a coerced abortion.^[3]

If a physician has reason to believe a patient is being coerced, another provision, §90-21.91, requires the physician or qualified professional to tell her that services are available and provide private access to a telephone and information about specified services.^[5]

What Should You Understand Before Signing?

Legal forms can contain a lot of information. Before signing an informed-consent document, make sure you actually understand what it says.

Consider whether you can answer yes to questions such as:

Do I understand which abortion method is being proposed?
Do I know the gestational age of my pregnancy?
Do I understand the risks and possible complications that have been explained to me?
Do I understand what will happen during the procedure or medication process?
Do I understand what follow-up care is expected?
Do I know what to do if I experience a complication?
Do I understand the alternatives that have been explained to me?
Have I had the opportunity to ask questions?
Have my questions been answered in a way I understand?
Am I making this decision without being forced or coerced?

For a more detailed list of questions to consider before consenting to an abortion, see Part 1: Why Is Informed Consent Important Before an Abortion?

Informed Consent Should Be More Than a Signature

North Carolina’s statutes contain detailed requirements concerning what information must be provided before surgical and medical abortions.

But from a patient’s perspective, there is an even simpler question:

Do I understand what I am agreeing to?

If you don’t understand something on a consent form or something a healthcare provider tells you, ask for an explanation.

You can say:

“I don’t understand this. Can you explain it?”

“Does this risk have any implications for me?”

“What are my alternatives?”

“What happens if I have a complication?”

Signing a form isn’t a substitute for understanding your medical care.

Key Takeaways

You deserve the opportunity to ask questions and understand what you’re consenting to before making a medical decision.

Take your first step to becoming fully-informed about all your pregnancy options – schedule a pregnancy options consultation with Hope’s Pathway Chatham.

Hope’s Pathway Chatham is a pregnancy help ministry supporting women, men, and families facing an unplanned pregnancy in Siler City and the larger Chatham County area of North Carolina. We provide medically-accurate and evidence-based information to help you understand all your options, so that you can make an informed decision. Share your thoughts, ask questions, and explore your options without fear of judgment. Make an appointment today.

Schedule a Free Options Consultation