US Massachusetts Governor Maura Healey on Monday signed a new law easing restrictions on abortions after 24 weeks of pregnancy, giving physicians greater discretion over whether such procedures can be performed.
The legislation, passed by the state legislature in a fast-tracked process late last month, replaces Massachusetts' existing legal framework for abortions at or beyond 24 weeks. The new law says that "an abortion may be performed by a physician based upon the professional judgment of the physician."
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Here is what the new law changes, why supporters backed it and why opponents have strongly criticised it.
What has Massachusetts changed?
The new law, H 5595, removes the state's existing four-pronged framework governing abortions at or beyond 24 weeks in situations involving serious risks to the pregnant patient or fetus.
Instead, the law places greater emphasis on a physician's professional judgment in deciding whether an abortion should be performed.
It also removes the existing requirement that abortions beyond 24 weeks be performed in a hospital, potentially allowing such care to be provided in other medical settings.
The law will take effect 90 days after Healey signed it on Monday.
Why did lawmakers change the law?
Supporters say the previous rules could prevent doctors from making decisions based solely on a patient's medical circumstances.
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They argue that some pregnancies develop serious complications well into the second or third trimester, creating situations that do not fit neatly into statutory categories.
Judiciary Committee Chair Representative Mike Day said lawmakers had revisited the issue several times over the past 16 years.
He described the latest legislation as an effort "in an effort to get it right, to get government out of the way of a health issue, and to lessen the trauma inflicted on pregnant women, who are suddenly confronted with unbelievably tragic news about their pregnancies more than six months into their term."
Day also said some doctors remained concerned about the legal consequences of providing care under the previous rules.
"We hear that some medical professionals are still uncomfortable with the specific language restrictions that they say continues to interfere with their professional medical judgment, and that some patients continue to have to leave the commonwealth or stay and endure unnecessary trauma because a treating physician is afraid that they will somehow run afoul of the law based on those restrictions," he said.
"We're also still hearing of patients who, after receiving this news, are ultimately unable to receive necessary medical care because they don't have the means to afford to leave Massachusetts for it."
Does the law mean abortions after 24 weeks will become routine?
Supporters say abortions after 24 weeks remain extremely uncommon.
According to Reproductive Equity Now, abortion care after 24 weeks accounts for less than 1% of abortions in the United States.
Massachusetts Department of Public Health data shows that 99 abortions were performed at 24 weeks or later in the state in 2024, compared with 84 in 2023.
The legislation does not require a patient to have an abortion. Public Health Committee Chair Representative Marjorie Decker stressed that the decision remains with the patient and physician.
"It does not tell a patient what decision to make. It does not force anyone to have an abortion. It does not take decision-making away from the patients," Decker said.
Why do supporters say the change is necessary?
Supporters have pointed to cases in which serious fetal or maternal complications are discovered late in pregnancy.
Kate Dineen, who supported the legislation, recalled travelling from Massachusetts to Washington, D.C., in 2021 after doctors discovered that her baby had suffered a stroke in the womb, as per NBC Boston. She was 33 weeks pregnant at the time.
"He would either die or survive for some period of time with a spectrum of devastating outcomes. And so upon learning of the prognosis, I asked, 'What are my options?' And I will never forget the response. 'You may still be able to explore termination if you're able to travel,'" Dineen said.
"Travel where? We were standing in our kitchen in Boston, just less than a mile from some of the best hospitals in the country."
Dineen said her circumstances did not qualify for an exception under Massachusetts' previous rules, forcing her to travel out of state.
She said her doctor's "highly capable hands were tied by Massachusetts state law."
The Massachusetts Health and Hospital Association, Beth Israel Lahey Health, Mass General Brigham, Tufts Medicine and UMass Memorial Health also supported the legislation. In a July letter to House Speaker Ron Mariano, the organisations said the existing framework "does not adequately meet the needs of all patients."
Worcester Senator Robyn Kennedy said the medical realities of complicated pregnancies cannot always be addressed through rigid legal categories.
"The reality is that medicine does not always fit into clearly defined legal categories," Kennedy said during the Senate debate. "Physicians need the ability to use their medical judgment and advise their patients when facing complex and rapidly changing medical circumstances."
What does Governor Healey say?
Healey has framed the legislation as a measure aimed at ensuring patients can receive care within Massachusetts rather than having to travel elsewhere.
"We've heard so many stories — stories that are filled with a lot of pain and anguish and heartache and a lot of trauma. We heard stories about the worst moments of a person's life, of a couple's life," Healey said at the bill-signing event.
"We're signing this law today so that new patients, people we won't know or won't meet, will be able to get the care that they need in Massachusetts."
She also linked the change to the broader national fight over abortion access following the US Supreme Court's 2022 decision overturning Roe v. Wade.
"We know that protecting abortion access and reproductive health care has been under fire," Healey said, adding, "Today, one in three women in America live in a state with an abortion ban."
Why are opponents angry?
Opponents argue that the new law removes safeguards around abortions later in pregnancy.
The Massachusetts Family Institute called the legislation "a dangerous attempt to remove virtually all remaining protections in the Commonwealth for unborn babies."
Massachusetts Family Action went further, saying the Legislature had "passed one of the most extreme abortion bills in the country — allowing abortion at any point in pregnancy, for any reason, outside the safeguards of a hospital."
The groups argue that eliminating the previous statutory restrictions and hospital requirement could make abortions later in pregnancy more widely available.
Supporters reject that characterisation and say the law is designed to give doctors greater flexibility in medically complicated cases rather than encourage late abortions.
How did the bill become law?
The legislation was introduced by Representative Christine Barber at the beginning of the current two-year legislative session.
It gained momentum on July 22 after being released from the House Ways and Means Committee.
The House passed it 119-33 on July 22. All Republicans who voted opposed the measure, while several Democrats also voted against it. Independent Representative Susannah Whipps voted in favour.
The Senate subsequently approved the bill on July 31 by a 15-4 standing vote.
Healey signed it into law on Monday.
Why is this politically important?
The abortion debate is likely to remain a significant issue in Massachusetts politics ahead of the November elections.
Healey herself said Monday that abortion would be an electoral issue.
"Abortion is on the ballot this November in Massachusetts and around the country," she said.
"My opponents are anti-abortion. One of my opponents, Mike Minogue, is proudly anti-abortion."
Republican gubernatorial candidate Mike Minogue has described himself as "pro-life" and said he would uphold the law if elected. Another Republican candidate, Brian Shortsleeve, has described himself as a "pro-choice Republican."
The Massachusetts law therefore comes amid a wider US political divide over abortion, with states taking sharply different approaches following the Supreme Court's decision to overturn Roe v. Wade.
What happens next?
The new law takes effect in 90 days.
Its practical impact will depend on how physicians, hospitals and other healthcare providers interpret and implement the new rules.
Supporters say it will give doctors the flexibility to respond to complex pregnancies and reduce the need for patients to travel outside Massachusetts.
"Massachusetts is affirming again that abortion is essential healthcare, and that politicians should never stand between a patient and their doctor. The significance of this law goes far beyond our state borders," said Claire Teylouni, interim executive director of Reproductive Equity Now.
ACLU of Massachusetts Executive Director Carol Rose also said the law would ensure "pregnant patients in Massachusetts will no longer have to travel far from their home state to access the care they need."
Opponents, meanwhile, are expected to continue challenging the legislation politically, arguing that Massachusetts has gone too far in removing restrictions on abortions later in pregnancy.
