The U.S. Supreme Court’s decision to overturn Roe v. Wade removed the constitutional right to abortion, returning the decision of abortion access to individual states.
In Washington state, abortions have been legal since 1970, and that has not changed even after the U.S. Supreme Court overturned Roe v. Wade.
Nationally, the Supreme Court decision has led to a patchwork of different restrictions and litigation across the nation, creating confusion and worry for providers and potential patients.
To address some of these concerns, these frequently asked questions and answers draw from resources published by the Washington State Department of Health; professional health regulators in Washington, including the Washington State Medical Commission, Board of Osteopathic Medicine and Surgery, Nursing Care Quality Assurance Commission, and Pharmacy Quality Assurance Commission; and the office of Washington Gov. Jay Inslee.
General Abortion Information
- What is an abortion, and when can they be performed in Washington?
Washington law defines abortion as “any medical treatment intended to induce the termination of a pregnancy except for the purpose of producing a live birth.” (RCW 9.02.170)
In Washington, abortions are legal up to the point of fetal viability or to protect the life or health of the pregnant individual. (RCW 9.02.110) Viability is defined in RCW 9.02.170 as the point in the pregnancy when “there is a reasonable likelihood of the fetus's sustained survival outside the uterus without the application of extraordinary medical measures.”
Viability is determined by the judgment of a physician, physician’s assistant (PA), advanced registered nurse practitioner (ARNP), or other health care provider acting within the provider's scope of practice on the particular facts of the case. (RCW 9.02.170)
Additionally, Washington legally considers a practitioner’s good faith judgment as a defense for violations of RCW 9.02. This means that if the health of the pregnant individual or viable fetus were at risk, providers acting in good faith are generally safeguarded. (RCW 9.02.130)
- What are the different types of abortion and at how many weeks can they be performed?
The type of abortion available to you depends on how far along you are in your pregnancy and other factors. A general description of each type is below.
- Medication—the abortion pill—is an option for most people up to 10-11 weeks of pregnancy (counted from the first day of your last period). This method uses a combination of medications (taken by mouth/swallowed) that cause your body to stop making pregnancy hormones and expel the pregnancy from your uterus through the vagina. You might have the choice to access medication abortion through an in-person or telemedicine appointment. The process may take a few hours or a few days to complete.
- Aspiration—suction or vacuum abortion—is generally an option up to 16 weeks after your last period. It uses gentle suction to remove the pregnancy. This procedure is done in a clinic and takes about 15 minutes.
- Dilation and evacuation—D&E—is generally used if it's been more than 16 weeks since your last period. This procedure dilates your cervix and removes the pregnancy. It is done in a clinic and might require 2 visits over 2 days.
Your provider will discuss pain management and anesthesia options that may be appropriate for you.
- Are abortions safe?
Clinical evidence clearly shows that legal abortions—whether by medication, aspiration, or dilation and evacuation—are safe and effective. Serious complications are rare, although the risk of a serious complication increases with the number of weeks you are pregnant.
In most cases, abortion does not impact future health. It does not increase the risk of breast cancer, depression, or infertility. You can find more answers to questions about your health and abortion care from The American College of Obstetricians and Gynecologists.
- How many abortions are performed in Washington?
Abortion is a common outcome of pregnancy. Data show that roughly 1 in 4 women will have an abortion by age 45.
People who seek an abortion and people who give birth are often the same people at different points in their reproductive lives. Nationally, more than half of people (59%) who have abortions have previously given birth.
- In 2020, there were 16,050 abortions among Washington residents, out of 99,613 pregnancies.
- People from other states were already traveling here for abortions before Roe v. Wade was overturned, due to limited access in other states and a growing number of restrictive state laws. There were 852 abortions performed in Washington for people who traveled here from out of state in 2020. Most of those people came from Idaho (371), Oregon (252), and Alaska (53). Overall, people seeking abortion in Washington came from 35 states, as well as from Canada.
- We expect the number of people from other states traveling here for abortions to increase with abortion bans and restrictions going into effect in other states.
Washington’s abortion rate has dropped every year since 2009. For more data on abortions in Washington, see the Washington Tracking Network dashboard.
Laws, Legislation, and Patient Rights in Washington State
- Are abortions legal in Washington state?
Yes. Abortions have been legal in Washington state since 1970, and that has not changed even after the U.S. Supreme Court overturned Roe v. Wade.
The law in Washington states, “every individual possesses a fundamental right of privacy with respect to personal reproductive decisions” including “the fundamental right to choose or refuse to have an abortion.” (RCW 9.02.100)
Further, state law makes it clear that no one may interfere with either a pregnant individual's right to choose an abortion prior to fetal viability or a health care practitioner’s right to provide an abortion. (RCW 9.02.110)
Under state law, regulators cannot inhibit, prevent, hamper, or interfere with a health care professional, acting within their scope of practice, from providing an abortion that meets the state standard of care.
Washington does not require a waiting period or parental, guardian, or partner consent for minors before an individual receives an abortion.
You should be aware that the policy holder of your insurance plan may be notified in certain instances (for instance, through credit card receipts or insurance claims) about abortion services accessed through the plan. See “What if I want to keep information about my abortion private?” section for more information on how to keep your abortion care confidential.
- What is Washington State doing to keep abortion legal?
On June 24, 2022, the day the Supreme Court overturned Roe v. Wade, the governors of California, Oregon and Washington issued a Multi-State Commitment to defend access to reproductive health care, including abortion and contraception. The 3 states commit to protect against efforts by other states that want to target providers or patients who seek legal reproductive health care services in Washington, California, or Oregon.
Later that month, Governor Jay Inslee approved $1 million in emergency funding for abortion care and services provided by clinics in the Washington State Department of Health’s Sexual and Reproductive Health Program. He also issued a directive (22-12) to the Washington State Patrol to refuse cooperation with investigatory requests related to abortion that come from agencies in states that don’t allow abortion.
Since then, Washington state lawmakers have been working on measures such as:
- Exploring additional funding in the future for abortion care and services.
- Developing more protections against out-of-state investigations and legal action against providers and patients.
- Expanding access to abortion, particularly in rural areas, by increasing access to medication abortion, removing barriers to telehealth for reproductive health care services, and growing the pool of qualified practitioners who may provide abortion and related services.
- Committing to defend against false and misleading reproductive health care information.
- Closing a legal loophole that allows non-health care organizations, such as crisis pregnancy centers, to collect, share, or sell private health information. (For more information, see the `What are crisis pregnancy centers?’ section below.)
- Prohibiting the collection of data from specific locations related to reproductive care.
- Ensuring hospital mergers don’t result in erosion of access to abortion care, particularly in rural areas.
- Who can get an abortion in Washington state?
People of any age have the right to independently consent for their own abortion care in Washington. Washington lawmakers have incorporated gender-neutral language in abortion laws to acknowledge that patients across the gender spectrum seek out and receive abortions.
You do not have to be a resident of Washington state nor a citizen of the United States to get abortion services here. In Washington, health care providers cannot deny you care based on your immigration status, and you do not have to share your immigration status to receive and abortion. More information about abortion rights for immigrants can be found in this resource from the National Immigration Law Center.
For more information on legal protections for abortion and other reproductive health care in Washington state, please refer to the Know Your Rights flier from the Washington State Attorney General’s Office or contact the If/When/How helpline.
Accessing Abortion Services in Washington State
- Who may perform an abortion in Washington state?
A physician (MD), osteopathic physician (DO), physician assistant (PA), advanced registered nurse practitioner (ARNP), certified nurse midwife (CNM), or other health care provider acting within the provider's scope of practice and trained in abortion care may provide an abortion as defined in RCW 9.02.170.
Providers can refer patients and the public to the Washington State Department of Health website for a collection of resources about who can provide abortions, insurance coverage mandates, privacy laws and more: DOH Abortion Resources webpage.
- What are crisis pregnancy centers? Are they in Washington and do they provide abortions?
Crisis pregnancy centers (CPCs), sometimes called pregnancy resource centers, are facilities that look like real clinics or health centers offering pregnancy care but do not provide abortions or other sexual and reproductive health services. There are crisis pregnancy centers located in Washington.
- Most CPCs are not legitimate medical clinics or do not have licensed medical professionals on staff.
- Generally, they are not required to follow HIPAA (Health Insurance Portability and Accountability Act) guidelines or to keep your information private.
According to a 2020 study of the crisis pregnancy center industry by The Alliance, a collaborative of state and regional law and policy members:
- Almost one-half (45%) of CPCs in Washington are affiliates of a U.S.-based evangelical anti-abortion organization called CareNet;
- 1 in 5 (20%) CPCs in Washington are affiliates of Heartbeat International, an international anti-abortion organization;
- The majority of CPCs in Washington – 6 in 10 (60%) – make false and/or biased claims on their websites. Some promote abortion “reversal” treatment, which is not based on science and does not meet clinical standards.
If you are seeking abortion services, you can avoid crisis pregnancy centers by locating them on the Crisis Pregnancy Center Map, which has the most up-to-date information on CPC locations in Washington but may not be comprehensive. To ensure you will get the care you need, contact the clinic directly.
- How can I find an abortion provider?
The Northwest Abortion Access Fund and the National Abortion Federation maintain lists of abortion providers in Washington state. You can also visit Abortion Finder to find abortion providers nationally. We recommend calling the clinic directly to confirm location and hours before you seek services. Other resources for finding abortion providers include ineedana.com and Aid Access.
- If you have private insurance (such as through your employer or your parent/guardian’s employer), check your policy for restrictions, such as a requirement to use certain providers.
- Patients enrolled in an Apple Health (Medicaid) managed-care organization have the option to seek abortion services outside of their managed-care organization without a provider referral. These managed- care organizations are Amerigroup, Community Health Plan of Washington, Coordinated Care of Washington, Molina Healthcare of Washington, and UnitedHealthcare Community Plan.
- I’m worried about the cost of an abortion. What can I do?
Health care clinics and providers can help you determine if you have insurance coverage and if abortion benefits are included in that coverage. They can also help you find out if you are eligible for a state insurance program, or help you find other ways to pay for your abortion and other costs associated with it. Some might also offer a sliding fee scale for abortion services depending on your income level.
We suggest you call the clinic you're interested in and let them know:
- If you are unsure of how to pay, or unsure of your insurance status. They can help you understand your coverage, the cost of service, and if help is available.
- If you have concerns about confidentiality. They can help you keep your information private.
- If you have concerns about travel costs to the clinic. They may have funds available to help cover travel costs or refer you to a local abortion fund like the Northwest Abortion Access Fund.
Private Insurance: State law requires all state-regulated plans to cover abortions if they cover maternity services.
- If your health coverage is through a Providence Health Plan, the Department of Health may be able to pay for your abortion services. See our Increasing Access to Reproductive Choice page for details on how to get this coverage.
- If you are pregnant and a Washington state resident, you may qualify for Apple Health for Pregnant Individuals (Medicaid) and may be able to have your abortion services covered through Medicaid even if you have a private insurance plan. This option may benefit those who want to keep their abortion services confidential from the policy holder of their private insurance plan.
You may have a private insurance plan that is not Washington state-regulated and may not cover abortions. It is important to always check with your insurance provider for coverage options if you are concerned about the cost of a health care service.
State Programs: Washington State Apple Health (Medicaid) provides abortion coverage for Washington residents who meet eligibility requirements, regardless of immigration status.
- You might be eligible for Apple Health for Pregnant Individuals or an Apple Health Managed Care plan if you already have Apple Health insurance. Both cover abortion services, post-abortion care, and post-abortion contraception.
- If you are seeking post-abortion care or post-abortion contraception only, you may be eligible for coverage through the Family Planning Only program.
- You can apply for Apple Health or sign up for a Health Benefit Exchange plan through the Washington Health Plan Finder. If you don't qualify for Apple Health, the application checks to see if you can get a subsidy to help pay for your Health Benefit Exchange plan.
Other Assistance: You might qualify for assistance from a clinic or the Northwest Abortion Access Fund if you:
- are an out-of-state resident; or
- are not eligible for Apple Health (Medicaid); or
- do not have private health insurance.
We encourage you to discuss your situation with an abortion provider, because some clinics may accept out-of-state Medicaid or have their own assistance funds.
- What if I have a medical emergency that requires an abortion?
If you have a medical emergency—such as an ectopic pregnancy or a miscarriage—that may require abortion as a treatment, you have a right to receive that service, regardless of the hospital where you choose to access care. If you are experiencing medical problems due to an incomplete abortion, you are not required to disclose that you took medication abortion pills or sought out abortion services prior to seeking emergency care.
You can access that treatment even at hospitals that are religiously affiliated and do not normally provide abortion services. That’s because Washington law (RCW 70.400.020) protects health care providers from retaliation from their employer if they treat a patient for pregnancy complications that are life-threatening or potentially disabling. That includes providing an abortion if a provider determines it is necessary.
In addition to hospitals, many clinics, including those funded under the DOH Sexual and Reproductive Health Program, are required to provide services and/or referrals for:
- Treatment of spontaneous abortions (miscarriages) or incomplete abortions
- Treatment for any medical problems resulting from a medically unsupervised abortion (for instance, when someone other than a provider, such as a patient, has induced an abortion).
- Medical procedures necessary for the termination of an ectopic pregnancy
You also have federal protections to receive emergency abortion services under the Emergency Medical Treatment and Labor Act (EMTALA). The law requires emergency room providers to give stabilizing medical treatment to any pregnant patient presenting to the hospital with an emergency medical condition. They are not permitted to wait until your medical condition declines to provide this care. Stabilizing treatment could include abortion.
The enforcement of EMTALA is a complaint driven process. If you or someone you know did not receive the emergency medical care required, you can file an EMTALA complaint through the Washington State Department of Health.
You can find more information about protections for providers who give abortion care in Washington state at the Department of Health’s website.
- What if I want to keep information about my abortion private?
In Washington, a state law gives you extra privacy protection for sensitive health care services, including abortion.
State Insurance: Apple Health (Medicaid) sends all communication about abortions to the email or physical address that the person receiving the abortion gives to their health plan.
Other State Regulated Insurance: If you have an insurance plan on the Washington Health Benefit Exchange, to protect your privacy, you must request that any information about sensitive health care services you receive should be sent to you directly. To do this, you or the clinic where you access services can print, complete, and send this Confidentiality Request Form (PDF) to your health insurance company. You can also call your insurance company to request confidentiality. (See the Office of the Insurance Commissioner webpage for more information.)
Private Insurance: If you have private insurance originating in Washington and are not the main policyholder (you are insured through someone else like a parent or spouse), you need to tell your health insurance company your communication preferences. You can contact them directly or submit the Confidentiality Request Form (PDF).
Make sure you talk to your health care provider about your privacy concerns.
Bedsider.org also offers information about maintaining privacy about your reproductive health care.
Other Sexual and Reproductive Care in Washington State
- Where can I go for other sexual and reproductive health care?
The DOH Sexual and Reproductive Health Program provides funding to clinics and county health departments so they can offer sexual and reproductive health care services for people throughout Washington state.
The 95 clinics in our network provide high-quality comprehensive sexual and reproductive health services.
Each clinic provides these services at a sliding fee:
- Most FDA-approved birth control methods, including long-acting reversible contraceptives (IUDs and implants)
- Emergency contraception
- Birth control education and counseling
- Pregnancy testing and comprehensive options for counseling and referral
- Preconception health counseling
- Infertility counseling, education, and referral
- Physical examinations for reproductive health
- Breast and cervical cancer screening
- Testing and treatment for sexually transmitted infections (STIs) and vaginal infections
- HIV testing and counseling
- Health promotion and disease prevention information
Additional services may also be offered at a sliding fee, depending on the clinic.
- What is emergency contraception and how can I get it in Washington state?
Emergency contraception can prevent pregnancy after unprotected sex if used within a certain timeframe. Emergency contraception will not cause an abortion and is not the same as the abortion pill.
Some emergency contraceptives taken by mouth—including Plan B One-Step, Next Choice One Dose, Next Choice, EContra EZ, My Way, After Pill, and other generics—are similar to birth control pills, but at a much higher dose.
- They’re available to people of all genders without a prescription and without age restrictions.
- They’re carried at most pharmacies, usually in the family planning aisle or over the counter.
- They can prevent pregnancy up to 5 days after sex, but they are more effective the sooner you take them after sex.
Other emergency contraceptives taken by mouth—including Ella and similar generics—are also available to people of all genders and without age restrictions up to 5 days after sex but require a prescription from a health care provider. A pharmacist may dispense emergency contraceptives if you have a valid prescription or chart order. As with all other prescribed medications, pharmacists must comply with all applicable laws and rules, including the requirement to ensure a prescribed contraceptive is safe and appropriate for each patient (WAC 246-945-305).
Some IUDs—including the ParaGard (the copper IUD), Mirena, and similar generics—can work as emergency contraception if you visit a health care provider and have the IUD inserted within 5 days after sex.
Additionally, Washington regulation mandates that all hospitals with emergency rooms must provide emergency contraception as a treatment option to any person who seeks treatment after a sexual assault (WAC 246-320-286).
For more information, please see this DOH webpage on emergency contraception.
The state Pharmacy Commission handles complaints about the dispensing of hormonal, non-hormonal, or emergency contraceptives by pharmacists and evaluates each complaint on its facts and circumstances.
- Are contraceptives covered by insurance?
Almost all* insurance plans, including all those offered through the Washington Health Benefit Exchange, must cover contraceptives at no cost to you (even if you haven't met your deductible). That includes emergency contraceptives. Patients of any age can access birth control in Washington state without parental, guardian, or partner consent.
Some plans may require you to pay for the cost of over-the-counter emergency contraceptives upfront and submit a reimbursement claim if you do not have a prescription. To avoid this, you can request a prescription for emergency contraception from your provider and fill it in advance to have on hand if needed.
Apple Health (Medicaid) and Washington's Family Planning Only program also cover contraceptives at no cost to you. If you are not eligible for comprehensive Apple Health, you might be eligible for Family Planning Only (for instance, there are no citizenship requirements for Family Planning Only).
You can apply for Apple Health or sign up for a Health Benefit Exchange plan through the Washington Health Plan Finder. If you don't qualify for Apple Health, the application checks to see if you can get a subsidy to help pay for your Health Benefit Exchange plan.
If this is not an option for you, contact one of the clinics we fund. They offer contraceptives—including emergency contraceptives—on a sliding-fee scale.
*The ACA’s preventative services requirement (including $0 contraception benefits) extends to non-grandfathered larger group, small group, and individual health plans. There are some exceptions for religious employers.