Massachusetts House approves bill to expand physician discretion for abortions after 24 weeks

The Massachusetts House voted 119–33 on July 22 to approve legislation that would change how abortions are regulated after 24 weeks of pregnancy, sending the measure to the state Senate for consideration.

The bill, H.5595, would not eliminate Massachusetts’ 24-week threshold for abortion care. Instead, it would change the legal standard physicians use when determining whether an abortion may be performed after that point in pregnancy.

Under current Massachusetts law, abortions after 24 weeks are generally permitted only under specific circumstances, including when they are necessary to preserve the pregnant patient’s life or physical or mental health, or when the fetus has a lethal anomaly or another qualifying serious fetal diagnosis.

The new legislation would replace those detailed statutory categories with a broader standard allowing a physician to exercise their professional medical judgment when determining whether an abortion is appropriate after 24 weeks.

Supporters say the change reflects the reality that pregnancy complications do not always fit neatly into rigid legal definitions. They argue that physicians should have the flexibility to respond to complex medical situations without worrying whether a patient’s condition precisely matches language written into state law.

Several Massachusetts hospital systems and reproductive rights advocates have supported the measure, arguing that current law has, in some cases, forced patients with severe pregnancy complications to seek care outside the state because their circumstances did not clearly qualify under existing statutes.

Opponents contend the legislation would significantly expand access to abortions later in pregnancy by replacing specific legal criteria with a physician judgment standard. They argue that the current law already provides exceptions for serious medical situations and that the proposed language would reduce legislative safeguards.

If approved by the Massachusetts Senate and signed into law, the bill would make Massachusetts one of several states that have moved to expand legal protections for abortion access in the years following the U.S. Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization.

The proposal reflects a broader trend among states that support abortion rights. Rather than simply preserving access that existed before Dobbs, lawmakers are increasingly revisiting their statutes to give physicians greater discretion in responding to complicated pregnancies and evolving standards of medical care.

The Senate has not yet voted on the measure.