Criminalizing Care: South Carolina’s Dangerous Proposed Total Abortion Ban 

Since the Dobbs decision stripped Americans of the constitutional right to obtain an abortion, 29 states have passed abortion bans based on gestational duration and 12 have passed total bans (Guttmacher Institute, 2025). Anti-abortion legislators in South Carolina are pushing to become the 13th, with a senate-proposed total ban to be heard in October. If advanced, this bill will exacerbate the region’s already extreme Ob-Gyn care deserts (March of Dimes PeriStats, 2023), threaten providers with imprisonment, and burden an already strained system of reproductive healthcare. 

The Current Landscape of Abortion Care in South Carolina 

Currently, South Carolina operates under a ban on abortion once cardiac activity is detectable in the embryo or fetus, often occurring around 6-weeks gestation. This means that it is illegal to provide an abortion to a pregnant patient 6 weeks after their last menstrual period (LMP). This is 4 weeks after a pregnancy begins with implantation in the uterine lining and when many may not know that they are pregnant yet. Thus, it is incredibly difficult to obtain an abortion in South Carolina. There are some exceptions in the law, but they are often ineffective in practice. These exceptions allow providers to perform abortions up to 12-weeks in circumstances of rape and incest only if the physician reports the case to law enforcement, including the patient’s name. The present exceptions also permit abortion in cases of fetal anomalies that are “incompatible with life” and to preserve the life and physical health of the pregnant person. Providers have difficulty interpreting the non-medical language of these exceptions and fear providing abortions even in these circumstances due to the immense threats of jail time and loss of license. (Center for Reproductive Rights, 2025). 

The Impact of SB 323 on Abortion Care (ACLU South Carolina, 2025). 

• The proposed ban, Senate Bill 323, would eliminate the current abortion exceptions for rape, incest, and fatal fetal anomalies. 

• It treats providing an abortion as a homicide.  

• It allows anyone who receives an abortion or aids someone else in receiving an abortion to be imprisoned for up to 30 years. This could be a friend who provides someone with gas money to leave the state for an abortion. 

• It criminalizes providing information about abortion. This could be a website, phone call, text, etc. 

• It criminalizes transporting a minor out of the state to receive an abortion. 

• It criminalizes abortion at any gestational duration (even if prior to 6 weeks). The bill’s language maintains the vague exception for abortion in cases that endanger the pregnant patient. It provides a list of conditions in which this exception applies and recognizes it as non-extensive. It goes on to stipulate: “However, when an unborn child is alive in utero, the physician must make all reasonable efforts to deliver and save the life of an unborn child during the process of separating the unborn child from the pregnant woman, to the extent that it does not adversely affect the life or physical health of the pregnant woman, and in a manner that is consistent with reasonable medical practice.” Anti-abortion legislators across the country have introduced this language of “separation” in efforts to divorce abortion from healthcare and define an abortion as such only when they deem the intervention “acceptable” or the patient “worthy” of it. This language strategy fails to honor the fundamental principle that everyone deserves access to quality care, including abortion care. The intervention is clinically referred to as an abortion whether or not the pregnant person is experiencing sepsis, whether or not the pregnancy was wanted, and whether or not serious fetal anomalies were diagnosed. Authors and abortion rights advocates Jessica Valenti and Kylie Cheung explain, “Some might ask, ‘What does it matter what they call the procedure, so long as women get the care they need?’ Well, it matters because when Republicans started citing ‘separation procedures,’ they also began outlining the type of procedures they’d consider acceptable means of ‘separation.’ Namely, induction of vaginal birth and c-sections” (Valenti & Cheung, 2025). SB 323 follows this pattern, paving the way for patients with life-threatening complications to be denied abortion care and instead forced to deliver or endure a C-section. 

Implications for Birth Control Access and National Policy 

In addition to its abortion restrictions, SB 323 attempts to legally redefine contraception to exclude things that prevent ovulation or implantation. This is not a medically sound definition. It would mean some forms of emergency contraception, certain hormonal birth control pills, and some IUDs would be excluded, opening the door for them to be classified as abortifacients, thus heavily restricted or banned. This language trick may also produce a chilling effect among providers dispensing these forms of birth control in the state. It is important to situate this in the context of a broader national effort to restrict access to birth control. On September 12, a spokesperson for USAID (now under the authority of a White House official) spoke to the New York Times about the planned destruction of $10 million worth of contraceptives once intended to be distributed to low-income countries. The spokesperson asserted, “President Trump is committed to protecting the lives of unborn children all around the world. The administration will no longer supply abortifacient birth control under the guise of foreign aid” (Nolen et al., 2025). This attempted redefinition is inaccurate. An abortion ends a pregnancy while birth control prevents a pregnancy. There is no such thing as “abortifacient birth control”. When keeping track of these patterns, one can conclude that SB 323 did not alter its language on birth control incidentally but did so as part of a coordinated attack on it (Ross, 2025). 

Finally, the South Carolina bill also reaches into public school classrooms across the state, mandating that students be shown an anti-abortion video created by Live Action, an organization with a history of promoting disinformation regarding abortion care. This provision is not the first to appear in a restrictive state. Once again, it is part of a national strategy employed by restrictive states to spread false information conducive to their legislative goals. 

SB 323 tells us a great deal about the priorities of the broader anti-abortion movement and may even serve as a dangerous blueprint for other states, considering that the bill was drafted by a large anti-abortion organization, National Right to Life. Some may question the bill’s likelihood of passage or write it off as a manifestation of only the most fringe aspects of the state’s anti-abortion majority. However, Valenti proposes that these bills are meant to desensitize the public, so that the next time a total ban is introduced, the outcry will be lesser. Carey Shofner, Board President of Palmetto State Abortion Fund (PSAF), posits that South Carolina is now serving as a “testing ground for extremist policies that could spread across the country” (Valenti & Cheung, 2025). 

This bill, insidious in some ways while overtly harmful in others, seeks to exercise aggressive control over our bodies and reproduction. It outlaws a form of healthcare that is vital to our ability to dictate our futures and participate as equal members of society. As a South Carolinian and an aspiring Ob-Gyn, it provokes significant personal and professional concerns.  

When I was 17, I decided I wanted to be an OB-GYN one day. In my third year as a pre-med student, this resolve remains just as strong and is reinforced daily. I am several years of training away from this ultimate goal. But I think every day about the legal climate that will await me when I embark on residency. Will I want to return to South Carolina to practice? Will I feel professionally equipped to navigate that? Will I be personally afraid to live there? What will my allies in the fight for abortion rights expect of me? To be there for patients in South Carolina because someone has to be? To lessen the burden on providers in a protective state experiencing an influx of out-of-state patients? These are considerations that should not be relevant, but that I nonetheless will have to contend with. With the introduction of SB 323, these questions are as salient as ever. 

Take Action 

• Read the bill in full here.  

• With the bill’s subcommittee hearing on October 1st, now is an incredible opportunity to join me in vocalizing your opposition. If you are able, please consider signing this petition against SB 323, donating to the Palmetto State Abortion Fund, or supporting  Planned Parenthood South Atlantic.  

• If you are in South Carolina, contact your legislator, the key lawmakers on the Medical Affairs Subcommittee, and the bill’s co-sponsors: Senators Richard Cash, Rex Rice, and Billy Garrett. 

References 

ACLU of South Carolina. (2025, September 8). Extreme abortion ban hearing scheduled for Oct. 1 in South Carolina. https://www.aclusc.org/en/press-releases/extreme-abortion-ban-hearing-scheduled-oct-1-south-carolina 

Center for Reproductive Rights. (2025, May 15). South Carolina – Center for Reproductive Rights. https://reproductiverights.org/maps/state/south-carolina/ 

Guttmacher Institute. (2025, August 25). State bans on abortion throughout pregnancy. https://www.guttmacher.org/state-policy/explore/state-policies-abortion-bans 

March of Dimes PeriStats. (2023). Where you live matters: Maternity care access in South Carolina.  https://www.marchofdimes.org/peristats/reports/south-carolina/maternity-care-deserts 

Nolen et al. (2025, Sept 11). $10 Million in Contraceptives Have Been Destroyed on Orders From Trump Officials. The New York Times. https://www.nytimes.com/2025/09/11/health/usaid-contraceptives-destroyed-trump.html  

Ross, C. (2025, September 25). South Carolina is trying to apply racketeering laws to criminalize abortion providers – Ms. magazine. Ms. Magazine. https://msmagazine.com/2025/09/25/south-carolina-rico-racketeering-abortion-clinic-provider/ 

Valenti, J., & Cheung, K. (2025, September 5). South Carolina Republicans move to ban birth control. Abortion, Every Day. https://jessica.substack.com/p/south-carolina-republicans-move-to