South Carolina Puts One More Boulder Into the Path to Abortion Access

Debbie Billings

South Carolina's "Woman's Right to Know" Act assumes that women make the decision to abort without thought and that the state should, therefore, impose a 24-hour period post-ultrasound during which they might reflect.

H.3245 is the latest attempt by South Carolina’s
legislature to undermine women’s ability to access safe abortion services. 
H.3245 effectively mandates a 24-hour waiting period for women seeking
an abortion, if she has an ultrasound to determine gestational age. 
If she does not have an ultrasound, then 24 hours still needs to pass
after a woman receives state-prepared
.  Section
1(2)(a) of H.3245 states specifically that, "The woman must
be presented by the physician who is to perform the abortion or by an
allied health professional working in conjunction with the physician
a written form containing the following statement: ‘You have the right
to review printed materials prepared by the State of South Carolina
which describe fetal development, list agencies which offer alternatives
to abortion, and describe medical assistance benefits which may be available
for prenatal care, childbirth, and neonatal care. You have the right
to view your ultrasound image.’ This form must be signed and dated by
both the physician who is to perform the procedure and the pregnant
woman upon whom the procedure is to be performed."   The
proponents of H.3245 are dressing this as "informed consent". 
It’s also called the "Women’s Right to Know" Act within South Carolina’s
abortion law
The use of both terms truly distorts the meaning of a very important
process in which any health care provider concerned about human rights
fully engages. 

South Carolina’s existing abortion law (Section 44-41-50) states that medical employees
("physician, nurse, technician or other person") are not required
to aid in abortions and cannot be demoted, dismissed, suspended or otherwise
disciplined by the employer.  

Throughout the state, only three clinics
provide elective abortion services; 91
of South Carolina
counties have no abortion provider.  South Carolina’s existing abortion law states that before obtaining an abortion,
a woman must be informed by the physician performing the abortion of
the probable gestational age of the fetus.  The three clinics that
provide first trimester elective abortion services routinely conduct
pre-abortion ultrasounds precisely to determine gestational age. Whether
or not this is medically necessary, clinics are following this practice
to protect themselves from malpractice suits and attempts to shut down
their services.  The "if" in H.3245 does not provide women
with a realistic opt-out option.  Performing an abortion without
the ultrasound proof of gestational age would leave providers vulnerable
to sanctions that could further limit women’s access to abortion services
in South Carolina.

Ultrasound has been touted in the public
eye as a fail proof technology that serves to "inform" women about
their pregnancy.  Yet determining gestational age without an ultrasound
is possible by a trained professionals; this is accomplished throughout
the world.  Ultrasounds must be interpreted and if this is done
by someone who is not trained to appropriately use the technology, the
"information" generated can be erroneous. (The extent to which this
is happening in anti-choice pregnancy "counseling" sites throughout
the US needs to be documented).  On March 19, 2009 I had the opportunity
to testify before South Carolina’s Senate Medical Affairs Subcommittee. 
Public testimony was given both by supporters and opponents of H.3245,
speaking to Subcommittee members Senators Thomas, Fair, Hutto, Pinckney and Bryant in 2-minute spots.  Supporters of the
Bill included several women who had negative abortion experiences during
the 1970s (including pre- Roe v. Wade).  One woman asked the Senators
to think about the "times that they gone shopping with their wives
and how long it took them to pick out a new dress." (Note: South Carolina has no female Senators).  This same woman emphasized the ways
in which "women’s bodies are raging with hormones" and how they
"needed help in making the decision to end life."  Others attributed
divorce, anger and food disorders to women terminating their pregnancies. 
Opponents of H.3245, including two physicians from two of the three
clinics that provide abortion services in South Carolina, emphasized
that most women seeking care have already reflected and come to their
decision to end their pregnancies.  In my own testimony, I stated
that, "This bill will negatively affect the ability of many women
in our state to access a legal medical service.  When a 24-hour
delay is put into place, women who do not have flexibility in their
jobs to be able to take off from work for several days and women whose
financial situation does not allow for making two office visits for
a service that should take just one will be most severely affected. 
In addition, the delay for many women may become much longer than 24
hours, as they find it impossible to make a second appointment within
the 24-hour period.   This delay can make the abortion more
expensive and less safe, especially if women seek untrained providers
or their own ways of ending their pregnancies."  

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I included these points in correspondence
to Senator John Courson, urging him to help defeat H.3245.  His
response included his understanding that H.3245 would put South Carolina
in line with 26 other states and that "for such a sensitive and important
issue, the 24-hour wait time does not seem to be unreasonable." 
Not unreasonable for whom?  He ends his correspondence by trying
to appeal to my "feminine side", I suppose, by stating, "Of the
seventeen women serving in the South Carolina General Assembly, only
four voted against H.3245."   Clearly Courson wants me to
see that most women in the General Assembly were "reasonable"; my
own conclusion is that we need to fully support the four women that
voted against H.3245 in educating their fellow Assembly members, both
women and men. 

H.3245 assumes that women make the
decision to abort quickly and without thought and that the State of
South Carolina should, therefore, impose a 24-hour period post-ultrasound
during which they might reflect.  Given the grave shortage of safe
abortion services in South Carolina, I suspect that during that 24-hour
period few women will be engaged in deep meditation and most will be
scrambling to find childcare, figuring out a way to take several days
off of work or school instead of just one, and finding an affordable
place to stay for several nights until the 24-hour period elapses since
most will have to travel for both the ultrasound and the abortion procedure. 
This, of course, assumes that they are able to schedule the abortion
for within 24 hours of the ultrasound. Many women will also be working
on a way to raise the funds to pay for two medical visits instead of
just one.  More than 326,00
female residents
of South
Carolina have no health insurance coverage.  Even women who have
insurance coverage through the State
Health Insurance Plan
come up with the cash themselves, unless the pregnancy is a result of
rape, incest or places the woman’s life at risk.   Some
may travel to neighboring states.  Others will find the barriers
to be insurmountable and will continue with their pregnancies. 
This is the true goal of proponents of H.3245 and of other constant
attempts to impose legislation to make abortion services less and less
accessible in South Carolina.   

Proof:  On April 6th The Greenville
News Published a 650 word article by Anti-Choice Senator Mike Fair titled "Waiting Period Makes
Senator Fair,
a publicly elected official who sees no line between Church and State
exclaims:  "H.3245 simply reflects common sense."  Why? 
Because according to him "The leading cause of death is abortion. 
Approximately 1.2 million unborn children die due to elective abortion
each year…Pregnancy should be a blessing.  Many do not recognize
the blessing at the time, but that is true of very many of the blessings
God bestows upon us….More time will equate to more life." 
Which way do you think Fair is voting on H.3245?

On April 3rd the Senate Committee on
Medical Affairs passed H.3245 with a vote of 10-6.   Roll
Call was not taken.  The Bill is now on the Senate Floor Calendar. 
South Carolina will be the first state to attempt to require that if
an ultrasound is performed, a mandatory 24-hour delay go into effect. 

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Reproductive rights are a public health issue. That's a fact.

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