20090423

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

April 23, 2009


By Debbie Billings


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 materials. 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 percent of South Carolina counties have no abortion provider. South Carolina's exsiting 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, Pickney 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."


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 326,000 female residents of South Carolina have no health insurance coverage. Even women who have insurance coverage through the State Health Insureance Plan must 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 Sense" 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.