In twenty years, the number of abortions performed in South Carolina has been cut almost in half — a dramatic downward trend that has coincided with a steady beat of efforts to curb access to the procedure, some successful and some not.
But the same trend has not held true when it comes to the overall number of S.C. women getting abortions.
The reason for the difference?
More and more S.C. women are getting abortions outside of South Carolina, according to an analysis by The State of national and state abortion statistics.
“Any sort of abortion restrictions isn’t going to reduce abortions. It’s going to drive people to access care in other places, or choose to terminate (their pregnancy) on their own,” said Ashley Lidow, associate director of policy and government relations for the Women’s Rights and Empowerment Network, which opposes abortion restrictions.
“That’s the trend we see not only in our state, but other states and other countries,” Lidow said. “If (conservative lawmakers) truly want to reduce abortion, they would increase contraceptive access and ... make it easy to be a parent in the state of South Carolina.”
Next year, South Carolina lawmakers will face pressure from anti-abortion groups to adopt what would become one of the most strict abortion bans in the country. That proposal, which would effectively ban all abortions at about six weeks of pregnancy, has passed the S.C. House and awaits action in the state Senate.
The S.C. bill is part of a flurry of legislative proposals and new laws sweeping state Legislatures, particularly in the South and Midwest.
New laws in places like Alabama and Georgia have been challenged in the courts. But abortion opponents see an opening under conservative judges appointed by President Donald Trump — an outcome that critics of the restrictions say would likely result in women of means traveling even farther to get access to abortions.
SC abortion rates hold steady
While nationally the U.S. abortion rate has steadily declined, according to the U.S. Centers for Disease Control and Prevention, the rate of South Carolina women who had abortions in 2017 was the same as it was in 1998. Eleven out of every 1,000 women in the state between the ages of 15 and 44 received an abortion in 1998 and 2017, according to DHEC.
That number climbed to 14.7 abortions per 1,000 women between 15 and 44 years of age in 2006 only to dip back to where it has historically hovered over the last 20 years: at 11 to 12 abortions per 1,000 women.
Fewer and fewer abortions, however, have been performed in South Carolina, as women increasingly are having the procedure elsewhere, according to South Carolina’s state health agency.
The State analyzed South Carolina’s most recent abortion statistics, released Friday by S.C. Department of Health and Environmental Control, alongside historical state and national data, from 1998 to 2018, provided through DHEC and the CDC. The State’s analysis found:
▪ From 2006 to 2015 (the most recent year for which national data was available), the U.S. abortion rate dropped 26% (from 15.9 to 11.8 abortions per 1,000 women ages 15 to 44 years). In South Carolina, the rate dropped less, from 14.7 to 12.2 abortions per 1,000 women ages 15 to 44 years old.
▪ In 2018, nearly 4,650 abortions were performed in South Carolina by licensed providers. That number is down about 47% from the 8,800 abortions performed by S.C. providers in 1998.
▪ More than 460 fewer abortions occurred in the state in 2018 than the previous year — the third largest drop in 20 years — according to the latest state abortion statistics released last week.
▪ Nearly 10,650 women who reported living in South Carolina had an abortion in 2017, according to DHEC. That number has fluctuated but has held relatively steady over the last two decades. Fewer than half — 5,112 — had the abortions in South Carolina, according to state numbers.
Numbers reported from other states of S.C. women who left to have an out-of-state abortion in 2018 were not yet available.
The statistics also show that few women come to South Carolina seeking an abortion.
Between 2012 and 2018, less than 5% of women who received abortions in South Carolina were out-of-state residents, according to DHEC data.
SC abortions continue to drop
The fact that the number of abortions occurring in the state have dropped precipitously has often been cited by anti-abortion groups as evidence that legislation to restrict abortions in this state is working.
“We mourn the loss of the babies who died by abortion, and are very grateful and thankful for all of the mothers who chose life,” said Holly Gatling with S.C. Citizens for Life. “And we are grateful and thankful the numbers are declining in South Carolina.”
Gatling attributed the drop to “electing pro-life legislators,” efforts of crisis pregnancy centers to provide free care, and growing public awareness of the harm posed by abortion.
“No women in South Carolina has to feel forced into an abortion. There is free care everywhere,” Gatling said.
She dismissed the overall number of South Carolinians who chose to end their pregnancy as irrelevant, and questioned the accuracy of DHEC’s abortion data for South Carolina women who had out-of-state abortions.
“We are only concerned with abortions occurring in South Carolina — the blood spilled on our soil,” Gatling said, arguing DHEC can’t verify the data of women who claimed a South Carolina address.
The CDC noted in its November report limitations in tracking abortions by a woman’s state of residence. The data is compiled and reported to the CDC by the central health agency where the abortion was performed rather than where the woman lived.
It also notes women cross state lines to get abortions for a variety of reasons, such as limited services or lack of providers in their area, being closer to clinics or services in another state, and less stringent regulatory requirements for obtaining an abortion.
Three outpatient clinics in Columbia, Charleston and Greenville provide abortions in South Carolina. Some S.C. hospitals, too, terminate pregnancies if the medical need arises.
The decline in abortions performed in state also comes as the teen birth rate in South Carolina has fallen by nearly 70% since peaking in 1991. South Carolina has the 16th highest teen birth rate in the nation for 15-19 year olds at 21.7 per 1,000 females, according to Fact Forward, previously the S.C. Campaign to Prevent Teen Pregnancy.
“While I’ve never seen a study that sets a definitive correlation (between teen birth and abortion rates) we do highly emphasize the prevention of unintended pregnancies using evidenced-based approaches,” said CEO Beth De Santis. “And, as a result, we have seen a reduction in teen birth rates since the early 1990s ... by helping teens make the right choices at the right time.”
A push for further restrictions
Current state law prohibits doctors from performing an abortion at 20 weeks of pregnancy, unless to protect the mother’s life or in the case of severe fetal anomaly.
The law was passed based on the much-disputed theory that fetuses can feel pain at that stage of development. The 20-week ban has yet to be challenged in court despite cries from critics that it is unconstitutional.
Doctors, women’s and reproductive rights groups say the restrictions prevent women from receiving comprehensive care in their own community, and harm poor women who lack the financial resources to leave South Carolina to terminate a pregnancy.
“Bans and restrictions like the ones we’ve seen passed in South Carolina only make accessing safe and legal abortion more difficult,” said Sarah Riddle, communications director for Planned Parenthood South Atlantic. “Women sometimes have to drive longer distances — including leaving their home state — to access safe and legal care. This can result in taking more time off of work, travel expenses and paying for extra childcare.”
Some conservative lawmakers and anti-abortion groups, however, are determined to go further.
In April, the GOP-controlled S.C. House of Representatives passed legislation to ban abortion once doctors can detect a fetal heartbeat by ultrasound, typically around the sixth week of pregnancy. That is before many women know they’re pregnant, and long before viability.
State data shows 44% of women who sought abortions in South Carolina in 2018 did so at six weeks or less. More than half — 55%— received an abortion between seven and 13 weeks post-fertilization.
The bill — which provides exceptions when the pregnancy endangers the mother’s life or physical health, or in cases of rape or incest — has the support of Republican S.C. Gov. Henry McMaster and could be taken up in the state Senate next year. Senate Democrats, though, pledge to fight it.
An unprecedented wave of abortion restrictions have swept through state legislatures this year, including a six-week ban in Georgia and a “near-total abortion ban” in Alabama, according to the Guttmacher Institute, a nonprofit research center on sexual and reproductive health.
Abortion rights groups, though, say they’re determined to push back against the sweeping effort to try to overturn Roe v. Wade and make abortion inaccessible. The 1973 U.S. Supreme Court decision that affirmed a woman’s right to an abortion before a fetus is viable outside the womb, usually about 24 weeks into a pregnancy.
Still, abortion opponents are hoping for a win.
“With new changes to the U.S. Supreme Court, it is our sincere hope that the legislation will withstand constitutional challenge and be implemented in order to save innocent, unborn lives when a heartbeat is present,” Gatling said.