The legislation, which was signed into law earlier this spring by Gov. Henry McMaster (R), bans abortions after an ultrasound detects cardiac activity, which is usually at about six weeks — before many women know they're pregnant.
The law contains exceptions for the life and health of the mother, as well as for medical emergencies and fatal fetal anomalies, and allows abortions before 12 weeks in cases of rape and incest, so long as there is a report to law enforcement.
The court ruled 4-1, with Chief Justice Donald Beatty as the lone dissenter.
The court struck down a nearly identical version of the law in January, ruling it violated South Carolina's constitutional right to privacy. But that 3-2 opinion was written by Justice Kaye Hearn, the court's only woman. Hearn was replaced after reaching mandatory retirement age, locking in an all-male court.
Writing for the majority, Justice John Kittredge said that this year's law was "materially different" than the 2021 version.
"The legislature has made a policy determination that … a woman's interest in autonomy and privacy does not outweigh the interest of the unborn child to live," Kittredge wrote. "We cannot say as a matter of law that the 2023 Act is unreasonable and thus violates the state constitution."
Abortion rights groups said the ruling will have devastating effects across the entire south, where South Carolina had been a surprising lifeline for abortion access.
While other southern states banned or severely restricted abortion, disagreements in the legislature over how strict the law should be led to an impasse, so abortion remained legal up to about 20 weeks after fertilization.
Catherine Humphreville, an attorney with Planned Parenthood Federation of America, said the group is seeking clarity from the court to confirm whether the ban took effect right away. Still, providers in South Carolina have already been forced to stop services for patients who are more than six weeks pregnant.
"This is already causing chaos and confusion throughout the state," Humphreville told reporters Wednesday.
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