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The arrest this week of a South Carolina woman accused of self-administering an abortion pill to end a pregnancy in 2021 prompted outrage among advocates who decried the criminalization of self-managed abortions.
According to a police report, a 33-year-old woman in Greeneville was taken to the hospital in October 2021 due to labor contractions. Police said she told staff she had taken the pill to terminate the pregnancy.
She gave birth to a stillborn fetus of 25 weeks and 4 days.
South Carolina law bans abortions after 20 weeks of pregnancy and criminalizes abortions without the presence of a physician or a certified hospital.
Farah Diaz-Tello, senior counsel and legal director for the national nonprofit If/When/How Lawyering for Reproductive Justice, said there is “an urgent need to repeal this law.”
“People deserve the ability to make decisions about the kind of reproductive health care they want,” Diaz-Tello said. “When the state imposes criminal penalties like this, it strips people of the dignity of making those decisions.”
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What is a self-managed abortion?
A self-managed abortion means ending one’s own pregnancy without a doctor or health care provider, Diaz-Tello said.
There are many reasons why someone may prefer such an option, said Shaina Goodman, director for reproductive health and rights at the National Partnership for Women & Families.
Some people may be unable to afford care or live far from clinics, making lack of transportation, ability to take to off work or access to child-care barriers in getting in-person care. A person’s immigration status may make them more vulnerable when trying to access health care. Self-managed abortions may also feel safer for people experiencing abuse or who’ve experienced sexual trauma.
South Carolina one of two states criminalizing self-managed abortions
South Carolina is one of two states in the country that criminalizes self-managed abortions, Diaz-Tello said. The other state is Nevada, where Diaz-Tello said the law is being challenged in a case currently before the state Supreme Court.
A few similar state laws have been repealed in the last couple years, including in Oklahoma, Arizona, New York and Delaware, Diaz-Tello said.
“It’s extremely rare in the present day and historically,” she said. “There’s been a long-standing principle of law in most states that people can’t be charged with a crime against their own pregnancy, and there is consensus across the political spectrum that we don’t want to see people criminalized for their own abortions.”
More than 70 anti-abortion groups, including National Right to Life, called on state lawmakers last year to reject legislation that would criminalize those who get abortions.
Still, analysis released by If/When/How last year found that, since 2000, law enforcement agencies and prosecutors in 26 states have brought charges against people who self-managed abortions or helped others do so, often using other criminal laws, including homicide laws. Marginalized communities are also disproportionately likely to be targeted for criminalization, according to the analysis.
The effect of criminalizing self-managed abortions
Cases like the one in South Carolina may have a chilling effect by making people hesitant to access abortion care even when it is legal, Diaz-Tello said.
“People who fear the possibility of criminal penalties for seeking health care, aren’t going to seek that health care,” she said. “We want people to access the care they need without fear of criminalization. That’s a matter of life and death.”
Even if they aren’t convicted, people facing criminalization face stigma and harmful treatment after their mugshots and names are released, Diaz-Tello added.
“These are real people,” she said. “They have families and lives and communities and people who love them. And the damage they face is real.”
Often, these cases come to the attention of law enforcement because health care personnel report them, Goodman said. In South Carolina, police said the hospital notified them of the incident.
But Goodman said “health care providers are not legally obligated” to inform law enforcement when they suspect someone has had a self-managed abortion.
South Carolina abortion bans
Around the time the woman was arrested, the South Carolina Legislature was grappling with a six-week abortion ban, which was blocked by a federal court in 2021 but went into effect once the U.S. Supreme Court overturned Roe v. Wade in the summer of 2022.
The two-year legal battle ended earlier this year when the state Supreme Court permanently blocked the six-week ban on Jan. 5, after ruling that the bill violated privacy rights enshrined in the state constitution. But the debate over abortion rights is far from over as state lawmakers have renewed efforts to pass recalibrated versions of abortion bans this session.
The U.S. Food and Drug Administration approved mifepristone in 2000 to end pregnancy, when used in combination with a second drug, misoprostol. The combination is approved for use up to the 10th week of pregnancy.
Mifepristone is taken first to dilate the cervix and block a hormone needed to sustain a pregnancy. Misoprostol is taken a day or two later, causing contractions to empty the uterus.
More than half of U.S. abortions are now done with pills rather than with a procedure, according to the Guttmacher Institute, a research group that supports abortion rights. In rare cases, the drug combination can cause excess bleeding, requiring emergency care.
Dip deeper
If/When/How offers a free legal helpline at (844) 868-2812 for people with questions about their access to abortion care and legal rights.
Contributing: Devyani Chhetri, Greenville News; Associated Press
Contact Christine Fernando at cfernando@usatoday.com or follow her on Twitter at @christinetfern.
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