A bill

to amend the South Carolina Code of Laws by enacting the "Reproductive freedom Bill of Rights Act"; by adding chapter 140 to title 44 so as to PROVIDE THAT A WOMAN MAY HAVE AN ABORTION PRIOR TO THE VIABILITY OF HER EMBRYO OR FETUS, TO PROVIDE FOR THE CIRCUMSTANCES IN WHICH A WOMAN MAY HAVE AN ABORTION AFTER THE VIABILITY OF HER FETUS, TO PROVIDE FOR THE PROCESS THROUGH WHICH A MINOR MAY HAVE AN ABORTION, TO PROVIDE THAT ASSISTIVE REPRODUCTIVE TECHNOLOGIES AND CONTRACEPTIVES SHALL BE AVAILABLE IN SOUTH CAROLINA, TO PROVIDE THAT PREGNANT WOMEN ARE ENTITLED TO QUALITY PRENATAL AND POSTNATAL HEALTH CARE, AND TO EXPAND MEDICAID TO FACILITATE THE DELIVERY OF QUALITY PRENATAL AND POSTNATAL HEALTH CARE; by amending Section 40-47-37, relating to the Practice of telemedicine, so as to PERMIT DOCTORS TO PRESCRIBE ABORTION-INDUCING DRUGS VIA TELEMEDICINE; by adding Section 38-71-48 so as to PROVIDE THAT HEALTH INSURANCE POLICIES THAT PROVIDE PREGNANCY AND CHILD BIRTH COVERAGE MUST ALSO OFFER COVERAGE FOR ABORTIONS AND RELATED SERVICES AND MEDICAL PROCEDURES INTENDED TO PERMANENTLY PREVENT PREGNANCY INCLUDING, BUT NOT LIMITED TO, TUBAL LIGATION, HYSTERECTOMY, AND VASECTOMY; by adding Section 38-71-49 so as to PROVIDE THAT HEALTH INSURANCE POLICIES MUST OFFER COVERAGE FOR ASSISTIVE REPRODUCTIVE TECHNOLOGIES; by amending Section 59-32-10, relating to COMPREHENSIVE HEALTH EDUCATION PROGRAM-DEFINED TERMS, so as to CHANGE CERTAIN DEFINITIONS; and by REPEALing CHAPTER 41 OF TITLE 44 RELATING TO ABORTION.

Whereas, the right to reproductive liberty is central to the exercise of personal autonomy and involves decisions people should be able to make free from compulsion of the State. This right is critical to ensuring equal protection and treatment under the law and upholding the right of all people to health, dignity, independence, and freedom; and

Whereas, all people in South Carolina have the basic right to determine if and when to become a parent; and

Whereas, all women should have control over their own reproductive health free from coercion, discrimination, and violation; and

Whereas, fifty percent of all pregnancies in South Carolina are unintended or unplanned; and

Whereas, South Carolina has the eighth highest maternal mortality rate in the nation; and

Whereas, South Carolina has the fifth highest infant mortality rate in the nation; and

Whereas, sixty percent of all pregnancies and childbirths in South Carolina are paid for through Medicaid coverage at a cost of more than $500 million annually; and

Whereas, abortion is safe whether provided via medication or the use of a procedure. Abortion is safer than pregnancy and childbirth, which is at least fourteen times more dangerous for women than abortion; and

Whereas, students who receive abstinence-only sexual health education are more likely to become pregnant and be diagnosed with a sexually transmitted disease than are their fellow students who receive comprehensive, medically accurate sex education, which includes information on preventing pregnancy and STDs. Now, therefore,

Be it enacted by the General Assembly of the State of South Carolina:

SECTION 1. This act may be cited as the "Reproductive Freedom Bill of Rights Act".

SECTION 2. Title 44 of the S.C. Code is amended by adding:

CHAPTER 140

Reproductive Rights

Article 1

Definitions

   Section 44-140-10. For the purposes of this chapter:

   (1) "Abortion" means the use of an instrument, medicine, drug, or other substance or device with intent to terminate the pregnancy of a woman known to be pregnant for reasons other than to increase the probability of a live birth, to preserve the life or health of the child after live birth, or to remove a dead fetus.

   (2) "Abortion-inducing drugs" means a medicine, drug, or any other substance prescribed or dispensed with the intent of terminating the clinically diagnosable pregnancy of a woman, with knowledge that the termination will with reasonable likelihood cause the death of the unborn child. This includes off-label use of drugs known to have abortion-inducing properties, which are prescribed specifically with the intent of causing an abortion, such as misoprostol (Cytotec) and methotrexate. This definition does not apply to drugs that may be known to cause an abortion but which are prescribed for other medical indications including, but not limited to, chemotherapeutic agents or diagnostic drugs. Use of such drugs to induce abortion is also known as "medical", "drug-induced."

   (3) "Assistive reproductive technologies" means treatments or procedures that involve the handling of human egg, sperm, and embryo outside the body with the intent of facilitating a pregnancy. Assistive reproductive technologies include, but are not limited to, in-vitro fertilization, egg, embryo, or sperm cryopreservation, egg or embryo donation, and gestational surrogacy.

   (4) "Contraceptive" means any drug, device, medication, or method used to prevent pregnancy. A contraceptive may prevent ovulation, fertilization, or implantation in the uterus.

   (5) "Department" means the Department of Health and Environmental Control.

   (6) "Emergency contraception" means a form of contraception that is effective if administered within a specified period of time after sexual intercourse.

   (7) "Hospital" means those institutions licensed for hospital operation by the department in accordance with Article 3, Chapter 7 of this title and which have also been certified by the department to be suitable facilities for the performance of abortions.

   (8) "Infertility" means the inability to establish pregnancy after twelve months of regular, unprotected sexual intercourse; or a person's incapacity for reproduction either as an individual or with his partner, which may be determined after a period of less than twelve months of regular, unprotected sexual intercourse, or based on medical, sexual, and reproductive history, age, physical findings, or diagnostic testing.

   (9) "Pregnant" means the condition of a woman carrying a developing embryo or fetus within her body. Pregnancy does not begin until a zygote is implanted in the uterine wall.

   (10) "Spontaneous abortion" means a noninduced embryonic or fetal death or passage of products of conception before twenty weeks gestation.

   (11) "Viability" means the state of fetal development when the life of the fetus may be continued indefinitely outside the womb by natural or artificial life-supportive systems. A legal presumption is hereby created that viability occurs no sooner than the twenty-fourth week of pregnancy, recognizing that some pregnancies may never become viable.

Article 3

Abortions Generally

   Section 44-140-310. An abortion may be performed or induced by a physician on a woman with her consent prior to the viability of her fetus. The decision to have an abortion prior to the viability of her fetus shall be solely that of the pregnant woman in consultation with her physician.

   Section 44-140-320. An abortion may be performed or induced by a physician after a fetus reaches viability only with a pregnant woman's consent and only when the:

   (1) abortion is necessary based upon her physician's best medical judgment to preserve the life or health of the woman;

   (2) pregnancy was the result of rape;

   (3) pregnancy was the result of incest; or

   (4) abortion is necessary based upon a fetal diagnosis that is incompatible with life.

   Section 44-140-330. A physician practicing telemedicine in accordance with the requirements contained in Section 40-47-37 may prescribe abortion-inducing drugs.

   Section 44-140-340. A pregnant woman may not be kept alive by artificial methods in order to carry a pregnancy to term without her consent. In the event of incapacity, a pregnant woman may not be kept alive by artificial methods in order to carry a pregnancy to term without the consent of her medical power of attorney, next of kin, or immediate family members, in that order of priority.

   Section 44-140-350. No person may seize any blood, DNA, medical waste, or anything related to an abortion in order to be used in prosecuting an allegation of rape or incest without the written consent of the woman upon whom the abortion was performed or induced. In the event that the woman upon whom the abortion was performed was a minor, consent must be obtained from one of her parents or legal guardian who is not alleged to have committed the rape or incest that resulted in the pregnancy.

   Section 44-140-360.(A) No private or nongovernmental hospital or clinic shall be required to admit any patient for the purpose of performing or inducing an abortion, nor shall such institutions be required to permit their facilities to be utilized to perform or induce abortions. No cause of action shall arise against any such hospital or clinic for refusal to perform or induce or to allow the performance or induction of an abortion if the institution has adopted a policy to not admit patients for the purpose of performing or inducing abortions; provided that no hospital or clinic shall refuse an emergency admittance.

   (B)(1) No physician, nurse, technician, or other employee of a hospital, clinic, or physician shall be required to recommend, perform, induce, or assist in the performance or induction of an abortion if he advises the hospital, clinic, or employing physician in writing that he objects to performing, inducing, assisting, or otherwise participating in such procedures. Such notice will suffice without specification of the reason therefor.

      (2) No physician, nurse, technician, or other person who refuses to perform, induce, or assist in the performance or induction of an abortion shall be liable to any person for damages allegedly arising from such refusal.

      (3) No physician, nurse, technician or other person who refuses to perform, induce, assist in the performance or induction of an abortion shall because of that refusal be dismissed, suspended, demoted, or otherwise disciplined or discriminated against by the hospital or clinic with which he is affiliated or by which he is employed. A civil action for damages or reinstatement of employment, or both, may be prosecuted by any person whose employment or affiliation with a hospital or clinic has been altered or terminated in violation of this chapter; provided that no physician, nurse, technician, or other person may refuse to provide care in a medical emergency.

      (4) Any physician who performs an abortion shall also provide, for proper compensation, necessary aftercare for his patient unless released by the patient in writing. The extent of aftercare required shall be that care customarily provided by physicians in such cases in accordance with accepted medical practice.

   (C) A private or nongovernmental hospital or clinic, or a physician, nurse, technician, or other person who refuses to provide emergency contraception to a rape victim must inform the rape victim as soon as practicable of her right to emergency contraception and where she can obtain emergency contraception, including a referral to another medical facility or physician.

   Section 44-140-370. Any abortion performed or induced in this State must be reported by the performing physician on the standard form for reporting abortions to the State Registrar, Department of Health and Environmental Control, within seven days after the abortion is performed or induced. The names of the patient and physician may not be reported on the form or otherwise disclosed to the State Registrar. The form must indicate from whom consent was obtained, circumstances waiving consent, and, if an exception was exercised pursuant to Section 44-140-320, which exception the physician relied upon in performing or inducing the abortion.

   Section 44-140-380.(A)(1) The department shall promulgate and enforce regulations for the certification of hospitals as defined in Section 44-140-10 as suitable facilities for the performance of abortions.

      (2) The department shall promulgate and enforce regulations for the licensing and certification of facilities other than hospitals as defined in Section 44-140-10(7) wherein abortions are to be performed or induced.

   (B)(1) A facility in which five or more abortions are performed or induced in a month must be licensed by the department to operate as an abortion clinic.

      (2) The department shall promulgate regulations concerning sanitation, housekeeping, maintenance, staff qualifications, emergency equipment and procedures to provide emergency care, medical records and reports, laboratory, procedure and recovery rooms, physical plant, quality assurance, infection control, and information on and access to patient follow-up care necessary to carry out the purposes of this section.

   Section 44-140-390.(A) A pregnant woman who is experiencing or has experienced a miscarriage or spontaneous abortion is immune from all legal action, including police investigation and prosecution.

   (B) Physicians are authorized to treat a woman experiencing a spontaneous abortion or miscarriage or who has already experienced a spontaneous abortion or miscarriage with any medical procedure or pharmaceutical deemed by medical professionals to be the appropriate standard of care.

   (C) Pharmacists are authorized to dispense medication known to induce abortions for the treatment of miscarriage or spontaneous abortion.

   Section 44-140-400. All medical schools in this State must include training on miscarriage and spontaneous abortion management in their required instruction of students who will provide reproductive care to women.

   Section 44-140-410. It is unlawful to deceive, or attempt to deceive, a woman, regardless of whether the woman is pregnant, by providing her with false or misleading information concerning the gestational age of her fetus, her due date, how much time she has to make a decision concerning an abortion, or any other false or misleading information that may impact a woman's decision concerning her pregnancy and whether to have an abortion. A person who violates this section is guilty of a felony, and, upon conviction, must be fined up to ten thousand dollar