On August 23, 2023, the South Carolina Supreme Court ruled that the state’s heartbeat law was allowed to go into effect. The law was passed in May 2023 but, before having a chance to go into effect, was soon thereafter blocked . South Carolina’s 2023 abortion report was released in two parts in June 2024, revealing that abortions increased in the first half of 2023 compared to 2022 for an overall higher annual total. Part one of the report covers data from January 1 through August 22, 2023, and part two covers data from August 23 through the end of 2023. The heartbeat law also brought changes to the state’s abortion reporting requirements, which is why the state released two different abortion reports. Data from both reports will be summarized below. However, changes to the state’s abortion reporting requirements involved a change in data suppression rules and, as a result, only some data from both reports could be aggregated. Consequently, Charlotte Lozier Institute (CLI) analyzed the data under three headings: complete year data, data from 1/1/23 – 8/22/23, and data from 8/23/23 – 12/31/23.
Statistics and Changes in South Carolina Abortions, 2022-2023
The data on Planned Parenthood’s market share only covers abortions performed in South Carolina from August 23, 2023, through December 31, 2023.
Abortion Totals and Trends
In 2023, there were 8,187 abortions reported in South Carolina, up 13% from the previous year. Drug-induced abortions, which made up 70% of reported abortions, increased by 9% from 5,217 in 2022 to 5,699 in 2023 (Fig. 1). CLI estimates that South Carolina’s abortion rate was 8.1 abortions per 1,000 women of childbearing age, an increase of 13% from the previous year (Fig. 2).1 As of July 2024, 12 states have released 2023 abortion statistics, five of which showed that abortions had increased from 2022.
Complete Year Data
In a change from previous reports, the state released abortion totals by women’s state of residence. Fifty-nine percent of abortions occurring in South Carolina were performed on South Carolina residents, while 41% were performed on out-of-state women. Similarly, for the first time the state published abortion totals by month, showing the dramatic impact that the enforcement of the state’s heartbeat law had on decreasing the number of abortions that occurred in the state. See the month-by-month breakdown below:
Over half (55%) of the abortions reported in South Carolina in 2023 were performed on women in their twenties, with 28% on women ages 20 to 24 and 27% on women ages 25 to 29. Twenty-one percent of the abortions were obtained by women ages 30 to 34, while 14% were on women ages 35 and older. Eight percent of the abortions were performed on girls ages 17 to 19. In the Part One report, 21 abortions were reported to have been performed on girls under the age of 15, but the total in the Part Two report was suppressed (because the value was less than 5). There were 101 abortions performed on girls ages 15 to 16 in the state’s Part One report but the total in Part Two was suppressed. In total, 10 abortions by maternal age were suppressed.
Seventy percent of South Carolina abortions were drug-induced. Twenty-two percent were electrical vacuum aspiration procedures, and 7% were performed using dilation and curettage. One percent of the abortions were performed using manual vacuum aspiration, and less than 1% were dilation and evacuation abortions. However, the dilation and evacuation total (21 abortions) only counted abortions from the Part One report as the total in Part Two was suppressed. Similarly, from January to August 22, five abortions were prostaglandin induction abortions while the number of abortions performed via prostaglandin induction was suppressed in Part Two of South Carolina’s report. The numbers of abortions by other, unspecified procedures, as well as by other induction methods, were suppressed. In total, 11 abortions by procedure type were suppressed.
For five abortions, an intra-fetal injection was used to kill the unborn baby. The report does not indicate the gestational ages of the five abortions that used an intra-fetal injection.
Part 1 Data: January 1, 2023 – August 22, 2023
During this time period, South Carolina limited abortion at 22 weeks of gestation (20 weeks post-fertilization) except when the life or a major bodily function of the mother would be threatened by a continued pregnancy or when the unborn child has a life-threatening abnormality. A total of 7,397 abortions occurred during this time period. Fifty percent of the abortions performed from January 1 through August 22 were performed at six weeks postfertilization or earlier. Forty-nine percent were performed between seven and 13 weeks postfertilization, and the number of abortions performed between 14 and 19 weeks postfertilization was suppressed. The number of abortions performed at 20 weeks postfertilization or later was also suppressed, as the value was less than five. All the abortions past 20 weeks postfertilization were performed because of a fetal anomaly. Overall, during this time, 22 abortions by postfertilization age were suppressed.
If an abortion at or after 20 weeks postfertilization was performed, the doctor was obligated to use the type of procedure that would give the unborn baby the best chance at survival, unless doing so would put the mother’s life or a major bodily function at increased risk. For all abortions past 20 weeks postfertilization, the procedure that would give the unborn baby the best chance of survival was used. The law also specified that, unless a medical emergency existed or the unborn baby had an abnormality, post-fertilization age must be determined before every abortion. Considering this law, ultrasound was used to determine post-fertilization age in advance of all but two South Carolina abortions (99.9%).
Part 2 Data: August 23, 2023 – December 31, 2023
During this period, South Carolina’s heartbeat law was in effect. This law prohibits abortion after fetal cardiac activity is detected (often around six weeks of gestation) except in the cases where the mother’s life or physical health is endangered by a continued pregnancy, in the cases of rape and incest, and/or anomalies in the unborn baby. The rape and incest exceptions apply only to pregnancy before 13 weeks of gestation. During this time period, 790 abortions occurred in South Carolina.
The heartbeat law also came with changes to the state’s abortion reporting requirements, including the reporting of abortions by gestational age, not postfertilization age, and that different data on exceptions to the state’s law would now be reported. Ninety-eight percent of the abortions performed during this period occurred at six weeks of gestation or earlier. Nine abortions each occurred between seven and 13 weeks and 14 and 19 weeks. Zero abortions occurred between 20 and 23 weeks of gestation. In 777 of the 790 cases, a fetal heartbeat was not detected before the abortion was performed. Of these 777 abortions, 772 were performed at six weeks of gestation or earlier, while five occurred between seven and 13 weeks of gestation.
The number of abortions that occurred after a heartbeat was detected but before 12 weeks of gestation was suppressed. Nine abortions occurred after a heartbeat was detected and after 12 weeks. However, the reasons for those abortions being performed were suppressed. If an abortion was performed after an unborn child’s heartbeat was detected, the doctor was obligated to use the type of abortion procedure that would give the unborn baby the best chance at survival, unless doing so would put the mother’s life or a major bodily function at increased risk. The number of abortions that followed this requirement was suppressed.
Abortion Facility Data
Of the 790 abortions that occurred in 2023 from August 23 through December 31, 71% were performed at Greenville Women’s Clinic. Twenty-eight percent were performed at South Carolina’s two Planned Parenthood locations, including 17% at the Planned Parenthood Columbia location and 11% at the Planned Parenthood Charleston location. Seven abortions occurred at the Medical University of South Carolina Medical Center. Five total abortions by performing facility were suppressed, with the exact totals per location also suppressed. These locations include Prisma Health Richland Hospital, Prisma Health Greenville Memorial Hospital, Prisma Health Patewood Hospital, and Spartanburg Medical Center. Because the facility data was only reported for a portion of the year, Planned Parenthood’s market share is not included in the above infographic.
State Ranking
In 2024, CLI reanalyzed abortion reporting across the 50 states, New York City, and the District of Columbia, and South Carolina was tied for 23rd best. To strengthen its reporting, South Carolina could report the race, level of education, and marital status of all women undergoing abortions in the state. The state could also collect and report information on complications resulting from abortion.
- National rates were calculated by the Guttmacher Institute. South Carolina rates were calculated by CLI using the following formula: (total number of abortions performed in South Carolina ÷ number of resident women ages 15-44 [based on most recent population estimates]) x 1,000. Rates may differ slightly from previous CLI articles due to revised population estimates. Population estimates were obtained from the CDC WONDER database. Estimates for 2005-2009 are intercensal estimates of the July 1 resident population. Estimates for 2010-2019 are Vintage 2020 postcensal estimates of the July 1 resident population. Estimates for 2020-2022 are Vintage 2022 postcensal estimates of the July 1 resident population. Estimates were produced by the U.S. Census Bureau and the National Center for Health Statistics. Rates for 2023 were calculated using the Vintage 2022 postcensal estimates because 2023 population estimates have not yet been released by the CDC.
- Abortion totals prior to 2017 are from the CDC. South Carolina did not report its drug-induced abortion total to the CDC in 2005.
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