Targeted Regulation of Abortion Providers (TRAP)
South Carolina imposes extra restrictions on abortion providers, despite the fact that all health-care providers already must comply with a variety of federal and state regulations governing health, safety, building and fire codes, and zoning requirements.
Restrictions on Where Abortion Services May Be ProvidedAmong the most common TRAP regulations are those restricting the provision of abortion services to hospitals or other specialized facilities, which place medically unnecessary and costly requirements on doctors and can decrease the availability of abortion care for women. South Carolina has such regulations, including:
Any provider that provides any second-trimester or five or more first-trimester (including non-surgical) procedures in a month must be licensed as an "abortion clinic." S.C. Code Ann. §§ 44-7-130 (22), 44-41-75 (Enacted 1995); S.C. Code Regs. 61-12.101B, 102A. Providers who provide abortion services between 18 and 26 weeks must additionally become licensed as ambulatory surgical centers. S.C. Code Regs 61-12. 302.
"Abortion clinics" are subject to more than 30 pages (including more than 40 sub-sections) of regulations regarding administration, professional qualifications, patient and employee testing, and physical-plant specifications. S.C. Code Regs. 61-12.202 - 205, 304, 305, 309, 401A, 605, 606, 806, 807A-L. Regulations include many requirements that are not medically related, such as: "All outside areas, grounds and/or adjacent buildings shall be kept free of rubbish, grass, and weeds...;" garbage cans stored outside must be cleaned immediately after being emptied; air temperature must be maintained at between 72 and 76 degrees in "patient areas;" and parking facility requirements. S.C. Code Regs. 61-12.605B, 605C, 606, 806, 807L(1).
All licensed facilities are subject to inspection at any time, and "inspectors shall have access to all properties and areas, objects, records and reports, and shall have the authority to make photocopies of those documents required in the course of inspections or investigations." S.C. Code Regs. 61-12.102 (F). There are no provisions that protect the privacy and/or confidentiality of the patients.
Abortion providers must enter into a signed written agreement with a board-certified OB/GYN who has admitting privileges at one or more local hospitals. Nothing in the statute requires hospitals or doctors to enter into such an arrangement. S.C. Code Regs. 61-12.205(C)(2).
An appellate court held that the regulations are constitutional. Greenville Women's Clinic v. Bryant, 222 F.3d 157 (4th Cir. 2000), cert. denied, 531 U.S. 1191 (2001). With one exception concerning the privacy of patient records, the district court on remand upheld the constitutionality of the regulations after considering additional constitutional challenges. The appellate court again upheld the constitutionality of the regulations, but reversed the district court's finding that allowing state inspectors access to clinic records violated patients' right to privacy. Greenville Women's Clinic v. Bryant, No. 6:96-1898-20 (D. S.C. Aug. 31, 2001), aff'd in part, rev'd in part, 317 F.3d 357 (4th Cir. 2002), cert. denied, 538 U.S. 1008 (2003).
South Carolina requires that second-trimester abortion services be provided in a hospital or state-certified clinic, and that abortion services after that point be provided in a hospital. S.C. Code Ann. § 44-41-20 (Enacted 1974).
Restrictions on Who May Provide Abortion ServicesSouth Carolina prohibits certain qualified health-care professionals from providing abortion services.
Only a physician licensed to practice medicine in the state may provide abortion care. S.C. Code Ann. §§ 44-41-10(b), -20 (Enacted 1974).