In a year already marked by heated legislative battles and shifting legal landscapes, abortion rights in the United States have once again taken center stage. On September 12, 2025, South Carolina lawmakers introduced Senate Bill 323, also known as the "Unborn Child Protection Act." This proposed legislation aims to repeal current safeguards embedded in the state’s six-week abortion ban, alter key legal definitions, and potentially create new legal implications for contraception and fertility treatments like in-vitro fertilization. A hearing on the bill is scheduled for early October, setting the stage for what could become one of the most consequential state-level abortion debates in recent memory.
South Carolina’s move comes at a time when medication abortion has emerged as the flashpoint in state legislatures across the country. According to Stateline, part of the States Newsroom network, medication abortion accounted for nearly two-thirds of all clinician-provided abortions in states without total abortion bans in 2023. This shift is largely due to the increased availability and safety of medication abortion, which involves taking two drugs—mifepristone and misoprostol—in succession. These medications not only terminate pregnancies but are also used by healthcare providers to manage miscarriages and treat postpartum hemorrhage.
Research cited by Stateline underscores the safety and efficacy of medication abortion, with complications requiring hospitalization occurring in less than 0.3% of patients. Furthermore, studies have shown that medication abortion provided via telehealth is just as effective and safe as in-person care. Yet, despite the evidence, access to these medications remains a battleground issue, with lawmakers on both sides of the aisle pushing for new restrictions or protections.
Republican-led states have taken a particularly aggressive stance. In 2024, Louisiana became the first state to reclassify mifepristone and misoprostol as Schedule IV controlled substances, placing them in the same legal category as drugs like Xanax and Valium. Hospitals in Louisiana have since had to implement new procedures, locking the medications in passcode-protected containers outside delivery rooms. Physicians have reported that these changes have interfered with their ability to treat patients effectively, particularly in emergency situations.
Following Louisiana’s lead, Republican lawmakers in Kentucky, Missouri, and Texas introduced similar bills in their most recent legislative sessions. However, all three measures died in committee—at least for now. According to Stateline, more states are expected to consider such legislation in upcoming sessions, signaling that the fight over abortion medication is far from over.
Telehealth, once a niche service, has become a significant provider of abortion care. By the end of 2024, one in four abortions was provided via telehealth, as reported by #WeCount, a national initiative by the Society of Family Planning. About half of these telehealth abortions came from providers in states with so-called "shield laws"—statutes designed to protect clinicians who prescribe abortion medication to patients in other states, even those with restrictive abortion laws.
Yet, the legal landscape is patchy and contentious. Nine states, including South Carolina, currently have laws that explicitly ban telehealth-provided medication abortion or the mailing of abortion drugs, according to the Kaiser Family Foundation (KFF). These states are Arizona, Arkansas, Florida, Indiana, Kentucky, Oklahoma, South Carolina, Texas, and West Virginia. Meanwhile, eight Democratic-led states—California, Colorado, Maine, Massachusetts, New York, Rhode Island, Vermont, and Washington—have enacted shield laws to protect their providers from out-of-state legal actions.
This patchwork of laws has led to escalating tensions between states. In July 2025, 15 Republican attorneys general signed a letter urging Congress to ban shield laws, arguing that such statutes interfere with states’ ability to enforce their own criminal laws. Jennifer Driver, who tracks reproductive state policy for the State Innovation Exchange, told Stateline that lawmakers in at least 14 states have introduced bills aimed at criminalizing the purchase, prescription, and distribution of medication abortion.
Texas has pushed the envelope even further. In September 2025, the Texas Legislature passed a first-of-its-kind bill that allows Texans to sue physicians, manufacturers, and others from outside the state who mail abortion medication into Texas. The bill also bans the manufacturing of abortion drugs within the state. The legislation is now awaiting Governor Greg Abbott’s expected signature, and legal experts anticipate a fierce battle over whether Texas can enforce its laws beyond its borders.
Louisiana, too, has doubled down on its anti-abortion stance. In June 2025, the state passed the "Justice for Victims of Abortion Drug Dealers Act," which allows the mother of a fetus to sue out-of-state doctors and activists for performing or facilitating a medication abortion. The law also extends the window for such lawsuits from three years to five years, a move that critics argue could have a chilling effect on providers nationwide.
Back in South Carolina, the proposed "Unborn Child Protection Act" is raising alarms among reproductive rights advocates and healthcare providers alike. The bill’s potential to alter legal definitions could have ripple effects far beyond abortion, possibly affecting access to contraception and fertility treatments such as in-vitro fertilization. While the full implications remain to be seen, the upcoming October hearing is expected to draw passionate testimony from both supporters and opponents.
The debate is not confined to legislative chambers. Across the country, activists, medical professionals, and ordinary citizens are weighing in, often with deeply personal stories. Some argue that restricting access to medication abortion and telehealth services disproportionately harms people in rural areas, where in-person clinics are few and far between. Others maintain that such restrictions are necessary to protect unborn life and uphold the moral fabric of society.
As the legal and political battles rage on, one thing is clear: the fight over abortion rights in America has entered a new phase, one defined as much by pills and telehealth as by clinics and courtrooms. The outcome of South Carolina’s legislative efforts, along with similar moves in Texas, Louisiana, and beyond, will likely set the tone for the next chapter in this deeply divisive debate.
With hearings on the horizon and new laws poised to reshape the landscape, Americans on all sides of the issue are watching closely. The stakes, for many, could not be higher.
