Two South Carolina OB-GYNs told a federal judge in Charleston this week that parts of the state's six-week abortion ban are so vague they often cannot tell when ending a pregnancy is actually legal. Their testimony opened a three-day bench trial at the J. Waites Waring Federal Courthouse over a lawsuit that argues the law's exceptions for serious maternal health risk and fatal fetal anomalies are unconstitutionally unclear.
The case, filed in January 2025, originally included five OB-GYNs suing Attorney General Alan Wilson and the state's 16 solicitors, according to the Post and Courier. All but two of the original plaintiffs have since dropped out, leaving Dr. Natalie Bingham and a South Carolina physician identified in court only as Jane Doe to carry the case forward. The lawsuit contends the exceptions allowing abortions to prevent a mother's death or serious injury, or in cases of fatal fetal anomalies, are too vague for doctors to apply with confidence, leaving them fearful of criminal prosecution and hesitant to perform abortions they believe are medically necessary and legally permitted.
A Doctor's Account From the Stand
Jane Doe testified on Wednesday that she has had two to three conversations a month with colleagues since 2023 about patients whose cases fall into legal gray zones — including pregnant patients with breast cancer, sickle cell disease or lupus. She said she has referred patients seeking abortions to another state because she feared facing felony charges if she misjudged the law's requirements.
“Is it serious if it causes a 20 percent chance of death, or does it have to be a 50 percent chance?” she asked, according to the outlet's account of her testimony. She added: “I feel very strongly that patients and doctors are trying to do the right thing, and are really struggling.” At her own practice, an abortion after six weeks requires two other doctors to agree the case meets an exception, and she said the procedure is performed only in the most severe cases.
51 Exceptions, and a Bigger Pool of Cases
State data cited in testimony show 51 abortions were performed after six weeks last year under the law's three exceptions. Jane Doe testified that the number of South Carolina pregnancies involving maternal health risks or potentially fatal fetal anomalies is larger than that figure, suggesting many eligible patients may not be getting exception-based abortions at all.
South Carolina's ban prohibits ending a pregnancy after detection of a fetal heartbeat — generally around six weeks — except in cases of serious maternal health risk, fatal fetal anomaly, rape or incest. Governor Henry McMaster signed the measure into law in 2023, after the state's previous abortion ban had been overturned earlier that year. The South Carolina Supreme Court separately upheld the current law in a challenge brought by Planned Parenthood South Atlantic, with justices ruling on May 14, 2025 that the 2023 law generally prohibits abortions once fetal-heartbeat electrical impulses are first detectable by diagnostic technology, unless an exception applies, according to the South Carolina Supreme Court's opinion.
The State Pushes Back
Attorneys for the defendants argue the maternal-health and fetal-anomaly exceptions are not vague at all. Thomas Limehouse, who represented South Carolina state government officials at trial, pointed out that some of the statutory phrases Dr. Louise King described as insufficiently specific also appear in a medical textbook she herself cited during testimony.
Martin Thompson, general counsel for the 13th Circuit Solicitor's Office, testified that his office would probably interpret the fatal fetal anomaly exception to include an anomaly that would limit a baby's life to a very short span after birth — even though the statute itself contains no such wording. Thompson and representatives of another solicitor's office testified that the law's reasonable-medical-judgment standard could limit prosecutions, particularly in cases where doctors disagree about a diagnosis. Convicting a doctor would likely require proof beyond a reasonable doubt that they did not exercise reasonable medical judgment. “Beyond a reasonable doubt is a high bar,” Thompson said. No doctor has been prosecuted under the ban since it took effect.
An Outside Physician's Perspective
Louise King, an obstetrician at Mass General Brigham who does not practice medicine in South Carolina, testified that doctors may struggle to match appropriate care — including the option of an abortion — to the ban's requirements. “It's not clear to me when I can offer what I consider the standard of care,” she said.
U.S. District Judge Richard Mark Gergel is overseeing the bench trial, which is scheduled to continue through Friday. A ruling is expected to come after the trial concludes rather than immediately, leaving South Carolina's OB-GYNs, and the patients they treat under the law's narrow exceptions, waiting to find out whether the ban's language will stand as written.
