South Carolina Bill: Miscarriage Care Can’t Be Called ‘Abortion’—Even When It Is

HB 4130 is conservatives' latest attack on medical language and care

Mar 07, 2025

Yesterday, South Carolina Republicans proposed a bill that would make it illegal for health care providers to classify miscarriage treatment as ‘abortion’—even when it is one.

Regardless of whether it advances, this a big deal—and part of the broader attack on medical language that I’ve warned about for years. Conservatives want to redefine abortion at will, ignoring scientific reality for whatever is most politically useful. If women suffer as a result, so be it.

HB 4130 would amend South Carolina’s health code to declare that “the medical record of a patient whose pregnancy terminated due to a miscarriage may not be coded…as an abortion or a medical procedure or healthcare related to an abortion.”

That means if a doctor prescribes a patient abortion medication or provides a procedure to help complete a miscarriage, it would be illegal to record that treatment as ‘abortion.’ Put another way: South Carolina doctors who accurately document their patients’ care would be breaking the law.

What’s especially telling is that the bill still requires doctors to report this care under the state’s abortion reporting law. So legislators don’t want miscarriage treatment labeled as abortion—but they do want it tracked as such.

Even miscarriages that aren’t treated with abortions would be affected. OBGYN Dr. Jessica Tarleton explains that when South Carolina doctors bill insurance, they use the same ICD-10 diagnosis codes as doctors nationwide, where miscarriages fall under categories like “spontaneous abortion” or “incomplete abortion.”

“We can’t just change the terms because we feel like it,” Tarleton says.

I want to reiterate how serious this is: If this bill passes, politicians—not medical professionals—would dictate how pregnancy loss is recorded and how medical language is defined.

And this isn’t just about South Carolina. Whether or not HB 4130 moves forward, it signals a chilling next step in the anti-abortion movement’s years-long campaign to rewrite national medical standards and language.

Since Roe fell, I’ve tracked Republican attempts to codify false definitions of abortion: Lawmakers in multiple states have amended their bans to dictate when treatment constitutes an abortion, while others have passed entirely new laws.

These anti-abortion legislators claim they’re just “clarifying” bans to help doctors understand when they can provide life-saving care. But the real goal has always been to embed political, medically false definitions into law.

South Dakota, for example, passed a law requiring the state’s health department to release an informational video for doctors explaining that treatment for an ectopic pregnancy or miscarriage are “not considered an abortion.”

Leaving aside the absurdity of politicians instructing literal doctors on what is and isn’t an abortion, the nefarious endgame here is to divorce abortion from healthcare. They want to make abortion something distinct, devious, and shameful.

Consider the ‘informational’ video released by South Dakota—a truly dystopian piece of work if you can stomach it. In it, Secretary of Health Melissa Magstadt says that when defining abortion, “intent plays a crucial role.”

Republicans love this talking point—claiming that abortion isn’t a medical intervention, but an intention. But abortion isn’t a feeling. You get the same pill or procedure whether your pregnancy is wanted or not.

To punishment-happy conservatives, however, defining abortion as an intention allows them to split women into two groups: those who ‘deserve’ care and those who don’t. If you wanted to be pregnant, you’re a ‘good woman’ whose abortion is forgivable. In fact, it’s not an abortion at all! But if you didn’t want to be pregnant—if you rejected your ‘proper’ place? Then you’re a murderer.

Abortion as an intention also opens the door for broader criminalization: If someone gives birth to a stillborn baby but once Googled an abortion clinic, that could be all it takes for a zealous prosecutor to charge them with a crime.

And the conservative effort to redefine abortion doesn’t stop at miscarriages and nonviable pregnancies. When Erin Hawley of Alliance Defending Freedom was questioned during a 2022 House Judiciary Committee about a 10 year-old rape victim, she said plainly, “That’s not an abortion, because it does not have the intent to end the life of the child.”

Catherine Glenn Foster, President of Americans United for Life, said the same: “If a 10 year-old became pregnant as a result of rape and it was threatening her life, then that’s not an abortion.”

So, to recap: Abortions for ectopic pregnancies and miscarriages aren’t abortions. Abortions for children aren’t abortions. Abortions to save someone’s life aren’t abortions. Essentially, any abortions that might poll well are no longer abortions.

I could go on, because this isn’t solely an illogical attack on medical language. Republicans are also trying to change standards of care by inventing terms like ‘maternal fetal separation’ and pushing doctors to give women with life-threatening pregnancies c-sections instead of abortions.

It’s all connected, and it starts with legislation like this in South Carolina. Republicans have codified fake abortion definitions before, but this bill would actually force doctors to participate in the farce. No matter what happens with HB 4130, lawmakers have crossed a dangerous line.