COLUMBIA, S.C. • South Carolina’s new all-male Supreme Court reversed course on abortion Wednesday, upholding a ban on most such procedures after about six weeks of pregnancy.

The continued erosion of legal abortion access across the U.S. South comes after Republican state lawmakers replaced the lone woman on the court, Justice Kaye Hearn, who reached the state’s mandatory retirement age.

The 4-1 ruling departs from the court’s own decision months earlier striking down a similar ban that the Republican-led Legislature passed in 2021. The latest ban takes effect immediately.

Writing for the new majority, Justice John Kittredge acknowledged that the 2023 law also infringes on “a woman’s right of privacy and bodily autonomy,” but said the state Legislature reasonably determined this time around that those interests don’t outweigh “the interest of the unborn child to live.”

“As a Court, unless we can say that the balance struck by the Legislature was unreasonable as a matter of law, we must uphold the Act,” Kittredge wrote.

Kittredge wrote that “we leave for another day” a determination on what the law’s language means for when exactly during a pregnancy the ban should begin, likely forecasting another long court fight on that question.

Chief Justice Donald Beatty provided the lone dissent, arguing that the 2023 law is nearly identical, with definitions for terms including “fetal heartbeat” and “conception” that provide no clarity on when the ban begins, exposing doctors to criminal charges if law enforcement disagrees with their expertise.

The 2023 law restricts most abortions once cardiac activity can be detected, declaring that this happens about six weeks after a pregnant woman’s last menstrual period. Lawmakers defined this as “the steady and repetitive rhythmic contraction of the fetal heart, within the gestational sac.”