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Mere weeks into her tenure, South Carolina’s first elected female sheriff, Kristin Graziano, has made clear that she is not one to back down from a fight. Especially not against the state’s male-dominated legislature.

On Wednesday night, Graziano, who is also South Carolina’s first openly gay sheriff, publicly challenged a new amendment to an abortion bill widely expected to pass the state legislature and be signed into law in the next few weeks. The amendment would outlaw most abortions, but provides an exception for survivors of rape and incest. In these cases, however, health-care providers would be required to report the name of the victim to police.

“This is absolute insanity to re-victimize the victim. Sheriffs should not be policing a woman’s body, religious beliefs, or personal health decisions,” Graziano wrote in a tweet responding to the amendment vote.

“I may be a new sheriff, but I’m not new at being a woman,” she added later.

Graziano expanded on her online comments in an email Thursday.

“It’s clear that this bill is intended to punish women. If this is passed, especially with this particular amendment, a victim’s privacy and safety are at risk,” Graziano wrote. “Women and girls need bodily autonomy.”

The sheriff cited more than 30 years of working in law enforcement, noting that many victims of these crimes feel they will endanger themselves or their families if they speak to police.

“I trust women to make the best decision for themselves,” she added.

Graziano also says law enforcement was not consulted before the amendment was tacked on.

It is unusual for police to publicly criticize state lawmakers for bills that don’t explicitly center on policing, and even more rare for law enforcement leadership to speak up about an antiabortion bill. But the sheriff’s comments were echoed by survivors and reproductive rights advocates, as well as OB/GYNs, who said the proposed exception, ostensibly inserted to protect survivors, would have the opposite effect.

“These exceptions only serve to make bans like these more politically palatable, to make people feel better about what they’re doing,” said Ann Warner, chief executive of the Women’s Rights and Empowerment Network (WREN), which has been advocating against the bill.

The bill would outlaw most abortions if the fetus’s heartbeat can be detected: a timeline of roughly six weeks, before many women are aware they’re pregnant, doctors say. The bill, which is the latest attempt by lawmakers in the Palmetto State to restrict abortion, was passed by the South Carolina Senate on Thursday and has been sent to the House, where it is expected to be passed quickly, reports the State. Gov. Henry McMaster (R) said he would sign the bill as soon as he can.

“If this gets upheld by the courts, we will have saved thousands of lives in South Carolina every year,” said state Senate Majority Leader Shane Massey (R), who proposed the survivor exception. Massey likened it to laws that require doctors to report when a child has been raped or the victim of incest.

“This extends that to adult women,” Massey said, according to the Post and Courier.

This comparison is inappropriate, said Patricia Seal, an OB/GYN working in Columbia, S.C. It is already hard enough for a patient to disclose a traumatic event to a health-care provider, she says. If the provider were forced to disclose that her patient could be contacted by police about the abuse, it would be “adding trauma to trauma.”

“I think it’s just going to prevent women from coming in to seek care,” she said.

Sara Barber, executive director of the South Carolina Coalition Against Domestic Violence and Sexual Assault, in testimony to the South Carolina Senate, warned that the abortion bill exception would have deleterious effects on survivors.

“One of the cornerstones of safety for survivors is their privacy and their ability to determine for themselves what actions they should pursue in healing,” Barber said. It’s “robbing a victim or survivor of the most personal decision-making around their bodies.”

Survivors have many reasons not to report these crimes to police. The person who raped them may be a current or former partner, and they may not feel ready to come forward or they may fear for their safety. If they’re reporting incest, it could upend their families. Women may also be worried about not being believed by law enforcement or lack faith that the report will end with consequences for their attacker.

According to a 2018 Washington Post report, less than 1 percent of reported rapes lead to felony convictions. For this reason, many advocates want to see lawmakers focus less on using the criminal justice system to aid survivors of sexual abuse, instead placing more resources into preventive initiatives and direct aid.

Because the requirement to report is so invasive, Graziano said the bill would actually hamper law enforcement’s ability to investigate these crimes.

“One thing law enforcement needs is the trust of the victim,” she said. Taking the decision to report out of their hands, particularly when they are seeking care to terminate an unwanted pregnancy, “will make our investigations much more difficult.”

Warner, of the advocacy group WREN, was struck by Graziano’s public opposition to the bill, nodding to the gender dynamics in the state legislature. The state Senate has just five female senators, only one of whom voiced support for the bill, and only after the exception amendment was added. Introduction of the bill and its amendments, as well as debates over the legislation, have been dominated by men.

“It just goes to show what happens when people outside of the good-old-boys’ network get elected to office, because Sheriff Graziano knows what this actually means to people on the ground,” Warner said.

This includes OB/GYNs who have blasted the proposed law. A letter signed by 325 South Carolina doctors called the restrictions “medically unjustified,” adding that the bill “[replaces] medical facts with political rhetoric and personal ideology,” and obstructed their ability to care for their patients.

Among the doctors who delivered the letter to lawmakers was Kristl Tomlin, an OB/GYN who questioned why state senators were prioritizing an abortion bill when health-care providers need help fighting the coronavirus pandemic. (It is the first bill the legislature has put forward, she noted.) Before the coronavirus hit the state, South Carolina had one of the worst maternal mortality rates in the nation, with infant mortality rates also tracking higher than most states. Tomlin described a lack of health literacy and quality access to health care for many South Carolinians, including “routine women’s health care” and contraceptive care.

“We have multiple counties where there is not a single practicing OB/GYN,” she said.

Lost in the debates on the Senate floor around the sanctity of life were the sanctity of her patients’ lives, Tomlin said. She regards her office as a “sacred place,” where they can share their experiences, and where they must trust her to care for them. Her job, if a pregnant survivor shares the details of her rape, is to provide her “with the best medical care that I can, in the safest way possible,” Tomlin said.

“I do not feel that it is my job to force the woman to report a crime that she does not feel comfortable reporting,” she continued, calling the amendment an “unethical and onerous duty” on physicians and law enforcement alike.

Graziano said her department will see what happens with the bill as it travels through the legislature “and, inevitably, the court system,” where its constitutionality will be challenged.

Both Seal and Tomlin, the OB/GYNs, say they have older colleagues who warn them about what it used to be like before Roe v. Wade, which legalized abortion nationwide in 1973. One colleague told Seal that every Monday morning at their clinic, an operating room had to be reserved just to treat women who had attempted to get illegal abortions on their own.

“I hope that’s not our future,” she said.

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