In Columbia, South Carolina, legislators are reviewing a contentious bill that could impose severe penalties on women who undergo abortions, with potential prison terms spanning decades. Additionally, this legislation may limit the availability of intrauterine devices (IUDs) and regulate in vitro fertilization practices, as it is debated by a select group of state senators on Tuesday.

This proposal marks the beginning of a lengthy legislative journey, requiring passage through at least six stages and featuring some of the most stringent abortion restrictions and penalties in the United States.

The subcommittee within the South Carolina Senate’s Medical Affairs Committee has the power to amend the bill during their Tuesday afternoon session. However, even with subcommittee approval, the bill’s future remains uncertain.

Despite its preliminary status, this proposal has advanced further than any similar efforts across the nation since the Supreme Court’s 2022 decision to overturn Roe v. Wade, which allowed states to enact their own abortion laws.

The proposed legislation seeks to prohibit all abortions unless the woman’s life is at risk. Current South Carolina law bans abortions once cardiac activity is detected, usually around six weeks into pregnancy—often before a woman is aware she is pregnant. The existing law also permits abortions for victims of rape or incest up to 12 weeks of gestation.

The proposal would also do things that aren’t being done in any other state. Women who get an abortion and anyone who helps them could face up to 30 years in prison. It appears to ban any contraception that prevents a fertilized egg from implanting, which would ban intrauterine devices and could limit in vitro fertilization.

Providing information about abortions would be illegal, leaving doctors worried they couldn’t suggest places where the procedure is legal.

Republican Sen. Richard Cash, who sponsors the bill and is one of the Senate’s most strident voices against abortion, will run Tuesday’s subcommittee. He acknowledged problems last month with potentially banning contraception and restricting the advice doctors can give to patients. But he has given no indication what changes he or the rest of the subcommittee might support. Six of the nine members are Republicans.

Abortion remains an unsettled issue in conservative states and how much more to restrict it is fracturing anti-abortion groups.

South Carolina Citizens for Life, one of the state’s largest and oldest opponents of abortion, issued a statement last month saying it can’t support Cash’s bill because women who get abortions are victims too and shouldn’t be punished.

On the other side, at least for this bill, are groups like Equal Protection South Carolina. “Abortion is murder and should be treated as such,” founder Mark Corral said.