The nation's top court Monday cleared the way for South Carolina to obtain medical records of women seeking abortions.

The U.S. Supreme Court declined to hear an appeal by a Greenville abortion clinic challenging state health regulations dealing with medical information kept by abortion clinics.

South Carolina is the only state with regulations requiring clinics to turn over entire patient files, said Bonnie Scott Jones, a lawyer for the New York-based Center for Reproductive Rights, which represented the Greenville Women's Clinic in its appeal.

Instead of having regulations, the state could subpoena medical records for abortion clinic investigations or get the patients' consent, she said.

The S.C. Department of Health and Environmental Control rules were part of the agency's overhaul in the mid-1990s of how abortion clinics were regulated. But the medical information regulations haven't taken effect because of a lengthy court appeal.

Allowing DHEC to obtain medical records - including identifying information, such as name, address and Social Security number - will discourage women from seeking legal abortions, abortion rights advocates say.

It also will put women and the doctors who do abortions at risk of harassment or violence by anti-abortion activists if DHEC releases the women's personal data, abortion rights advocates say.

"We're very disappointed that the Supreme Court didn't recognize what a serious invasion of privacy this law is," said Vicki Saporta, president of the National Abortion Federation in Washington, D.C. "We think it will adversely impact women's access to abortion services."

DHEC, in court papers, said the regulations are needed to protect patients' health and make abortion clinics safer.

Agency officials declined comment Monday.

In 1998, 8,801 abortions were done in South Carolina, DHEC records show. The number dropped to 7,687 in 1999, with another slight drop to 7,527 in 2000.

The DHEC Web site lists three licensed abortion clinics: Planned Parenthood of South Carolina Inc. in Columbia, Charleston Women's Medical Center and Greenville Women's Clinic.

DHEC likely would ask for patient files only when doing a licensing investigation of the clinic, said Trey Walker, spokesman for S.C. Attorney General Henry McMaster. His office was a defendant in the lawsuit.

"The regulations are reasonable health and safety measures that do not infringe on anyone's constitutional rights," he said.

But the public might learn about a patient's personal information during open licensing proceedings, Jones said. And DHEC couldn't stop all possible leaks from its agency.

"My fear is ... that women's identities and medical histories will be made known, which will damage their reputations," she said.

New federal privacy rules don't prohibit state health departments from collecting patient information at abortion clinics, Jones said. It's unclear, however, whether the federal rules would prevent the S.C. health agency from releasing the information to third parties.

South Carolina's constitution bans unwarranted invasions of privacy, University of South Carolina law professor Eldon Wedlock said. But DHEC might need to contact a patient during an investigation of a clinic, he said.

The Greenville Women's Clinic sued the state in 1996 after DHEC adopted health and safety regulations for abortion clinics statewide. Rules governing such things as instrument sterilization and cleanliness standards eventually withstood court challenges, though medical information regulations were challenged in a later appeal.

The Center for Reproductive Rights is challenging Arizona's efforts to require abortion clinics to release some identifying information of patients, Jones said. The U.S. Supreme Court could eventually decide to hear that case if a lower federal court ruling conflicts with its counterpart in the S.C. case, she said.

"It's not like this case is ended," Jones said.