It all started in 2007 in South Carolina — a first-of-its-kind bill was introduced requiring women to view an ultrasound before an abortion. By the time the bill was sent to the governor's desk, it was slightly less pernicious — it didn't require women to view ultrasounds, just that physicians offer them. Since then we've seen similar bills pass like the wind across a total of 12 states, including in South Dakota, Michigan, Utah, Georgia, Idaho and Wisconsin, requiring doctors to offer women an ultrasound and to be "given the opportunity to view the ultrasound."
Now a new round of ultrasound legislation is spreading across the country — it has already hit Louisiana, Alabama and Mississippi — and this time, women are forced to view the ultrasounds. Women must also listen to, in detail as outlined by law, information on the ultrasound and to certify in writing that all this has been done. In Oklahoma a law has just been passed that even some anti-choice advocates don't want to see instituted.
This week, in an override of Oklahoma's Governor Brad Henry's veto, the state Congress passed an omnibus abortion bill that both the Oklahoma State Medical Association and the Oklahoma chapter of the Association for Obstetricians and Gynecologists (ACOG) opposed on the grounds that it is invasive (on both a literal and figurative level) for both patient and physician, paves the way for more lawsuits, punishes physicians with outrageous fines, legislates that the providers post signs and even mandates what the signs must say, and forces the doctors to use certain language when talking to their patients about what they are seeing in the ultrasound.
More specifically, the law requires physicians to perform a vaginal ultrasound (if that option provides the best image, which it almost always does for pregnancies in the first trimester) one hour prior to an abortion on women who seek an abortion and to point out features like the heartbeat as well as fetal development – even if the woman has been a victim of rape. Yes, you read that correctly. The bill kindly allows that a woman may "avert her eyes" while receiving the vagina probe but there is no option, according to Dr. Dana Stone, chair of the state's chapter of ACOG, to "opt out of the procedure."
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Now, not only do we have legislators mandating what kinds of information women receive but also what kinds of medical care they should receive. But the bill goes farther than that – much farther.
The law levies extreme fines against physicians who fail to comply. And also allows for new avenues for doctors to be sued. If a physician fails to send a written explanation of any adverse reaction to a medication abortion a woman experiences to her or his State Board of Medical Licensure the physician can be fined anywhere from $10,000 to more than $100,000. In addition, both the father of the baby and the maternal grandparents are given the right to sue the doctor for violating the new law. Dr. Stone correctly points out that this is not a conservative stance in the slightest.
Dr. Dana Stone knows a lot about this bill — against which she desperately fought. She sent talking points to her Senators prior to the passage of the bill outlining the various problems. She also attempted to get an op-ed published in the largest daily newspaper in the state, The Daily Oklahoman, prior to its passage into law. But she was turned down by the Opinion page editor with this response:
"The bill you reference passed the House by an overwhelming margin on Tuesday, having also gotten overwhelming support in the Senate. It is thus too late to urge readers to contact lawmakers [emphasis mine] to vote against the bill."
In fact, the editor was wrong. It was not "too late to urge readers to contact lawmakers to vote against the bill." The Senate had not yet voted on the legislation — there was an opportunity for readers to act if they so chose. Even more disturbing than the editor's mistake was his decision not to publish commentary from one of their state's leading expert medical voices.
Here is the rejected letter:
The people I admire most stand by their bedrock values, even when those values benefit people with whom they disagree. Republicans have long promoted the conservative principle of limited government. They believe that government intervention is often misguided, and most decisions are best left to the individuals and organizations closest to any issue. I hold that belief as well. I am stunned, then, that a Republican-sponsored bill in the state legislature would take government invasion to the extreme. Senator Todd Lamb has sponsored a bill that mandates an unnecessary, invasive test before a woman can undergo a medical procedure she is paying for herself. The fact that Senate Bill 1878 deals with the controversial issue of abortion and claims to work for informed consent should not make this government intrusion any more acceptable to true conservatives. The bill requires a woman to endure an ultrasound performed by a probe placed in her vagina, even against her wishes, before a pregnancy termination is done. Other simple alternatives exist to educate a woman about the development of an embryo. The state of Oklahoma cannot justify this personal and intimate violation. Pro-choice and pro-life Oklahomans who find this level of government intrusion offensive should contact their state legislators and ask them to vote against this bill.
Dana Stone, M.D, Oklahoma City
In an AP article about the law, Oklahoma Rep. Rebecca Hamilton offered this astoundingly insensitive commentary on the debate: "I've had numerous ultrasounds in my life, and they're not that onerous…It's not that big a deal."
Yes, ladies – just get over it. Being forced by the government to have a vaginal ultrasound, view the ultrasound, listen to a physician go through a government imposed speech about the ultrasound image and then sign a piece of paper so that the government knows you've gone through their imposed ringer is just "not a big deal," okay?
And, really, why listen to the doctors on this one? We've got elected officials who clearly feel they've got a handle on health care provision, as evidenced by this section in the law detailing what physicians must do:
1. Perform an obstetric ultrasound on the pregnant woman, using either a vaginal transducer or an abdominal transducer, whichever would display the embryo or fetus more clearly;
2. Provide a simultaneous explanation of what the ultrasound is depicting;
3. Display the ultrasound images so that the pregnant woman may view them;
4. Provide a medical description of the ultrasound images, which shall include the dimensions of the embryo or fetus, the presence of cardiac activity, if present and viewable, and the presence of external members and internal organs, if present and viewable; and
5. Obtain a written certification from the woman, prior to the abortion, that the requirements of subsection B have been complied with; and
6. Retain a copy of the written certification prescribed by paragraph 5 of this subsection. The certification shall be placed in the medical file of the woman and shall be kept by the abortion provider for a period of not less than seven (7) years. If the woman is a minor, then the certification shall be placed in the medical file of the minor and kept for at least seven (7) years or for five (5) years after the minor reaches the age of majority, whichever is greater.
These kinds of laws are misleading and unnecessary on so many levels it's hard to know where to start. Anti-choice advocates are brilliant at enacting legislation based on invisible claims of wrong-doing, pretending to care about women's health and well-being when in fact they are using precious legislative, human and financial resources that could be funneled towards laws and advocacy that actually help women; laws that expand health care coverage, protect women from domestic violence, provide needed resources for child-care and more.
Here's to hoping that physicians and health care consumers can come together more cohesively to challenge new laws that mandate the way physicians provide care and the way patients receive it.
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