The Oklahoma Law and My Ultrasound

Martha Kempner

On Tuesday, while the Oklahoma Legislature was voting to override a gubernatorial veto and reinstate a law requiring women to have ultrasounds before allowing them to have an abortion, I was, well, having an ultrasound.

On Tuesday, while the Oklahoma Legislature was voting to override a gubernatorial veto and reinstate a law requiring women to have ultrasounds before allowing them to have an abortion, I was, well, having an ultrasound. This is not the first state law that requires this procedure prior to abortion but this one takes it one step further and mandates that the doctor or technician set up a monitor so the woman can see it and that he or she describe the heart, limbs, and organs of the fetus.  The law does not make an exception for pregnancies caused by rape or incest. 

Perhaps, it was because I’d just gone through the procedure or perhaps it’s just the pregnancy hormones raging through my system but the thought of a woman being forced to go through this when all she wanted was to exercise her legal and moral right to terminate the pregnancy made me cry.  That kind of manipulation is cruel. 

My husband tried to console me by saying that I shouldn’t worry, at those very early ultrasounds the images are so murky and the fetus has so little resemblance to a human baby that it will not successfully convince any woman to change her mind.  He may be right – at my first scan, the fetus was more alien than baby. Then again, I could see and hear a heartbeat, and despite the fact that the fetus was smaller than a grape, the magnified images let me see a tiny developing spine.  We’ve all watched those stereotypical scenes in movies and sitcoms where a couple goes to the OB and are chatting, fighting, texting, or otherwise not paying attention until the sound of the heartbeat stops them cold and brings tears to their eyes.   Clearly, changing the mind of women who are seeking abortions is exactly what the lawmakers are hoping to do but I’m not sure that whether they succeed matters.  Just trying is degrading and damaging to women. 

I wanted to be pregnant, so for me the goal of the 8-week scan was to hear a heartbeat and confirm that this was a viable pregnancy.  After all, at that stage of pregnancy one doesn’t look pregnant or necessarily feel any different. It was heartening to learn that the home pregnancy test was right.  I wouldn’t exactly say that it was an emotional experience for me but the thought “okay, there really is something in there” kept going through my head.  In my opinion, this isn’t a thought that women seeking an abortion in early pregnancy should be forced to have. 

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Our society seems to have a romantic fantasy about the unplanned pregnancy that changes a woman’s life for the better.  Think about the Judd Apatow movie, Knocked Up, or the new Jenna Elfman sitcom, Accidently On Purpose.  We seem to enjoy the idea that an unexpected pregnancy can join two unlikely people together and created an instant loving family. One of the lawmakers who voted for this veto has clearly bought into such a vision saying that, “maybe someday these babies will grow up to be police officers and arrest bad people, or will find a cure for cancer.” In real life, though, it rarely works that way. 

Most women who seek abortions know what they want; they have made a well-reasoned, intelligent decision that for whatever reason — be it relationship, money, job situation, or long-term goals– carrying this pregnancy to term would not be good for them, for their families, or for the resulting child.  These women do not need somebody to say: “Really, are you sure? Before you say anything let me just show you a heartbeat, your baby’s heartbeat.”  Such questions are manipulative, patronizing, and unfair. 

Similarly, women who go to a clinic and are unsure of the option that is best for them should also not be exposed to such manipulations.  These women need to sit down with an informed and impartial counselor who has no agenda of her own and is not required to promote the agenda of conservative lawmakers.  

Unfortunately, the Oklahoma law has a second provision that is even more insidious.  This provision prevents women who have had a disabled baby from suing a doctor for withholding information about birth defects while the child was in the womb.  According to the New York Times, “…the bill’s sponsors maintain that it merely prevents lawsuits by people who wish, in hindsight, that a doctor had counseled them to abort a disabled child.”  That explanation seems suspect to me, and I agree with choice advocates who see this as designed to protect doctors who purposely mislead women to keep them from having abortions.

The ultrasound I had on Tuesday is referred to as an anatomy scan and typically takes place in the 20th week of pregnancy, the halfway point.  The 45-minute procedure goes over every centimeter of the developing fetus and carefully measures the arms, legs, brain, and kidneys.  It takes a detailed look at all four chambers of the heart, and checks blood flow through the umbilical cord.  And, for expectant parents who want to know, it can determine the biological sex by carefully examining the genitals.

There was, in fact, a monitor set up directly in front of me.  Half the time, my husband and I had no idea what we were looking at but certain things were obvious.  The head looked like a head, possibly one of skeleton, but a head nonetheless.  Each vertebrae of the spine was visible, and the hands and feet were unmistakable. Such tests answer the question “does it have ten fingers and ten toes?” long before birth. Of course, we all know that that age-old question is a bit of a stand-in for: “Is everything normal?” or “Is there anything wrong?”

If, the technician had found that there was no blood flow to one of the fetus’s kidney, that the heart was growing outside the its chest, or any other number of anomalies that can now be determined pre-birth, my husband and I would have had to make a decision about whether to continue the pregnancy.  In this case, we would have turned to the doctors not to “counsel us to abort a disabled child,” but to give us the information we needed to make that decision for ourselves.  To tell us based on the extent of the anomaly and the most up-to-date research what we could anticipate for this child.   The thought that the sonographer or the physician on call could withhold information from us in order to influence our decision sends shivers down my spine. 

In this pregnancy alone, I have had 6 sonograms, all performed by different technicians and physicians none of whom I have met more than once.  I have no idea what their personal views are on abortion and I shouldn’t have to care.  But this law, in essence, allows their opinions on abortion to be more important than my own. 

In truth, I was a little disappointed with technician to whom I was assigned on Tuesday.  While the other ones had smiled and said things like “oh that looks good” throughout the procedure, this one had a serious look on her face that bordered on a scowl and stayed quiet unless prompted.  Not the reassurance I needed.  At one point, confirming the amniocentesis’s finding that the fetus is a girl, she said, “yes, I don’t see a pee-pee.” I later joked to friends that the sex educator in me felt compelled to reply “ok, but do you see labia?” 

For women in Oklahoma, the technician who they pick out of the phone book or to whom they are referred is no joking matter – it can now mean a lifetime of raising a disabled child because somebody else thought they should.  Moreover, while I was able to trust my technician’s professional opinion despite our personality differences, until this law is struck down by a court, and I have to believe it will be, women in Oklahoma can no longer have such feelings of trust.   

And that, even without a system full of pregnancy hormones, is enough to make me want to cry. 

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (R-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.