On Clueless Congressmen and Trans-vaginal Ultrasounds

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Commentary Law and Policy

On Clueless Congressmen and Trans-vaginal Ultrasounds

Robyn Swirling

Rep. Sean Duffy  “probably agrees” with mandatory transvaginal ultrasound legislation. But he doesn’t really know because, he says, “I haven’t had one.” Well, I have. I’ve had several, in fact. So, Rep. Duffy, pull up a chair and let me explain how a transvaginal ultrasound works, and how it feels.

Cross-posted with permission from The 9th And I.

Rep. Sean Duffy is a Republican congressman from Wisconsin, but you might remember him better from his days on Real World: Boston. Last week at a town hall, Rep. Duffy was asked whether he believed trans-vaginal ultrasounds should be mandatory for abortions, an issue that is currently up for debate in his home state of Wisconsin, as well as in Indiana. A bill mandating trans-vaginal ultrasounds was previously considered in Virginia, but ultimately defeated. Rep. Duffy responded by saying that he didn’t know anything about the legislation, but couldn’t comment on legislating a medical procedure that has been discussed at length in the news lately, other than to say that he “probably agrees” with it. But he doesn’t really know because, he says, “I haven’t had one.”

Well, I have. I’ve had several, in fact. So, Rep. Duffy, pull up a chair and let me explain how a trans-vaginal ultrasound works, and how it feels.

The first time I had a 9 inch-long (230mm) hard plastic cylindrical probe inserted into my vagina, I was 15 years old. I was having extreme, sharp pains in my lower abdomen and was brought to the emergency room by a counselor at my summer music program in upstate New York. After having my first ever pelvic exam performed by an alarmingly young male doctor, I was brought into an ultrasound room. I had only been told that I would have an ultrasound to determine if an ovarian cyst had burst, as they suspected, and I figured it would be like the kind I’d seen them use on pregnant women on TV: on top of the stomach, with the gel. Instead, the male technician showed me the ultrasound wand, instructed me to put my feet in stirrups, and inserted the wand.

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The technician pressed the wand against my cervix and pushed it further up and to the right side, prompting a sharp pain that didn’t subside until he finished pressing the wand hard against multiple parts of my insides to get a picture of my ovaries and uterus. The procedure lasted longer than usual because my bladder was too full to get out of the way, so he had to press harder and in more places in order to get a clear image.

In suffering with ovarian cysts and endometriosis for years after that experience, as well as with cervical dysplasia, I have had occasion for several more trans-vaginal ultrasounds. In total, I’ve had 9.

Two of my most recent trans-vaginal ultrasound experiences were when I had an abortion, in early 2010. I first consulted an obstetrician to confirm the pregnancy, and she did a trans-vaginal ultrasound after being unable to see what she needed to see with an external one. They also did one at Planned Parenthood, to confirm the particular procedure they were planning was appropriate to the gestational age and development, and to ensure that I wasn’t so far along that my abortion would be illegal in Texas. That ultrasound was not mandated by Texas law at the time (it is now), but they have always been a standard part of Planned Parenthood’s medical treatment.

That particular trans-vaginal ultrasound was extremely painful too, and not because I was regretting my decision or didn’t want to see the fetus on the screen or hear it described. It just physically hurt. I knew exactly what I was doing; the procedure had been described to me by the nurse, by written materials I was forced to read, and by information I was forced to listen to 24 hours before the procedure. And while some women may regret their decision, and some may have had a tremendously difficult time reaching the decision to be there, every single one of them knows what an abortion is and what it does. That’s why she’s there, and she doesn’t need a hard piece of plastic pressed against her cervix and a visual reminder that she’s pregnant to shame her into keeping a child for which she is unprepared.

Legally requiring a painful and invasive medical procedure is not good medicine, and it’s not good policy. The American Medical Association, American College of Obstetrics & Gynecology, and other medical associations that are just filled to the brim with doctors issue evidence-based medical guidelines and best practices. They are perfectly capable of issuing guidelines for how best to perform an abortion. And, guess what? They have! (And they say that “the available evidence does not support the use of pre-abortion ultrasound to increase safety.”)

If a doctor tells me that I need to have a trans-vaginal ultrasound to determine the gestational age of a pregnancy or to suss out the cause of a gynecological issue, fine. But I’ll be damned if I’m going to let legislators do it to coerce and shame me, and millions of other women.