Forced Ultrasound

Last updated: March 18, 2016

Forced ultrasound laws require that providers perform an ultrasound within a specified period of time before a woman obtains an abortion in order to fulfill state “informed consent” requirements for an abortion procedure. Many ultrasound laws also contain “speech and display” requirements, which require the provider to show and describe the ultrasound image to a woman seeking an abortion. Ultrasounds are medical procedures generally performed for various reasons at the advice and discretion of a doctor and her patient. Because legislation mandating such procedures circumvents professional medical guidance and discretion and the consent of the patient, we refer to these as “forced ultrasound” laws.

The purported purpose of these forced ultrasound laws, which are based on a model bill authored by Americans United for Life, is to ensure that women make an informed choice about whether or not to get an abortion, to promote the woman’s physical and psychological health, and to protect a state’s interest in protecting life. In reality, however, these laws compel doctors to perform medically unnecessary procedures, raising the costs of abortion care, and imposing additional burdens on the free exercise of women’s rights.

Mandatory ultrasound laws attempt to dissuade women from getting an abortion using emotional appeals and manipulation. However, the attempt is almost always unsuccessful: One study demonstrates that women who view an ultrasound image are not likely to change their mind about going through with the abortion. Another study shows that Texas’s law in particular is a burden on women and does not dissuade most women from getting an abortion.

Mandatory ultrasound laws undermine a key provision of Planned Parenthood v. Casey, which prohibits regulations that pose an “undue burden” on a woman’s constitutional right under Roe v. Wade to choose an abortion.

Forced ultrasound bills raise additional constitutional concerns. The “speech and display” requirements of the laws compel doctors to provide potentially unnecessary and medically irrelevant information, and may violate the First Amendment, which proscribes compelled speech in certain circumstances. Also, the laws may force women to undergo medical procedures to which they have not consented, thus violating their 14th Amendment due process rights.

In addition, forced ultrasound laws require doctors to violate medically established guidelines set forth by the American Congress of Obstetricians and Gynecologists (ACOG), which state that the use of ultrasonography without a medical indication is not only inappropriate, but also contrary to responsible medical practice.

Examples of Forced Ultrasound Laws (last updated January 4, 2016)

According to the Guttmacher Institute, twenty-five states regulate the provision of an ultrasound by abortion providers. Thirteen states have forced ultrasound laws. Three of those states–Louisiana, Texas, and Wisconsin—require the abortion provider to display and describe the ultrasound image. Nine states—Alabama, Arizona, Florida, Indiana, Kansas, Mississippi, North Carolina, Ohio, and Virginia—require that the abortion provider offer an opportunity to view the image. None of these states expressly require the use of a transvaginal ultrasound. However, many of these states require that the ultrasound image depict the dimensions of the fetus and the presence of the fetus’s external members and internal organs. This sort of detail can only be achieved by using a transvaginal wand, because transvaginal ultrasounds produce higher quality images at earlier gestational stages than transabdominal ultrasounds do. For this reason, in practice, these laws force women to undergo a transvaginal ultrasound in order to obtain an abortion.

The U.S. Supreme Court has yet to address the constitutionality of forced ultrasound laws. Lower courts, however, have reached conflicting conclusions. In 2011, after a district court blocked Texas’s sonogram law, the Fifth Circuit Court of Appeals reversed that decision and ruled that the law is constitutional. Texas’s law is currently in effect.

In 2012, Oklahoma’s forced ultrasound law was permanently blocked by the Oklahoma Supreme Court on state constitutional grounds. The U.S. Supreme Court declined to review the decision.

In 2014, a federal district court judge permanently blocked North Carolina’s forced ultrasound law. In March 2015, North Carolina appealed the Fourth Circuit ruling to the U.S. Supreme Court. In June 2015, the Supreme Court declined to consider North Carolina’s appeal. The Fourth Circuit’s ruling is therefore final.

Mandatory ultrasound laws attempt to dissuade women from getting an abortion using emotional appeals and manipulation. One study demonstrates that women who view an ultrasound image are not likely to change their mind about going through with the abortion. Another study shows that Texas’s law in particular is a burden on women and does not dissuade most women from getting an abortion.

Nevertheless, state legislatures continue to introduce these laws based on AUL’s model. New York and Tennessee are currently considering forced ultrasound laws. Iowa and Kentucky both failed to pass their forced ultrasound laws in 2015.

Laws

Title Number State Proposed Status
Indiana Omnibus Abortion Bill (HEA 1210) HEA 1210 Indiana January 12, 2011 Current
Arkansas Human Heartbeat Protection Act (SB 134) SB 134 Arkansas January 28, 2013 Blocked/Enjoined
Arizona Omnibus Abortion Bill (HB 2036) HB 2036 Arizona January 9, 2012 Blocked/Enjoined
Wisconsin Ultrasound/Admitting Privileges Bill (SB 206) SB 206 Wisconsin June 4, 2013 Blocked/Enjoined
Texas Bill to Repeal Forced Ultrasound Law (SB 34) SB 34 Texas July 9, 2013 Failed to Pass
Texas Bill Amending Woman’s Right to Know Act to Include Mandatory Sonogram and Waiting Period (HB 15) HB 15 Texas February 11, 2011 Current
Michigan Forced Ultrasound Bill (HB 4187) HB 4187 Michigan February 6, 2013 Failed to Pass
Wisconsin Ultrasound/Admitting Privileges Bill (AB 227) AB 227 Wisconsin June 3, 2013 Blocked/Enjoined
Florida Third-Trimester Abortion Ban (HB 1047) HB 1047 Florida February 20, 2014 Current
New Mexico Woman’s Right to Know Act (HB 122) HB 122 New Mexico January 16, 2013 Failed to Pass
Arizona Bill to Amend and Repeal Informed Consent Requirements (HB 2679) HB 2679 Arizona February 12, 2014 Failed to Pass
Wisconsin Bill to Repeal Ultrasound/Admitting Privileges Bill (SB 623) SB 623 Wisconsin February 20, 2014 Failed to Pass
Missouri Forced Ultrasound Bill of 2014 (HB 1379) HB 1379 Missouri January 14, 2014 Failed to Pass
Missouri Forced Ultrasound Bill of 2014 (HB 1148) HB 1148 Missouri December 6, 2013 Failed to Pass
Missouri Ultrasound Informed Consent Act (HB 1613) HB 1613 Missouri January 27, 2014 Failed to Pass
Missouri Forced Ultrasound Bill of 2013 (HB 298) HB 298 Missouri January 23, 2013 Failed to Pass
Missouri Forced Ultrasound Bill of 2013 (SB 393) SB 393 Missouri February 27, 2013 Failed to Pass
Alabama Bill Amending Woman’s Right to Know Act to Increase Waiting Period (HB 489) HB 489 Alabama February 13, 2014 Failed to Pass
Alabama Bill Amending Informed Consent Requirements (HB 360) HB 360 Alabama February 28, 2013 Failed to Pass
Ohio Bill Amending Informed Consent Requirements and Increasing Waiting Period (HB 200) HB 200 Ohio June 11, 2013 Failed to Pass
Tennessee Forced Ultrasound Law (SB 632) SB 632 Tennessee February 6, 2013 Failed to Pass
Tennessee Forced Ultrasound Law (HB 984) HB 984 Tennessee January 31, 2013 Failed to Pass
Mississippi Bill Amending Forced Ultrasound Law (HB 1292) HB 1292 Mississippi February 5, 2013 Failed to Pass
Virginia Bill Amending Forced Ultrasound Law 2014 (HB 547) HB 547 Virginia January 6, 2014 Failed to Pass
Virginia Bill to Repeal Forced Ultrasound Requirement 2014 (HB 1056) HB 1056 Virginia January 8, 2014 Failed to Pass
Virginia Bill Regarding Forced Ultrasound Requirement 2014 (HB 546) HB 546 Virginia January 6, 2014 Failed to Pass
Virginia Bill to Repeal Forced Ultrasound Requirement 2014 (SB 617) SB 617 Virginia January 15, 2014 Failed to Pass
Virginia Bill Regarding Repeal of Forced Ultrasound Requirement (HB 1560) HB 1560 Virginia January 4, 2013 Failed to Pass
Virginia Bill Regarding Repeal of Forced Ultrasound Requirement (SB 1082) SB 1082 Virginia January 9, 2013 Failed to Pass
Virginia Bill Amending Forced Ultrasound Law 2013 (HB 1776) HB 1776 Virginia January 8, 2013 Failed to Pass
Virginia Bill Regarding Forced Ultrasound Requirement 2013 (SB 1332) SB 1332 Virginia January 18, 2013 Failed to Pass
Virginia Bill Regarding Forced Ultrasound Requirement 2013 (HB 1775) HB 1775 Virginia January 8, 2013 Failed to Pass
Indiana Omnibus Abortion Bill (SB 371) SB 371 Indiana January 8, 2013 Blocked/Enjoined
Indiana Bill Amending Informed Consent Requirements (SB 489) SB 489 Indiana January 14, 2013 Failed to Pass
Kentucky Ultrasound Bill (SB 5) SB 5 Kentucky February 5, 2013 Failed to Pass
Kentucky Ultrasound Bill with State-Run info Website (HB 575) HB 575 Kentucky March 4, 2014 Failed to Pass
Kentucky Ultrasound Bill (SB 8) SB 8 Kentucky January 7, 2014 Failed to Pass
Kentucky Ultrasound Bill with Face-to-Face Consult (HB 184) HB 184 Kentucky January 9, 2014 Failed to Pass
Iowa Woman’s Right to Know Act (SF 12) SF 12 Iowa January 2, 2015 Failed to Pass
Tennessee Forced Ultrasound Bill (HB 2) HB 2 Tennessee November 13, 2014 Failed to Pass
Mississippi 72-Hour Waiting Period Bill (SB 2138) SB 2138 Mississippi January 9, 2015 Failed to Pass
Virginia Bill Amending Forced Ultrasound Law 2015 (SB 920) SB 920 Virginia January 8, 2015 Failed to Pass
Virginia Bill to Repeal Forced Ultrasound Requirement 2015 (HB 1524) HB 1524 Virginia January 6, 2015 Failed to Pass
Virginia Bill to Repeal Forced Ultrasound Requirement 2015 (SB 733) SB 733 Virginia December 15, 2014 Failed to Pass
Iowa Forced Ultrasound Bill (HF 58) HF 58 Iowa January 21, 2015 Failed to Pass
Arizona Bill to Amend and Repeal Informed Consent Requirements (HB 2435) HB 2435 Arizona January 15, 2015 Failed to Pass
Arizona Bill Amending Informed Consent Requirements to Add Rape and Incest Exception (HB 2665) HB 2665 Arizona February 9, 2015 Failed to Pass
Tennessee Forced Ultrasound Bill (SB 775) SB 775 Tennessee February 11, 2015 Failed to Pass
Kentucky Forced Ultrasound Bill (SB 7) SB 7 Kentucky February 3, 2015 Failed to Pass
Maryland Ultrasound Bill (SB 158) SB 158 Maryland January 30, 2015 Failed to Pass
Illinois Ultrasound Opportunity Act (HB 2701) HB 2701 Illinois February 19, 2015 Proposed
New Mexico Woman’s Informed Decision Act (SB 652) SB 652 New Mexico February 2, 2015 Failed to Pass
New York Ultrasound Informed Consent Act (A 3717) A 3717 New York January 27, 2015 Failed to Pass
Wyoming Ultrasound Bill (HB 156) HB 156 Wyoming January 23, 2015 Failed to Pass
Iowa Forced Ultrasound Bill (HF 573) HF 573 Iowa March 9, 2015 Failed to Pass
North Carolina Woman’s Right to Know Act (HB 854) HB 854 North Carolina Current
New York Women’s Right to Know Act (S 178) S 178 New York January 27, 2015 Failed to Pass
Rhode Island Forced Ultrasound Bill (H 5648) H 5648 Rhode Island February 26, 2015 Failed to Pass
Illinois Ultrasound Opportunity Act (HB 2683) HB 2683 Illinois February 21, 2013 Failed to Pass
Maryland Ultrasound Opportunity Bill (SB 85) SB 85 Maryland January 8, 2014 Failed to Pass
New Jersey Full Disclosure Ultrasound Act (A 108) A 108 New Jersey January 16, 2014 Failed to Pass
New Jersey Full Disclosure Ultrasound Act (S 352) S 352 New Jersey January 14, 2014 Failed to Pass
Maryland Ultrasound Opportunity Bill (SB 726) SB 726 Maryland February 1, 2013 Failed to Pass
New York Ultrasound Informed Consent Act (A 6566) A 6566 New York April 9, 2013 Failed to Pass
New York ‘Woman’s Right to Know’ Act (A 3252) A 3252 New York January 24, 2013 Failed to Pass
New York ‘Woman’s Right to Know’ Act (S 4996) S 4996 New York May 3, 2013 Failed to Pass
Rhode Island Informed Consent for Abortion Bill (H 5435) H 5435 Rhode Island February 13, 2013 Failed to Pass
Rhode Island Informed Consent for Abortion Bill (H 7303) H 7303 Rhode Island January 30, 2014 Failed to Pass
Florida for Life Act 2016 (SB 1718) SB 1718 Florida January 11, 2016 Failed to Pass
Florida for Life Act 2016 (HB 865) HB 865 Florida January 12, 2016 Failed to Pass
New Jersey Full Disclosure Ultrasound Act (S 476) S 476 New Jersey January 12, 2016 Proposed
Colorado Women’s Reproductive Information Guarantee for Health and Transparency (RIGHT) Act (SB 285) SB 285 Colorado April 28, 2015 Failed to Pass
Colorado Women’s Reproductive Information Guarantee for Health and Transparency (RIGHT) Act (HB 1218) HB 1218 Colorado February 4, 2016 Failed to Pass
Alabama Ultrasound Access Act (HB 183) HB 183 Alabama February 11, 2016 Failed to Pass
Tennessee Women’s Ultrasound Right to Know Act (HB 1459) HB 1459 Tennessee January 4, 2016 Failed to Pass
Tennessee Women’s Ultrasound Right to Know Act (SB 1769) SB 1769 Tennessee January 19, 2016 Failed to Pass
Indiana Omnibus Abortion Bill (HB 1337) HB 1337 Indiana January 12, 2016 Blocked/Enjoined
Idaho Ultrasound Availability Bill (H 516) H 516 Idaho February 17, 2016 Current
Kentucky Forced Ultrasound Bill (SB 152) SB 152 Kentucky February 4, 2016 Failed to Pass
Illinois Ultrasound Opportunity Act of 2016 (HB 5022) HB 5022 Illinois February 8, 2016 Failed to Pass
Maryland Ultrasound Opportunity Bill (SB 626) SB 626 Maryland February 5, 2016 Failed to Pass
New Jersey Full Disclosure Ultrasound Act (A 689) A 689 New Jersey January 27, 2016 Proposed
Rhode Island Informed Consent for Abortion Bill (H 7313) H 7313 Rhode Island January 22, 2016 Failed to Pass
South Carolina ‘Women’s Ultrasound Right to Know Act’ (H 4629) H 4629 South Carolina January 12, 2016 Failed to Pass