Forced Ultrasound

This law topic summary was last updated on: April 20, 2017

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 April 20, 2017)

According to the Guttmacher Institute, twenty-six states regulate the provision of an ultrasound by abortion providers. Fourteen states have forced ultrasound laws. Four of those states–Kentucky, 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.

In January 2017, the ACLU filed a lawsuit challenging Kentucky’s forced ultrasound law. That litigation is ongoing.

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, many of which are based on AUL’s model “Woman’s Right to Know Act.”

Laws

Title Number State Proposed Status
Indiana Omnibus Abortion Bill (HEA 1210) HEA 1210 Indiana Jan 12, 2011 Current
Arkansas Human Heartbeat Protection Act (SB 134) SB 134 Arkansas Jan 28, 2013 Blocked/Enjoined
Arizona Omnibus Abortion Bill (HB 2036) HB 2036 Arizona Jan 9, 2012 Blocked/Enjoined
Wisconsin Ultrasound/Admitting Privileges Bill (SB 206) SB 206 Wisconsin Jun 4, 2013 Blocked/Enjoined
Texas Bill to Repeal Forced Ultrasound Law (SB 34) SB 34 Texas Jul 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 Feb 11, 2011 Current
Michigan Forced Ultrasound Bill (HB 4187) HB 4187 Michigan Feb 6, 2013 Failed to Pass
Wisconsin Ultrasound/Admitting Privileges Bill (AB 227) AB 227 Wisconsin Jun 3, 2013 Blocked/Enjoined
Florida Third-Trimester Abortion Ban (HB 1047) HB 1047 Florida Feb 20, 2014 Current
New Mexico Woman’s Right to Know Act (HB 122) HB 122 New Mexico Jan 16, 2013 Failed to Pass
Arizona Bill to Amend and Repeal Informed Consent Requirements (HB 2679) HB 2679 Arizona Feb 12, 2014 Failed to Pass
Wisconsin Bill to Repeal Ultrasound/Admitting Privileges Bill (SB 623) SB 623 Wisconsin Feb 20, 2014 Failed to Pass
Missouri Forced Ultrasound Bill of 2014 (HB 1379) HB 1379 Missouri Jan 14, 2014 Failed to Pass
Missouri Forced Ultrasound Bill of 2014 (HB 1148) HB 1148 Missouri Dec 6, 2013 Failed to Pass
Missouri Ultrasound Informed Consent Act (HB 1613) HB 1613 Missouri Jan 27, 2014 Failed to Pass
Missouri Forced Ultrasound Bill of 2013 (HB 298) HB 298 Missouri Jan 23, 2013 Failed to Pass
Missouri Forced Ultrasound Bill of 2013 (SB 393) SB 393 Missouri Feb 27, 2013 Failed to Pass
Alabama Bill Amending Woman’s Right to Know Act to Increase Waiting Period (HB 489) HB 489 Alabama Feb 13, 2014 Failed to Pass
Alabama Bill Amending Informed Consent Requirements (HB 360) HB 360 Alabama Feb 28, 2013 Failed to Pass
Ohio Bill Amending Informed Consent Requirements and Increasing Waiting Period (HB 200) HB 200 Ohio Jun 11, 2013 Failed to Pass
Tennessee Forced Ultrasound Law (SB 632) SB 632 Tennessee Feb 6, 2013 Failed to Pass
Tennessee Forced Ultrasound Law (HB 984) HB 984 Tennessee Jan 31, 2013 Failed to Pass
Mississippi Bill Amending Forced Ultrasound Law (HB 1292) HB 1292 Mississippi Feb 5, 2013 Failed to Pass
Virginia Bill Amending Forced Ultrasound Law 2014 (HB 547) HB 547 Virginia Jan 6, 2014 Failed to Pass
Virginia Bill to Repeal Forced Ultrasound Requirement 2014 (HB 1056) HB 1056 Virginia Jan 8, 2014 Failed to Pass
Virginia Bill Regarding Forced Ultrasound Requirement 2014 (HB 546) HB 546 Virginia Jan 6, 2014 Failed to Pass
Virginia Bill to Repeal Forced Ultrasound Requirement 2014 (SB 617) SB 617 Virginia Jan 15, 2014 Failed to Pass
Virginia Bill Regarding Repeal of Forced Ultrasound Requirement (HB 1560) HB 1560 Virginia Jan 4, 2013 Failed to Pass
Virginia Bill Regarding Repeal of Forced Ultrasound Requirement (SB 1082) SB 1082 Virginia Jan 9, 2013 Failed to Pass
Virginia Bill Amending Forced Ultrasound Law 2013 (HB 1776) HB 1776 Virginia Jan 8, 2013 Failed to Pass
Virginia Bill Regarding Forced Ultrasound Requirement 2013 (SB 1332) SB 1332 Virginia Jan 18, 2013 Failed to Pass
Virginia Bill Regarding Forced Ultrasound Requirement 2013 (HB 1775) HB 1775 Virginia Jan 8, 2013 Failed to Pass
Indiana Omnibus Abortion Bill (SB 371) SB 371 Indiana Jan 8, 2013 Blocked/Enjoined
Indiana Bill Amending Informed Consent Requirements (SB 489) SB 489 Indiana Jan 14, 2013 Failed to Pass
Kentucky Ultrasound Bill (SB 5) SB 5 Kentucky Feb 5, 2013 Failed to Pass
Kentucky Ultrasound Bill with State-Run info Website (HB 575) HB 575 Kentucky Mar 4, 2014 Failed to Pass
Kentucky Ultrasound Bill (SB 8) SB 8 Kentucky Jan 7, 2014 Failed to Pass
Kentucky Ultrasound Bill with Face-to-Face Consult (HB 184) HB 184 Kentucky Jan 9, 2014 Failed to Pass
Iowa Woman’s Right to Know Act (SF 12) SF 12 Iowa Jan 2, 2015 Failed to Pass
Tennessee Forced Ultrasound Bill (HB 2) HB 2 Tennessee Nov 13, 2014 Failed to Pass
Mississippi 72-Hour Waiting Period Bill (SB 2138) SB 2138 Mississippi Jan 9, 2015 Failed to Pass
Virginia Bill Amending Forced Ultrasound Law 2015 (SB 920) SB 920 Virginia Jan 8, 2015 Failed to Pass
Virginia Bill to Repeal Forced Ultrasound Requirement 2015 (HB 1524) HB 1524 Virginia Jan 6, 2015 Failed to Pass
Virginia Bill to Repeal Forced Ultrasound Requirement 2015 (SB 733) SB 733 Virginia Dec 15, 2014 Failed to Pass
Iowa Forced Ultrasound Bill (HF 58) HF 58 Iowa Jan 21, 2015 Failed to Pass
Arizona Bill to Amend and Repeal Informed Consent Requirements (HB 2435) HB 2435 Arizona Jan 15, 2015 Failed to Pass
Arizona Bill Amending Informed Consent Requirements to Add Rape and Incest Exception (HB 2665) HB 2665 Arizona Feb 9, 2015 Failed to Pass
Tennessee Forced Ultrasound Bill (SB 775) SB 775 Tennessee Feb 11, 2015 Failed to Pass
Kentucky Forced Ultrasound Bill (SB 7) SB 7 Kentucky Feb 3, 2015 Failed to Pass
Maryland Ultrasound Bill (SB 158) SB 158 Maryland Jan 30, 2015 Failed to Pass
Illinois Ultrasound Opportunity Act (HB 2701) HB 2701 Illinois Feb 19, 2015 Failed to Pass
New Mexico Woman’s Informed Decision Act (SB 652) SB 652 New Mexico Feb 2, 2015 Failed to Pass
New York Ultrasound Informed Consent Act (A 3717) A 3717 New York Jan 27, 2015 Failed to Pass
Wyoming Ultrasound Bill (HB 156) HB 156 Wyoming Jan 23, 2015 Failed to Pass
Iowa Forced Ultrasound Bill (HF 573) HF 573 Iowa Mar 9, 2015 Failed to Pass
North Carolina Woman’s Right to Know Act (HB 854) HB 854 North Carolina Current
New York ‘Woman’s Right to Know’ Act (S 178) S 178 New York Jan 27, 2015 Failed to Pass
Rhode Island Forced Ultrasound Bill (H 5648) H 5648 Rhode Island Feb 26, 2015 Failed to Pass
Illinois Ultrasound Opportunity Act (HB 2683) HB 2683 Illinois Feb 21, 2013 Failed to Pass
Maryland Ultrasound Opportunity Bill (SB 85) SB 85 Maryland Jan 8, 2014 Failed to Pass
New Jersey Full Disclosure Ultrasound Act (A 108) A 108 New Jersey Jan 16, 2014 Failed to Pass
New Jersey Full Disclosure Ultrasound Act (S 352) S 352 New Jersey Jan 14, 2014 Failed to Pass
Maryland Ultrasound Opportunity Bill (SB 726) SB 726 Maryland Feb 1, 2013 Failed to Pass
New York Ultrasound Informed Consent Act (A 6566) A 6566 New York Apr 9, 2013 Failed to Pass
New York ‘Woman’s Right to Know’ Act (A 3252) A 3252 New York Jan 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 Feb 13, 2013 Failed to Pass
Rhode Island Informed Consent for Abortion Bill (H 7303) H 7303 Rhode Island Jan 30, 2014 Failed to Pass
Florida for Life Act 2016 (SB 1718) SB 1718 Florida Jan 11, 2016 Failed to Pass
Florida for Life Act 2016 (HB 865) HB 865 Florida Jan 12, 2016 Failed to Pass
New Jersey Full Disclosure Ultrasound Act (S 476) S 476 New Jersey Jan 12, 2016 Proposed
Colorado Women’s Reproductive Information Guarantee for Health and Transparency (RIGHT) Act (SB 285) SB 285 Colorado Apr 28, 2015 Failed to Pass
Colorado Women’s Reproductive Information Guarantee for Health and Transparency (RIGHT) Act (HB 1218) HB 1218 Colorado Feb 4, 2016 Failed to Pass
Alabama Ultrasound Access Act (HB 183) HB 183 Alabama Feb 11, 2016 Failed to Pass
Tennessee Women’s Ultrasound Right to Know Act (HB 1459) HB 1459 Tennessee Jan 4, 2016 Failed to Pass
Tennessee Women’s Ultrasound Right to Know Act (SB 1769) SB 1769 Tennessee Jan 19, 2016 Failed to Pass
Indiana Omnibus Abortion Bill (HB 1337) HB 1337 Indiana Jan 12, 2016 Blocked/Enjoined
Idaho Ultrasound Availability Bill (H 516) H 516 Idaho Feb 17, 2016 Current
Kentucky Forced Ultrasound Bill (SB 152) SB 152 Kentucky Feb 4, 2016 Failed to Pass
Illinois Ultrasound Opportunity Act of 2016 (HB 5022) HB 5022 Illinois Feb 8, 2016 Failed to Pass
Maryland Ultrasound Opportunity Bill (SB 626) SB 626 Maryland Feb 5, 2016 Failed to Pass
New Jersey Full Disclosure Ultrasound Act (A 689) A 689 New Jersey Jan 27, 2016 Proposed
Rhode Island Informed Consent for Abortion Bill (H 7313) H 7313 Rhode Island Jan 22, 2016 Failed to Pass
South Carolina ‘Women’s Ultrasound Right to Know Act’ (H 4629) H 4629 South Carolina Jan 12, 2016 Failed to Pass
Missouri Bill Regarding the Cardiac Activity of a Fetus During an Ultrasound (HB 404) HB 404 Missouri Jan 4, 2017 Failed to Pass
Kentucky Ultrasound Informed Consent Act (HB 2) HB 2 Kentucky Jan 3, 2017 Current
Indiana Forced Ultrasound and Extended Waiting Period Bill (SB 118) SB 118 Indiana Jan 4, 2017 Failed to Pass
Illinois Ultrasound Opportunity Act (HB 283) HB 283 Illinois Jan 11, 2017 Proposed
Connecticut Forced Ultrasound Bill (SB 330) SB 330 Connecticut Jan 19, 2017 Proposed
Wyoming Ultrasound Bill (HB 182) HB 182 Wyoming Jan 19, 2017 Current
Tennessee Fetal Heartbeat Bill (HB 108) HB 108 Tennessee Jan 26, 2017 Proposed
Tennessee Fetal Heartbeat Bill (SB 244) SB 244 Tennessee Jan 31, 2017 Proposed
New York Ultrasound Informed Consent Act (A 5374) A 5374 New York Feb 8, 2017 Proposed
Alabama Ultrasound Access Act (HB 131) HB 131 Alabama Feb 7, 2017 Failed to Pass
Idaho Bill Regarding Abortion Reversal Information (S 1131) S 1131 Idaho Mar 2, 2017 Failed to Pass
Alabama Ultrasound Access Act (SB 272) SB 272 Alabama Mar 7, 2017 Failed to Pass
Colorado Women’s Reproductive Information Guarantee for Health and Transparency (RIGHT) Act (SB 284) SB 284 Colorado Apr 3, 2017 Failed to Pass
South Carolina Fetal Heartbeat Bill (S 467) S 467 South Carolina Feb 23, 2017 Proposed
New York ‘Woman’s Right to Know’ Act (S 5067) S 5067 New York Mar 6, 2017 Proposed