“Are we now going to have to convince our patients we are not raping them?” A longtime abortion provider posed that question to colleagues on a listserv this week, and it demonstrates what is wrongheaded about the rhetoric that abortion rights supporters have been using to oppose ultrasound laws. In the short run, the labeling has sent pro-life legislators running. But in the long run, it risks turning a benign and routine part of the abortion procedure into cause for alarm.
Pro-choice commentators have called the transvaginal form of ultrasound that’s standard early in pregnancy “rape,” “forced vaginal penetration,” and an “unnecessary medical procedure” in response to bills in Virginia and elsewhere that would, practically speaking, require all abortion recipients to undergo an ultrasound by this method. In the short run, this framing galvanized a pro-choice backlash against the Virginia ultrasound bill. Faced with 1,000 protesters at the state capitol, widespread condemnation in the media, and ridicule on the late night comedy shows, Gov. Bob McDonnell partially backed off the ultrasound mandate he’d earlier indicated he would sign. McDonnell said that “mandating an invasive procedure in order to give informed consent is not a proper role for the state,” making it clear that the outcry over requiring a transvaginal ultrasound led to his reconsideration. In Alabama, the governor is backing away from a similar bill.
As a sociologist who has long studied and supported the pro-choice movement—and chronicled the rise of its opponents—I am heartened by the rare sight of a partial retreat by anti-abortion forces, and by evidence of new energy among abortion rights supporters. A group of Virginia women has just formed a “Women’s Strike Force” to defeat anti-abortion politicians. But I have considerable concerns about what calling these ultrasounds “rape” and “unnecessary” will mean for abortion patients and providers. The reality is that most abortion patients do receive an ultrasound to date their pregnancies. Since most abortions take place in the first trimester of pregnancy, many of these ultrasounds are performed with a transvaginal probe, the most effective method for viewing early-stage pregnancies. In the end, whether an ultrasound is performed, and which method is used, reflects either the practice of the abortion provider, the patient’s medical history, or—for a relatively small number of women—an aversion to the transvaginal method. Most of the time, however, the transvaginal ultrasound is a useful and common tool that helps providers perform abortions safely and well.
But now that women have heard abortion supporters describe this form of ultrasound as “rape,” will more of them be terrified when they arrive at a clinic and are informed they will have such a procedure? Or might they be scared off altogether? Will abortion clinic staff who perform the ultrasound be seen as “rapists,” as the provider I mentioned earlier worried? This is a possibility not lost on the anti-abortion website LifeNews, which recently ran the headline, “If Ultrasound is Rape, Arrest Planned Parenthood Staffers.”
Ultrasound mandates are terrible public policy, but not because of the particular method that they stipulate. These laws are terrible because it is not the job of legislators to intervene in the doctor-patient relationship, or to demand that all patients be treated alike. The essence of good abortion care—indeed of good health care generally—is the recognition that one size does not fit all, and each patient must be treated as an individual. That is the reason why providers who routinely perform transvaginal ultrasounds on most of their patients use other methods for women who have a particular fear of the probe. Or why the minority of providers who don’t do routine ultrasounds will order one for a woman whose pregnancy cannot be dated using other methods.
The record in states like Texas that already have ultrasound laws shows that the entire purpose is to make the abortion experience more difficult for the patient and provider alike. Until the Texas ultrasound law went into effect a few months ago, ultrasounds were performed by trained technicians, and a woman could choose whether or not she wished to see her ultrasound and hear a description of it.
Now the patient must hear a description of her fetus’ development (though she can decline an offer to see the ultrasound and hear the fetal heartbeat); she must wait at least 24 hours before she can have her abortion; a doctor must perform the ultrasound, and this doctor must be the same one who performs the abortion. For patients who work, this means a second day of lost wages and often a second day of paying for childcare, since many abortion patients are mothers (61 percent nationally). For clinic managers and physicians, the devil is also in the details: The Texas requirements mean scheduling headaches for clinic managers and physicians, since the doctors typically circulate among different clinics. In some instances, I have been told, some Texas clinics are no longer able to provide abortions because of the law.
What the ultrasound laws in Texas and elsewhere apparently have not done is make women change their minds about the procedure. As Tracy Weitz, a sociologist who has studied the impact of the laws, said in the New York Times, “Women are having abortions because of the conditions of their lives, their economic situation, their partner situation, their age, and the ultrasound doesn’t change that.”
It will be adding insult to injury if abortion patients—already beleaguered by so many obstacles to accessing this procedure quickly and with dignity—were to internalize the message that the transvaginal ultrasound they will likely be asked to undergo is tantamount to rape. Pro-choice advocates must oppose these pointless and manipulative ultrasound mandates. But let’s find better language to make our case.