On "Forced" Ultrasounds

I know that this is mainly a blog about teething and tantrums and different types of baby poo, but June is taking an uncharacteristically long nap so I might as well write about what's on my mind. And what's on my mind is the hysteria around the so-called "forced ultrasound bill" in Virginia right now. It's about to get political up in hurrr.  


For friends and family who don't want to get into politics, here's something to occupy you. 

I can't look away. 

One of my friend's twitter profiles states that he "prefers facts, not hysteria." I couldn't agree more. Which is why every time I see a hashtag about "forced ultrasounds," or a status update equating ultrasounds to rape, I'm none too enthused. 


The issue here is a proposed law that mandates an ultrasound before acquiring an abortion. Many pro-choice advocates are skeptical of this bill because they say that the mission of this law is to shame women and guilt them into refusing abortion. Some even say that mandatory trans-vaginal ultrasounds are akin to "forced penetration" -- meaning that your doctor is going to tie you down and force an ultrasound probe inside your vagina. 


Personally, I prefer facts to a lot of unfounded hysteria. The facts are that Planned Parenthood, the nation's biggest abortion provider, already requires an ultrasound to take place before any abortion is performed -- which is the "medical standard," according to Planned Parenthood official Adrienne Schreiber. Additionally, a 2003 study notes that all abortions at surveyed clinics -- even early, non-surgical abortions -- are conditional on a trans-vaginal ultrasound before and after the procedure, to make sure the procedure was a success. And although there are many feminists who are decrying trans-vaginal ultrasounds as "forced penetration," Schrieber says that women always have the option to wait a few weeks until the baby matures and a trans-abdominal ultrasound can be performed (Schreiber makes a good point, though: If you're not comfortable getting an ultrasound, you're probably not going to be comfortable getting an abortion, either). And even with all these mandatory ultrasound policies, no doctor is tying anyone down and forcing anything inside their vagina. Nobody is being forcibly penetrated. Nobody is being forced to do anything. However, for the safety of the patient, in order to obtain an abortion, an ultrasound of some type is non-negotiable. 


So the facts are that ultrasounds are already necessary and commonplace, and a reasonable conjecture is that a trans-vaginal ultrasound is no more invasive than the actual abortion. This is why it irks me to see women complaining of "forced" anything, or protesting riotously outside Virginia's capitol steps. In what world does it make sense to protest against more medical information? How would that benefit a hypothetical patient, or the patient's doctor, for that matter? Retained fetal tissue can result in infection, sepsis, and possibly death, and ultrasounds are the most effective way to make sure nothing is retained. If your concern is truly women's health, then your first priority should be making sure that pre- and post-abortion ultrasounds are sacrosanct. 


(Make no mistake, though: I think abortion is a hideous procedure. When I say that doctors need an ultrasound to "complete the procedure," what I'm really saying is that they need to make sure all parts of the dismembered baby -- like its head or tiny limbs -- have all been evacuated from the uterus. Let's call a spade a spade here: When we use cute euphamisms like "women's health" and "procedure," we're talking about dilating the uterus, dismembering the baby in utero, and aspirating whatever's left. We're talking about injecting a woman's womb with saline solution. In other cases, the doctor crushes the baby's head with scissors. Or, in some cases, we're talking about inducing early labor and just neglecting the baby until it dies on its own. Those are the facts. So, taking these facts into consideration -- yes, I have a moral problem with that. I don't mean to imply that there is no moral component to this procedure, because I think there is. But the issue of providing ultrasounds is not about my morals or anyone else's, for that matter - it is about medical assessment.) 


On a similar note, I think we have to talk about the issue of informed consent here. I'm of the opinion that before you can fully consent to a procedure, you need to know what the procedure is, and how it is being done. In fact, the definition of informed consent according to the American Medical Association means assessing the procedure with the patient, as well as discussing risks and benefits. So working within these parameters, an ultrasound would certainly help the patient properly consent. In the first place, ultrasounds determine what kind of procedure to perform. Based on the gestational age of the baby, doctors can perform D&C abortions, D&X abortions, or more. Upon affirming the gestational age, the benefits and risks of each abortion type can then be discussed. 


When I was in labor with J, and I begged for an epidural, the nurse at my bedside took five minutes (or in other words, a freaking lifetime) to explain to me every single pro and con of having an epidural, how the procedure would take place, how long it would be expected to last, and every conceivable ramification it could possibly have on my laboring. Even though I literally was shouting Don't care! Don't care! Don't care! Not listening, don't care!, it was still her responsibility, as my care provider, to inform me. What I did with the information was my choice. It wasn't a moral judgement. It wasn't an attempt to get me to change my mind. It wasn't about the patriarchy imposing its will on me or my doctor not "trusting women" enough to make my own medical decisions. It was about health, knowledge, and informed consent.    


So next time I see the hashtag #noforcedultrasounds, I'm going to turn into the hulk. And I think you should, too. 

HULK THINK INFORMED CHOICE REASONABLE. HULK APPROVE LAW.