Anti-abortion activists realize that Roe v Wade is the law of the land and they may not get it overturned. Although they have continued to try to get a case up to the Supreme Court (notably, the recently passed bill in Nebraska banning abortions after 20 weeks may be the one to get there), they have not had much success with this. Instead, they have put significant effort into changing the laws in individual states to restrict access to care as much as possible.
Many of these laws direct medical professionals to interact with their patients in certain ways. There are laws that require that providers read women misleading scripts about the purported (and disproven) risks of abortion. They require women to have an ultrasound and in some cases require them to listen to the sound of the fetal heart tones during the ultrasound.
On April 19th, the Oklahoma Senate passed a law that mandates a level of intrusion beyond any I have yet seen. The law requires that in some cases ultrasounds prior to performing procedures must be performed transvaginally. If this law is signed by the governor, providers in Oklahoma will have to insert an ultrasound probe into the vagina of any woman needing an abortion in the earlier weeks of pregnancy. The rationale cited by lawmakers is that women should be able to see the image as clearly as possible, and that the image is clearer with a transvaginal ultrasound.
It is true that in some cases the picture is more clear if the ultrasound is done vaginally. However, as a provider I don’t need such a precise image. I only need to know for sure that the pregnancy is in the uterus, and how big the pregnancy is. Transvaginal ultrasound is not required for this. An ultrasound probe on a woman’s abdomen is usually just fine, and is less invasive.
Doctors always use the least invasive option we have when choosing a test. The fact that a state legislature would presume to tell doctors how to do their jobs and to force them to use a more invasive imaging test than necessary is frightening. I completed 4 years of medical school and 3 years of residency training. I think I know better than an Oklahoma state senator what imaging test to use.
Supporters of the law argue that women should have as much information as possible prior to the procedure. I agree, with the caveat that they should have access to as much information as they want prior to the procedure. When my patients want to see the ultrasound, I gladly show them. They are routinely surprised to see that, contrary to what anti-abortion rights activists tell them, there is no baby in their uterus. They can see the gestational sac, the fetal pole, the yolk sac, and can see that that pregnancy inside them is very small, and that the fetus is not a baby. Many women ask to see the tissue I remove after the abortion, and again are surprised at what they see, and are uniformly relieved.
Some of my patients don’t want to see the ultrasound. That’s fine with me. People come to me from difficult circumstances. Some are victims of rape or intimate partner violence; others are teenagers who’ve never had a pelvic exam, and still others are cognitively disabled. If these people don’t need a vaginal ultrasound, you can be sure I won’t do a vaginal ultrasound. I am a doctor who has spent years studying and practicing medicine, and I know better than the Oklahoma Senate how to take care of my patients.