New Oklahoma Law is Intrusive Beyond Belief

22 Apr

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.

7 Responses to “New Oklahoma Law is Intrusive Beyond Belief”

  1. Amanda April 22, 2010 at 1:02 pm #

    I’m glad to see a medical professional agrees!
    ” I think I know better than an Oklahoma state senator what imaging test to use.” I would love for other doctors like you to be able to make that point to the senators of Nebraska, Oklahoma, and my own state of Kansas (I wrote yesterday’s blog on the political issues of all this).

  2. Stephanie April 22, 2010 at 4:19 pm #

    Where are all the Teabaggers yelling for the government to get its hands of their bodies? Oh wait, women don’t count.
    On another note, as an employee at a Rape Crisis Center, I am extremely concerned for survivors of sexual assault. Even if the survivor was molest 25 years ago, that vaginal ultrasound could really trigger some terrible memories and feelings. And the fact that the patient cannot object to it…it breaks my heart that many survivors may see a serious setback in their healing process because of this law.

  3. Courtroom Mama April 22, 2010 at 10:24 pm #

    This is absolutely terrifying to me, and I hope that people litigate the fuck out of it. This feels punitive, and it literally makes me feel ill. Like the legislature is saying “you wanted to have sex? here’s your sex.”

  4. Shayna April 26, 2010 at 10:44 am #

    Have any of you have a vaginal ultrasound? First you have to have a full bladder, so you need to pee, desperately – not comfortable, and then something is IN YOU – you are invaded by a plastic stick… it’s not sexy, it’s not fun. I know it’s a technician doing it to see if everything is okay, but it’s not a pleasant experience, and definitely not one I would want forced on me.

  5. Steph April 26, 2010 at 2:07 pm #

    I’ve had a transvaginal ultrasound and that shit sucks. I agree with you, Shayna — if only the people who created this law had to experience a transvaginal ultrasound themselves. Maybe that’s what it would take to provoke some empathy?

  6. Jameson April 27, 2010 at 3:16 am #

    This is nothing less than state-sanctioned rape. May the people – and I use that term very lightly – may the people who pushed this garbage through experience the same lack of compassion they’d gladly force on others.

  7. Sarah R September 5, 2010 at 4:09 pm #

    @Stephanie: I whole heartedly agree with your statement that a transvaginal u/s can cause trauma to a rape survivor countless years after her attack.

    While undergoing fertility treatments and testing I had several transvaginal ultrasounds. I needed to be sedated for them because it was so traumatic for me. I can imagine the trauma a forced transvaginal u/s would cause a woman who was a rape survivor.

    It’s about time legislators accepted the fact that women are, in fact, people and not just life support systems for our reproductive equipment.

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