Proposed Virginia Law Will Force Women To Undergo Invasive Ultrasound Examinations
A bill likely to become law in Virginia will require all women seeking abortions to undergo an invasive ultrasound examination.
The Commonwealth of Virginia is on the verge of passing into a law a bill that would require every woman seeking an abortion to undergo a completely unnecessary and invasive medical procedure whether she wants it to happen to her or not:
Virginia is set to add itself to a list of seven states that require woman to get an ultrasound before receiving an abortion.
Kristi Hamrick, a spokeswoman for American’s United for Life, said that the issue surrounding the Virginia bill is not “some kind of political phenomenon,” but instead “about a life-saving test.”
“Ultrasounds are the gold standard in medical care for pregnant woman,” Hamrick said. “Woman have died from abortion-inducing drugs, when there is an ectopic pregnancy, for example. It is vital to protect woman’s health, and ultrasounds are absolutely vital for protecting woman’s health, for determining how far along is the pregnancy.”
Amy Bryant, an OB/GYN at the University of North Carolina, Chapel Hill who offers abortions as part of her practice, said, however, that, “there is no absolute medical necessity for this,” and the determination to do an abortion, “should be at the physician’s discretion.”
“Physicians that do abortions are fully medically trained and know when it’s indicated to do an ultrasound or not, and do it accordingly,” Bryant said. “And sometimes, women present for abortion having had an ultrasound elsewhere. Requiring them to have this specific kind of ultrasound prior to an abortion can be stressing, can be unnecessary… and, in my opinion, should not be mandated in such a way that it might not be medically necessary for a particular patient.”
Hamrick, however, said, “determining what is sound medical care, is absolutely of interest to states,” adding that state oversight, “happens in a number of other settings, not just this one.”
The law would require a woman, without her consent, to receive an ultrasound and give her “an opportunity to view the ultrasound image of her fetus prior to the abortion,” an option she can decline.
Virginia isn’t the first state to pass a law like this, of course. Such laws have become law in recent years in states such as Texas and Oklahoma and, so far at least, they have been upheld by the Courts that have considered them. It’s worth considering, though, exactly what laws like this require. I’ve gotten the impression that when many people hear about a law requiring a pregnant woman to get a sonogram, they have in mind the type of external devices that have become common for most pregnant mothers to be exposed to during various stages of their pregnancy. We’re talking, of course, about what some have referred to as the “jelly on the belly” external sonogram that requires no penetration of the body. That’s not the only form of sonogram device, however, and given the fact that most abortions take place within the first 12 weeks of pregnancy, the type of medical test that these laws require is particularly invasive:
Many women receive abortion very early in their pregnancies, which would mean that, in some cases, a trans-vaginal ultrasound would be required.
Bryant described it as an invasive procedure, where a probe goes inside the vagina to see the pregnancy, adding that, “every woman who has had an abortion thinks long and hard about the decision she’s making and does not need [a] state-mandated, coercive procedure to try and help dissuade her from having an abortion.”
Democratic Delegate David Englin issued a statement this week blasting GOP support for the bill:
This bill will require many women in Virginia to undergo vaginal penetration with an ultrasound probe against their consent in order to exercise their constitutional right to an abortion, even for nonsurgical, noninvasive, pharmaceutical abortions. This kind of government intrusion shocks the conscience and demonstrates the disturbing lengths Republican legislators will go to prevent women from controlling their own reproductive destiny.
I offered an amendment that would have protected women from the unwanted vaginal penetration required by this bill. House Republicans rejected that amendment. The next time Virginia Republicans speak the words ‘government intrusion’ I hope voters will remember this vote and hold them accountable for their hypocrisy
Proponents of the bill, of course, don’t see it that way. To them, this law requiring non-consensual penetration by an ultrasound device is necessary in order to ensure that woman are “informed” before going ahead with an abortion. It’s a patently silly idea, of course. The idea that a woman getting an abortion doesn’t know what it is that’s going to happen to her is just absurd. Do these people actually believe that a woman faced with an unplanned pregnancy just wakes up one morning and says “Gee, I think I’ll get an abortion today.”? Perhaps they do, but the reality of the situation is far different. Countless anecdotal evidence makes it clear that, for nearly every woman that goes through this, the decision terminate a pregnancy is one fraught with emotion, suggesting that it is something that these women find as easy to do as getting their hair done is both ignorant and offensive.
Just how offensive? Well, Dahlia Lithwick does a good job of capturing that:
Proponents seem to be of the view that once a woman has allowed a man to penetrate her body once, her right to bodily autonomy has ended.
During the floor debate on Tuesday, Del. C. Todd Gilbert announced that “in the vast majority of these cases, these [abortions] are matters of lifestyle convenience.” (He has since apologized.) Virginia Democrat Del. David Englin, who opposes the bill, has said Gilbert’s statement “is in line with previous Republican comments on the issue,” recalling one conversation with a GOP lawmaker who told him that women had already made the decision to be “vaginally penetrated when they got pregnant.” (I confirmed with Englin that this quote was accurate.)*
That’s the same logic that animates the bill’s sponsor in the House of Delegates, Del. Kathy J. Byron, who insisted this week that, “if we want to talk about invasiveness, there’s nothing more invasive than the procedure that she is about to have.” Decoded, that means that if you are willing to submit to sex and/or an abortion, the state should be allowed to penetrate your body as well.
That certainly seems to be where the bills supporters are coming from. How else to explain their apparent desire to force every woman in Virginia to submit themselves to a state-mandated examination if they want to get a procedure permitted under the law? Oh that’s right, they want to “inform” women.
The reality, of course, is that laws like this have nothing to do with “informing” women, and everything to do with making it more and more difficult for them to obtain legal abortions. If the law requires an ultrasound prior to having an abortion, that means that abortion clinics that can’t afford ultrasound equipment will find it difficult to stay in business. Since the ultrasound itself is unlikely to be covered by any insurance plan, it also means that the procedure itself becomes more expensive for women, who will now have to fork over the additional money for the test itself, which often runs into the hundreds of dollars. Since current law makes it impossible for states to outlaw early-term abortions, they are passing laws like this for the sole purpose of making it harder for them to be obtained even though they’re technically legal. We saw something very similar last year in Kansas, where new regulations regarding the condition of abortion clinics that had little to do with sound medical practice threatened to shut down nearly every clinic in the state.
This isn’t really an abortion issue to my mind, though. Yes, it’s wrapped up in abortion politics and ones opinion on laws like this is likely to be influenced heavily by how one feels about abortion. At the same time, though, there are fundamental issues of personal liberty involved here that go beyond that one divisive issue. Regardless of how you feel about abortion itself, the real question is whether the state should have any right at all to force anyone to undergo a medical procedure of any kind against their will. In this particular case, there is no evidence that a trans-vaginal ultrasound is medically necessary and the invasiveness of the procedure itself is such an affront to personal liberty and dignity that Virginia should be embarrassed to have this statute on its books.
What’s ironic about all of this is the hypocrisy that’s being revealed here. While Republicans in Washington and on the campaign trail are speaking out against an HHS regulation that they contend would improperly require religious institutions to violate their fundamental beliefs, their colleagues just an hour and a half south in Richmond are on the verge of passing a law that would require every woman in Virginia who wants an abortion to lie on a table, open her legs, and have a probe stuck inside of her for no reason other than to propagandize about the supposed evils of abortion. David Frum notes the mixed message that this sends:
Conservatives in Washington correctly argue that the state should allow religious institutions latitude for their conscientious beliefs free from government mandates. It does dangerously complicate the narrative if—at the same time—conservatives down the road in Richmond are enacting mandates requiring physical intrusion into women’s bodies before those women are allowed to exercise their own conscientious beliefs. Freedom for some must be freedom for all, and the rights of churches are most convincingly upheld by those who also uphold the rights of women.
In the end, it shouldn’t matter how one feels about abortion when it comes to a law like the one Virginia is considering. There is no acceptable justification for a state to require anyone to undergo an unnecessary medical procedure. Virginia Republicans should be ashamed of themselves.
FTFY, Really tho, that is all this is, raping her, and denigrating her even more. I can find no one word for people who would do such a thing more descriptive than “disgusting”.
Having checked with the two OB’s in the family, your medical knowledge is lacking, at best. The stupidity in these laws is the added cost, not the mythical “JAM A CAMERA UP HER VAGINA!!!” hysteria. Nobody can get self-righteous about the added cost of the HHS mandate if they support this.
No problem Doug….according to one conservative idiot it’s just like sex. This is what conservatives call not allowing govt intrusion into our affairs. If this is passed and the genius governor of VA doesn’t veto it I’d hazard it alone will ensure both the election of Kaine and Obama holding VA.
@David:
You used pejorative language but how exactly is it not a un necessary invasive procedure?
I don’t agree with the requirement, but I don’t see how an ultrasound qualifies as an invasive procedure. Doesn’t an ultrasound just involve rubbing a transducer over their belly?
@Brummagem Joe: According to one member of the Virginia legislature, it’s not invasive because the tramp already allowed one foreign body to penetrate her, therefore she has no reason to object…
@Stormy Dragon: From Doug’s post:
Stormy Dragon – read more closely. Early on in pregnancy (I believe Doug cites 12 weeks or less), an ultrasound requires inserting a probe into the woman’s vagina, not just the belly-rubbing we see on TV. What Virginia is passing into law is state-mandated vaginal penetration without a woman’s consent. ie, rape.
@MM:
Ah okay, I’d never heard of a trans-vaginal ultrasound before, so I agree that is an invasive procedure.
I think you’re correct, but I think there’s also an element of some hard-right radicals thinking women are that stupid, plus the hope of inflicting discomfort and shame on women those same radicals regard as whores.
Remember, when you vote for Republicans, this is what you vote for. the Republicans march lock-step into the crazy, no matter how reasonable any individual Republican seems.
I wish we had two reasonable parties in this country,
@WR:
Ohhhhh…..that’s alright then.
I’d be way more impressed with prolifer arguments if I’d ever see a campaign dedicated to getting men to keep their dicks in their pants unless they’re willing to assume ALL the responsibilities of fatherhood – including paying for support until the kid is 18. That at least would imply a certain – you’ll pardon the expression – even-handedness to the whole argument. Until then, I think it’s really the issue of women’s sexuality that these people have issues with.
Pretty outrageous. And surprising it would pass Constitutional muster.
@David: What medical insight is Doug lacking?
I would suggest that anyone who truly believes this is “a life-saving test” also gets a colonoscopy every time they need a brain scan!
@David: According to Maria at Crooked Timber, who undergoes TVUs regularly during her in-vitro fertilization regime, it is absolutely about having a camera – really a d;ldo that takes pictures – into your vagina and hard against your cervix.
@Stormy Dragon:
Boo not knowing everything! Boo!
Ah, the Internet, the ultimate live action hysteria bin.
In any event, when I went off to law school it so happened to be at a left-wing university (I know, redundant), at a time when the chattering classes were in high dudgeon mode over some recent SCOTUS rulings on abortion and some other hot button social issues. I didn’t have much of an interest in social issues, being a crypto atheist and not possessing ovaries nor wishing that I possessed them. Yet I couldn’t help but be a tad curious, given all the noise. So I sat down and read the Constitution and then read a number of SCOTUS opinions and more particularly a number of dissenting opinions.
The conclusion I drew is that all of these hot button social issues — abortion restrictions, euthanasia, contraband, sodomy, etc. — are the archetypal examples of items which should be left to the exclusive province of the individual states.
So if Oregon wants to allow physician-assisted suicide I have no objections. If Nevada wants to allow possession of marijuana for medicinal purposes I have no objections. If Virginia wants to require ultrasounds as a prerequisite to getting an abortion I have no objections. If Washington State wants to permit gay marriages I have no objections.
Granted, the SCOTUS went in a different direction and as a result we’re stuck with federal dominion over these items. It’s unfortunate. The Feds need not have been involved. They created a Pandora’s Box, from which the country still hasn’t extricated itself.
@Stormy Dragon:
Probably because not reading.
@Tsar Nicholas II: Sorta agree – I like the idea of federalism, but it has to account for the nation needing to draw lines somewhere. For example, I’d rather not allow states to roll back women’s suffrage.
Also, federalism hits a ceiling on the level of national institutions – DADT is not the business of the individual states.
But to the topic of this Virginia bill, it’s appalling. It doesn’t get much more personally intrusive than this. Add in the sexism (accountability for the sperm donor? no?), the… meanness behind it, and you just shake your head.
Also, the politics. Really, GOP, this is the hill you wanna die on?
@Gold Star for Robot Boy:
and
@Tsar Nicholas II:
Federalism is an important part of our system and one that has been weakened far too much over the past century or so. However, I think it’s important to remember that there is no such thing as “states rights.” Only individuals have rights. And when individual states act in a manner that violates the rights of their citizens, it is the duty of the Federal Government — either through Congress via legislation under Section 5 of the 14th Amendment or the Judiciary when a proper case is brought before them — to step in and protect the individual from the state.
@Gold Star for Robot Boy:
This is only Part One of the abortion legislation that has passed the Virginia legislature this year. There’s also a Personhood bill out there. I’ll be writing about that one tomorrow.
@Tsar Nicholas II:
Physician heal thyself?
There are several variations on the mandatory ultra-sound theme and not all of them seem to require the trans-vaginal approach; in this the Virginia Repubs seem particularly vile. All of them appear (after a quick google adventure) to require that the performing physician “explain” to the client what the U/S shows by reading from a state-provided checklist all the images that the test reveals.
This is being contested vigorously by lawyers from the Center for Reproductive Rights and the ACLU on ‘free-speech’ grounds as well as, of course, contending that these requirements ‘burden’ people participating in a legal and protected procedure.
It is difficult to see how a long campaign to get this into Federal courts wouldn’t successfully overturn these laws. But by then other laws will have been passed through wing-nut dominated legislatures. So the only real remedy is to vow to never, ever, for any reason vote for a Republican if you value your liberty.
As what, a janitor?
@JohnMcC:
What the law says isn’t the point. The point is that, medically, the “jelly-on-the-belly” external ultrasound won’t show much of anything during the first trimester, which is when most abortions occur.
In order to comply with the law, doctors will have to use the trans-vaginal device.
@Doug Mataconis: (facepalm)
ATTENTION, VA GOP: NOT EVEN MISSISSIPPIANS WENT FOR THAT.
Check that facepalm – I have neither enough faces nor palms for this.
@Doug Mataconis:
Weakening of federalism was an inevitable consequence of becoming a modern state. Do you really think the shape of our polity was possible with a federal/state relationship that looked liked it did in 1900? But otherwise you are of course right. As a side issue have you read that book of Eric Posner’s The Executive Unbound.
@An Interested Party:
Pre-empting Gingrich?….but did he graduate and pass the bar?
@JohnMcC:
Basically, as of now, I agree these people are at bottom authoritarians (some who like right wing operatic rhetoric might say proto fascists).
@Doug Mataconis: Which is why the U/S law is being contested in Texas, NC and Florida which do not have in the language of their laws the transvaginal requirement. And congratulations on a post without misspellings!!
Libs, dems, progressives don’t look a gift horse in the mouth. Once this gets on the national radar watch the rabbits run for the hills.
@Doug Mataconis:
Thank you, Doug.
@Doug Mataconis: A few commenters have mentioned rape. Doug, you’re the lawyer. Lest people think this is metaphorical, is it not the case that in many, or all, states, penetration of the vagina with anything at all without the consent of the woman is legally rape? No ifs, no buts.
I know that years ago in Texas the wife of a good friend of mine was penetrated by an assailant’s finger tip, and the cops said it was rape. Does the FBI not now count unwanted penetration of a vagina or anus, female or male, as rape?
If this is true, how can any court uphold this?
My guess is that it would be justified in court as a medical necessity preliminary to an abortion to determine the difficulty of the procedure (that’s the legal argument), and would be looked at as not more invasive than the speculum used in a pap smear.
Because, you know, women let things like that go up there anyway.
What’s the cost of this procedure? Best price I’ve had for a jelly-belly (for other purposes) is $200.
Why downfist? Because it doesn’t agree with your emotional reactions? That’s the pro-life legal argument. Doesn’t mean I agree with it.
Don’t be silly. Life begans with ovulation. God weeps when an egg is wasted. God loves ova
@Brummagem Joe: My guess is that the Tsar never passes a bar as long as he’s got the price of a Schlitz in his pocket…
@Janis Gore: The speculum would be rape if the woman was coerced into allowing it. But you raise a good point. Has anyone reported who’s paying for this unnecessary ultrasound?
@gVOR08:
No. But I’d like to know the insurance companies’ take on this bill.
@Stormy Dragon:
Hey… D’ya see that picture up at the top?
And that long, thick stick that looks like a computerized robotic penis?
They (the State of Virginia Republicans) wish to have that inserted into women.
Fully and deep.
.
Sorry… I wanted to say something snarky, but words fail me.
Republicans are oxymorons!
they said “Government stay out of our church!” when Obama wanted every business to provide insurance coverage for all women Who Wanted Birth Control. (emphasis on Who Wanted. not mandated)
Yet days later try to push a bill in Virginia and many other states to force women to have an invasive trans-vaginal ultrasound probe if they want an abortion.’
Ok Women haters. You cannot have it both ways!
Does Virginia’s law require some foreign object to be “inserted into the vagina, and then moved around”? I live in the state and the answer is “no”. The law clearly states that the sonogram “shall be made pursuant to standard medical practice in the community.” Abdominal and transvaginal ultrasounds are both effective at early stages of pregnancy. Transabdominal ultrasound cannot reliably diagnose pregnancies that are less than 6 weeks’ gestation. Transvaginal ultrasound can detect pregnancies earlier, at approximately 4-1/2 to 5 weeks. So, yes, transvaginal is more reliable for detecting pregnancies for about a week. How does this require a woman to have a transvaginal ultrasound? It doesn’t.
You can argue about whether or not this is sound policy, but please be clear about what the law would or would not require.
@Janis Gore: What’s the cost of this procedure? Best price I’ve had for a jelly-belly (for other purposes) is $200.
After an initial phone call to my OB/GYN the cost of the trans-vaginal ultrasound is approximately $600+ depending on where you live. The patient also must be anesthetized which is an additional $400+. Maximum cost could be as high $1300.
The procedure is somewhat painful as the hard probe must be pushed and prodded until a good ‘read’ can be had. And by the way.. this procedure is not needed to determine if an ectopic pregnancy is occurring. If that were the case symptoms would appear on their own. If probe were needed to determine gestation dates, then all pregnant women would have to have a trans-vaginal probe ultra-sound. As a mother of two I can tell you this was never even brought up.
I won’t doubt your numbers, But why the cost for anesthetics? I can see that for a 14-year-old, but not a 30-year-old.
What I did not know: apparently: ultrasounds are already part of Planned Parenthood’s abortion procedure.
So this new law does what that’s exactly different from the current law? Oh yeah: I guess it requires the doctor to show the woman the ultrasound picture which, I suppose, might dissuade some women from actually having the abortion. I guess that more information is considered a bad thing in this case.
No, it requires a woman to make two visits, with considerable costs.
You’re stuck in the Middle Ages, boys. Your mapmaking ability turned your heads.
@Janis Gore:
I honestly am not sure. These were just numbers my OB/GYN quoted me. Personally I believe it could be done without anesthesia but some are more sensitive to pain then others.
Thank you for responding , Kristin. It’s rare rhat this forum flakes off into women’s issues.
@physics geek:
If PP abortion providers automatically do a trans-vaginal ultra-sound with every abortion then the patient agrees to this procedure when they go there and it is their choice to proceed. Other doctors do NOT do this step as they assume the person is in the right mind without the forced informed consent bs. The woman can go to another provider if she so chooses. With this VA law she will lose that choice all together.
As for the extra mandated procedure which the woman now has to pay for.. which of course is NOT covered by insurance… is okay because mandates that suit theocrats are good.
This controversy has been raging since I was a girl. Makes me glad I’m menopausal.
I’ve gone through this trans-vaginal ultrasound for another medical reason and it is NOT a cake walk. It IS completely invasive even with consent. I can’t imagine the pain that a WOMAN who has decided to get an abortion would have to go through to get this procedure done even if her doctor doesn’t think it is necessary. Can you imagine if this had been a rape victim? There should be an opt-out period. If a WOMAN and her doctor feel it is important then the procedure would be deemed important to the health of the WOMAN. If there was an issue with the abortion procedure, after all these years, to the health of the WOMAN, then why haven’t all the states adopted it. Because we leave it to the doctor’s expertise and not the politicians. It is quite obvious that the statute was written without knowledge (or maybe it was) of the various medical procedures that are used to diagnose fetal “gestation”. On another note didn’t Virginia fight against the government’s “forcing” it’s healthcare on them. How funny! Thank you for a different take on this particular bill, nicely written Doug.
I saw at the blog “The League of Ordinary Gentlemen” the other day a discussion of of James Paulos’ article” What Are Women For.”
An apt commenter said, “They’re for what they aren’t against.”
@physics geek: I would suggest that you visit the actual websites rather than third party website to get the facts. Virginia’s law requires an ultrasound to determine the gestational age of the fetus; this is the whole purpose of the bill. A WOMAN has to consent to get an abortion. It isn’t left to the doctor to determine which test is necessary. Doctors have been determining the age of the fetus without an ultrasound for eons. An ultrasound is NOT necessary unless determined so by a qualified doctor – not a politician. I’ve had two children without having an ultrasound (jelly on the belly) done, my doctor did a fine job predicting the gestational age of both of them. So many things are different about this bill that are not being done now. A doctor offers me a choice of treatment options, there is no option here. This is not a bill to support women’s health, it is a bill to make it more difficult for a woman to obtain an abortion, it is pretty obvious. It seems to me energy should be spent on so many other things to improve PEOPLE’s lives. The quote you delivered about Planned Parenthood is not correct. Their own website says, “have a physical exam — which may include an ultrasound”. This bill is actually a wolf in sheep clothing.
I savor, result in I found exactly what I used to be taking a look for. You’ve ended my four day lengthy hunt! God Bless you man. Have a great day. Bye